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Glenn Ullum A, Barati Sedeh F, Jemec GBE, Ibler KS. Professional Cleaners' and Healthcare Workers' Ability to Recognize Hand Eczema. Acta Derm Venereol 2024; 104:adv27985. [PMID: 38501841 DOI: 10.2340/actadv.v104.27985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/30/2024] [Indexed: 03/20/2024] Open
Abstract
Timely intervention reduces the risk of a poor prognosis in hand eczema, making early recognition of symptoms important in high-risk professions. However, limited data exist regarding the ability of cleaners and healthcare workers to recognize hand eczema. The aim of this study was to examine cleaners' and healthcare workers' ability to recognize hand eczema in clinical photographs and to assess the severity of the disease. Cleaners and healthcare workers completed a questionnaire consisting of 16 questions and participated in a structured interview referring to a validated photographic severity guide for chronic hand eczema, which comprised clinical photographs of hand eczema at varying levels of severity. Eighty cleaners and 201 healthcare workers (total N = 281) participated in the study. The rates of correctly identified hand eczema in clinical photographs (cleaners/ healthcare workers) were: 41.2%/57.7% (mild hand eczema), 81.2%/92.0% (moderate hand eczema), 85.0%/94.5% (severe hand eczema) and 82.5%/97.0% (very severe hand eczema). The proficiency of healthcare workers in recognizing hand eczema was significantly higher than that of cleaners. The results indicate that a large proportion of cleaners and healthcare workers fail to recognize mild hand eczema in clinical photographs. Healthcare workers had higher success rates in recognizing hand eczema in all severity categories. Symptom underestimation may lead to under-reporting of the true prevalence of hand eczema, with consequent loss of opportunities for prevention.
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Affiliation(s)
- Anna Glenn Ullum
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Farnam Barati Sedeh
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Sophie Ibler
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Thyssen JP, Ahlström MG, Bruze M, Rustemeyer T, Lidén C. Metals. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_35-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Isothiazolinone Content of US Consumer Adhesives: Ultrahigh-Performance Liquid Chromatographic Mass Spectrometry Analysis. Dermatitis 2019; 30:129-134. [PMID: 30829801 DOI: 10.1097/der.0000000000000455] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There are limited data regarding the prevalence and concentration of isothiazolinone preservatives in consumer adhesives. OBJECTIVES The aim of this study was to determine the prevalence and concentration of 5 specific isothiazolinones (methylisothiazolinone [MI], methylchloroisothiazolinone [MCI], benzisothiazolinone [BIT], butyl BIT, and octylisothiazolinone) in US adhesives. METHODS Thirty-eight consumer adhesives were analyzed using ultrahigh-performance liquid chromatographic-mass spectrometry. Fisher exact tests were used to test for isothiazolinone content and: 1) glue format (2) application purpose and 3) extraction method. RESULTS Nineteen adhesives (50%) had at least 1 isothiazolinone, and 15 contained 2 isothiazolinones. Frequencies and concentrations were as follows: MI (44.7%; 4-133 ppm), MCI (31.6%; 7-27 ppm), BIT (15.8%; 10-86 ppm), and octylisothiazolinone (2.6%; 1 ppm). Butyl BIT was not detected in any of the adhesives. Format (stick vs liquid) was not statistically associated with isothiazolinone presence. At least half of adhesives in the following application purposes had at least 1 isothiazolinone: shoe, craft, fabric, and school. All-purpose glues had a statistically significant lower concentration of MI and MCI, whereas craft glues were associated with higher concentrations of MI and MCI. Compared with other glues, fabric adhesives were associated with a higher risk of containing BIT. CONCLUSIONS Half of the tested adhesives contained at least 1 isothiazolinone. Methylisothiazolinone and MCI were the most common. Consumers and dermatologists should be aware of adhesives as a source of isothiazolinones.
