Occupational Dermatoses Research Articles

Occupational Dermatosis.

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. 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.

The role of the dermatologist in the immune-mediated/allergic diseases - position statement of the EADV task force on contact dermatitis, EADV task force on occupational skin diseases, UEMS-EBDV subcommission allergology and European Dermatology Forum.

The members of the Task Force on Contact Dermatitis and the Task Force on Occupational Dermatoses of the European Academy of Dermatology and Venereology (EADV), of the European Dermatology Forum (EDF), and the members of the UEMS Sectionof Dermatology-Venereology (UEMS-EBDV) we want to vindicate the fundamental role that the specialist in Dermatology has in the diagnosis and management of Immuno-mediated /allergic Diseases. In disagreement with the blueprint paper of the UEMS section of Allergology (2013), in which dermatologists are excluded from one of their core activities it was decided to write this consensus paper. The skin occupies a crucial place in the broad spectrum of allergic diseases; there is no other organ with such a multitude of different clinical conditions mediated by so many pathogenetic immune mechanisms. Subsequently, dermatologists play a fundamental role in the management of immune-mediated diseases including among others contact dermatitis, atopic dermatitis, urticaria and angioedema or cutaneous adverse drug, food and arthropod reactions. The essential role of dermatology in the diagnostic, therapeutic and preventive management of immune mediated /allergic diseases which is crucial for patient management is justified from both the academic and professional point of view. Based on the best care of the patient with cutaneous immune allergic disease a multidisciplinary approach is desirable and the dermatologist has a pivotal role in patient management. Be so good and no one will not ignore you, dermatologist. Ideally Dermatology should be governed according the following Henry Ford statement: "Arriving together is the beginning; keeping together is progress; working together is success."

A review of non‐glove personal protective equipment‐related occupational dermatoses reported to EPIDERM between 1993 and 2013

Personal protective equipment (PPE) is defined as equipment that protects the wearer's body against health/safety risks at work. Gloves cause many dermatoses. Non-glove PPE constitutes a wide array of garments. Dermatoses resulting from these have hitherto not been documented. To determine the incidence and types of non-glove PPE-related dermatoses. We analysed incident case reports from dermatologists of non-glove PPE-related dermatoses to a UK-wide surveillance scheme (EPIDERM) between 1993 and 2013. The dermatoses associated with non-glove PPE accounted for 0.84% of all occupational skin disease. Of all PPE-related cases, 194 (9.2%) were attributable to non-glove PPE. Of these, 132 (68.0%) occurred in men, and the median age (both male and female) was 42 years (range 18-82 years). The non-glove PPE-related dermatoses were diagnosed as: allergic contact dermatitis (47.4%), irritant contact dermatitis (16.0%), friction (11.3%), occlusion (11.3%), unspecified dermatitis (8.8%), acne (3.1%), infections (1.5), and contact urticaria (0.52%). The industries most associated with non-glove PPE-related dermatoses were manufacturing (18.6%), public administration and defence (17.0%), health and social work (15.5%), and transport, storage, and communication (9.8%). Clothing, footwear, facemasks and headgear need to be recognized as causes of dermatoses occurring at body sites less commonly associated with occupational skin disease.

Sociodemographic and clinical profile of patients with occupational contact dermatitis seen at a work-related dermatology service, 2000 - 2014

Background:Occupational dermatoses are common, especially contact dermatitis. Epidemiological studies on these dermatoses are scarce in Brazil and they are necessary as part of the public policy to protect workers' health.Objectives:To identify sociodemographic and clinical profile of patients with occupational contact dermatitis seen between 2000 and 2014 at an occupational dermatology service.Methods:It is a cross-sectional and retrospective study, based on information obtained from the service's database.Results:Of 560 patients with conclusive patch test, 289 (46.9%) presented occupational dermatoses and 213 occupational contact dermatitis with predominance of the allergic type in relation to the irritative type (149:64 respectively). The odds of occupational dermatoses were higher among men and lower among patients aged 50 years or older and with higher level of education. Regarding the possibility of presenting occupational allergic contact dermatitis, only the gender variable was statistically significant. The professions most seen were cleaners, construction workers, painters, mechanics/metallurgists and cooks. The commonest allergens were nickel sulfate, potassium dichromate, cobalt chloride, carba-mix and formaldehyde.Study limitations:The main limitations of this study are the fact that it was carried out in a tertiary service of occupational dermatoses and the lack of access to some allergens outside the patch test baseline series.Conclusions:It was possible to identify the sociodemographic and clinical profile of patients with suspected occupational contact dermatitis seen at the Service, beyond the professional groups and allergens related to a high risk of occupational contact dermatitis in this population.

