1
|
Hon KL, Leung AKC, Cheng JWCH, Luk DCK, Leung ASY, Koh MJA. Allergic Contact Dermatitis in Pediatric Practice. Curr Pediatr Rev 2024; 20:478-488. [PMID: 37365784 DOI: 10.2174/1573396320666230626122135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/10/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) is prevalent among pediatric population, adolescent and young adults. Patients with ACD experience a lot of sociopsychological and qualityof- life (QoL) difficulties. Children and their caregivers alike are vulnerable to the burden of ACD. OBJECTIVES We have, in this paper, provided an overview of ACD and discussed common and unusual causes of ACD. METHODS We performed an up-to-date literature review in the English language on "allergic contact dermatitis" via PubMed Clinical Queries, using the keywords "allergic contact dermatitis" in August 2022. The search included meta-analyses, randomized controlled trials, clinical trials, casecontrol studies, cohort studies, observational studies, clinical guidelines, case series, case reports, and reviews. The search was restricted to English literature and children. RESULTS ACD may be acute or chronic and it affects more than 20% of children and adults with significant quality-of-life impairments. ACD is manifested by varying degrees of cutaneous edema, vesiculation, and erythema. The hypersensitivity reaction is one of the most prevalent forms of immunotoxicity in humans. Localized acute ACD lesions can be managed with high-potency topical steroids; if ACD is severe or extensive, systemic corticosteroid therapy is often required to provide relief within 24 hours. In patients with more severe dermatitis, oral prednisone should be tapered over 2-3 weeks. Rapid discontinuation of corticosteroids can result in rebound dermatitis. Patch testing should be performed if treatment fails and the specific allergen or diagnosis remains unknown. CONCLUSION ACD is common and can be a physically, psychologically, and economically burdensome disease. Diagnosis of ACD is primarily based on history (exposure to an allergen) and physical examination (morphology and location of the eruption). Skin patch test can help determine the causative allergen. Allergen avoidance is the cornerstone of management. Topical mid- or highpotency corticosteroids are the mainstay of treatment for lesions on less than 20% of the body area. Severe cases of ACD may require treatment with systemic corticosteroids.
Collapse
Affiliation(s)
- Kam Lun Hon
- Department of Paediatrics, CUHKMC, The Chinese University of Hong Kong, Hong Kong, China
| | - Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - James W C H Cheng
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kwun Tong, Hong Kong, China
| | - David C K Luk
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kwun Tong, Hong Kong, China
| | - Agnes S Y Leung
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Mark J A Koh
- Department of Dermatology, KK Women's and Children's Hospital, Bukit Timah Road, Singapore
| |
Collapse
|
2
|
Larese Filon F, Maculan P, Crivellaro MA, Mauro M. Effectiveness of a Skin Care Program With a Cream Containing Ceramide C and a Personalized Training for Secondary Prevention of Hand Contact Dermatitis. Dermatitis 2023; 34:127-134. [PMID: 36939821 PMCID: PMC10029085 DOI: 10.1089/derm.2022.29002.flf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Background/Objectives: The aim of our study was to investigate the effectiveness of personalized training on skin protection associated with the regular use of ceramide-containing cream (CC) versus other creams (OC) for improving hand contact dermatitis. Methods: We performed a double-center randomized trial that enrolled workers with hand dermatitis. All workers received personalized training. The intervention was 3 times per day application of the study emollient. The control arm used an emollient of choice without ceramide, as needed. The primary outcome was improvement in hand dermatitis at 1 and 3 months of follow-up. Results: In total, 102 patients with hand dermatitis were enrolled in this study. Improvement in dermatitis was found in 40%, 52.5%, 50%, and 63% of OC and CC, at the first and second follow-ups, respectively. The use of CC was significantly associated with an improvement in dermatitis (odds ratios 2.6; 95% confidence intervals 1.30-5.2), analyzed using generalized equation estimation during the follow-up. Conclusion: Our study demonstrated that an educational personalized intervention could improve the signs and symptoms in patients with hand dermatitis, and the use of a CC resulted in a significantly better outcome during the 3 months of follow-up.
Collapse
Affiliation(s)
| | - Pietro Maculan
- Unit of Occupational Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | | | - Marcella Mauro
- From the *Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| |
Collapse
|
3
|
Tesfaye AH, Engdaw GT, Aragaw FM, Kabito GG. Prevalence and risk factors of work-related contact dermatitis symptoms among healthcare cleaners during the COVID-19 pandemic in Northwest Ethiopia: a multicentre cross-sectional survey. BMJ Open 2022; 12:e069019. [PMID: 36446456 PMCID: PMC9710345 DOI: 10.1136/bmjopen-2022-069019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This study was aimed to explore the prevalence and risk factors of work-related contact dermatitis (WRCD) symptoms among cleaners working in healthcare institutions in Gondar city, Northwest Ethiopia, during the COVID-19 pandemic. DESIGN A multicentre cross-sectional study was conducted from September to October 2021. An interviewer-administered standardised Nordic Occupational Skin Questionnaire, V.2002 (NOSQ-2002) was used to assess WRCD. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. The association between dependent and independent variables was computed with a binary logistic regression. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05. SETTING The study was conducted in Gondar city healthcare institutions, Northwestern Ethiopia. PARTICIPANTS A total of 409 cleaners participated in this study. OUTCOME MEASURES The primary outcome is the prevalence of WRCD symptoms, which was measured using the NOSQ-2002. RESULTS The response rate was 95.6%. The majority, 302 (73.8%), of the study participants were female. The mean age (±SD) was 31 (±7.87) years old. The overall prevalence of self-reported WRCD during the last 12 months was 213 (52.1%) (95% CI (47.1% to 57.0%)). The highest symptoms reported were skin redness, 51.6% (n=110), and the most affected skin body sites were hands (hand dermatitis), 74.2% (n=158). Hand washing frequency more than 20 times per day (AOR=1.73, 95% CI (1.03 to 2.92)), personal history of eczema (AOR=1.46, 95% CI (1.01 to 2.42)) and lack of training on skin hazards (AOR=2.06, 95% CI (1.16 to 3.63)) were factors influencing the occurrence of WRCD. CONCLUSIONS This study revealed the prevalence of WRCD is common during the COVID-19 pandemic. Adjusting hand washing frequency per day, educating people with atopy about the avoidance of exposure to skin irritants and providing training on skin hazards were recommended to minimise the condition.