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Herman A, Aerts O, de Montjoye L, Tromme I, Goossens A, Baeck M. Isothiazolinone derivatives and allergic contact dermatitis: a review and update. J Eur Acad Dermatol Venereol 2018; 33:267-276. [PMID: 30284765 DOI: 10.1111/jdv.15267] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/20/2018] [Indexed: 01/12/2023]
Abstract
Allergic contact dermatitis (ACD) from isothiazolinones has frequently been described in the literature. Following an epidemic of sensitization to methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) in the 1980s, and more recently to MI, the Scientific Committee on Consumer Safety of the European Commission banned their use in leave-on products, while restricting that in rinse-off cosmetics. Despite a decreasing prevalence of ACD from MCI/MI and MI, cases caused by occupational exposure and non-cosmetic isothiazolinone sources are on the rise. Moreover, sensitization to newer and lesser known isothiazolinones has been reported. This paper reviews the epidemiology of contact allergy to different isothiazolinones, clinical presentation of isothiazolinone-induced ACD, most relevant sensitization sources and potential cross-reactions between isothiazolinone derivatives. It also provides an update on recent legislative measures.
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Affiliation(s)
- A Herman
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - O Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and University of Antwerp (UA), Antwerp, Belgium
| | - L de Montjoye
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - I Tromme
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - A Goossens
- Department of Dermatology, University Hospital KU Leuven, Leuven, Belgium
| | - M Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Occupational Contact Dermatitis in North American Production Workers Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014. Dermatitis 2017; 28:183-194. [DOI: 10.1097/der.0000000000000277] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bruze M, Mowitz M, Zimerson E, Bergendorff O, Dahlin J, Engfeldt M, Isaksson M, Pontén A, Svedman C. No contact allergy to acrylic acid and methacrylic acid in routinely tested dermatitis patients. Contact Dermatitis 2017; 76:116-118. [DOI: 10.1111/cod.12627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/10/2016] [Accepted: 05/10/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
| | - Erik Zimerson
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
| | - Ann Pontén
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 205 02 Malmö Sweden
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Vauhkala AR, Pesonen M, Suomela S, Kuuliala O, Suuronen K, Aalto-Korte K. Occupational contact allergy to methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone. Contact Dermatitis 2015; 73:150-6. [DOI: 10.1111/cod.12413] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/05/2015] [Accepted: 04/13/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Anna-Reetta Vauhkala
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); FI-00250 Helsinki Finland
- Department of Dermatology; Skin and Allergy Hospital, Helsinki University Central Hospital (HUCH); FI-00029 Helsinki Finland
| | - Maria Pesonen
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); FI-00250 Helsinki Finland
| | - Sari Suomela
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); FI-00250 Helsinki Finland
| | - Outi Kuuliala
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); FI-00250 Helsinki Finland
| | - Katri Suuronen
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); FI-00250 Helsinki Finland
| | - Kristiina Aalto-Korte
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); FI-00250 Helsinki Finland
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Tran N, Pecquet C, Francès C. Dermatite des mains chez le personnel hospitalier : rôle des isothiazolinones des savons hospitaliers. ARCH MAL PROF ENVIRO 2014. [DOI: 10.1016/j.admp.2014.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Friis UF, Menné T, Flyvholm MA, Bonde JPE, Lepoittevin JP, Le Coz CJ, Johansen JD. Isothiazolinones in commercial products at Danish workplaces. Contact Dermatitis 2014; 71:65-74. [PMID: 24850171 DOI: 10.1111/cod.12235] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 02/19/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND In recent years, a steep increase in the frequency of occupational contact allergy to isothiazolinones has been reported from several European countries. OBJECTIVE To examine the extent and occurrence of isothiazolinones in different types of product at Danish workplaces. METHODS Seven different isothiazolinones were identified in the Dictionary of Contact Allergens: Chemical Structures, Sources, and References from Kanerva's Occupational Dermatitis. By use of the chemical names and Chemical Abstracts Service numbers for these chemicals, information on products registered in the Danish Product Register Database (PROBAS) was obtained. RESULTS All seven isothiazolinones were registered in PROBAS. The top three isothiazolinones registered were: benzisothiazolinone (BIT), registered in 985 products, methylisothiazolinone (MI), registered in 884 products, and methylchloroisothiazolinone (MCI)/MI, registered in 611 products. The concentration ranges were 0.01 ppm to 45% for BIT, 0.01 ppm to 10% for MI, and 0.01 ppm to 14.1% for MCI/MI. The most common product type was 'paint and varnish'; five of the seven isothiazolinones were registered in this type of product. CONCLUSION Isothiazolinones are present in multiple products registered for use at workplaces, and may occur in high concentrations.
