Incidence Of Occupational Skin Diseases Research Articles

Description of Occupational Contact Dermatitis Related to the Use of Personal Protective Equipment with a History of Atopy in Health Workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital.

Coronavirus disease 2019 was declared a pandemic by WHO in March 2020. The Indonesian Ministry of Health has recommended many prevention strategies including the use of hand sanitizers (HSs) and the use of personal protective equipment (PPE), especially for healthcare workers. Previous research reported that the increase in the use of HS and PPE is directly proportional to the increase in the incidence of occupational skin diseases. To find out the prevalence of work-related contact dermatitis patients related to the use of PPE in healthcare workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan, with a history of atopy dermatitis. This was a descriptive study including 104 healthcare workers. The results of the study were analysed using prevalence and frequency data distribution. In this study, we found that the majority of occupational skin diseases in healthcare workers are female (n = 64; 62.5%), and the most common age group was 31-33 years old (44.2%). The incidence of contact dermatitis due to the use of PPE in healthcare workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan, was found only in 15 subjects (14.4%), and only 5 (33.3%) of them had a history of suffering from atopy dermatitis. There is high prevalence of contact dermatitis due to PPE at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan; in 104 research subjects, only 15 people (14.4%) suffered from work-related contact dermatitis with a history of atopy in 5 people (33.3%).

UK rates of occupational skin disease attributed to rubber accelerators, 1996-2012.

Natural and synthetic rubbers containing rubber accelerators are well-known causes of allergic contact dermatitis (ACD). Latex contact urticaria (CU) has been widely reported, especially when powdered latex glove use was commonplace. Consequently, interventions to reduce latex exposure by altering glove manufacture were introduced. This study aimed to analyse trends in UK-reported incidence of occupational skin disease associated with rubber accelerators. We analysed cases reported to EPIDERM (part of The Health and Occupation Research network) of occupational ACD caused by natural and synthetic rubber products, between 1996 and 2012. For the studied period, a decreasing incidence of ACD associated with rubber products was found, with an average annual change of -1.2% [95% confidence interval (CI) -3.1 to 0.7]. The number of cases of latex CU (n = 580) significantly declined. The number of cases of ACD caused by mercapto mix and mercaptobenzothiazole (n = 177) and thiuram mix (n = 603) also declined. Reports of ACD associated with carba mix and its constituents (n = 219) increased significantly, by an average annual percentage of 10.1% (95%CI: 6.1-14.2). Twenty-six cases of ACD caused by rarer rubber compounds were identified, highlighting skin disease attributable to less widely recognized chemicals. These data show a falling reported incidence of occupational ACD attributed to rubber chemicals, but within this a significant rise attributable to the constituents of the carba mix. Clinicians should recognize the changing diversity of chemicals used in rubber manufacturing, and consider including carba mix in their baseline series and testing beyond this in suspect cases to avoid false-negative results.