Collapse
Affiliation(s)
- Amensisa Hailu Tesfaye
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Garedew Tadege Engdaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebisa Guyasa Kabito
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
4
|
Contact Urticaria Syndrome: a Comprehensive Review. CURRENT DERMATOLOGY REPORTS 2022; 11:194-201. [PMCID: PMC9672538 DOI: 10.1007/s13671-022-00379-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
|
5
|
Heichel T, Sonsmann FK, John SM, Krambeck K, Maurer J, Nienhaus A, Nordheider K, Stasielowicz L, Wilke A, Brans R. Effects and acceptance of semipermeable gloves compared to cotton gloves in patients with hand dermatoses: Results of a controlled intervention study. Contact Dermatitis 2022; 87:176-184. [PMID: 35396860 DOI: 10.1111/cod.14123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/16/2022] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Semipermeable gloves might be an alternative to cotton gloves in management of hand dermatoses. OBJECTIVES To compare acceptance and tolerability of gloves made of cotton or a semipermeable Sympatex membrane in patients with hand dermatoses and their effect on skin lesions when worn overnight. METHODS 199 patients with work-related symmetrical hand dermatoses were asked to wear a cotton glove (COT) on one hand and a Sympatex glove underneath a cotton glove (SYM/COT) on the other hand for nineteen consecutive nights. The severity of skin lesions was regularly examined. A questionnaire on acceptance and tolerability was used in a subset of 126 patients. RESULTS Data on skin lesions were available for 183 participating patients (92%). The severity did not differ substantially between hands covered with SYM/COT or COT over time. Questionnaire data were available for 120 patients (95%). SYM/COT received better ratings regarding climate conditions while COT showed superiority in wearing comfort, practicality and appearance. CONCLUSIONS Both SYM/COT and COT were well tolerated and accepted in patients with hand dermatoses. Hence, SYM/COT may serve as suitable alternative for COT as comfort gloves supporting therapeutic efforts. The observed slight differences may influence the decision when selecting the glove type. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Theres Heichel
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Flora K Sonsmann
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Lower-Saxonian Institute of Occupational Dermatology at the University of Osnabrück, Osnabrück, Germany
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Lower-Saxonian Institute of Occupational Dermatology at the University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Hamburg, Germany
| | - Kathrin Krambeck
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Hamburg, Germany
| | - Julia Maurer
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Service Research in Nursing, Institute for Health Service Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kathrin Nordheider
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | | | - Annika Wilke
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Lower-Saxonian Institute of Occupational Dermatology at the University of Osnabrück, Osnabrück, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Lower-Saxonian Institute of Occupational Dermatology at the University of Osnabrück, Osnabrück, Germany
| |
Collapse
|
6
|
Jamil W, Svensson Å, Josefson A, Lindberg M, Von Kobyletzki L. Incidence Rate of Hand Eczema in Different Occupations: A Systematic Review and Meta-analysis. Acta Derm Venereol 2022; 102:adv00681. [PMID: 35098319 PMCID: PMC9631253 DOI: 10.2340/actadv.v102.360] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hand eczema is a chronic disease that results in economic and psychosocial burdens. The aim of this study was to systematically review and assess the magnitude of the association between exposure related to occupations and the incidence rate of hand eczema. A systematic search in PubMed, EMBASE, CINAHL and Cochrane databases, from inception to September 2017, of full-text observational studies reporting incident cases of hand eczema during employment, and a supplementary search in PubMed to September 2020, were conducted. Among 2,417 screened abstracts, 15 studies fulfilled the inclusion criteria. Incidence rates were reported per 100 person-years. Based on the Newcastle-Ottawa Scale, 9 studies were good quality, 2 fair quality, and 4 poor quality. Hairdressers had a high incidence of hand eczema of 21.4 (95% confidence interval [CI] 15.3–27.4), as did nurses, 16.9 (95% CI 11.2–22.7), and metal workers, 12.4 (95% CI 3.5–21.3). Hairdressers were predominantly women, and metal worker were predominantly men. Office occupations had an incidence rate of hand eczema of 4.9 (95% CI 1.2–9.6). The high risk of hand eczema for hairdressers, nurses, and metal workers, should be considered by healthcare policymakers. Even occupations with low irritant profile, such as office workers, were at risk of developing hand eczema, and more occupations should be investigated regarding the related risk of developing hand eczema.
Collapse
Affiliation(s)
| | | | | | | | - Laura Von Kobyletzki
- Department of Occupational and Environmental Dermatology, Malmö, Lund university,.
| |
Collapse
|
7
|
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
|
8
|
|
9
|
Houle MC, Holness DL, DeKoven J. Occupational Contact Dermatitis: An Individualized Approach to the Worker with Dermatitis. CURRENT DERMATOLOGY REPORTS 2021; 10:182-191. [PMID: 34540358 PMCID: PMC8439371 DOI: 10.1007/s13671-021-00339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
Purpose of Review To provide an up-to-date, customizable approach to the worker presenting with dermatitis. Recent Findings Occupational contact dermatitis (OCD) is often a result of combined allergic, irritant, and endogenous factors. Potential causes of OCD can be categorized in 3 main groupings: workplace materials, personal protective equipment, and skin care. Although patterns of dermatitis may provide some indication of the etiological factor(s), patch testing remains essential in the diagnosis of allergic OCD. Management of OCD may require changes in workplace practices to reduce worker exposure to the causative agents and improve skin care practices. Summary OCD is a multifaceted condition with significant consequences for affected workers and their families, employers, and insurers. A methodical and individualized approach to the patient with OCD should ensure timely and accurate diagnosis(es).
Collapse
|
10
|
Holness DL, Gomez P, Kudla I, Skotnicki S, DeKoven JG. Occupational contact dermatitis: Return to work using a multidisciplinary clinic model. Contact Dermatitis 2021; 85:686-692. [PMID: 34293189 DOI: 10.1111/cod.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/24/2021] [Accepted: 07/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Occupational contact dermatitis often results in work disruption. Return-to-work (RTW) is an important outcome. OBJECTIVE The objective of this study was to determine RTW outcomes and factors associated with such outcomes using a multidisciplinary clinic model. METHODS Chart abstraction was performed for 194 workers who received RTW assistance over a 6-year period. Elements abstracted included demographic and diagnostic information and information about the RTW program including principles, program components, barriers, and facilitators. RESULTS Of the 902 workers seen for dermatologic assessment, 194 received RTW assistance. At initial assessment, 37% were not working because of their skin disease, and at follow-up, 7% were not working because of their skin disease. The RTW plan components included a graduated or trial of RTW, specific recommendations for avoiding exposure, personal protective equipment, skin management, and ongoing skin monitoring. Principles associated with successful RTW included good communication and the availability of modified work and a worker adherence to the plan. Barriers included lack of modified work, unresponsive employers, and ongoing skin problems. CONCLUSIONS Specific approaches are important to identify if RTW is to be successful for workers with occupational contact dermatitis.
Collapse
Affiliation(s)
- D Linn Holness
- Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.,MAP Centre for Urban Health Solutions, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Pilar Gomez
- Occupational Medicine Clinic, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Irena Kudla
- Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Occupational Medicine Clinic, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sandy Skotnicki
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Joel G DeKoven
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| |
Collapse
|
11
|
Worm M, Reese I, Ballmer-Weber B, Beyer K, Bischoff SC, Bohle B, Brockow K, Claßen M, Fischer PJ, Hamelmann E, Jappe U, Kleine-Tebbe J, Klimek L, Koletzko B, Lange L, Lau S, Lepp U, Mahler V, Nemat K, Raithel M, Saloga J, Schäfer C, Schnadt S, Schreiber J, Szépfalusi Z, Treudler R, Wagenmann M, Werfel T, Zuberbier T. Update of the S2k guideline on the management of IgE-mediated food allergies. Allergol Select 2021; 5:195-243. [PMID: 34263109 PMCID: PMC8276640 DOI: 10.5414/alx02257e] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/21/2021] [Indexed: 01/02/2023] Open
Abstract
Not available.