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Affiliation(s)
- Ulrik Fischer Friis
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark
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Mose AP, Lundov MD, Zachariae C, Menné T, Veien NK, Laurberg G, Kaaber K, Avnstorp C, Andersen KE, Paulsen E, Mortz CG, Sommerlund M, Danielsen A, Thormann J, Kristensen O, Kristensen B, Andersen BL, Vissing S, Nielsen NH, Johansen JD. Occupational contact dermatitis in painters - an analysis of patch test data from the Danish Contact Dermatitis Group. Contact Dermatitis 2012; 67:293-7. [DOI: 10.1111/j.1600-0536.2012.02074.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Monsálvez V, Fuertes L, Frutos JOD, Vanaclocha F. Sensibilización a metil-cloro-isotiazolinona/metilisotiazolinona tras quemadura por exposición profesional masiva accidental. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:224-6. [DOI: 10.1016/j.ad.2010.06.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 04/28/2010] [Accepted: 06/14/2010] [Indexed: 10/18/2022] Open
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Sensitization to Methylchloroisothiazolinone-Methylisothiazolinone After a Burn Caused by Massive Accidental Occupational Exposure. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/s1578-2190(11)70792-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Aalto-Korte K, Jungewelter S, Henriks-Eckerman ML, Kuuliala O, Jolanki R. Contact allergy to epoxy (meth)acrylates. Contact Dermatitis 2009; 61:9-21. [DOI: 10.1111/j.1600-0536.2009.01574.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Isaksson M, Bruze M, Gruvberger B. Cross-reactivity between methylchloroisothiazolinone/methylisothiazolinone, methylisothiazolinone, and other isothiazolinones in workers at a plant producing binders for paints and glues. Contact Dermatitis 2007; 58:60-2. [DOI: 10.1111/j.1600-0536.2007.01168.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Isaksson M, Zimerson E. Risks and possibilities in patch testing with contaminated personal objects: usefulness of thin-layer chromatograms in a patient with acrylate contact allergy from a chemical burn. Contact Dermatitis 2007; 57:84-8. [PMID: 17627645 DOI: 10.1111/j.1600-0536.2007.01156.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report a case of a chemical burn from dipropylene glycol diacrylate (DPGDA) spilt on working shoes, followed by active sensitization, thus giving an occupational allergic contact dermatitis on the patient's dorsal feet. Diagnostic tests included patch testing with acetone extracts made from the different shoe layers and thin-layer chromatograms. An invisible spot on the thin-layer chromatography plate gave a test eczema and was further investigated with gas chromatography-mass spectrometry. DPGDA was detected in the spot.
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Affiliation(s)
- Marléne Isaksson
- Department of Occupational and Environmental Dermatology, University Hospital MAS, Lund University, Malmö SE 205 02, Sweden.
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Svedman C, Ekqvist S, Möller H, Björk J, Gruvberger B, Holmström E, Bruze M. Unexpected sensitization routes and general frequency of contact allergies in an elderly stented Swedish population. Contact Dermatitis 2007; 56:338-43. [PMID: 17577375 DOI: 10.1111/j.1600-0536.2007.01119.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Contact allergy to stent material has been proposed to be a risk factor for restenosis, after percutaneous transluminal coronary angioplasty (PTCA) and stenting. Information on the general frequency of contact allergy in the elderly population is scarce and knowledge of possible sensitization routes is important to investigate. The aim of this study was to investigate contact allergy to stent materials and other allergens. Here we report our findings on the frequency of contact allergies apart from those from stent material. In this retrospective study, we patch tested an elderly population, treated with PTCA and stented, with our standard series. A dermatitis population served as controls. We found a high frequency of contact allergy in both groups but a greater 'contact allergy burden', with generally higher frequencies for contact allergens, in the dermatitis patients as expected. Myroxylon pereirae and caine mix were apart from metals exceptions with statistically significant higher frequencies (P < 0.01) for the stented patients. Contact allergy to nonmetal sensitizers is common in an elderly Swedish stent population although, on the whole, substantially less than in an age and sex-matched dermatitis population. The findings indicate the importance of the oral mucosa for sensitization. In a general population that has been treated with a special medication/treatment procedure, contact allergies not suspected (such as to M. pereirae and to the metals) might suddenly peak. This underlines the importance of a careful evaluation of new products and routines with regard to contact allergies in the population.