Trends of Occupational Exposure to Chemical Agents in Finland in 1950–2020

The aim of this study was to quantitatively estimate the long-term trends of occupational exposure to chemical agents in Finland for surveillance, prevention, and risk assessment purposes. We studied trends by utilizing the Finnish job-exposure matrix (FINJEM), which includes occupation-specific estimates of the prevalence P (percent of employed) and average level L (agent-specific units) of inhalation exposure to chemical agents at different time periods. We used FINJEM data to calculate national estimates of the numbers of exposed workers (N exp), and the prevalence of and level of exposure to 41 chemical agents in 1950, 1970, 1990, and 2008. We also estimated the prevalence of employees exposed to levels exceeding 50% of the Finnish occupational exposure limit (OEL) (P high) and national occupational inhalation exposure (NOIE = N exp × L). Future exposures in 2020 were estimated according to the predicted change of the occupational structure of the labor force and the observed agent-specific exposure trends in 1990-2008. We estimated dermal exposure indirectly from the statistics of occupational skin diseases in 1975-2009. Inhalation exposure to most chemical agents had decreased. Using 1990 as the reference (100), the median values of P for 1950, 1970, 1990, 2008, and 2020 were 91, 149, 100, 58, and 41, respectively. The corresponding values were 218, 224, 100, 30, and 14 for P high, 151, 121, 100, 78, and 66 for L, and 119, 176, 100, 38, and 20 for NOIE. The trends varied considerably according to the agent. Exposure of, for example, asbestos, benzene, and benzo(a)pyrene substantially decreased. The annual incidence of occupational skin diseases due to chemical factors decreased from 6.9 per 10 000 employed in 1975-1979 to 4.6 per 10 000 in 2000-2009, suggesting a decrease in dermal exposure. Inhalation exposure to most chemical agents has decreased in Finland since 1970. High exposures and the average level of exposure started to decrease already in the 1950s. The declining incidence of occupational skin diseases suggests that dermal exposure has also diminished. However, high exposures still exist and cause a substantial amount of occupational diseases and symptoms. Chemical exposures and the related disease burden are expected to continue decreasing in the future. These results cannot be generalized to other countries, particularly if the development phase of technology and the occupational structure of the labor force differ significantly from those in Finland.

The prevalence and possible causes of contact dermatitis in farmworkers

The National Agricultural Workers Survey estimates that immigrants constitute approximately 78% of the migrant and seasonal farmworkers in the United States. Migrant farmworkers, defined as those traveling at least 75 miles and establishing a temporary abode within the previous year for work, made up 42% of the crop workers in 2001–2002.1 Farmworkers are exposed to hazardous working conditions, such as exposure to pesticides, working long hours in hot climates, and working with dangerous machinery. These working conditions predispose agricultural workers to occupational skin disease, among other health problems.2 Contact dermatitis, an irritating and inflammatory skin reaction to a foreign substance, is one of the most common skin problems among farmworkers. However, there is limited research involving the prevalence and specific etiologies of contact dermatitis in migrant farmworkers. In many countries, occupational contact dermatitis is the most common reportable occupational disease, and makes up 30% of payable compensation.3 It is difficult to accurately compare data from different countries due to differences in the reporting of occupational diseases and the fact that national registries are often incomplete.4 In the United States, the Bureau of Labor Statistics acquires data regarding occupational disease from an annual survey that includes a representative random sample of business establishments in private industries. In the sector of agriculture, forestry, fishing, and hunting, the incidence of nonfatal occupational injuries/illnesses was 6.4 per 100 full time workers, second only to manufacturing in the goods producing industries.5 However, the incidence of occupational skin disease may actually be underreported of by 10 to 50 times, according to some estimates.4 Due to the paucity of data specific to skin disease in migrant farmworkers, we describe the existing knowledge on the prevalence of occupational contact dermatitis in any farmworker.

Notification of occupational skin diseases by dermatologists in The Netherlands

A voluntary surveillance scheme of occupational skin diseases (OSDs) in The Netherlands starting in 2001 aimed to improve insight in the incidence of OSD especially occupational contact dermatitis (OCD), risk professions and causal agents. This paper presents the results of this scheme during 2001-05. Reports of new cases of OSD received from the participating dermatologists on a monthly basis were analysed. Data evaluated included information on diagnosis, sex, age, sickness, absenteeism, profession and causal agents. Relative differences in incidence rates between industries or branches were estimated by calculating incidence rate ratios. About 80% of the notifications concerned OCD. The highest number of notifications was recorded in the first year of the scheme. This was probably due to reporting of a mixture of incident and prevalent cases. During the following 5 years, the number of yearly notifications of OSD declined. Hairdressers, nurses, metalworkers, mechanics and cleaners were the most commonly affected professions. Wet work and irritating substances were the most frequently reported causal agents. Most patients with OCD were not absent from work. A voluntary surveillance scheme with dermatologists provides valuable data about the distribution of OCD in risk professions and the causal agents. However, it has certain limitations in assessing trends in incidence. Active medical surveillance in populations at risk should be encouraged not only to improve secondary prevention but also to obtain more reliable information about the incidence of OCD.