Collapse
Affiliation(s)
- Margitta Worm
- Allergology and Immunology, Department of Dermatology, Venereology, and Allergology, Charité – Universitätsmedizin Berlin, Germany
| | - Imke Reese
- Nutritional Counseling and Therapy, Focus on Allergology, Munich, Germany
| | - Barbara Ballmer-Weber
- University Hospital Zurich, Department of Dermatology, Zurich, Switzerland, and Cantonal Hospital St. Gallen, Department of Dermatology and Allergology, St. Gallen, Switzerland
| | - Kirsten Beyer
- Clinic of Pediatrics m. S. Pneumology, Immunology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Germany
| | - Stephan C. Bischoff
- Institute of Nutritional Medicine and Prevention, University of Hohenheim, Stuttgart, Germany
| | - Barbara Bohle
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria
| | - Knut Brockow
- Department of Dermatology and Allergology, Biederstein, Klinikum rechts der Isar, Technical University of Munich, Germany
| | - Martin Claßen
- Klinik für Kinder und Jugendmedizin/Päd. Intensivmedizin, Eltern-Kind-Zentrum Prof. Hess Klinikum Bremen-Mitte
| | - Peter J. Fischer
- Practice for Pediatric and Adolescent Medicine m. S. Allergology and Pediatric Pneumology, Schwäbisch Gmünd
| | - Eckard Hamelmann
- University Clinic for Pediatric and Adolescent Medicine, Evangelisches Klinikum Bethel gGmbH, Bielefeld
| | - Uta Jappe
- Research Group Clinical and Molecular Allergology, Research Center Borstel, Airway Research Center North (ARCN), member of the German Center for Lung Research (DZL), Borstel
- Interdisciplinary Allergy Outpatient Clinic, Medical Clinic III, University Hospital Schleswig-Holstein, Lübeck
| | | | | | - Berthold Koletzko
- Pediatric Clinic and Pediatric Polyclinic, Dr. von Haunersches Kinderspital, Department of Metabolic and Nutritional Medicine, Ludwig-Maximilians-University, Munich
| | - Lars Lange
- Pediatric and Adolescent Medicine, St.- Marien-Hospital, Bonn
| | - Susanne Lau
- Clinic of Pediatrics m. S. Pneumology, Immunology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Germany
| | - Ute Lepp
- Practice for Pulmonary Medicine and Allergology, Buxtehude
| | | | - Katja Nemat
- Practice for Pediatric Pneumology/Allergology at the Children’s Center Dresden (Kid), Dresen
| | | | - Joachim Saloga
- Department of Dermatology, University Medical Center, Johannes Gutenberg-University Mainz
| | - Christiane Schäfer
- Nutritional Therapy, Focus on Allergology and Gastroenterology, Schwarzenbek, Germany
| | - Sabine Schnadt
- German Allergy and Asthma Association, Mönchengladbach, Germany
| | - Jens Schreiber
- Pneumology, University Hospital of Otto von Guericke University, Magdeburg, Germany
| | - Zsolt Szépfalusi
- University Hospital for Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Regina Treudler
- Clinic of Dermatology, Venereology and Allergology, University Medical Center Leipzig, Germany
| | | | - Thomas Werfel
- Clinic of Dermatology, Allergology and Venerology, Hannover Medical School, Germany, and
| | - Torsten Zuberbier
- Department of Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin
| |
Collapse
|
12
|
Holness DL. Occupational Dermatitis and Urticaria. Immunol Allergy Clin North Am 2021; 41:439-453. [PMID: 34225899 DOI: 10.1016/j.iac.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Occupational contact dermatitis is the most common occupational skin disease (OSD), and most of them are irritant in nature. There is less information available about contact urticaria than contact dermatitis. There are several strategies to prevent OSD, although workplace studies suggest there are gaps in their use in the workplace. Because early detection leads to improved outcomes, screening for dermatitis in industries such as health care would be useful. Both diagnosis and management involve 2 components: the actual disease diagnosis and medical treatment and the work-relatedness and management of the workplace to reduce exposures.
Collapse
Affiliation(s)
- Dorothy Linn Holness
- Department of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
| |
Collapse
|
13
|
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
|
14
|
Nicholson PJ. Henri de Toulouse-Lautrec, La Blanchisseuse, 1888. Occup Med (Lond) 2021. [DOI: 10.1093/occmed/kqab018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
15
|
Moldovan HR, Manole I, Suru A, Butacu AI, Tatu AL, Lupu A, Dascalu M, Tiplica GS, Salavastru CM. Prevention of Hand Eczema among Nurse Apprentice (PREVEDERM): An Interventional Study. Ann Work Expo Health 2021; 65:167-175. [PMID: 33559677 DOI: 10.1093/annweh/wxaa122] [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: 01/24/2020] [Revised: 11/03/2020] [Accepted: 11/11/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Workers in the healthcare sector are at high risk of developing occupational hand eczema mainly due to frequent exposure to irritants and/or allergens. Amongst workers in healthcare, nurses are at higher risk of developing hand dermatitis. OBJECTIVES To evaluate the effectiveness of a short educational intervention program in preventing occupational hand eczema in nurse apprentices, using two objective tools, namely TEWL and EH, and the HECSI score. METHODS Data regarding professions, wet work exposure, activities performed during working hours, self-reported eczema were collected from 230 nurse students, divided in two study groups: the intervention and the control group (CG). The intervention group (IG) was given education about risks and proper skin care and was provided with cosmeceuticals to be used for skin care during hospital activity. The evaluation of skin properties was performed using questionnaires, HECSI score, measurement of transepidermal water loss (TEWL) and epidermal hydration (EH). RESULTS A number of 139 apprentice nurses completed the study. Of those participants who completed the study, 19.1% from CG and 19.6% from IG reported, at T1, hand eczema in the last 3 months, while at T2 (3 months later), 59.52 % of the CG and only 11.34 % from the IG stated having eczema in the last 3 months. In the IG, results showed an improvement of CM with 17% and of TEWL with 16%, with only a 0.5% improvement of CM in CG and a marked impairment of TEWL by 33%. CONCLUSION Hand eczema is a common occupational dermatosis affecting the medical staff, even during apprenticeship. Early preventive training programs are effective in reducing the burden of occupational contact dermatitis.
Collapse
Affiliation(s)
- Horatiu Remus Moldovan
- Occupational Medicine Department, GE Palade University of Medicine, Pharmacy, Science and Technology of Targu-Mures, Gheorghe Marinescu, Târgu Mureș, Romania
| | - Ionela Manole
- Dermatology Research Unit, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania
| | - Alina Suru
- Dermatology Research Unit, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania
| | - Alexandra-Irina Butacu
- Dermatology Research Unit, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania
| | - Alin Laurentiu Tatu
- Faculty of Medicine and Pharmacy, Dunarea de Jos University, Clinical Medical Department, Galati, Romania, Alexandru Ioan Cuza, Galati, Romania.,Saint Parascheva Clinical Hospital of Infectious Diseases, Dermatology Department, Traian, Galati, Romania
| | - Adriana Lupu
- Faculty of Medicine and Pharmacy, University Dunarea de Jos, Alexandru Ioan Cuza,Galati, Romania
| | - Mihai Dascalu
- Department of Computer Science, Faculty of Automated Control and Computers, University Politehnica of Bucharest, Splaiul Independentei, Bucharest, Romania
| | - George-Sorin Tiplica
- Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania.,Second Department of Dermatology, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania
| | - Carmen Maria Salavastru
- Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania.,Pediatric Dermatology Department, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania
| |
Collapse
|
16
|
Zack B, Arrandale VH, Holness DL. A Qualitative Study to Identify Characteristics of a Desirable Training Program for Prevention of Occupational Skin Disease. Ann Work Expo Health 2021; 65:230-238. [PMID: 33559679 DOI: 10.1093/annweh/wxaa111] [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: 12/19/2019] [Revised: 10/19/2020] [Accepted: 02/08/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Training and education may be effective strategies for the prevention of work-related contact dermatitis. While there is some information in the literature related to skin-specific training experiences, there is very little information available on workers' preferences related to content and format and to barriers and facilitators to training. OBJECTIVES To understand workers' experiences and preferences for workplace training and barriers and facilitators to training. METHODS Following ethics approval, 24 patients with work-related contact dermatitis participated in semi-structured interviews obtaining information on training experiences, perceived training effectiveness, desired training characteristics, and barriers and facilitators to training. An inductive thematic analysis was used to identify themes. RESULTS Though many workers had received general workplace health and safety training, none reported training about skin exposure and disease prevention. Examples of what the workers perceived as good training included first aid training, while Workplace Hazardous Materials Information System training was felt to be ineffective. Desired content of training for preventing skin exposures included information on the hazards, short- and long-term health impacts, and potential symptoms and personal protective equipment. They desired multi-modal presentation (e.g. in-person and online supplement), hands-on training with visual content and suggested the use of personal stories and negative messaging. Training that could be applied outside the workplace was also valued. Barriers and facilitators to implementation included factors related to the training program itself, the organization, and the regulatory landscape. CONCLUSIONS These findings can help to shape more effective workplace training programs for skin protection.