Occupational dermatoses among healthcare workers in a hospital center in Portugal.

Skin diseases account for more than 35% of occupational diseases, affecting 1/1,000 workers annually. To characterize occupational dermatoses affecting hospital workers and identify possible triggers and susceptibility factors. Cross-sectional study in which we analyzed information extracted from electronic medical records of workers who performed periodic examinations in the course of one year. About 3.56% of 1,741 included workers had a diagnosis of occupational dermatosis, being mainly women (76.85%). Thirty-four (54.84%) of the affected workers had irritant contact dermatitis, 17 (27.42%) latex allergy, 6 (9.68%) allergic dermatitis, and 5 (8.06%) two concomitant conditions. We found significant difference in prevalence as a function of occupational group (p=0.008), being highest for nursing assistants (5.11%). Prevalence was also higher for employees allocated to surgery departments (8.47%, p=0.001). Main triggers were skin disinfectants, latex, nitrile gloves, and prolonged contact with water (4.84%). The quality of the analyzed data depends on the quality of the analyzed medical records. Most subjects were nursing assistants, which fact hinders the generalization of the results. The prevalence of occupational dermatosis was just 3.56%, which might be explained by previously implemented preventive measures. The employees most frequently affected were those allocated to surgery departments and nursing assistants. Skin disinfectants were the most frequent triggers.

The state of occupational dermatoses in Turkey

The state of occupational dermatoses in Turkey

Occupational Dermatosis

Introduction: Occupational dermatosis is defined as any pathological condition of the skin for which job exposure can be shown to be a major direct or contributory factor. The commonest occupational dermatosis is a work-related contact dermatitis. The aim of the study was to find the pattern and diagnosis of occupational dermatosis in our community as no such study has been carried out in Nepal.Materials and Methods: This was a prospective study of 70 ambulatory patients with work-related dermatoses presented to the Dermatology Department of Kist medical. Data on socio-demographic characteristics, on lifestyle and temporal factor, the type of contact dermatitis, location and etiological factors were gathered through a structured questionnaire.Results: More females (n=39; 60%) cases were affected by contact dermatitis compared to men (n=31; 40%), without a significant difference (p=0.5). Most of our patients belonged to the age group of 20-39 years accounting to 38 cases (54%). The mean age of patients was 34 years old (16 – 70 year), with 49 (70%) of them living in urban area and 21 (30%) living in rural area, (p<0.05). Regarding the dermatological diagnosis the most common occupational disease was irritant contact dermatitis (n=29; 41.4%), allergic dermatitis (n=19; 27.1%), dermatophytosis (n=13; 18.6 %), photoallergic (n=6; 8.6%) and miscellaneous in 3 (4.3%) cases.Conclusions: Irritant contact dermatitis is more common than allergic contact dermatitis. Occupational dermatitis can cause significant morbidity and most cases are encountered in the younger age group. Therefore use of protective clothes, gloves should be advised to those vulnerable occupations.Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 24-28

Occupational Contact Dermatitis in the Canadian Aircraft Industry.

Aircraft building exposes workers to irritant and sensitizing products. The aim of this article was to study occupational dermatoses among aircraft workers over 25 years. The files of aerospace workers referred between 1990 and 2015 were extracted from the database of the McGill University Health Centre contact dermatitis clinic. These were subdivided according to demographics, type of work, patch testing results, and final diagnosis. Of 305 workers, 58% were 40 years or younger; one third were women. Onset of dermatitis varied from 2 months to 25 years, but 120 cases (39%) occurred during the first 3 years. Fifty-one percent of the cases involved assemblers, and 27% were composite material technicians, which were overrepresented as they constitute 10% of the workforce. Of the 305 workers, 152 suffered from allergic contact dermatitis, and 96 had irritant contact dermatitis. Of those with allergic contact dermatitis, 124 reacted to epoxy-based workplace products, but only 48 had positive patch tests to commercially available epoxy allergens. More than 60% of the cases of epoxy allergy would have been missed without testing with workplace products.

