1
|
Jacobsen G, Rasmussen K, Bregnhøj A, Isaksson M, Diepgen TL, Carstensen O. Causes of irritant contact dermatitis after occupational skin exposure: a systematic review. Int Arch Occup Environ Health 2022; 95:35-65. [PMID: 34665298 PMCID: PMC8755674 DOI: 10.1007/s00420-021-01781-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 07/11/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE Irritant contact dermatitis (ICD) is a major cause of occupational disease. The aim was to review the relation between exposure to occupational irritants and ICD and the prognosis of ICD. METHODS Through a systematic search, 1516 titles were identified, and 48 studies were included in the systematic review. RESULTS We found that the evidence for an association between ICD and occupational irritants was strong for wet work, moderate for detergents and non-alcoholic disinfectants, and strong for a combination. The highest quality studies provided limited evidence for an association with use of occlusive gloves without other exposures and moderate evidence with simultaneous exposure to other wet work irritants. The evidence for an association between minor ICD and exposure to metalworking fluids was moderate. Regarding mechanical exposures, the literature was scarce and the evidence limited. We found that the prognosis for complete healing of ICD is poor, but improves after decrease of exposure through change of occupation or work tasks. There was no substantial evidence for an influence of gender, age, or household exposures. Inclusion of atopic dermatitis in the analysis did not alter the risk of ICD. Studies were at risk of bias, mainly due to selection and misclassification of exposure and outcome. This may have attenuated the results. CONCLUSION This review reports strong evidence for an association between ICD and a combination of exposure to wet work and non-alcoholic disinfectants, moderate for metalworking fluids, limited for mechanical and glove exposure, and a strong evidence for a poor prognosis of ICD.
Collapse
Affiliation(s)
- Gitte Jacobsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark.
- Department of Occupational Medicine, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark.
| | - Kurt Rasmussen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Anne Bregnhøj
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Thomas L Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ole Carstensen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| |
Collapse
|
2
|
Abstract
Surfactants, many of which are used as detergents, can be found in many common household items, such as shampoos, conditioners, soaps, and cosmetics. One should recognize the multitude of surfactants that are used in today's products to identify any potential allergic contact dermatitis (ACD) or irritant contact dermatitis (ICD). Given their abundance in everyday products, it is understandable that many cases of occupational contact dermatitis that arise can be attributed to surfactants. The products most connected with ACD are cocamidopropyl betaine, oleamidopropyl dimethylamine, decyl glucoside, 3-dimethylaminopropylamine, amidoamine, and cocamide diethanolamine. Similarly, the most common surfactant-related causes of ICD are sodium lauryl sulfate and benzalkonium chloride. It is important for dermatologists to identify the causes and differentiate between the two, to adjust treatments and products accordingly. Here, the most frequently used surfactants, as well as their correlation between ACD and ICD, will be reviewed.
Collapse
|
3
|
Abstract
This article discusses contact urticaria syndrome definition, history, epidemiology, occupational relevance, mechanisms, clinical manifestations, diagnostic tools, agents responsible, and how to prevent and treat the patients affected. Contact urticaria syndrome is often misdiagnosed because it is not well known or recognized by physicians. Commonly the patient recognizes the cause of the clinical symptom, but the cause can be exceptional or new. Triggers include proteins, chemical compounds, agricultural chemicals, metals, plants, foods, and other substances. The objective of this article is to help dermatologists, toxicologists, and immunologists by providing diagnostic tools to avoid the culprit agent and treat the patients.
Collapse
Affiliation(s)
- Ana M Gimenez-Arnau
- Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, Passeig Maritim 25-29, Barcelona 08021, Spain.
| | - Howard Maibach
- Department of Dermatology, University of California, San Francisco, 90 Medical Center Way, San Francisco, CA 9413, USA
| |
Collapse
|
4
|
Larese Filon F, Pesce M, Paulo M, Loney T, Modenese A, John S, Kezic S, Macan J. Incidence of occupational contact dermatitis in healthcare workers: a systematic review. J Eur Acad Dermatol Venereol 2021; 35:1285-1289. [PMID: 33336403 PMCID: PMC8248138 DOI: 10.1111/jdv.17096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/11/2020] [Indexed: 11/07/2022]
Abstract
Healthcare workers (HCWs) can be considered at an increased risk of developing occupational contact dermatitis (OCD) due to repetitive hand washing with soaps and disinfectants and extended use of gloves for many hours during the day. The aim of this study was to summarize the incidence of OCD in HCWs. We searched the databases PubMed/MEDLINE (1980-present), EMBASE (1980-present) and Cochrane Library (1992-present) through May 2020 using the search term 'incidence of contact dermatitis in HCWs' according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Overall, 16 studies (six cohorts; 10 register-based) with follow-up periods between 1987 and 2013 fulfilled the inclusion criteria. The incidence of OCD reported in studies using registers of occupational diseases ranged from 0.6 to 6.7 per 10 000 person-years. The cohort studies reported incidence from 15.9 to 780.0 per 10 000 person-years; the incidence was higher in studies which included apprentice nurses. A higher incidence was also observed amongst dental practitioners, particularly dental technicians and nurses, compared to other HCWs. Studies reporting incidence data are very scarce and results differed by study design, type of contact dermatitis and investigated HCWs. Our study highlighted the dearth of high-quality data on the incidence of OCD and the possible underestimation of disease burden. Prospective cohort studies with harmonized designs, especially exposure assessment and outcome ascertainment, are required to provide more accurate, valid and recent estimates of the incidence of OCD. A high incidence amongst specific occupational groups suggests the need to undertake intervention studies with a focus on prevention, particularly during pandemics such as COVID-19.
