OCCUPATIONAL CONTACT DERMATITIS IN CAR REPAIR WORKERS AT THE INDUSTRIAL ZONE IN ZAGAZIG CITY

Abstract

Background: Occupational contact dermatitis (OCD) is a common skin disorder with a poor prognosis, resulting in a noteworthy economic impact for society & for an individual and amenable to public health interventions. Objectives: 1) determining the prevalence of contact dermatitis(CD)among car repair workers. 2) studying somerisk factors associated with CD and 3) Conducting an intervention skin care education program to control this problem and evaluate its impact on knowledge, attitude, symptoms and signs of CD. Subjects and methods: 1- A comparative cross-sectionalstudy was conducted on 87 car repair workers (29 car tinkers, 29 car mechanics and 29 car painters) with regular and direct exposure to chemical materials at the Industrial Zone in Zagazig City and non-exposed control group consisted of 76 booksellers. All workers were subjected to questionnaire, clinical examination and those who diagnosedclinically as CD were patch-tested. 2- Intervention study with a skin care education program was carried out on 47 car repair workers. Re-evaluation of the intervention group was done after 5 months as regard knowledge, attitude, symptoms and signs of CD. Results: The total prevalence of CD among car repair workers(18.4%) was significantly higher compared to their controls(3.9%), with the highest prevalence among car mechanics (24.1%), and car painters (20.7%). 16.1% of car repair workers reported recurrent dermatitis in the last 12 months. The most commonly affected areas were the fingers, webs and hands(81.3%). 40% of car repair CD cases found to have allergic CD and 60% have irritant CD. Nickel accounted for most positive patch test reactions (33.3%). Hammering, friction with repaired parts and sanding of painting parts with cementing the car body with pastes were the most important procedures at the workplace that start and worsen CD cases. The young car repair workers, who smoke and with past history of atopy had a significant high risk to develop CD. After the intervention study, a significantly higher knowledge level about CD causes, risk factors, prevention, with change in the attitude and behavior of workers and decreased in the reported symptoms and signs of CD. Conclusion and recommendations: Car repair workers are at high risk for OCD, irritant as well as allergic, due to exposure to various chemicals at work. Young age, smoking, atopy and duration of work are found to be risk factors for CD. Skin care education program is an important tool for primary prevention of CD and control ofexposure to substances hazardous to the skin. More long-term large-scale studies are needed to confirm further the cost-effectiveness of this and other skin protection programs.