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Reeder MJ, Idrogo-Lam A, Aravamuthan SR, Warshaw EM, DeKoven JG, Silverberg JI, Adler BL, Atwater AR, Taylor JS, Houle MC, Belsito DV, Yu J, Botto N, Mowad CM, Dunnick CA, DeLeo VA, Pratt MD. Occupational Contact Dermatitis in Construction Workers: A Retrospective Analysis of the North American Contact Dermatitis Group Data, 2001-2020. Dermatitis 2024. [PMID: 38888884 DOI: 10.1089/derm.2024.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Background: Construction workers (CWs) are at risk for occupational contact dermatitis (CD) owing to workplace exposures. Objective: Determine the prevalence of occupational allergic CD and characterize common occupational allergens in CWs referred for patch testing in the United States and Canada. Methods: Retrospective cross-sectional analysis of patients patch tested by the North American Contact Dermatitis Group from 2001 to 2020. Results: Of 47,843 patch-tested patients, 681 (1.4%) were CWs. Compared with non-CWs, CWs were more likely to be male (91.0% vs 30.9%) have occupational skin disease (36.9% vs 11.4%) and have hand involvement (37.2% vs 22.5%) (all P < 0.0001). Of 681 CWs, 60.1% (411) had clinically relevant positive patch test reactions, and nearly 1/3 of CWs (128) had occupationally relevant reactions. Most common occupationally relevant allergens were potassium dichromate 0.25% pet. (30.5%, 39/128), bisphenol A epoxy resin 1% pet. (28.1%, 36/128), carba mix 3% pet. (14.8%, 19/128), cobalt (ii) chloride hexahydrate 1% pet. (14.1%, 18/128), and thiuram mix 1% pet. (14.1%, 18/128). Top sources of occupationally relevant allergens were cement/concrete/mortar (20.4%, 46/225), gloves (15.1%, 34/225), and coatings (paint/lacquer/shellac/varnish/stains) (9.8%, 22/225). Conclusions: Occupational CD in North American CWs is common. In this group, frequently identified etiological sources of occupational allergic CD included metals, epoxy resin, and rubber.
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Affiliation(s)
- Margo J Reeder
- From the *Department of Dermatology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
| | - Alexander Idrogo-Lam
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Srikanth R Aravamuthan
- From the *Department of Dermatology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
| | - Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Marie-Claude Houle
- Division of Dermatology, CHU de Quebec, Laval University, Quebec City, Canada
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA
| | - Jiade Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nina Botto
- Department of Dermatology, University of California, San Francisco, California, USA
| | - Christen M Mowad
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ontario, Canada
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2
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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.
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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
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3
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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
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4
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Kalboussi H, Kacem I, Aroui H, El Maalel O, Maoua M, Brahem A, El Guedri S, Chatti S, Ghariani N, Mrizak N. Impact of Allergic Contact Dermatitis on the Quality of Life and Work Productivity. Dermatol Res Pract 2019; 2019:3797536. [PMID: 30941167 PMCID: PMC6421021 DOI: 10.1155/2019/3797536] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/02/2019] [Accepted: 02/05/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Allergic contact dermatitis (ACD) is a common chronic skin disease that generates considerable public-health and socioeconomic costs. This disease affects the quality of life and the occupational activity of patients. AIMS To assess the quality of life (QOL) of patients with ACD and study the impact of this disease on their work productivity. METHODS This is a cross-sectional study carried out from January 2012 to December 2014. All patients diagnosed with ACD in the Dermato-Allergology Unit of the Occupational Medicine Department at Farhat Hached University Hospital, in Sousse, were included. The impact of skin disease on the QOL of affected persons was assessed using the Dermatology Life Quality Index (DLQI). The work productivity was measured using the Work Productivity and Activity Impairment Allergic Specific questionnaire (WPAI: AS). RESULTS The study population consisted of 150 patients. The average score of DLQI was 6.5. Over the previous 7 days, absenteeism rate was 25.9 ± 15.3%, presenteeism rate was 50.2 ± 32%, overall work productivity loss was 29.6 ± 19.4%, and daily activity impairment was 50.4 ± 32.3%. The DLQI score was significantly associated with atopy (p = 0.03), relapses strictly greater than 10 (p = 0.02), presenteeism (p <10-3), overall work productivity loss (p = 0.01), and daily activity impairment (p = 0.03). CONCLUSION The impact of ACD on QOL and occupational activity seems important and requires specific attention from the occupational physician.