Collapse
Affiliation(s)
- Bethany Zack
- Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Victoria H Arrandale
- Dalla Lana School of Public Health, Toronto, ON, Canada.,Occupational Cancer Research Centre, Toronto, ON, Canada
| | - D Linn Holness
- Dalla Lana School of Public Health, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Occupational Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, ON,Canada
| |
Collapse
|
17
|
Lee EB, Lobl M, Ford A, DeLeo V, Adler BL, Wysong A. What Is New in Occupational Allergic Contact Dermatitis in the Year of the COVID Pandemic? Curr Allergy Asthma Rep 2021; 21:26. [PMID: 33779825 PMCID: PMC8006117 DOI: 10.1007/s11882-021-01000-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 12/17/2022]
Abstract
Purpose of Review This article aims to summarize some recent trends in occupational allergic contact dermatitis (ACD), including dermatitis related to pandemic-level personal protective equipment in healthcare workers, hazards patients may experience when working from home, and occupational perspectives on the recent American Contact Dermatitis Society (ACDS) allergens of the year and ACDS Core Allergen Series updates. Recent Findings Recent ACDS Allergens of the Year may be particularly relevant to healthcare workers, including isobornyl acrylate, which is present in glucose sensors and propylene glycol present in hand cleansers and disinfectants. Lavender, limonene, and linalool, all of which are new additions to the ACDS Core Allergen Series, have been reported as causes for occupational ACD in massage therapists and aromatherapists. Isothiazolinone allergy continues to rise in both consumer and occupational settings. Finally, the COVID-19 pandemic has resulted in a wave of occupational ACD in healthcare workers to personal protective equipment, and revealed new potential allergens for individuals working from home. Summary Occupational allergic contact dermatitis continues to exert a significant occupational disease burden. Remaining aware of the current trends in allergens may allow for earlier recognition, diagnosis, and treatment, subsequently helping our patients to work in healthier and safer environments.
Collapse
Affiliation(s)
- Erica B Lee
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Marissa Lobl
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Aubree Ford
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Vincent DeLeo
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA.
| |
Collapse
|
18
|
Brans R, John SM, Frosch PJ. Clinical Aspects of Irritant Contact Dermatitis. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_16] [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]
|
19
|
Rehabilitation and Prevention of Hand Eczema. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_71] [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]
|
20
|
Lee S, Lee SH, Lee W. Impact of occupational dust exposure on dermatologic symptoms among Korean workers. Toxicol Ind Health 2020; 36:971-978. [PMID: 33107405 DOI: 10.1177/0748233720964636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Occupation-related dust exposure is common, especially with increased industrialization. While occupational dust-related health issues caused by inhalation or ingestion have been well studied, only a few studies have examined the dermatologic effects of occupational dust exposure. This study aimed to investigate the association between occupational dust exposure and dermatologic symptoms in Korean workers. Among the large-scale representative data from the fifth Korean Working Conditions Survey, 45,700 workers were selected for study. Occupational dust exposure level was categorized as none, moderate, and severe, and dermatologic symptoms were assessed using a questionnaire on health problems. We analyzed the association between occupational dust exposure and dermatologic symptoms using multivariate logistic regression. Risks of skin problems and work-related skin problems were significantly associated with the level of occupational dust exposure in a dose-dependent manner (odds ratio (95% confidence interval): moderate, 1.51 (1.14-2.01); severe, 2.39 (1.74-3.29) in general skin problems; moderate, 1.72 (1.22-2.42); severe, 3.06 (2.11-4.44) in work-related skin problems). We, thus, demonstrate an association between occupational dust exposure and skin problems. As skin absorption of dust is a major route of dust exposure at the workplace, it is necessary to determine the efficacy of continuous management of occupational dust exposure.
Collapse
Affiliation(s)
- Seunghyun Lee
- The First Department of Internal Medicine, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Sang Ha Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, 13137Gachon University College of Medicine, Incheon, Republic of Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, 13137Gachon University College of Medicine, Incheon, Republic of Korea
| |
Collapse
|
21
|
Lv G, Fan J. Silencing ICAM-1 reduces the adhesion of vascular endothelial cells in mice with immunologic contact urticaria. Gene 2020; 760:144965. [PMID: 32687948 DOI: 10.1016/j.gene.2020.144965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Immunologic contact urticaria (ICU) is an immediate response of wheal caused by various contactants in vulnerable individuals, with undefined pathogenesis. METHODS In the present study, we aim to explore the effects of intercellular cell adhesion molecule-1 (ICAM-1) gene silencing by RNA inference (RNAi) on vascular endothelial cells (VECs) adhesion molecule expression and cell-cell adhesion in ICU mice. Sixty BALB/c mice were selected, among which 48 mice were used for establishment of ICU models. VECs from normal and ICU mice were grouped into different groups. Expressions of ICAM-1, eosinophilic cationic protein (ECP), total immunologlobulin E (tIgE), L-selectin (CD62L), integrin, alpha L (CD11a) in tissues and cells were evaluate by RT-qPCR and western blotting. Cell proliferation was evaluated by MTT assay and EdU staining and cell adhesive function by cell-cell adhesion assay. RESULTS Compared with normal mice, ICU mice had increased expressions of ICAM-1, ECP, tIgE, CD62L, and CD11a.ICAM-1 gene silencing decreased expressions of ECP, tIgE, CD62L, and CD11a, enhanced cell proliferation, and more activity in cell adhesion. CONCLUSION These findings indicate that RNAi-mediated gene silencing of ICAM-1 may decrease VECs adhesion expression and reduce cell-cell adhesion in mice with ICU.
Collapse
Affiliation(s)
- Gaomei Lv
- Department of Pediatric Internal Medicine, Linyi People's Hospital, Linyi 276002, PR China
| | - Jingang Fan
- Department of Pediatric Internal Medicine, Linyi People's Hospital, Linyi 276002, PR China.
| |
Collapse
|
22
|
Dobashi K, Usami A, Yokozeki H, Tsurikisawa N, Nakamura Y, Sato K, Okumura J, Yamaguchi M, Kunio Dobashi, Akiyama K, Usami A, Yokozeki H, Ikezawa Z, Tsurikisawa N, Nakamura Y, Sato K, Okumura J, Takayama K, Adachi M, Matsunaga K, Naito K, Nakazawa T, Ohta K, Okano M, Tohda Y, Watanabe M, Yamaguchi M. Japanese guidelines for occupational allergic diseases 2020. Allergol Int 2020; 69:387-404. [PMID: 32471740 DOI: 10.1016/j.alit.2020.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Indexed: 12/23/2022] Open
Abstract
Occupational allergic diseases are likely to worsen or become intractable as a result of continuous exposure to high concentrations of causative allergens. These are socioeconomically important diseases that can lead to work interruptions for patients and potentially job loss. We published the first guideline for managing occupational allergic diseases in Japan. The original document was published in Japanese in 2013, and the following year (2014) it was published in English. This guideline consists of six chapters about occupational asthma, occupational allergic rhinitis, occupational skin diseases, hypersensitivity pneumonitis, occupational anaphylaxis shock, and the legal aspects of these diseases. Providing general doctors with the knowledge to make evidence-based diagnoses and to understand the occupational allergic disease treatment policies, was a breakthrough in allergic disease treatment. Due to the discovery of new occupational allergens and the accumulation of additional evidence, we published a revised version of our original article in 2016, and it was published in English in 2017. In addition to including new knowledge of allergens and evidence, the 2016 revision contains a "Flowchart to Diagnosis" for the convenience of general doctors. We report the essence of the revised guidelines in this paper.