Collapse
Affiliation(s)
- F. Larese Filon
- Clinical Unit of Occupational MedicineUniversity of TriesteTriesteItaly
| | - M. Pesce
- Clinical Unit of Occupational MedicineUniversity of TriesteTriesteItaly
| | - M.S. Paulo
- Institute of Public HealthCollege of Medicine and Health SciencesUnited Arab Emirates UniversityAl AinUAE
| | - T. Loney
- College of MedicineMohammed Bin Rashid University of Medicine and Health SciencesDubaiUAE
| | - A. Modenese
- Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena & Reggio EmiliaModenaItaly
| | - S.M. John
- Department DermatologyEnvironmental MedicineHealth TheoryUniversity of OsnabrückOsnabrückGermany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm)University of OsnabrückOsnabrückGermany
| | - S. Kezic
- Coronel Institute of Occupational HealthDepartment of Public and Occupational HealthAmsterdam UMCAmsterdamThe Netherlands
| | - J. Macan
- Institute for Medical Research and Occupational HealthZagrebCroatia
| |
Collapse
|
5
|
Scheinman PL, Vocanson M, Thyssen JP, Johansen JD, Nixon RL, Dear K, Botto NC, Morot J, Goldminz AM. Contact dermatitis. Nat Rev Dis Primers 2021; 7:38. [PMID: 34045488 DOI: 10.1038/s41572-021-00271-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/04/2023]
Abstract
Contact dermatitis (CD) is among the most common inflammatory dermatological conditions and includes allergic CD, photoallergic CD, irritant CD, photoirritant CD (also called phototoxic CD) and protein CD. Occupational CD can be of any type and is the most prevalent occupational skin disease. Each CD type is characterized by different immunological mechanisms and/or requisite exposures. Clinical manifestations of CD vary widely and multiple subtypes may occur simultaneously. The diagnosis relies on clinical presentation, thorough exposure assessment and evaluation with techniques such as patch testing and skin-prick testing. Management is based on patient education, avoidance strategies of specific substances, and topical treatments; in severe or recalcitrant cases, which can negatively affect the quality of life of patients, systemic medications may be needed.
Collapse
Affiliation(s)
- Pamela L Scheinman
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Marc Vocanson
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Rosemary L Nixon
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Kate Dear
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Nina C Botto
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Johanna Morot
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Ari M Goldminz
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.
| |
Collapse
|
6
|
Frosch PJ, Mahler V, Weisshaar E, Uter W. Occupational Contact Dermatitis: General Aspects. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Pesonen M, Koskela K, Aalto-Korte K. Contact urticaria and protein contact dermatitis in the Finnish Register of Occupational Diseases in a period of 12 years. Contact Dermatitis 2020; 83:1-7. [PMID: 32243591 DOI: 10.1111/cod.13547] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although occupational contact urticaria (CU) and protein contact dermatitis (PCD) are considered frequent among workers with exposure to proteinaceous materials, data on occupations at risk and the main causes of these occupational skin diseases are relatively limited. OBJECTIVES To report the causative agents and risk occupations for CU and PCD in the Finnish Register of Occupational Diseases (FROD). METHODS We retrieved from the FROD all recognized cases of CU/PCD in the years 2005-2016. RESULTS With 570 cases, CU and PCD constituted 11% of all recognized cases of occupational skin diseases in the study period. Occupations with the highest incidence of CU/PCD included bakers, chefs and cooks, farmers and farm workers, veterinarians, gardeners, and hairdressers. The most common causative agents were cow dander and flour and grain, followed by natural rubber latex (NRL) and other food. In food-related occupations, wheat and other flours were by far the most common cause of CU/PCD, with 76 cases, whereas fish and other animal-derived food caused 33 and other plant-derived food caused 23 cases. CONCLUSIONS Apart from the Finnish peculiarity of cow dander allergy, a striking finding was a large share of CU/PCD caused by flours in food handlers as compared to other food.
Collapse
Affiliation(s)
- Maria Pesonen
- Finnish Institute of Occupational Health, Occupational Health Unit, Helsinki, Finland
| | - Kirsi Koskela
- Finnish Institute of Occupational Health, Occupational Health Unit, Helsinki, Finland
| | - Kristiina Aalto-Korte
- Finnish Institute of Occupational Health, Occupational Health Unit, Helsinki, Finland
| |
Collapse
|
8
|
França D, Sacadura-Leite E, Fernandes-Almeida C, Filipe P. Occupational dermatoses among healthcare workers in a hospital center in Portugal. Rev Bras Med Trab 2020; 17:285-291. [PMID: 32368662 PMCID: PMC7195876 DOI: 10.5327/z1679443520190393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/08/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Skin diseases account for more than 35% of occupational diseases, affecting 1/1,000 workers annually. OBJECTIVE To characterize occupational dermatoses affecting hospital workers and identify possible triggers and susceptibility factors. METHODS Cross-sectional study in which we analyzed information extracted from electronic medical records of workers who performed periodic examinations in the course of one year. RESULTS About 3.56% of 1,741 included workers had a diagnosis of occupational dermatosis, being mainly women (76.85%). Thirty-four (54.84%) of the affected workers had irritant contact dermatitis, 17 (27.42%) latex allergy, 6 (9.68%) allergic dermatitis, and 5 (8.06%) two concomitant conditions. We found significant difference in prevalence as a function of occupational group (p=0.008), being highest for nursing assistants (5.11%). Prevalence was also higher for employees allocated to surgery departments (8.47%, p=0.001). Main triggers were skin disinfectants, latex, nitrile gloves, and prolonged contact with water (4.84%). CONCLUSION The quality of the analyzed data depends on the quality of the analyzed medical records. Most subjects were nursing assistants, which fact hinders the generalization of the results. The prevalence of occupational dermatosis was just 3.56%, which might be explained by previously implemented preventive measures. The employees most frequently affected were those allocated to surgery departments and nursing assistants. Skin disinfectants were the most frequent triggers.