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Affiliation(s)
- Cecilia Svedman
- Department of Occupational and Environmental Dermatology, University Hospital MAS, Malmö, Lund University, Lund, Sweden.
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Pontén A, Carstensen O, Rasmussen K, Gruvberger B, Isaksson M, Bruze M. Epoxy-based production of wind turbine rotor blades: occupational dermatoses. Contact Dermatitis 2004; 50:329-38. [PMID: 15274722 DOI: 10.1111/j.0105-1873.2004.00346.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Occupational dermatoses were investigated in a factory producing rotor blades for wind turbines by an epoxy-based process. In a blinded study design, 603 workers were first interviewed and thereafter clinically examined. Based on a history of work-related skin disease, clinical findings of dermatitis, or both, 325 (53.9%) of the workers were patch tested with a specially profiled occupational patch-test series and the European standard patch-test series. Calculated on all investigated workers, 17.1% of the workers were diagnosed with occupational dermatoses caused by work. Occupational allergic contact dermatitis was found in 10.9% of the workers. The estimated frequency of irritant contact dermatitis caused by work was 6.1%. Dermatitis on the hands was associated with contact allergy to epoxy resin (P = 0.017). The number of days on leave before the clinical examination was negatively associated with the presence of dermatitis (P = 0.001). Among workers employed 7-12 months, the frequency of occupational contact allergy was higher than that among workers employed for </=6 months (P = 0.004). Females both washed their hands more often (P < 0.001) and used more moisturizers/protection creams at work (P < 0.001) than males. No sex differences were found concerning dermatitis on the hands.
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Affiliation(s)
- A Pontén
- Department of Occupational and Environmental Dermatology, Malmö University Hospital, Malmö, Sweden.
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Gruvberger B, Isaksson M, Frick M, Pontén A, Bruze M, Pontén ANN. Occupational dermatoses in a metalworking plant. Contact Dermatitis 2003; 48:80-6. [PMID: 12694210 DOI: 10.1034/j.1600-0536.2003.480205.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In a plant producing advanced components for engines and drivelines we undertook a survey of occupational dermatoses, based on a questionnaire, clinical examination, and patch testing with a standard series and a series of samples from the working environment. The questionnaire was given to all 430 employees and it was answered and returned by 382 of these. 214 reported having had or having skin manifestations during the time of employment suspected of being work-related. 183 employees (164 metal workers, 19 office staff) participated in the clinical investigation, 182 (163 metal workers, 19 office staff) being patch tested. Occupational dermatoses were diagnosed in 23 of these 163 (14.1%) and in 1 of these 19 (5.3%). In all, irritant contact dermatitis was diagnosed in 12 metal workers, occupational allergic contact dermatitis in 11 (10 metal workers and 1 office clerk) and folliculitis in 1 metal worker. In the 11, neat oils were the cause in 4 workers, a water-based cutting fluid in 3 and various biocides in 4.