Prevalence of skin diseases amongst Moroccan fishermen.

The main objective was to evaluate the prevalence of skin diseases amongst fishermen, to specify the different clinical forms, associations and most frequent localisations, and to identify potential aetiological factors. The secondary objectives were to assess the knowledge, attitudes and practices of seafarers regarding occupational dermatoses to conduct information, awareness and education campaigns on risk factors and behaviours and to propose adapted prevention. This cross-sectional survey involved 1102 artisanal fishermen who attended the annual legal medical consultation at the occupational health service. All participants were men and had a regular activity for at least 2 years. It included an individual questionnaire, a clinical examination and a technical visit to the workplace Results: The skin disorders were palmar hyperkeratosis in 67.1% of fishermen, plantar hyperkeratosis in 59.4%, scares in 52.2%, facial wrinkling in 32%, and marine stings in 11.2%. The skin infections were fungal (44.4%), bacterial (8.3%), viral (5.5%) and scabies (1%). Only 192 (17.4%) fishermen did not have any dermatologic disease, 43% had one type of dermatologic diseases, 27.2% two types, 9.5% three types and 2.5% four types. Concerning personal protective equipment, only 87.4% wore protective clothing, 12.8% high visibility clothing, 52.6% safety shoes, 30.1% protective gloves, and 63.5% protective caps or hats. Only, 12% knew that mycosis were infectious origin and were contagious. Eighty-two per cent ignored the mode of contamination, 78% the means of prevention and 91% the existence of a medical treatment. Ninety-five per cent thought that pityriasis versicolor was due to sunrays especially in summer and not to fungus. The elaboration of the prevention approach needs a cooperative spirit; it will be more accepted and applied by all fishermen, if their representatives are involved in its preparation. The realisation of information and sensitization campaigns about the skin health must be based on the results of prevalence surveys.

Analysis of Dental Professionals' and Dental Students' Care for their Skin.

ObjectivesTo determine prevalence of undesirable, work-related skin lesions and their localizations in dental professionals and students, and to collect data about diagnostic procedures they undergo and skin care they take when these lesions occur.Subjects and methodsOur research included 444 respondents (dentists, dental assistants, dental technicians, dental students) who filled out a questionnaire. They were asked to specify if they had observed any lesions on their skin and where; if they had undergone any treatments and in what way; if they had undergone any allergy tests; and if they had taken any protective measures.ResultsOf all the respondents that took part in the survey, 249 (56.1%) reported undesirable skin reactions commonly on their hands and fingers (96%). Before our survey, only 15% of them had seen a dermatologist, while 33% had undergone allergy tests (without a dermatologists’ clinical examination). Also, 45% of them sometimes used soaps for sensitive skin and the majority (61%) of them used protective hand creams 1-2 times per day.ConclusionAlthough a large number of dental professionals and students have noticed work-related skin lesions, only some of them sought dermatologists’ professional help and most of them did not take care of their skin adequately when those lesions occurred. According to the results of this study, it is necessary to take additional preventive measures to increase dental professionals’ and students’ awareness of occupational dermatoses and adequate skin care.

Occupational dermatoses reported in Brazil from 2007 to 2014

BackgroundOccupational diseases are very prevalent in the world, especially in developing countries. Occupational dermatoses are responsible for most of these cases. However, epidemiological studies are rare in Brazil.ObjectivesTo verify the panorama of occupational skin diseases in Brazil describing frequencies of work-related dermatoses and their sociodemographic and occupational patterns.MethodsWe used retrospective data from the Notifiable Diseases Information System, (from 2007-2014) tabulated with the Tab program for Windows - TabWin12. We used intentional non-probability sampling and sequential selection, considering all notified occupational dermatoses.ResultsAll cases of occupational dermatoses referred to in the period were analyzed (n = 4710). Males and the age group of 35-49 years were the most affected. The most affected body area was the upper limb (34.2%) and the hand (25.4%). The "causative agent" field in the forms was not filled in 69.4% of cases, with chrome as the most prevalent cause reported (11.8%). ICD-10 codes more prevalent were L23, L24, and L25, corresponding to 34.2% of the sample. In total, 29% of patients needed to take a sick leave. No cases evolved to death and there were 0.2% of total as permanent disability.Study limitationsThe amount of missing information for various items in the system draws attention.ConclusionsTreatment of patients with occupational dermatitis include the identification and removal of the causative agent and specific treatment of the disease. Diagnosis delay in cases of occupational dermatoses brings social and financial consequences to the work and life of workers.