Collapse
Affiliation(s)
- Diana França
- Occupational Health Department, North Lisbon Hospital Center – Lisbon, Portugal
| | - Ema Sacadura-Leite
- Occupational Health Department, North Lisbon Hospital Center – Lisbon, Portugal
| | | | - Paulo Filipe
- Dermatology Department, North Lisbon Hospital Center – Lisbon, Portugal
| |
Collapse
|
9
|
Aalto‐Korte K, Koskela K, Pesonen M. 12‐year data on dermatologic cases in the Finnish Register of Occupational Diseases I: Distribution of different diagnoses and main causes of allergic contact dermatitis. Contact Dermatitis 2020; 82:337-342. [DOI: 10.1111/cod.13488] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Kristiina Aalto‐Korte
- Occupational Health UnitFinnish Institute of Occupational Health (FIOH) Helsinki Finland
| | - Kirsi Koskela
- Occupational Health UnitFinnish Institute of Occupational Health (FIOH) Tampere Finland
| | - Maria Pesonen
- Occupational Health UnitFinnish Institute of Occupational Health (FIOH) Helsinki Finland
| |
Collapse
|
10
|
An uncommon outbreak of irritant contact dermatitis caused by rubber accelerators: a historical cohort study. J RUBBER RES 2019. [DOI: 10.1007/s42464-019-00023-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Süß H, Dölle-Bierke S, Geier J, Kreft B, Oppel E, Pföhler C, Skudlik C, Worm M, Mahler V. Contact urticaria: Frequency, elicitors and cofactors in three cohorts (Information Network of Departments of Dermatology; Network of Anaphylaxis; and Department of Dermatology, University Hospital Erlangen, Germany). Contact Dermatitis 2019; 81:341-353. [PMID: 31173644 DOI: 10.1111/cod.13331] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/30/2019] [Accepted: 06/04/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Contact urticaria (CU) is an infrequent, mostly occupational disease that may be life-threatening (CU syndrome stage 4). OBJECTIVES To identify the current frequency, elicitors and cofactors of CU. PATIENTS Three cohorts were retrospectively analysed for CU: (a) patients from the Information Network of Departments of Dermatology (IVDK) database (2000-2014; n = 159 947); (b) patients from an allergy unit (Department of Dermatology, University Hospital Erlangen, 2000-2015; n = 4741); and (c) patients from the Anaphylaxis Registry (2007-2015: 6365 reported cases, including 2473 patients with Ring and Messmer grade III-IV reactions) for severe cases with skin/mucosal manifestations occurring at the workplace vs cases not occurring at the workplace (n = 68 vs n = 1821). RESULTS Four hundred and forty-eight CU patients (0.28%) were diagnosed in the IVDK cohort, and 16 (0.34%) (10 of immunological aetiology, and 6 of non-immunological aetiology) in the Erlangen cohort. The most frequent elicitors in the IVDK cohort were cosmetics, creams, sun protection agents (although these were less frequent in CU patients than in controls without CU; 26.8% vs 35.6%, P < .0001), and gloves (significantly more frequent in CU patients than in controls; 18.1% vs 6.5%, P < .0001). The most frequent elicitors in the Erlangen cohort were natural rubber latex and sorbic acid. Among the MOAHLFA index characteristics, in both cohorts occupational disease was more common in CU patients than in patients without CU. CU was significantly associated with allergic rhinitis and allergic asthma. Wet work was a relevant cofactor. In the Anaphylaxis Registry, 19 cases (0.3%) were identified with severe reactions including skin symptoms at the workplace linked to common occupational elicitors. CONCLUSIONS CU is a rare occupational skin manifestation with a frequency of <0.4% in the examined patients; it may, however, progress to anaphylaxis. Preventive measures are important, and should take into account the identified elicitors and cofactors.
Collapse
Affiliation(s)
- Helene Süß
- Department of Dermatology, Allergy Unit, University Hospital Erlangen, Erlangen, Germany
| | - Sabine Dölle-Bierke
- Division of Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), University Medicine Göttingen, Göttingen, Germany
| | - Burkhard Kreft
- Department of Dermatology and Venereology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Eva Oppel
- Department of Dermatology and Allergology, University Hospital of Munich; Ludwig-Maximilian University Munich, Munich, Germany
| | - Claudia Pföhler
- Department of Dermatology and Allergology, Saarland University Hospital, Homburg, Germany
| | - Christoph Skudlik
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Margitta Worm
- Division of Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Vera Mahler
- Department of Dermatology, Allergy Unit, University Hospital Erlangen, Erlangen, Germany.,Division of Allergology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| |
Collapse
|
12
|
|
13
|
Hulls PM, Money A, Agius RM, de Vocht F. Work-related ill-health in radiographers. Occup Med (Lond) 2018; 68:354-359. [PMID: 29788277 DOI: 10.1093/occmed/kqy076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background In the UK in 2015/16, 1.3 million workers self-reported a work-related illness (WRI) of which an estimated 41% were due to musculoskeletal disorders (incidence rate 550 cases per 100000 people) and 37% were related to stress, anxiety and depression. Little is known about the incidence of WRIs in radiographers. Aims To analyse the medically reported incidence of WRIs among radiographers in the UK between 1989 and 2015. Methods Incident cases reported by physicians to The Health and Occupation Research (THOR) network through its specialist schemes from 1989 to 2015 were analysed, using the Labour Force Survey as denominator where appropriate. Results In total, 218 cases (966 estimated cases) were reported. Of these 190 were in women. The mean age was 40.2 (20-91 years) SD ± 11.8 years. Most cases were reported to the Occupational Physicians Reporting Activity (OPRA) scheme (n = 92). A skin diagnosis was the most frequently reported (n = 77), followed by musculoskeletal (n = 60). Within the EPIDERM scheme, radiographers had the highest incidence rate when compared to all other occupations. Conclusions Radiographers had a higher incidence of WRI compared to all other occupations. The most frequently reported WRI was skin conditions. The observed increase in incidence is likely to be due to the increase in the number of radiographers over that time period, although there was no evidence that WRI within radiographers are declining.
Collapse
Affiliation(s)
- P M Hulls
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A Money
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - R M Agius
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - F de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
14
|
Helaskoski E, Suojalehto H, Kuuliala O, Aalto-Korte K. Occupational contact urticaria and protein contact dermatitis: causes and concomitant airway diseases. Contact Dermatitis 2017; 77:390-396. [PMID: 28795430 DOI: 10.1111/cod.12856] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Contact urticaria (CU) and protein contact dermatitis (PCD) are mainly induced by an immediate, IgE-mediated immunological mechanism. Immediate sensitization is also linked to asthma and/or allergic rhinitis. OBJECTIVES To report causes of work-induced CU and PCD, and to evaluate the occurrence of concomitant airway diseases. METHODS We retrospectively reviewed the patient files of cases diagnosed with CU or PCD at the Finnish Institute of Occupational Health during 1995-2011. We obtained data on occupation, exposures, clinical and immunological test results, and diagnosed occupational skin and respiratory diseases. RESULTS Altogether, 291 cases of occupational CU or PCD were diagnosed during the study period. The most common causes were flour, cow dander, natural rubber latex and acid anhydrides. Concomitant occupational asthma caused by the same agent as the skin disease was detected in 60 patients (21%), and occupational rhinitis was detected in 111 patients (38%). CONCLUSIONS Almost half of the patients (46%) with occupational CU and PCD had concomitant occupational airway disease. Patients with CU/PCD should always be asked about respiratory symptoms, and preventive measures at the workplace should include protection of both the skin and the airways.