The incidence of occupational skin disease as reported to The Health and Occupation Reporting (THOR) network between 2002 and 2005

Estimated incidence rates for occupational skin disease in the U.K. are provided by voluntary surveillance schemes involving dermatologists and occupational physicians. These rates allow monitoring of occupational dermatoses, and intervention planning aimed at reducing workplace risks. To summarize occupational skin disease reported to The Health and Occupation Reporting (THOR) network (2002-2005), and to provide baseline information for comparison with future studies of occupational skin disease in the U.K. and beyond. Incidence rates for occupational dermatoses were calculated using THOR data as numerators, and Labour Force Survey data or information from the most recent U.K. survey on provision of occupational physician services as denominators. In the U.K. (2002-2005) the average annual incidence rate of work-related skin disease reported to THOR by dermatologists was 91.3 [95% confidence interval (CI) 81.8-101.1] per million, and by occupational physicians was 316.6 (95% CI 251.8-381.3) per million. Most reports were of contact dermatitis: dermatologists 68.0 (95% CI 59.8-76.2) per million, occupational physicians 259.7 (95% CI 200.8-318.6) per million. Information produced by THOR is an important source for calculating incidence rates of occupational skin disease. A range of reporting groups should also be used when building an overall picture of occupational skin disease incidence in the U.K.

Secondary individual prevention of hand dermatitis in geriatric nurses

The incidence of occupational skin disease (OSD) in geriatric nurses (GNs) is increasing in Germany. A prospective controlled study of secondary individual prevention (SIP) of OSD in GNs was conducted. Two hundred and nine participants completed questionnaires prior to the start of the program and 3 months after its conclusion. One hundred and two GNs participated in an interventional program (intervention group, IG). Severity of OSD was classified upon each visit. Delta-TEWL values were measured at regular intervals. Findings were compared with those for 107 control group (CG) participants consulting a dermatologist on demand. SIP was not offered to CG participants. Upon entry, 89% of IG and 90% CG complained of OSD (NS). Dermatologic examination revealed skin changes in 90% of IG at first consultation. Upon study completion, 59% of IG was free of OSD. Questionnaires 3 months after study completion revealed skin lesions in 53% of IG and 82% of CG (p<0.01). Delta-TEWL measurements reflected significant improvement of the epidermal barrier during SIP in IG (median 6.9-3.0 g/m(2)/h, p<0.001). Three months after study completion, 96% of IG and 86% of CG were still employed. Objective dermatologic and skin physiologic data reveal that SIP in GNs is effective in the secondary prevention of OSD. Further, IG was superior to CG in terms of health maintenance and employment.