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Affiliation(s)
- H. Kalboussi
- Occupational Medicine Department, Teaching Hospital Farhat Hached Sousse, Tunisia
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
| | - I. Kacem
- Occupational Medicine Department, Teaching Hospital Farhat Hached Sousse, Tunisia
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
| | - H. Aroui
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
- Occupational Medicine Department, Teaching Hospital Ibn Jazzar Kairouan, Tunisia
| | - O. El Maalel
- Occupational Medicine Department, Teaching Hospital Farhat Hached Sousse, Tunisia
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
| | - M. Maoua
- Occupational Medicine Department, Teaching Hospital Farhat Hached Sousse, Tunisia
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
| | - A. Brahem
- Occupational Medicine Department, Teaching Hospital Farhat Hached Sousse, Tunisia
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
| | - S. El Guedri
- Occupational Medicine Department, Teaching Hospital Farhat Hached Sousse, Tunisia
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
| | - S. Chatti
- Occupational Medicine Department, Teaching Hospital Farhat Hached Sousse, Tunisia
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
| | - N. Ghariani
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
- Dermatology Department, Teaching Hospital Farhat Hached Sousse, Tunisia
| | - N. Mrizak
- Occupational Medicine Department, Teaching Hospital Farhat Hached Sousse, Tunisia
- Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Tunisia
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5
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Beyan AC, Demiral Y, Cimrin A. Employment status changes of workers after referral to an occupational disease clinic. J Occup Health 2018; 60:494-501. [PMID: 30305480 PMCID: PMC6281635 DOI: 10.1539/joh.2017-0282-oa] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: Occupational diseases (OD) are among the most significant issues of work life, with economic, medical, social, and ethical aspects. The majority of studies concerning OD focus on the causes or medical outcomes of OD. There are a limited number of studies investigating the social and economic impacts of being diagnosed with an OD. One of the important social aspects of OD is the employability of workers after an OD diagnosis. The aim of this study is to evaluate the changes in employment status after the OD diagnosis process. Methods: This is a cross sectional study. There were 204 eligible cases, and 198 (97%) completed the study. The study data were obtained from patient files, including OD Committee reports and questionnaires applied via telephone interview. Results: Among the 198 applicants, 170 (85.9%) were male and 146 (73.7%) were diagnosed with an OD. Of these workers, 106 (53.5%) had quit their current jobs. Of those workers, 89 out of 106 were in the OD group, and 17 were in the non-OD group. Diagnosis with OD (OR: 3.1 CI: 1.4-6.8) and non-union membership (OR: 11.1 CI: 5.2-23.5) increased the likelihood of quitting the job after an OD diagnosis. Conclusion: The short-term prognosis of OD was relatively poor. OD diagnosis or even referral to an outpatient clinic may cause quitting the job. Policies should account for the risk of unemployment after an OD diagnosis, and OD surveillance systems should obtain data on the employment status of workers following diagnosis.
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Affiliation(s)
- Ayse Coskun Beyan
- Dokuz Eylul University Medical Faculty, Department of Occupational Medicine
| | - Yucel Demiral
- Dokuz Eylul University Medical Faculty, Department of Occupational Medicine
| | - Arif Cimrin
- Dokuz Eylul University Medical Faculty, Department of Occupational Medicine
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Al-Otaibi ST, Alqahtani HAM. Management of contact dermatitis. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2015. [DOI: 10.1016/j.jdds.2015.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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7
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Holness DL. Occupational skin allergies: testing and treatment (the case of occupational allergic contact dermatitis). Curr Allergy Asthma Rep 2014; 14:410. [PMID: 24408535 DOI: 10.1007/s11882-013-0410-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Occupational contact dermatitis, including occupational allergic contact dermatitis, is one of the most common occupational diseases. Making a timely and accurate diagnosis is important to improving the outcome. Taking a work history and patch testing are essential elements in the diagnostic process. Management, based on an accurate diagnosis, must include both medical treatment to address the disease and workplace modifications as appropriate to reduce exposure the causative agents.
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Affiliation(s)
- D Linn Holness
- Department of Occupational and Environmental Health, St. Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada,
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8
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Stefaniak AB, Plessis JD, John SM, Eloff F, Agner T, Chou TC, Nixon R, Steiner MFC, Kudla I, Linn Holness D. International guidelines for the in vivo assessment of skin properties in non-clinical settings: part 1. pH. Skin Res Technol 2012; 19:59-68. [PMID: 23279097 PMCID: PMC3747458 DOI: 10.1111/srt.12016] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2012] [Indexed: 11/27/2022]
Abstract
Background Skin surface pH is known to influence the dissolution and partitioning of chemicals and may influence exposures that lead to skin diseases. Non-clinical environments (e.g. workplaces) are highly variable, thereby presenting unique measurement challenges that are not typically encountered in clinical settings. Hence, guidelines are needed for consistent measurement of skin surface pH in environments that are difficult to control. Methods An expert workshop was convened at the 5th International Conference on Occupational and Environmental Exposure of Skin to Chemicals to review available data on factors that could influence the determination of skin surface pH in non-clinical settings with emphasis on the workplace as a worst case scenario. Results The key elements of the guidelines are: (i) minimize, to the extent feasible, the influences of relevant endogenous (anatomical position, skin health, time of day), exogenous (hand washing, barrier creams, soaps and detergents, occlusion), environmental (seasonality), and measurement (atmospheric conditions) factors; (ii) report pH measurements results as a difference or percent change (not absolute values) using a measure of central tendency and variability; and (iii) report notable deviations from these guidelines and other relevant factors that may influence measurements. Conclusion Guidelines on the measurement and reporting of skin surface pH in non-clinical settings should promote consistency in data reporting, facilitate inter-comparison of study results, and aid in understanding and preventing occupational skin diseases.
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