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Affiliation(s)
- Birgitta Gruvberger
- Department of Occupational and Environmental Dermatology, Malmö University Hospital, Sweden
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Livesley EJ, Rushton L, English JSC, Williams HC. Clinical examinations to validate self-completion questionnaires: dermatitis in the UK printing industry. Contact Dermatitis 2002; 47:7-13. [PMID: 12225406 DOI: 10.1034/j.1600-0536.2002.470102.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A self-completion questionnaire sent to 2600 Nottinghamshire members of the Graphical Paper and Media Union elicited a 62% response. Forty one per cent of respondents reported suffering a skin complaint at some time and 11% had a current skin problem on the hand. This paper reports the validation stage of the study. Samples of 45 'cases' of self-reported dermatitis and 60 'controls', who reported they had never suffered a skin complaint, were clinically examined. All 45 self-reported cases were clinically confirmed as dermatitis. Occupationally related irritant contact dermatitis (ICD) was diagnosed in 20 (44%); 26 (58%) complaints were thought to be induced or exacerbated by occupation. Of the controls, 21 (35%) were also diagnosed with a skin complaint, the majority being mild, with an occupational association in 17, the majority (15) being ICD. Sixteen ICD cases were patch tested resulting in positive reactions to colophony, neomycin, nickel and potassium dichromate (2 of each). Two cases of basal cell carcinoma on the face were also identified, of which the participants were unaware. Although there was no false positive self-reporting there was a considerable number of false negatives, demonstrating the importance of clinical validation of questionnaires relating to industrial skin disease. This study has highlighted the need for improvement in skin care provision in the printing industry.
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Affiliation(s)
- E J Livesley
- North London Cancer Network, Grays Inn Division, Royal Free Hospital, Pond Street, London
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Svensson Å, Möller H, Björkner B, Bruze M, Leden I, Theander J, Ohlsson K, Linder C. Rheumatoid arthritis, gold therapy, contact allergy and blood cytokines. BMC DERMATOLOGY 2002; 2:2. [PMID: 11860615 PMCID: PMC65540 DOI: 10.1186/1471-5945-2-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2001] [Accepted: 02/01/2002] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study the clinical and biochemical effects of a low starting dose for gold therapy in rheumatoid arthritis patients with a contact allergy to gold. METHODS Serum cytokines were assayed before and 24 h after the first injection of gold sodium thiomalate (GSTM). RESULTS Contact allergy to gold was found in 4 of 19 patients. Compared to gold-negative patients (starting dose: 10 mg GSTM), there was a larger increase in serum TNFalpha (p < 0.05), sTNF-R1 (NS), and IL-1 ra (p < 0.05) in gold-allergic patients. CONCLUSIONS Cytokines are released in blood by GSTM in RA patients with gold allergy. To minimize the risk of acute adverse reactions the starting dose of GSTM should be lowered to 5 mg. Alternatively, patients should be patch-tested before gold therapy; in test-positive cases, 5 mg is recommended as the first dose.
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Affiliation(s)
- Åke Svensson
- Department of Dermatology, Malmö University Hospital, Sweden
| | - Halvor Möller
- Department of Dermatology, Malmö University Hospital, Sweden
| | - Bert Björkner
- Department of Dermatology, Malmö University Hospital, Sweden
| | - Magnus Bruze
- Department of Dermatology, Malmö University Hospital, Sweden
| | - Ido Leden
- Department of internal medicine, Section of Rheumatology, Kristianstad Central Hospital, Malmö, Sweden
| | - Jan Theander
- Department of internal medicine, Section of Rheumatology, Kristianstad Central Hospital, Malmö, Sweden
| | - Kjell Ohlsson
- Department of Surgical Pathophysiology, Malmö University Hospital, Sweden
| | - Carina Linder
- Department of Surgical Pathophysiology, Malmö University Hospital, Sweden
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Abstract
The validity of questionnaire answers with respect to hand eczema was investigated. Car mechanics, dentists and office workers answered a questionnaire on the occurrence of hand eczema on any occasion during the past 12 months. "Yes"-responders and a random sample of "no"-responders were subsequently interviewed and examined by a dermatologist. 10.0% of the car mechanics, 12.0% of the dentists and 12.5% of the office workers were found to have hand eczema despite previous "no"-answers. In the same populations, 81%, 94% and 80% of the "yes"-answers were confirmed at the clinical examination. Considering false-negative and false-positive answers, the sensitivity was 53-59% and the specificity 96-99% in the 3 groups. The 1-year prevalence changed from self-reported 15% to estimated 21% in the car mechanics, from 15% to 24% in the dentists and from 15% to 23% in the office workers. It is concluded that self-reported 1-year prevalence of hand eczema considerably underestimates the true prevalence.