Collapse
Affiliation(s)
- Eva Helaskoski
- Occupational Medicine, Finnish Institute of Occupational Health, 00251, Helsinki, Finland.,Department of Public Health, University of Helsinki, 00014, Helsinki, Finland
| | - Hille Suojalehto
- Occupational Medicine, Finnish Institute of Occupational Health, 00251, Helsinki, Finland
| | - Outi Kuuliala
- Occupational Medicine, Finnish Institute of Occupational Health, 00251, Helsinki, Finland
| | - Kristiina Aalto-Korte
- Occupational Medicine, Finnish Institute of Occupational Health, 00251, Helsinki, Finland
| |
Collapse
|
15
|
Bensefa-Colas L, Telle-Lamberton M, Faye S, Bourrain JL, Crépy MN, Lasfargues G, Choudat D, Momas I. Occupational contact urticaria: lessons from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P). Br J Dermatol 2015. [PMID: 26212252 DOI: 10.1111/bjd.14050] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Occupational contact urticaria (OCU) is an occupational contact dermatitis that can cause serious health consequences and disability at work. OBJECTIVES To describe OCU and its temporal trends by the main causal agents and activity sectors in a nationwide scheme in France. METHODS Using data from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P), we described OCU reported during the period 2001-10 and analysed the temporal trends of OCU and OCU attributed to the most frequent agents over the study period. Trends analyses were supported by reporting odds ratios using a logistic regression model with reference to 2001, or with time as a continuous variable. RESULTS During the study period, 251 cases of OCU were reported in RNV3P, half of which were due to natural rubber latex, in particular in the health and social work activity sector (HSW). The number of these cases declined significantly over the study period (19% per year), and particularly after 2006. Conversely, the other causes of OCU did not decrease. CONCLUSIONS Using surveillance data from a French national network, this study has found that there was a significant decline in OCU due to natural rubber latex, particularly in the HSW, when powdered latex gloves were banned from French hospitals. Our results show the effectiveness of this preventive measure, and suggest that this practice should be extended to other sectors.
Collapse
Affiliation(s)
- L Bensefa-Colas
- Occupational Diseases Department, University Hospital of Centre of Paris-Cochin, AP-HP, 27 Rue du Faubourg Saint Jacques, 75014, Paris, France.,Laboratoire Santé Publique et Environnement, Paris Descartes University, Sorbonne Paris Cité, EA 4064, Paris, France
| | | | - S Faye
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Paris-Est University, Maisons-Alfort, France
| | - J-L Bourrain
- Exploration des Allergies, University Hospital of Montpellier, Montpellier, France
| | - M-N Crépy
- Occupational Diseases Department, University Hospital of Centre of Paris-Cochin, AP-HP, 27 Rue du Faubourg Saint Jacques, 75014, Paris, France
| | - G Lasfargues
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Paris-Est University, Maisons-Alfort, France.,Paris-Est University, Créteil, France
| | - D Choudat
- Occupational Diseases Department, University Hospital of Centre of Paris-Cochin, AP-HP, 27 Rue du Faubourg Saint Jacques, 75014, Paris, France
| | | | - I Momas
- Laboratoire Santé Publique et Environnement, Paris Descartes University, Sorbonne Paris Cité, EA 4064, Paris, France
| |
Collapse
|
16
|
Money A, Carder M, Hussey L, Agius RM. The utility of information collected by occupational disease surveillance systems. Occup Med (Lond) 2015; 65:626-31. [DOI: 10.1093/occmed/kqv138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
17
|
Cahill JL, Williams JD, Matheson MC, Palmer AM, Burgess JA, Dharmage SC, Nixon RL. Occupational skin disease in Victoria, Australia. Australas J Dermatol 2015; 57:108-14. [DOI: 10.1111/ajd.12375] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 05/31/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Jennifer L Cahill
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc.; Melbourne Victoria Australia
| | - Jason D Williams
- Contact Dermatitis Investigation Unit; The Dermatology Centre; Salford Royal NHS Foundation Trust; Manchester UK
| | - Melanie C Matheson
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology; School of Population Health; University of Melbourne; Melbourne Victoria Australia
| | - Amanda M Palmer
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc.; Melbourne Victoria Australia
| | - John A Burgess
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology; School of Population Health; University of Melbourne; Melbourne Victoria Australia
| | - Shyamali C Dharmage
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology; School of Population Health; University of Melbourne; Melbourne Victoria Australia
| | - Rosemary L Nixon
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc.; Melbourne Victoria Australia
- Department of Medicine; University of Melbourne; Melbourne Victoria Australia
| |
Collapse
|
18
|
Vijendren A, Yung M, Sanchez J. Occupational health issues amongst UK doctors: a literature review. Occup Med (Lond) 2015; 65:519-28. [DOI: 10.1093/occmed/kqv088] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
19
|
Turner S, Forman SD, McNamee R, Wilkinson SM, Agius R. Investigating work-related neoplasia associated with solar radiation. Occup Med (Lond) 2014; 65:22-8. [PMID: 25421392 DOI: 10.1093/occmed/kqu156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Both solar and non-solar exposures associated with occupation and work tasks have been reported as skin carcinogens. In the UK, there are well-established surveillance schemes providing relevant information, including when exposures took place, occupation, location of work and dates of symptom onset and diagnosis. AIMS To add to the evidence on work-related skin neoplasia, including causal agents, geographical exposure and time lag between exposure and diagnosis. METHODS This study investigated incident case reports of occupational skin disease originating from clinical specialists in dermatology reporting to a UK-wide surveillance scheme (EPIDERM) by analysing case reports of skin neoplasia from 1996 to 2012 in terms of diagnosis, employment, suspected causal agent and symptom onset. RESULTS The suspected causal agent was 'sun/sunlight/ultraviolet light' in 99% of the reported work-related skin neoplasia cases. Most cases reported (91%) were in males, and the majority (62%) were aged over 65 at the time of reporting. More detailed information on exposure was available for 42% of the cases, with the median time from exposure to symptom onset ranging from 44 (melanoma) to 57 (squamous cell carcinoma) years. Irrespective of diagnostic category, the median duration of exposure to 'sun/sunlight/ultraviolet light' appeared longer where exposures occurred in the UK (range 39-51 years) rather than outside the UK (range 2.5-6.5 years). CONCLUSIONS It is important to provide effective information about skin protection to workers exposed to solar radiation, especially to outdoor workers based outside the UK.