Collapse
|
23
|
Keefe AR, Demers PA, Neis B, Arrandale VH, Davies HW, Gao Z, Hedges K, Holness DL, Koehoorn M, Stock SR, Bornstein S. A scoping review to identify strategies that work to prevent four important occupational diseases. Am J Ind Med 2020; 63:490-516. [PMID: 32227359 DOI: 10.1002/ajim.23107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts. METHODS To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants. RESULTS We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity. CONCLUSIONS This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.
Collapse
Affiliation(s)
- Anya R. Keefe
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
| | - Paul A. Demers
- Occupational Cancer Research Centre, Cancer Care Ontario Toronto Ontario Canada
| | - Barbara Neis
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
| | | | - Hugh W. Davies
- Occupational and Environmental Health, School of Population and Public HealthUniversity of British Columbia Vancouver British Columbia Canada
| | - Zhiwei Gao
- Department of Clinical Epidemiology, Faculty of MedicineMemorial University St. John's Newfoundland Canada
| | - Kevin Hedges
- Occupational Health Clinics for Ontario Workers Ottawa Ontario Canada
| | - D. Linn Holness
- Department of Medicine and Public Health SciencesSt. Michael's Hospital/University of Toronto, Toronto, Ontario, Canada
| | - Mieke Koehoorn
- Occupational and Environmental Health, School of Population and Public HealthUniversity of British Columbia Vancouver British Columbia Canada
| | - Susan R. Stock
- Division of Biological Risks and Occupational HealthInstitut national de santé publique du Québec (Quebec Institute of Public Health) Montreal Quebec Canada
- Department of Social and Preventive MedicineSchool of Public Health, Université de Montreal Montreal Quebec Canada
| | - Stephen Bornstein
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
| |
Collapse
|
24
|
Nicholson PJ. Pierre-Auguste Renoir, The Sweeper, 1889. Occup Med (Lond) 2020. [DOI: 10.1093/occmed/kqy168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
25
|
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
|
26
|
Santarossa M, Mauro M, Belloni Fortina A, Corradin MT, Larese Filon F. Occupational contact dermatitis in Triveneto: Analysis of patch test data of the North Eastern Italian Database from 1996 to 2016. Contact Dermatitis 2020; 82:370-379. [DOI: 10.1111/cod.13512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Monica Santarossa
- Department of Medical Sciences, Clinical Unit of Occupational MedicineUniversity of Trieste Trieste Italy
| | - Marcella Mauro
- Department of Medical Sciences, Clinical Unit of Occupational MedicineUniversity of Trieste Trieste Italy
| | - Anna Belloni Fortina
- Padua Hospital Internal Medicine Department – DIMED, Paediatric Dermatology UnitUniversity of Padua Padua Italy
| | - Maria T. Corradin
- Pordenone Hospital – Internal and Specialistic DepartmentOspedale Santa Maria degli Angeli Pordenone Italy
| | - Francesca Larese Filon
- Department of Medical Sciences, Clinical Unit of Occupational MedicineUniversity of Trieste Trieste Italy
| |
Collapse
|
27
|
Rehabilitation and Prevention of Hand Eczema. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_71-1] [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]
|
28
|
Abstract
Allergic contact dermatitis is common, resulting in considerable morbidity. Diagnosis is based on a thorough history, physical examination, and patch testing. Several commercially available panels of patch testing are currently used. Allergens are found in a wide variety of daily products, occupational exposures, and foods. The mainstay of treatment is avoidance of the allergen, and databases like Contact Allergen Management Program and Contact Allergen Replacement Database help patients to select products that do not contain allergens to which they are sensitized. Topical corticosteroids can be used to treat exacerbations, but should be avoided in long-term treatment.
Collapse
Affiliation(s)
- Stacy Nassau
- Department of Internal Medicine, Section of Allergy and Immunology, NYU Winthrop University Hospital, 120 Mineola Boulevard, Suite 410, Mineola, NY 11501, USA.
| | - Luz Fonacier
- Department of Internal Medicine, Section of Allergy and Immunology, NYU Winthrop University Hospital, 120 Mineola Boulevard, Suite 410, Mineola, NY 11501, USA
| |
Collapse
|
29
|
Abstract
Apart from endogenous factors, hand eczema is often caused by irritant or allergic contact dermatitis related to occupational or non-occupational exposure to skin hazards. This enables several complementary approaches on the level of primary, secondary and tertiary prevention. A high priority is set on identification and subsequent reduction or elimination of causative exposures. Important preventive approaches include legal regulations, technical and organizational measures as well as correct use of adequate personal protective equipment (e.g. protective gloves). Interventions based on health education are conducted to improve individual protective behaviour. Even though evidence-based proof of effectiveness is limited, preventive measures are considered of particular importance for avoidance of occupational hand eczema and its adverse sequelae. Therefore, a complex, step-wise approach to occupational skin diseases has been established in Germany. In recent years, the positive impact of secondary and tertiary preventive measures of this approach has been demonstrated.
Collapse
Affiliation(s)
- R Brans
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland.
| | - C Skudlik
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland
| |
Collapse
|
30
|
Nicholson PJ. Missed opportunities to identify occupational asthma in acute secondary care. Occup Med (Lond) 2019; 68:485. [PMID: 30212903 DOI: 10.1093/occmed/kqy083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
31
|
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on occupational contact dermatitis including gaps in knowledge and practice. Occupational contact dermatitis is the most common occupational skin disease. RECENT FINDINGS New sources of exposure for known allergens and new allergens are continually being reported. Through clinical databases and surveillance systems, effects of prevention efforts or introduction of new allergens or new uses of known allergens can be monitored. Though the diagnostic process is clear, there are delays in workers seeking care. As early detection and intervention improves outcomes, screening should be implemented. Gaps in primary prevention in the workplace are identified and should be addressed to reduce the burden of disease. Surveillance systems support the prevention mandate. Understanding limitations of our knowledge and identifying gaps in practice can lead to initiatives to address research and practice needs and improve prevention of occupational dermatoses.
Collapse
Affiliation(s)
- Dorothy Linn Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, Toronto, Canada. .,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada. .,MAP Centre for Urban Health Solutions, St Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada.
| |
Collapse
|
32
|
Shakik S, Arrandale V, Holness DL, MacLeod JS, McLeod CB, Peter A, Demers PA. Dermatitis among workers in Ontario: results from the Occupational Disease Surveillance System. Occup Environ Med 2019; 76:625-631. [PMID: 31320492 PMCID: PMC6824611 DOI: 10.1136/oemed-2018-105667] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/24/2019] [Accepted: 06/19/2019] [Indexed: 11/21/2022]
Abstract
Objectives Dermatitis is the most common occupational skin disease, and further evidence is needed regarding preventable risk factors. The Occupational Disease Surveillance System (ODSS) derived from administrative data was used to investigate dermatitis risk among industry and occupation groups in Ontario. Methods ODSS cohort members were identified from Workplace Safety and Insurance Board (WSIB) accepted lost time claims. A case was defined as having ≥2 dermatitis physician billing claims during a 12-month period within 3 years of cohort entry. A 3-year look-back period prior to cohort entry was used to exclude prevalent cases without a WSIB claim. Workers were followed for 3 years or until dermatitis diagnosis, age 65 years, emigration, death or end of follow-up (31 December 2016), whichever occurred first. Age-adjusted and sex-adjusted Cox proportional hazard models estimated HRs and 95% CIs. The risk of dermatitis was explored using a job exposure matrix that identifies exposure to asthmagens, many of which also cause contact dermatitis. Results Among 597 401 workers, 23 843 cases of new-onset dermatitis were identified. Expected elevated risks were observed among several groups including furniture and fixture industries, food and beverage preparation and chemicals, petroleum, rubber, plastic and related materials processing occupations and workers exposed to metal working fluids and organic solvents. Decreased risk was observed among farmers, nurses and construction industries, and occupations exposed to latex and indoor cleaning products. Conclusions ODSS can contribute to occupational dermatitis surveillance in Ontario by identifying occupational groups at risk of dermatitis that can then be prioritised for prevention activities.