Epidemiologie des beruflich bedingten Handekzems

Occupational skin diseases constitute about 30% of all occupational diseases worldwide and also in Germany. Thereby, occupational skin diseases take the leading position of all occupational diseases. About 90% of occupational skin diseases are eczemas which are usually located on the hands. According to estimates of the registers for occupational skin diseases in Northern Bavaria and the Saarland, Germany, which have been effective since 1990 and 1999, the incidence of occupational skin diseases is 6.7 and 6.8 per 10,000 full-time workers and year. Other incidence estimates from Western industrialized countries range between 5 and 19 cases per 10.000 full-time workers and year. Population-based estimates for a 1-year prevalence of hand dermatitis, which rely on an assessment by questionnaire, range between 6.7% in Germany and 8.9% in Norway. Studies, which included a skin examination for outcome assessment, e.g. revealed a point prevalence of 0.5% for cases which should be seen by a physician in a sample of 20,749 US citizens or a 1-year prevalence of 10.6% for a sample of 16,587 subjects from Sweden. According to a cross-sectional study from Denmark, school children in the age of 12 - 16 years exhibited hand eczema in 3.2% at the time of investigation and reported a 1-year prevalence of 7.3%. For the latter, the predominance of female gender was confirmed (10.1% vs. 4.6%). Epidemiological studies on occupational hand dermatitis are for several methodological reasons hardly comparable. This is due to different sample sizes and selection criteria, the use of different measures of frequency and outcome assessment including the fact that no generally accepted and validated diagnostic criteria exist. Population-based as well as studies in different occupational groups revealed a higher prevalence in women. Larger studies in food- and metal-processing industries as well as in hairdressing apprentices showed a marked increase in eczema prevalence during the 3-year period of apprenticeship. For example, prevalence of hand dermatitis increased in apprentices of food industry from East-Thuringia from 17.5% to 27.5%, in hairdressing apprentices from Northwest Germany from 12.9% to 23.9% and in apprentices of metal industry from 0 to 23%, i.e. from 8.6% to 14.1%. The latter study was performed in apprentices of the car industry and allowed to distinguish the increase in hand eczema between metalworkers (9,2% to 15.3%), blue-collar workers (8.8% to 14.1%), and white-collar workers (4.6% to 6.9%). The Prevention of Occupational Skin Disease in Hairdressers Study (POSH) clearly demonstrated that the prevalence estimates largly depend on the chosen outcome definition. For various definitions of hand eczema the prevalence at the end of apprenticeship varied between 2.7% and 23.9%. A high 3-year prevalence of 20.7% was also observed in German office workers and an expected high 1-year prevalence of 46% was reported for female cleaners from Denmark. The overall high and during apprenticeship further increasing prevalence of occupational hand dermatitis calls for intense and specific measures of prevention.

An exploratory analysis of occupational skin disease among Latino migrant and seasonal farmworkers in North Carolina.

Occupational skin disease is highly prevalent among all agricultural workers. However, few data exist on risk factors for occupational skin disease among migrant and seasonal farmworkers. The goal of this analysis was to further document the prevalence of occupational skin disease among Latino farmworkers and delineate risk factors. This exploratory analysis used data collected in repeated survey interviews with Latino farmworkers in North Carolina in June and July (early season) and in August and September (late season), 1999. Respondents were largely male (95%) and from Mexico (95%), with about one-third each age 18-24, 25-34, and 35 and older. About half were in the U.S. on work contracts. Independent variables included the physical environment (crops worked), the social environment (having received pesticide safety training, having a work contract), and behavior and individual characteristics (re-wearing work clothes, showering after work, age). The dependent measures were reporting having had itching or burning skin or a skin rash in the two months prior to each interview; 24% of the respondents in the early season, and 37% in the late season reported skin disease signs and symptoms during the previous two months. Those reporting signs and symptoms in the early season were more likely to report them in late season. Significant independent risk factors for skin signs and symptoms in early season were re-wearing work clothes, showering after work, and being age 35 or older. In late season, those who had not received pesticide safety training had lower odds of reporting skin disease signs and symptoms, after adjusting for other potential risk factors. This exploratory study indicates that Latino migrant and seasonal farmworkers experience a high incidence of occupational skin disease. Further research is required with improved measurement of skin disease signs and symptoms, diagnosis of specific skin disease, and improved measurement of risk factors.

Occupational contact dermatitis II: risk assessment and prognosis.

Contact dermatitis is a common and important condition in the occupational setting. In a companion paper, I describe changes in the incidence of recorded occupational skin disease from 1972 to 1999. Despite substantial improvements in workplace hygiene, the incidence of occupational skin disease remains half of that recorded in 1972. In the companion paper, it is argued that a more sophisticated approach to prevention and management may be required to substantially reduce the burden of occupational skin disease further. In this paper, I address the present state of risk assessment (including components of hazard identification, measuring or estimating dermal exposure, percutaneous absorption, dose-response relationships, and risk characterization) and the poor prognosis of serious occupational contact dermatitis, with a view to potential improvements in practice and outcomes.

Impact of preventive strategies on trend of occupational skin disease in hairdressers: population based register study

Hairdressing is one of the occupations most hazardous to the skin.1 Various efforts have been made in Germany in the past 10 years to reduce the incidence of occupational skin...