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Affiliation(s)
- B Meding
- Occupational Dermatology, National Institute for Working Life, Stockholm, Sweden
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Connolly MC, Kirby B, Bhushan M, O'Driscoll JB, Beck MH. Occupational allergic contact dermatitis from methylchloroisothiazolinone and methylisothiazolinone (MCI/MI) in a silicone-emulsion lock lubricant. Contact Dermatitis 2001; 44:246-63. [PMID: 11260242 DOI: 10.1034/j.1600-0536.2001.044004246.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M C Connolly
- Contact Dermatitis Investigation Unit, Dermatology Centre, University of Manchester School of Medicine, Hope Hospital, Salford, Manchester M6 8HD, UK
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Corazza M, Mantovani L, Bacilieri S, Virgili A. A child with "occupational" allergic contact dermatitis due to MCI/MI. Contact Dermatitis 2001; 44:53-4. [PMID: 11156028 DOI: 10.1034/j.1600-0536.2001.440107-20.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M Corazza
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Ferrara, Italy
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Fewings J, Menné T. An update of the risk assessment for methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) with focus on rinse-off products. Contact Dermatitis 1999; 41:1-13. [PMID: 10416701 DOI: 10.1111/j.1600-0536.1999.tb06200.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) has been widely used during the last 20 years for the preservation of aqueous systems in cosmetics, toiletries and in various industrial applications. MCI/MI has a broad spectrum of activity against fungi and bacteria at very low concentrations. The allergic contact potential of MCI/MI has been known for many years. This paper provides a review of pre-clinical and clinical experimental studies as well as experience from dermatology clinics worldwide. This forms the basis for an update of the risk assessment for the use of MCI/MI in rinse-off products. The scientific data indicate that the actual sensitization rate observed with a contact allergen is extremely dependent on dose and type of exposure. This review of the data leads to the conclusion that, under normal use conditions, within the current permitted/ recommended use concentrations for MCI/MI of up to 15ppm, the risk of primary sensitization from the use of rinse-off products is negligible, and elicitation of allergic contact dermatitis in MCI/MI-sensitized individuals rare, after exposure to MCI/MI-preserved rinse-off products.
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Affiliation(s)
- J Fewings
- Department of Dermatology, University of Copenhagen, Gentofte Hospital, Denmark
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Chockalingam S, Dega R, Goodier D. Skin burn associated with paint on synthetic plaster cast. Injury 1999; 30:301-2. [PMID: 10476302 DOI: 10.1016/s0020-1383(99)00078-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Gruvberger B, Bruze M. Can glutathione-containing emollients inactivate methylchloroisothiazolinone/methylisothiazolinone? Contact Dermatitis 1998; 38:261-5. [PMID: 9667443 DOI: 10.1111/j.1600-0536.1998.tb05740.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Many persons are exposed to preservatives/biocides based on methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), since toiletries and cosmetics, as well as products/water-based systems used occupationally, may all contain MCI/MI. In toiletries and cosmetics, the MCI/MI concentration is often below 15 ppm (0.0015%). In some industries, workers handle high concentrations of MCI/MI, which can cause chemical burns and induce sensitization if skin is exposed. Contact allergy to MCI/MI is common and reports on chemical burns have been published. Thus, there is a need for prevention of skin diseases caused by MCI/MI. The inactivation of MCI/MI by glutathione (GSH) in emollients, containing different amounts of lipids, was studied by HPLC. Various amounts of GSH were added to Fenuril, Essex, and Locobase, giving 3 preparations of each emollient containing 0.10%, 0.50% and 2.0% GSH, respectively. The inactivation of 15 ppm MCI/MI and the total inactivating capacity of GSH in these preparations, kept at room temperature and refrigerated, was studied over a period of 6 months. The inactivating capacity of GSH in the emollients was almost equivalent, regardless of the lipid contents of the emollients, type of storage and age. On the other hand, the GSH concentration in the emollients had a crucial importance on the inactivation of MCI/MI. Emollients containing 2% GSH were capable of inactivating up to 2400 ppm MCI/MI.
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Affiliation(s)
- B Gruvberger
- Department of Occupational and Environmental Dermatology, University Hospital, Malmö, Sweden
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