Collapse
Affiliation(s)
- Sharara Shakik
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Victoria Arrandale
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Dorothy Linn Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Occupational Health, St Michael's Hospital, Toronto, Ontario, Canada
| | - Jill S MacLeod
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Christopher B McLeod
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alice Peter
- Population Health and Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| |
Collapse
|
33
|
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
|
34
|
Leskur D, Bukić J, Petrić A, Zekan L, Rušić D, Šešelja Perišin A, Petrić I, Stipić M, Puizina‐Ivić N, Modun D. Anatomical site differences of sodium lauryl sulfate‐induced irritation: randomized controlled trial. Br J Dermatol 2019; 181:175-185. [DOI: 10.1111/bjd.17633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 01/03/2023]
Affiliation(s)
- D. Leskur
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - J. Bukić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - A. Petrić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
- Split‐Dalmatia County Pharmacy Kneza Ljudevita Posavskog 12 b 21000 Split Croatia
| | - L. Zekan
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
- Split‐Dalmatia County Pharmacy Kneza Ljudevita Posavskog 12 b 21000 Split Croatia
| | - D. Rušić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - A. Šešelja Perišin
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - I. Petrić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
- Split‐Dalmatia County Pharmacy Kneza Ljudevita Posavskog 12 b 21000 Split Croatia
| | - M. Stipić
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - N. Puizina‐Ivić
- Department of Dermatovenerology University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| | - D. Modun
- Department of Pharmacy University of Split School of Medicine Šoltanska 2 21000 Split Croatia
| |
Collapse
|
35
|
Nichol K, Copes R, Kersey K, Eriksson J, Holness DL. Screening for hand dermatitis in healthcare workers: Comparing workplace screening with dermatologist photo screening. Contact Dermatitis 2019; 80:374-381. [DOI: 10.1111/cod.13231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/31/2018] [Accepted: 01/21/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Kathryn Nichol
- Collaborative Academic PracticeUniversity Health Network Toronto Ontario Canada
- Dalla Lana School of Public HealthUniversity of Toronto Toronto Ontario Canada
- Centre for Research Expertise in Occupational Disease Toronto Ontario Canada
| | - Ray Copes
- Dalla Lana School of Public HealthUniversity of Toronto Toronto Ontario Canada
- Environmental and Occupational HealthPublic Health Ontario Toronto Ontario Canada
| | - Karon Kersey
- Occupational Health and SafetyUniversity Health Network Toronto Ontario Canada
| | - Jonas Eriksson
- Collaborative Academic PracticeUniversity Health Network Toronto Ontario Canada
| | - Dorothy L. Holness
- Dalla Lana School of Public HealthUniversity of Toronto Toronto Ontario Canada
- Centre for Research Expertise in Occupational Disease Toronto Ontario Canada
- Division of Occupational Medicine, Department of MedicineUniversity of Toronto Toronto Ontario Canada
- Division of Occupational MedicineSt Michael's Hospital Toronto Ontario Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge InstituteSt Michael's Hospital Toronto Ontario Canada
| |
Collapse
|
36
|
Burke KM, Wright AJ, Parsons V, Madan I. Influences on use of hand moisturizers in nurses. Occup Med (Lond) 2019; 68:340-342. [PMID: 29741666 DOI: 10.1093/occmed/kqy068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Nurses are at high risk of hand dermatitis. Regular hand moisturizing can prevent dermatitis, but nurses' use of hand moisturizers is suboptimal. Aims To establish (i) what beliefs about hand dermatitis and hand moisturizer use are associated with hand moisturizer use by nurses at home and at work and (ii) if hand moisturizer use behaviours in nurses are associated with the prevalence of hand dermatitis. Methods We used a questionnaire to investigate nurses' knowledge, beliefs and behaviours regarding hand dermatitis and use of hand moisturizers. Results The response rate was 55/65 (85%). Forty-two (76%) participants agreed that applying hand moisturizers reduced the risk of dermatitis, and 53 (96%) agreed that dermatitis increased the risk of skin carrying pathogenic organisms. Frequent moisturizer application was associated with beliefs that it was part of the nurse's role to apply hand creams, a belief that they had had training in the use of moisturizers and believing that patients approved of them moisturizing their hands. Conclusions Hand moisturizer use by nurses can be improved by enhancing their beliefs that it is part of their professional role to apply hand cream regularly.
Collapse
Affiliation(s)
- K M Burke
- Medical School, St George's University of London, London, UK
| | - A J Wright
- Division of Health and Social Care Research, King's College London, London, UK
| | - V Parsons
- Occupational Health Department, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - I Madan
- Occupational Health Department, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| |
Collapse
|
37
|
Brans R, John SM, Frosch PJ. Clinical Aspects of Irritant Contact Dermatitis. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_16-1] [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]
|
38
|
Scope and Efficacy of Preventive Measures in Contact Dermatitis. CURRENT TREATMENT OPTIONS IN ALLERGY 2018. [DOI: 10.1007/s40521-018-0181-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
39
|
Wilke A, Brans R, Nordheider K, Braumann A, Hübner A, Sonsmann FK, John SM, Wulfhorst B. Skin Protection Seminars to Prevent Occupational Skin Diseases: Results of a Prospective Longitudinal Study in Apprentices of High-risk Professions. Saf Health Work 2018; 9:398-407. [PMID: 30559987 PMCID: PMC6284163 DOI: 10.1016/j.shaw.2018.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 02/16/2018] [Accepted: 05/12/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Occupational skin diseases (OSDs) are frequent in professions with exposure to skin hazards. Thus, a health educational intervention for apprentices of high-risk professions was conducted. It was the aim of this study to gain insight into possible effects of this intervention. METHODS A one-time skin protection seminar was conducted in 140 apprentices of health-related and non-health-related professions [trained cohort (TC)]. In addition, 134 apprentices of the same occupations were monitored [untrained cohort (UTC)]. The OSD-specific knowledge and the skin condition of the hands were assessed at baseline (T0), after the seminar (T1), and after 6 (T2) and 12 months (T3). RESULTS The OSD-specific knowledge increased in all cohorts from T0 to T3, but we found a significantly higher knowledge in the TC at T2 (p < 0.001, t = 3.6, df = 196, 95% confidence interval = 0.9, 3.3) and T3 (p < 0.001, t = 3.8, df = 196, 95% confidence interval = 1.0, 3.2) compared to the UTC. Our results indicated a better skin condition of the hands in the TC of the health-related professions but not in the non-health-related professions. CONCLUSION The study indicates that an educational intervention may positively influence the disease-specific knowledge and the prevalence of OSD in apprentices. However, definite conclusions cannot be drawn because of the heterogeneous study cohorts and the study design. Future research should aim at tailoring primary prevention to specific target groups, e.g., in view of the duration and frequency of skin protection education, different professions, and gender-specific prevention approaches.