Occupational dermatoses in the Brazilian South region recorded in a reporting system (2007 to 2016).

Occupational dermatoses must be mandatorily reported in Brazil. To characterize the reporting of occupational dermatoses in the Brazilian South region, and describe the profile of the involved workers. Retrospective and descriptive study of 396 cases of occupational dermatoses reported from 2007 through 2016 via the Information System for Notifiable Diseases. 3.6 and 2.2 cases / 10,000 workers / year were of men and women, respectively. The highest incidence of occupational dermatoses corresponded to age range 50 to 64 years old, 1.8 cases / 10,000 workers / year, and to maintenance and repair workers, 3.6 cases / 10,000 workers / year. Most cases involved whites (77%) and workers not having completed elementary school (37.6%). Patch testing was only performed for 11.4% of cases. Reinforcing measures to promote the use of personal protective equipment is necessary, as well as to improve reporting and sensitize professionals to perform accurate reports in official systems.

Hand warts among butchers in a supermarket in São Paulo.

Butchers are exposed to biological hazards as a function of their continuous handling of meat containing blood, fat and fluids. Biological hazards include contamination with viruses, such as the papillomavirus (HPV), especially HPV type 7, which is associated with the so-called "butcher's wart." To investigate wart-like lesions among meat handlers. Cross-sectional descriptive study conducted at a supermarket in São Paulo in 2017. Twenty-four employees allocated to the meat handling section were interviewed and subjected to skin visual examination; lesions were photographed. Most participants were male (87.5%) and half of them (50.0%) were within age range 31 to 40 years old. Only one employee had started working in this section less than 2 years earlier. Wart-like lesions or scars with black dots on their center were found on the hands of 11 butchers (45.8%). Almost half of the participants had history of hand warts. Most of the participants with lesions were male, aged up to 40, right-handed and had worked as meat handlers for 2 years at least. We might infer we found cases of wart-like occupational dermatosis among butchers at a supermarket in São Paulo.

Clinical correlation of patch testing in suspected Allergic Contact Dermatitis

Allergic contact dermatitis (ACD) is the classic presentation of delayed type hypersensitivity response to exogenous agents.(1) Rapid urbanization, westernization of lifestyles, poor quality of objects available and extremely relaxed vigilance on adherence to product safety guidelines make any developing country like India highly susceptible to allergic contact dermatitis (ACD).(2) ACD affects social, occupational and psychological performance of an individual and adds to the morbidity. It accounts for 20% of the occupational dermatoses encountered in clinical practice . (3) The best treatment for ACD is avoidance of further exposure to the initiating allergen. This makes the identification of the allergen important. Patch test remains the standard test for the diagnosis and identification of ACD . (4) This study was conducted to identify the various presentations of ACD and to correlate the patch test results with the clinically suspected allergen. An attempt was also be made to identify the most common allergen in the study population.

Contact sensitization of children: a two-decade years history in Naples

Contact sensitization (CS) and allergic contact dermatitis (ACD) were once thought to be rare in children. The aim of our study was to assess CS and ACD in children affected by eczematous conditions referring to our contact and occupational dermatoses service, and to compare the obtained data to the results of a similar study performed in our Department in late Eighties. A retrospective analysis of Patch Test data from the Database of Contact Allergy of the Department of Dermatology, University Federico II of Naples, was performed. Moreover results were compared to previous data recorded and analyzed in our center. Of the 416 examined patients, tested during 2005-2010 with the pediatric series, 37.5% developed at least one positive reaction, 15.4% was diagnosed with ACD. The most common allergen was nickel sulphate (16.8%) and the most frequently involved body sites were head and neck (16.3%). Compared to the 1989 study data, our current results highlighted an increase of CS (P<0.001) and ACD diagnosis (P<0.01). ACD and CS are significantly increased during the last 20 years in our young patients population. The widespread chemical use and premature adult-like attitude may be responsible for earlier and extended exposure to sensitizers.