Collapse
Affiliation(s)
- S Turner
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK,
| | - S D Forman
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
| | - R McNamee
- Centre for Biostatistics, University of Manchester, Manchester M13 9PL, UK
| | - S M Wilkinson
- Department of Dermatology, Leeds General Infirmary, Leeds LS1 3EX, UK
| | - R Agius
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
| |
Collapse
|
20
|
Bensefa-Colas L, Telle-Lamberton M, Paris C, Faye S, Stocks S, Luc A, Bourrain JL, Crépy MN, Dupas D, Frimat P, Garnier R, Lehucher-Michel MP, Pairon JC, Soulat JM, Lasfargues G, Choudat D, Momas I. Occupational allergic contact dermatitis and major allergens in France: temporal trends for the period 2001-2010. Br J Dermatol 2014; 171:1375-85. [DOI: 10.1111/bjd.13133] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2014] [Indexed: 01/17/2023]
Affiliation(s)
- L. Bensefa-Colas
- Occupational Diseases Department; University Hospital of Centre of Paris COCHIN; AP-HP; 27 rue du faubourg Saint Jacques 75014 Paris France
- Laboratoire Santé Publique et Environnement; Paris Descartes University; Sorbonne Paris Cité EA 4064 Paris France
| | | | - C. Paris
- EA-7298 INGRES; Lorraine University; Vandoeuvre Les Nancy France
- Occupational Diseases Department; University Hospital; Nancy France
| | - S. Faye
- Agence Nationale de Sécurité Sanitaire (ANSES); Maisons-Alfort France
| | - S.J. Stocks
- Centre for Occupational and Environmental Health; Centre for Epidemiology; Institute of Population Health; University of Manchester; Oxford Road Manchester M13 9PT U.K
| | - A. Luc
- EA-7298 INGRES; Lorraine University; Vandoeuvre Les Nancy France
| | - J.-L. Bourrain
- Occupational Diseases Department; CHU de Grenoble; 38043 Grenoble Cedex 9 France
| | - M.-N. Crépy
- Occupational Diseases Department; University Hospital of Centre of Paris COCHIN; AP-HP; 27 rue du faubourg Saint Jacques 75014 Paris France
| | - D. Dupas
- Occupational Diseases Department; University Hospital; Nantes France
| | - P. Frimat
- Occupational Diseases Department; University Hospital; Lille France
| | - R. Garnier
- Occupational Diseases Department; APHP; Denis Diderot University; Paris France
| | - M.-P. Lehucher-Michel
- Occupational Diseases Department; Aix-Marseille University; EA 3279 Marseille France
| | - J.-C. Pairon
- Inserm U 955; Occupational Diseases Department; Centre Hospitalier Intercommunal de Créteil; Créteil France
| | - J.-M. Soulat
- Occupational Diseases Department; University Hospital; Toulouse France
| | - G. Lasfargues
- Agence Nationale de Sécurité Sanitaire (ANSES); Maisons-Alfort France
| | - D. Choudat
- Occupational Diseases Department; University Hospital of Centre of Paris COCHIN; AP-HP; 27 rue du faubourg Saint Jacques 75014 Paris France
| | - I. Momas
- Laboratoire Santé Publique et Environnement; Paris Descartes University; Sorbonne Paris Cité EA 4064 Paris France
| | | |
Collapse
|
21
|
Wold L, Chen JK, Lampel HP. Hand dermatitis: an allergist's nightmare. Curr Allergy Asthma Rep 2014; 14:474. [PMID: 25228264 DOI: 10.1007/s11882-014-0474-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Hand dermatitis is a common skin complaint. We use our hands to explore our environment; subsequently, our hands are in frequent contact with potential allergens and irritants. Patients with hand dermatitis may present to their allergist with this complaint. Approaching the diagnosis and treatment of hand dermatitis can be challenging, as both internal and external factors may contribute to the overall condition. Furthermore, the differential diagnosis of hand dermatitis is broad and the cause often multifactorial. Obtaining a thorough history and performing a focused examination may help the clinician differentiate between multiple causes of hand dermatitis. Numerous treatment options exist for hand dermatitis, and new potential treatments are in development as well. We aim to provide the allergist with a streamlined toolkit for help in the diagnosis and management of hand dermatitis.
Collapse
Affiliation(s)
- Lindsey Wold
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL, 60064, USA,
| | | | | |
Collapse
|
22
|
Money A, Carder M, Noone P, Bourke J, Hayes J, Turner S, Agius R. Work-related ill-health: Republic of Ireland, Northern Ireland, Great Britain 2005-2012. Occup Med (Lond) 2014; 65:15-21. [PMID: 25324486 DOI: 10.1093/occmed/kqu137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Data on work-related ill-health (WRIH) in the Republic of Ireland is inconsistent. AIMS To compare the incidence of WRIH in the Republic of Ireland (ROI), Northern Ireland (NI) and Great Britain (GB) reported by clinical specialists in skin and respiratory medicine and by specialist occupational physicians (OPs). METHODS Analysis of data reported to three surveillance schemes in The Health and Occupation Research (THOR) network in ROI and corresponding UK schemes. RESULTS Contact dermatitis was the most frequently reported skin disease in the three areas. Asthma was the most frequently-reported respiratory disease in the ROI, while asbestos-related cases predominate in GB and NI. Mental health disorders, followed by musculoskeletal disorders were reported most frequently by OPs. Annual average incidence rates for skin disease were 2 per 100000 employed (95% confidence interval [CI] 1.9-2.8) in the ROI and 7 per 100000 for GB (95% CI 4.8-9.4). Unadjusted incidence rates for respiratory disease were 1 (95% CI 0.3-1) and 8 (95% CI 6.1-10.7) per 100000 in the ROI and GB, respectively; adjusted for reporter non-response, these figures increased to 15 (95% CI 11.3-19.6) and 32 (95% CI 28.4-35.6) per 100000 respectively. CONCLUSIONS This is the first paper to include THOR data on WRIH from the ROI, NI and GB. Consistent and dedicated data collection in the ROI via the THOR schemes is viable and important in the light of a deficit of occupational ill-health data. Sustained efforts to improve participation are underway.