Collapse
Affiliation(s)
- Annika Wilke
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Kathrin Nordheider
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Antje Braumann
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Hamburg, Germany
| | - Anja Hübner
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Flora K. Sonsmann
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Britta Wulfhorst
- Faculty of Human Sciences/Department of Educational Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| |
Collapse
|
40
|
Meng ZD, Wang XL, Du TP, Wang Y, Qin GF, Zhao HB, Chen YJ, Tian B. Effects of RNA interference-mediated E-selectin gene silencing on cell adhesion molecule expression and cell-cell adhesion in vascular endothelial cells in mice with immunologic contact urticaria. J Cell Biochem 2018; 120:115-125. [PMID: 30206961 DOI: 10.1002/jcb.27150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/18/2018] [Indexed: 11/12/2022]
Abstract
Contact urticaria is recognized as the wheal and flare reaction at a site from direct contact with a chemical or protein agent. Ongoing studies have proposed that gene silencing may have a promising future in finding optimal treatment of a variety of disease; hence, the aim of the study was to investigate the effect of RNA interference-mediated E-selectin ( SELE) gene silencing on cell adhesion molecule expression and on cell-cell adhesion in vascular endothelial cells (VECs) in a mouse model of immunologic contact urticaria (ICU). Following the successful establishment of mouse models of ICU induced by antidinitrophenol immunoglobulin E (IgE) combining 2,4-dinitrofluorobenzene challenge, enzyme-linked immunosorbent assay and immunohistochemistry were used to measure the levels of IgE, interleukin 4 (IL-4), interferon-γ (IFN-γ), and histamine as well as the positive expression rate of SELE, respectively. The siRNA- SELE vector was constructed and transfection efficiency was estimated prior to performing quantitative reverse-transcription polymerase chain reaction and Western blot assay to determine the relative expression of SELE, eosinophil cationic protein (ECP), intercellular adhesion molecule 1 (ICAM-1), L-selectin (CD62L), and the alpha chain of leukocyte function-associated antigen-1 (CD11a). Adhesion assay was then performed to assess the cell adhesion ability in VECs. Elevated levels of IgE, IL-4, IFN-γ, and histamine and increased positive expression rate of SELE were indicative of successful establishment of mouse models of ICU. Furthermore, the relative expression levels of SELE, ECP, ICAM-1, CD62L, and CD11a were highest in the OE- SELE group. Besides, cell adhesion ability of VECs was notably promoted. Collectively, the current study define the potential role of SELE silencing as an inhibitor to ICU development by inhibiting cell adhesion ability of VECs.
Collapse
Affiliation(s)
- Zu-Dong Meng
- The First Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Xiao-Lan Wang
- The First Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Tian-Ping Du
- Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Yu Wang
- The First Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Gui-Fang Qin
- The Second Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Hong-Bo Zhao
- The Second Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Yu-Jie Chen
- The First Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Bo Tian
- The Second Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| |
Collapse
|
41
|
|
42
|
Nichol K, McKay SM, Ruco A, Holness DL. Testing the Hand Dermatitis Screening Tool in the Home Health Care Sector. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2018. [DOI: 10.1177/1084822318780012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Workers exposed to wet work are at an increased risk for occupational contact dermatitis and may benefit from screening to detect early disease. The objective of this study was to assess the prevalence of hand dermatitis in home care workers, identify factors that influence presence of disease, and explore feasibility and importance of workplace screening in the home care sector. Following institutional ethics approval, nurses, personal support workers, and rehab therapists at one large home care provider in Ontario, Canada, self-screened for hand dermatitis using the Hand Dermatitis Screening Tool and accompanying photo guide and completed a short feasibility evaluation. Of the 220 participants, 18% had a positive screen for hand dermatitis and 77% reported exposure to wet work. In all, 93% of participants reported using the tool took less than 2 minutes and 84% reported screening for hand dermatitis is important. In conclusion, prevalence of hand dermatitis in home care workers is higher than reported in the general population. Workplace screening for hand dermatitis was deemed important, and the tool was feasible to use in the home care sector.
Collapse
Affiliation(s)
- K. Nichol
- VHA Home HealthCare, Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
| | - S. M. McKay
- VHA Home HealthCare, Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada
| | - A. Ruco
- VHA Home HealthCare, Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada
- St. Michael’s Hospital, Toronto, Ontario, Canada
| | - D. L. Holness
- University of Toronto, Ontario, Canada
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
- St. Michael’s Hospital, Toronto, Ontario, Canada
| |
Collapse
|
43
|
Moldovan HR, Voidazan ST, John SM, Weinert P, Moldovan G, Vlasiu MA, Szasz ZA, Tiplica GS, Szasz S, Marin AC, Salavastru CM. The Eastern European experience on occupational skin diseases. Make underreporting an issue? J Eur Acad Dermatol Venereol 2018; 31 Suppl 4:5-11. [PMID: 28656727 DOI: 10.1111/jdv.14315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND While legislation in most of the Eastern European countries is nowadays widely harmonized with the legal safety and health provisions of Western countries, there is still a sustained resistance to the notification of occupational skin diseases (OSD). OBJECTIVE The aim of the study was to identify the main barriers in notification and recognition of OSD in 22 Eastern European countries. METHODS An online survey was administered to key persons in the field of occupational safety and health in 22 Eastern European countries. Multiple variables of the notification system were studied, including clinical, organizational and educational issues. RESULTS The main causes of underreporting OSD are ineffective enforcement of occupational safety and health legislation, contractual relationship employer-employee, long duration of the notifying process, restrictions of the notification systems in terms of who is entitled to notify an OSD, ineffective regulations in regards to the pre-employment and periodical medical examination, ineffective compensation schemes, restraints and hesitations, mainly from the doctors, inappropriate mentalities - fear of losing the jobs, fining of the employers by the authorities, stigmatization of the workers with OSD, additional costs for employers, stakeholders' lack of interest in notifying, lack of guidelines and protocols and lack of preventive programmes. CONCLUSIONS The most valuable method for a proper recognition of OSD is to increase the awareness of physicians involved in the management of OSD (occupational physicians, GPs, dermatologists), as well as employers and workers. There is an urgent need to improve national legislation, to develop and promote adequate preventive programmes, emphasizing ethical, legal, economical and psychological aspects in order to achieve an increased recognition and a real reporting of OSD, and to enforce an international action plan for Eastern Europe in order to improve the notification of OSD.
Collapse
Affiliation(s)
- H R Moldovan
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - S T Voidazan
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - S M John
- Department of Dermatology and Environmental Medicine, University of Osnabrueck, Osnabrueck, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrueck, Osnabrueck, Germany
| | - P Weinert
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrueck, Osnabrueck, Germany
| | - G Moldovan
- Mediconsult Medical Centre, Tirgu-Mures, Romania
| | - M A Vlasiu
- Mures County Clinical Hospital, Tirgu-Mures, Romania
| | - Z A Szasz
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - G S Tiplica
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - S Szasz
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - A C Marin
- University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania
| | - C M Salavastru
- Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| |
Collapse
|
44
|
Fonacier L, Noor I. Contact dermatitis and patch testing for the allergist. Ann Allergy Asthma Immunol 2018. [PMID: 29522811 DOI: 10.1016/j.anai.2018.03.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To review of contact dermatitis (CD) and its key allergens and provide updates and recommendations for the practicing allergist. DATA SOURCES Through the use of various scientific search engines (eg, PubMed and MEDLINE), we reviewed literature on CD, patch tests (PTs), key allergens, occupational dermatitis, and treatment. STUDY SELECTIONS Studies on CD, important allergens, and PTs were considered. RESULTS Contact-induced dermatitis may be due to allergic CD, irritant CD, systemic CD, contact urticaria, and protein CD. Key allergens include metals (nickel, gold), topical medicaments (topical corticosteroids), and cosmetics and personal care products (fragrances and preservatives such as methyl- and methylchloro-isothiazolinone). Present relevance of a positive PT result is the combination of definite, probable, and possible relevance and should be correlated with the patient's history and physical examination. Treatment of allergic CD includes identification of relevant allergens, patient education, avoidance, and provision of alternative products the patient can use. CONCLUSION CD is a common inflammatory skin disease and should be suspected in patients presenting with acute, subacute, or chronic dermatitis. The gold standard for diagnosing allergic CD is a PT. This article provides practical recommendations for the diagnosis and management of CD commonly seen by the allergist in their practice.