Collapse
Affiliation(s)
- A Money
- Centre for Occupational and Environmental Health, Centre for Epidemiology, Institute of Population Health, University of Manchester, Manchester M13 9PL, UK,
| | - M Carder
- Centre for Occupational and Environmental Health, Centre for Epidemiology, Institute of Population Health, University of Manchester, Manchester M13 9PL, UK
| | - P Noone
- Health Service Executive, Dublin North East, Ireland
| | - J Bourke
- South Infirmary-Victoria Hospital, Cork, Ireland
| | - J Hayes
- Cavan Monaghan Hospital, Lisdaran, Cavan, Ireland
| | - S Turner
- Centre for Occupational and Environmental Health, Centre for Epidemiology, Institute of Population Health, University of Manchester, Manchester M13 9PL, UK
| | - R Agius
- Centre for Occupational and Environmental Health, Centre for Epidemiology, Institute of Population Health, University of Manchester, Manchester M13 9PL, UK
| |
Collapse
|
23
|
St. Louis T, Ehrlich E, Bunn T, Kanotra S, Fussman C, Rosenman KD. Proportion of dermatitis attributed to work exposures in the working population, United States, 2011 behavioral risk factor surveillance system. Am J Ind Med 2014; 57:653-9. [PMID: 24619601 PMCID: PMC4801023 DOI: 10.1002/ajim.22311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND The US employer-based surveillance system for work-related health conditions underestimates the prevalence of work-related dermatitis. OBJECTIVE The authors sought to utilize information from workers to improve the accuracy of prevalence estimates for work-related dermatitis. METHODS Three state health departments included questions in the 2011 Behavioral Risk Factor Surveillance System survey designed to ascertain the prevalence of dermatitis in the working population, as well as healthcare experiences, personal perceptions of work-relatedness, and job changes associated with dermatitis. RESULTS The percentage of working respondents who reported receiving a clinician's opinion that their dermatitis was work-related was between 3.8% and 10.2%. When patients' perceptions were considered, the work-related dermatitis prevalence estimate increased to between 12.9% and 17.6%. CONCLUSIONS Including patients' perceptions of work-relatedness produced a larger prevalence estimate for work-related dermatitis than the previously published estimate of 5.6%, which included only those cases of dermatitis attributed to work by healthcare professionals.
Collapse
Affiliation(s)
- Thomas St. Louis
- Occupational Health Unit, Connecticut Department of Public Health, 410 Capitol Ave., MS# 11EOH, Hartford, Connecticut 06134-0308, Telephone: (860) 509-7759, Fax: (860) 509-7785
| | - Emily Ehrlich
- Health Statistics & Surveillance, Survey and Research Unit, Connecticut Department of Public Health, Hartford, Connecticut
| | - Terry Bunn
- College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Sarojini Kanotra
- Chronic Disease Prevention Branch, Kentucky Department for Public Health, Frankfort, Kentucky
| | - Chris Fussman
- Lifecourse Epidemiology and Genomics Division, Michigan Department of Community Health, Lansing, Michigan
| | - Kenneth D. Rosenman
- Division of Occupational and Environmental Medicine, Michigan State University, East Lansing, MI
| |
Collapse
|
24
|
Yakut Y, Uçmak D, Akkurt ZM, Akdeniz S, Palanci Y, Sula B. Occupational skin diseases in automotive industry workers. Cutan Ocul Toxicol 2013; 33:11-5. [PMID: 23638861 DOI: 10.3109/15569527.2013.787088] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Studies on occupational skin diseases in workers of the automotive industry are few. AIM To investigate the prevalence of occupational skin diseases in workers of the automotive industry. MATERIALS AND METHODS Between September and December 2011, a total of 405 workers from the automotive repair industry in Diyarbakır were interviewed. They were active workers in the repair industry who had been employed for at least six months. Business owners, sellers of spare parts and accounting officers were not included. The employees were examined at their workplaces and the working conditions were observed. Detailed dermatological examination was performed. RESULTS The mean age of the 405 workers who participated in the study was 27.7 ± 10.3. The mean working time of employees was 13.3 ± 10.4 years. All of the employees were male. Dermatological diseases were not detected in 144 out of 405 workers (35.6%) and at least one condition was diagnosed in 261 (64.4%). The most frequent diagnosis was callus, hyperkeratosis, clavus (27.7%), followed by nail changes (16.8%) and superficial mycoses (12.1%). Contact dermatitis was seen at a rate of 5.9%. DISCUSSION Traumatic lesions such as hyperkeratotic lesions and nail changes were found most frequently. Traumatic lesions were common among individuals who did not use gloves. Most nail changes were localized leuconychia, a finding not reported in the studies on automotive industry workers. In accordance with the literature, irritant contact dermatitis was observed in patients with a history of atopy and who had been working for a long time. CONCLUSION Occupational skin diseases comprise an important field in dermatology, deserving much attention. Further studies on occupational dermatology are necessary.
Collapse
|
25
|
|
26
|
Crepy M. Dermatites de contact professionnelles chez les personnels de santé : actualités. REVUE FRANCAISE D ALLERGOLOGIE 2013. [DOI: 10.1016/j.reval.2013.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
27
|
|
28
|
Hussey L, Carder M, Money A, Turner S, Agius R. Comparison of work-related ill-health data from different GB sources. Occup Med (Lond) 2012; 63:30-7. [PMID: 23071174 DOI: 10.1093/occmed/kqs181] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A number of data sources help inform policy decisions regarding the risk of work-related ill-health. AIMS To compare self-reported and medically reported data from multiple sources and discuss their benefits and limitations in providing estimates of work-related ill-health incidence in Great Britain. METHODS Sources included The Health & Occupation Reporting network (THOR & THOR-GP (THOR in General Practice)) and the survey of Self-reported Work-related Illness (SWI). Results from SWI and THOR from GPs, rheumatologists, psychiatrists, dermatologists and respiratory physicians (2006-2009) were compared. THOR-GP data also included patient referrals information. RESULTS Overall incidence rates were highest when calculated from self-reported data, and lowest from clinical specialists. SWI rates were higher than GP rates for mental ill-health (SWI 790, GP 500 per 100 000 persons employed) and 'other' diagnoses (SWI 368, GP 41), whereas incidence rates for musculoskeletal (SWI 670, GP 684) and skin diagnoses (SWI 38, GP 152) were higher from GPs. Very few cases of musculoskeletal and mental ill-health were referred to clinical specialists (<1%). Skin (15%) and respiratory (26%) cases were referred more frequently. Case mix varied by data source. CONCLUSIONS SWI is more inclusive than THOR-GP; however, reports are unsubstantiated by medical opinion. Clinical specialist reports are subject to biases such as severity and referral patterns. GP data benefit from their inclusion of less severe cases than reports from secondary care and may give a better reflection of the incidence of diseases with a work-related aetiology unrecognized by self-reporting individuals.
Collapse
Affiliation(s)
- L Hussey
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK.
| | | | | | | | | |
Collapse
|
29
|
Baumeister T, Uter W, Weistenhöfer W, Drexler H, Kütting B. On the lookout for precursor lesions: where does dry skin end and slight hand eczema begin? Contact Dermatitis 2011; 66:63-71. [DOI: 10.1111/j.1600-0536.2011.01969.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
30
|
|
31
|
Steiner MFC, Dick FD, Scaife AR, Semple S, Paudyal P, Ayres JG. High prevalence of skin symptoms among bakery workers. Occup Med (Lond) 2011; 61:280-2. [DOI: 10.1093/occmed/kqr039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
32
|
Weistenhöfer W, Baumeister T, Drexler H, Kütting B. How to quantify skin impairment in primary and secondary prevention? HEROS: a proposal of a hand eczema score for occupational screenings. Br J Dermatol 2011; 164:807-13. [DOI: 10.1111/j.1365-2133.2010.10181.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
33
|
Nicholson PJ, Llewellyn D, English JS. Evidence-based guidelines for the prevention, identification and management of occupational contact dermatitis and urticaria. Contact Dermatitis 2011; 63:177-86. [PMID: 20831687 DOI: 10.1111/j.1600-0536.2010.01763.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Occupational contact dermatitis is the most frequently reported work-related skin disease in many countries. A systematic review was commissioned by the British Occupational Health Research Foundation in response to a House of Lords Science and Technology Committee recommendation. OBJECTIVES The systematic review aims to improve the prevention, identification and management of occupational contact dermatitis and urticaria by providing evidence-based recommendations. METHODS The literature was searched systematically using Medline and Embase for English-language articles published up to the end of September 2009. Evidence-based statements and recommendations were graded using the Royal College of General Practitioner's three-star system and the revised Scottish Intercollegiate Guidelines Network grading system. RESULTS Three thousand one hundred and fifty-five abstracts were identified and screened. From these, 786 full papers were obtained and appraised. One hundred and nineteen of these studies were used to produce 36 graded evidence statements and 10 key recommendations. CONCLUSIONS This evidence review and its recommendations focus on interventions and outcomes to provide a robust approach to the prevention, identification and occupational management of occupational contact dermatitis and urticaria, based on and using the best available medical evidence.
Collapse
|
34
|
Statham B, Mughal A, Bodger O. The relationship between the proportion of the population tested annually and the rate of patients with positive patch test reactions. Contact Dermatitis 2010; 64:54-7. [DOI: 10.1111/j.1600-0536.2010.01824.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
35
|
|
36
|
English J, Aldridge R, Gawkrodger DJ, Kownacki S, Statham B, White JML, Williams J. Consensus statement on the management of chronic hand eczema. Clin Exp Dermatol 2010; 34:761-9. [PMID: 19747339 DOI: 10.1111/j.1365-2230.2009.03649.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The management of chronic hand eczema is often inadequate. There are currently no evidence-based guidelines specifically for the management of chronic hand eczema, and evidence for established treatments for hand eczema is not of sufficient quality to guide clinical practice. This consensus statement, based on a review of published data and clinical practice in both primary and secondary care, is intended to guide the management of chronic hand eczema. It describes the epidemiology and pathogenesis of hand eczema, its diagnosis and its effect on patients' quality of life. Management strategies include a skin education programme, lifestyle changes, and the use of emollients, barriers and soap substitutes. Topical drug therapy includes topical steroids and calcineurin inhibitors. Treatment with psoralen ultraviolet A and systemic therapies may then be appropriate, although there is no strong evidence of efficacy. Alitretinoin has been shown to be effective in a randomized controlled trial, and is currently the only treatment specifically licensed for the treatment of hand eczema. Recommendations for management are summarized in a treatment algorithm.
Collapse
Affiliation(s)
- J English
- Department of Dermatology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | | | | | | | | | | | | |
Collapse
|
37
|
Keegel T, Moyle M, Dharmage S, Frowen K, Nixon R. The epidemiology of occupational contact dermatitis (1990-2007): a systematic review. Int J Dermatol 2009; 48:571-8. [DOI: 10.1111/j.1365-4632.2009.04004.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
38
|
Bourke J, Coulson I, English J. Guidelines for the management of contact dermatitis: an update. Br J Dermatol 2009; 160:946-54. [DOI: 10.1111/j.1365-2133.2009.09106.x] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
39
|
Kütting B, Weistenhöfer W, Baumeister T, Uter W, Drexler H. Current acceptance and implementation of preventive strategies for occupational hand eczema in 1355 metalworkers in Germany. Br J Dermatol 2009; 161:390-6. [PMID: 19416271 DOI: 10.1111/j.1365-2133.2009.09085.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The effectiveness of a skin care programme is based mainly on the effectiveness of the products used and the frequency and diligence of the application of skin care products. OBJECTIVES The present cross-sectional study was aimed at evaluating the implementation and acceptance of generally recommended skin protective means at the workplace. METHODS We included in our study 1355 metalworkers, employed in 19 factories, mainly of small or medium-size. The majority of participants were male (96.7%, n = 1310). The investigation included a standardized interview and a dermatological examination of the hands. RESULTS More than half of all participants (52.4%) had suffered from skin problems of the hands at some time. Three hundred and ninety-six subjects (29%) indicated they followed the skin protection regimen as it was generally recommended, i.e. the use of barrier creams in combination with moisturizers. A similar number of participants (28%) denied any use of protective creams. In general, compliance in men was significantly poorer than in women. Participants with past or present history of hand eczema used both barrier creams and moisturizers significantly more often. The skin condition of the hands, examined using a quantitative score, did not differ significantly in the four subgroups defined by different skin protection measures. While acceptance of protective measures was limited, these were available in all factories. CONCLUSIONS Although barrier creams and moisturizers are highly recommended as effective means to prevent irritant contact dermatitis in Germany, our data prove that the compliance of application in this group at special risk for hand eczema is extremely low.