Collapse
Affiliation(s)
- Luz Fonacier
- Department of Medicine, State University of New York at Stony Brook, Stony Brook, New York; Department of Allergy, New York University Winthrop Hospital, Mineola, New York.
| | - Irum Noor
- Department of Allergy, New York University Winthrop Hospital, Mineola, New York
| |
Collapse
|
45
|
Zack B, Arrandale V, Holness DL. Skin-specific training experience of workers assessed for contact dermatitis. Occup Med (Lond) 2018; 68:203-206. [DOI: 10.1093/occmed/kqy022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- B Zack
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Health and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - V Arrandale
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - D L Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Health and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
46
|
Ruff S, Engebretsen K, Zachariae C, Johansen J, Silverberg J, Egeberg A, Thyssen J. The association between atopic dermatitis and hand eczema: a systematic review and meta‐analysis. Br J Dermatol 2018; 178:879-888. [DOI: 10.1111/bjd.16147] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 02/06/2023]
Affiliation(s)
- S.M.D. Ruff
- Department of Dermatology and Allergy Herlev and Gentofte Hospital University of Copenhagen Kildegaardsvej 28 DK‐2900 Hellerup Denmark
| | - K.A. Engebretsen
- Department of Dermatology and Allergy Herlev and Gentofte Hospital University of Copenhagen Kildegaardsvej 28 DK‐2900 Hellerup Denmark
- National Allergy Research Centre (Department of Dermatology and Allergy) Herlev and Gentofte Hospital University of Copenhagen Kildegaardsvej 28 DK‐2900 Hellerup Denmark
| | - C. Zachariae
- Department of Dermatology and Allergy Herlev and Gentofte Hospital University of Copenhagen Kildegaardsvej 28 DK‐2900 Hellerup Denmark
| | - J.D. Johansen
- National Allergy Research Centre (Department of Dermatology and Allergy) Herlev and Gentofte Hospital University of Copenhagen Kildegaardsvej 28 DK‐2900 Hellerup Denmark
| | - J.I. Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences Feinberg School of Medicine at Northwestern University Chicago IL U.S.A
| | - A. Egeberg
- Department of Dermatology and Allergy Herlev and Gentofte Hospital University of Copenhagen Kildegaardsvej 28 DK‐2900 Hellerup Denmark
| | - J.P. Thyssen
- Department of Dermatology and Allergy Herlev and Gentofte Hospital University of Copenhagen Kildegaardsvej 28 DK‐2900 Hellerup Denmark
- National Allergy Research Centre (Department of Dermatology and Allergy) Herlev and Gentofte Hospital University of Copenhagen Kildegaardsvej 28 DK‐2900 Hellerup Denmark
| |
Collapse
|
47
|
Gupta T, Arrandale VH, Kudla I, Holness DL. Gaps in Workplace Education For Prevention of Occupational Skin Disease. Ann Work Expo Health 2017; 62:243-247. [DOI: 10.1093/annweh/wxx093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 11/21/2017] [Indexed: 11/14/2022] Open
|
48
|
Kudla I, Houle MC, Velykoredko Y, Gomez P, DeKoven J, Skotnicki S, Holness DL. Introducing a “Workplace Prescription” to Facilitate Return to Work for Workers With Occupational Contact Dermatitis. J Cutan Med Surg 2017; 21:573-575. [DOI: 10.1177/1203475417716328] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Irena Kudla
- Department of Occupational and Environmental Health, St Michael’s Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Marie-Claude Houle
- Contact and Occupational Dermatitis Clinic, Hôtel-Dieu de Québec, Québec, QC, Canada
- Université Laval, Québec, QC, Canada
| | - Yuliya Velykoredko
- University of Toronto Postgraduate Medicine Program in Dermatology, Toronto, ON, Canada
| | - Pilar Gomez
- Department of Occupational and Environmental Health, St Michael’s Hospital, Toronto, ON, Canada
- Department of Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Joel DeKoven
- Department of Occupational and Environmental Health, St Michael’s Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sandy Skotnicki
- Department of Occupational and Environmental Health, St Michael’s Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - D. Linn Holness
- Department of Occupational and Environmental Health, St Michael’s Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute St Michael’s Hospital, Toronto, ON, Canada
| |
Collapse
|
49
|
Alfonso J, Bauer A, Bensefa-Colas L, Boman A, Bubas M, Constandt L, Crepy M, Goncalo M, Macan J, Mahler V, Mijakoski D, Ramada Rodilla J, Rustemeyer T, Spring P, John S, Uter W, Wilkinson M, Giménez-Arnau A. Minimum standards on prevention, diagnosis and treatment of occupational and work-related skin diseases in Europe - position paper of the COST Action StanDerm (TD 1206). J Eur Acad Dermatol Venereol 2017; 31 Suppl 4:31-43. [DOI: 10.1111/jdv.14319] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 12/23/2022]
Affiliation(s)
- J.H. Alfonso
- Department of Occupational Medicine and Epidemiology; National Institute of Occupational Health; Oslo Norway
| | - A. Bauer
- Department of Dermatology; University Allergy Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - L. Bensefa-Colas
- Department of Occupational and Environmental Diseases; AP-HP; Paris Descartes University; Sorbonne Paris Cité; Paris France
- Laboratoire Santé Publique et Environnement; Paris France
| | - A. Boman
- Institute of Environmental Medicine; Occupational and Environmental Dermatology; Stockholm Sweden
| | - M. Bubas
- Department for Education and Information; Croatian Institute for Health Protection and Safety at Work; Zagreb Croatia
| | - L. Constandt
- Fedris, Agence Fédérale des risques professionnels; Brussels Belgium
| | - M.N. Crepy
- Department of Occupational and Environmental Diseases; AP-HP; Paris Descartes University; Sorbonne Paris Cité; Paris France
| | - M. Goncalo
- Clinic of Dermatology; University Hospital and Faculty of Medicine; University of Coimbra; Coimbra Portugal
| | - J. Macan
- Unit for Occupational and Environmental Health; Institute for Medical Research and Occupational Health; Zagreb Croatia
| | - V. Mahler
- Department of Dermatology; University Hospital of Erlangen; Erlangen Germany
| | - D. Mijakoski
- Institute for Occupational Health of Republic of Macedonia; Skopje Macedonia
| | - J.M. Ramada Rodilla
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM); CIBER de Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
| | - T. Rustemeyer
- Department of Dermatology and Allergology; VU University Medical Centre; Amsterdam The Netherlands
| | - P. Spring
- Department of Dermatology; University of Lausanne; Lausanne Switzerland
| | - S.M. John
- Department of Dermatology, Environmental Medicine; University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Lower-Saxony Institute of Occupational Dermatology (NIB); Osnabrück Germany
| | - W. Uter
- Department of Medical Informatics, Biometry and Epidemiology; Friedrich-Alexander Universität Erlangen/Nürnberg; Erlangen Germany
| | | | - A.M. Giménez-Arnau
- Department of Dermatology; Hospital del Mar; Institut Mar d´Investigacions Mèdiques (IMIM); Universitat Autònoma de Barcelona; Barcelona Spain
| |
Collapse
|
50
|
Zack B, Arrandale VH, Holness DL. Preventing Occupational Skin Disease: A Review of Training Programs. Dermatitis 2017; 28:169-182. [DOI: 10.1097/der.0000000000000278] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|