Collapse
Affiliation(s)
- B Kütting
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany.
| | | | | | | | | |
Collapse
|
40
|
Stutz N, Becker D, Jappe U, John SM, Ladwig A, Spornraft-Ragaller P, Uter W, Löffler H. Nurses' perceptions of the benefits and adverse effects of hand disinfection: alcohol-based hand rubs vs. hygienic handwashing: a multicentre questionnaire study with additional patch testing by the German Contact Dermatitis Research Group. Br J Dermatol 2008; 160:565-72. [PMID: 19067700 DOI: 10.1111/j.1365-2133.2008.08951.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Nurses have a high risk of developing hand eczema due to hand disinfection procedures. OBJECTIVES To investigate the perception of nurses regarding the adverse effects of hand washing (HW) and alcoholic disinfection (ADI), and to obtain data on the prevalence of hand dermatitis and sensitization to alcohols and alcohol-based hand rubs (ABHRs). METHODS A self-administered questionnaire survey, carried out as a pilot study (PS), followed by a modified multicentre study (MC) in five hospitals. Patch tests to ethanol (80%), 1-propanol (60%), 2-propanol (70%) and ABHRs were performed in a subsample. RESULTS The majority (PS 60.1%; MC 69.5%) of nurses considered ADI to be more damaging than HW. Mostly, ADI and HW were suspected to have irritant effects (ADI 79.2%/52.1%; HW 65.5%/36.2%) compared with an allergenic potential (ADI 10.4%/5.8%; HW 7.8%/3.9%). The prevalence of hand dermatitis in the MC was 13.4% by self-diagnosis and 22.4% by symptom-based questions. In 50 tested individuals no sensitization and only two irritant reactions to alcohols and three single-positive reactions to ABHRs were observed, none of the latter related to alcohols. CONCLUSIONS Although ADI is known to cause less skin irritation than HW, nurses perceive ADI as more damaging, resulting in: (i) a low compliance with ADI and (ii) a higher prevalence of hand dermatitis because the more deleterious HW is preferred. This may result in an increase in occupational disease and nosocomial infections. Educational programmes should promote ADI as a procedure with good efficiency and skin tolerability to reduce the prevalence of hand eczema in nurses and to enhance compliance with hand hygiene standards.
Collapse
Affiliation(s)
- N Stutz
- Department of Dermatology, Philipp University, Marburg, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Anveden Berglind I, Alderling M, Järvholm B, Lidén C, Meding B. Occupational skin exposure to water: a population-based study. Br J Dermatol 2008; 160:616-21. [PMID: 18811687 DOI: 10.1111/j.1365-2133.2008.08850.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Occupational exposure to skin irritants, in particular to water, is an important risk factor for hand eczema. OBJECTIVES To assess occupational skin exposure to water in the general population. METHODS As part of a public health survey in Stockholm, Sweden, 18,267 gainfully employed individuals aged 18-64 years completed a questionnaire with previously validated questions regarding occupational skin exposure to water. RESULTS Altogether 16% reported exposure to water for (1/2) h or more a day, and 13% reported exposure to water more than 10 times a day. Furthermore, 7% reported water exposure of more than 2 h and 6% of more than 20 times a day. Women reported more water exposure than men and many female-dominated occupations were seen to comprise water exposure. Women were also more exposed than men within the same jobs. Young adults were more exposed than older. A total of 18% were employed in high-risk occupations for hand eczema. Fifty-nine per cent of individuals employed in high-risk occupations reported water exposure at work, compared with 11% in low-risk occupations. CONCLUSIONS A total of 20% of the population of working age acknowledged occupational skin exposure to water, which was found to be more common in young adults and women. Using job title as a proxy for water exposure gives an underestimation due to misclassification. In assessing occupational skin exposure to water, both exposure time and frequency should be considered.
Collapse
Affiliation(s)
- I Anveden Berglind
- Department of Occupational and Environmental Health, Stockholm Centre for Public Health, Norrbacka, Stockholm SE-171 76, Sweden.
| | | | | | | | | |
Collapse
|
42
|
Crépy MN, Zerbib D, Descatha A, Choudat D, Ameille J. Atlas iconographique interactif de dermatologie professionnelle. ARCH MAL PROF ENVIRO 2008. [DOI: 10.1016/j.admp.2008.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
43
|
Fluhr JW, Darlenski R, Angelova-Fischer I, Tsankov N, Basketter D. Skin irritation and sensitization: mechanisms and new approaches for risk assessment. 1. Skin irritation. Skin Pharmacol Physiol 2008; 21:124-35. [PMID: 18523410 DOI: 10.1159/000131077] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cutaneous irritation presents a major health problem with serious social and occupational impact. The interaction between an irritant and the human skin depends on multiple factors: the intrinsic properties and the nature of the irritant itself, and specific individual- and environment-related variables. The main pathological mechanisms of irritancy include skin barrier disruption, induction of a cytokine cascade and involvement of the oxidative stress network; all of them resulting in a visible or subclinical inflammatory reaction. In vivo, different non-invasive parameters for the evaluation of skin irritation and irritant potential of compounds and their specific formulations have been introduced, such as epidermal barrier function, skin hydration, surface pH, lipid composition, skin colour and skin blood flow. The diverse physiological changes caused by irritating agents require implementation of a multiparametric approach in the evaluation of cutaneous irritancy.
Collapse
|
44
|
Research Snippets. J Invest Dermatol 2007. [DOI: 10.1038/sj.jid.5701150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|