Dermatoses among automobile mechanics in Mansoura, Egypt

ABSTRACTThis cross-sectional study was carried out in Mansoura, Egypt to assess the prevalence of occupational dermatoses and their possible risk factors on a convenience sample of car mechanics. Sociodemographic and occupational data were collected, and clinical examination was done. Prevalence of skin diseases was 45.4% and that of exclusively occupational skin diseases was 9.2%. Irritant contact dermatitis, eczema, and tar/oil acne were the most common types (4.6%, 3.1%, 3.1%, respectively). The logistic regression analysis revealed that the risk of occupational dermatoses increased significantly with lack of use of personal protective equipment, longer duration of work, and presence of workplace chemicals (adjusted odds ratio [95% CI] were 7.2 [2.7, 19.0], 4.3 [1.7, 10.9], and 3.7 [1.3, 10.5], respectively). Health education and safety measures are essential for prevention and control of hazardous workplace practices and exposure.

Occupational dermatoses: An Asian perspective

Occupational dermatoses contribute to a significant portion of work-related diseases, especially in Asia, where a major portion of the workforce is in the unorganized sector. This review article is focussed on the frequency and pattern of occupational skin diseases reported across Asian countries and type of allergens implicated in different occupations. The literature was searched systematically using key words 'occupational dermatoses,' 'occupational skin disease' and name of each Asian country. Ninty five full-text articles were considered relevant and evaluated. Some of the dermatoses seen in industrial workers in Asian countries are similar to those in Western countries, including dermatoses due to chromate in construction and electroplating workers, epoxy resin, and chromate in painters, wood dust in workers in the furniture industry, azo dyes in textile workers and formaldehyde and chromates in those working in the leather and dyeing industries, dermatoses in domestic workers, chefs and health-care workers. Dermatoses in workers engaged in agriculture, beedi (tiny cigars) manufacture, agarbatti (incense sticks) production, fish processing, carpet weaving, sanitation and those working in coffee plantations and coal mines appear to be unique to Asian countries. Recognition of clinical patterns and geographic variations in occupational skin diseases will provide an impetus to further strengthen future research in these areas, as well as improving their management.

Occupational Dermatoses among Cottage Industry Workers of Kashmir Valley in North India.

Introduction:Cottage industry is usually a small-scale industry operated from home by family members using their own equipment. Kashmir has a unique cottage industry of its own which deals with production of many handicrafts, which may lead to a peculiar pattern of skin diseases in these artisans. Aim: The aim of this study was to find out the pattern of skin disorders in the cottage industry workers of Kashmir valley, with primary focus on the occupation-related dermatoses and to identify the most common cutaneous manifestation in these workers.Materials and Methods:This was a cross-sectional descriptive study in which 1062 cottage industry workers engaged in different crafts were screened. A detailed history taking and examination was carried out in each worker and the diagnosis was made on clinical grounds. Wherever deemed necessary, relevant investigations were done to establish the nature of the disease.Results:A total of 1062 workers were evaluated for the presence of skin disorders. The male-to-female ratio was 1:1.5. The mean age of the study group was 30.3 years ± 10.79 years, with maximum number of workers (164) belonging to the crewel embroidery industry. The mean duration of work was 6.4 ± 2.08 hours/day. A total of 953 workers (89.7%) had cutaneous manifestations, with callosities being the most common finding seen in 371 workers (35%), followed by cumulative insult dermatitis seen in 201 workers (19%).Conclusion:Cottage industry of Kashmir valley is a unique occupational group where a high percentage of workers had cutaneous manifestations related to their occupation, with callosities being the most common finding. Information and better knowledge regarding these dermatoses are important in devising strategies to improve the health scenario of these workers. Simple measures such as proper use of instruments, use of protective gloves, guarded use of chemicals, and hand washing may be very beneficial in reducing the burden of health problems in these workers.

Pattern of Skin Diseases and Occupational Dermatoses in Veterinarians and Veterinary Workers of Kashmir.

Background:Across the globe, skin disorders represent a frequent occupational concern for many health professionals including veterinarians and there is a serious impact of skin diseases on their lives and careers. But little is known about the prevalence and distribution of skin diseases (especially occupational) within this important professional group across Asia, especially India.Materials and Methods:The study was a cross-sectional study carried out over a period of one year in which veterinarians and veterinary workers of Kashmir valley were screened for various skin diseases and occupational dermatoses.Results:The study group comprised 910 veterinarians and associated workers working across the valley with the majority being males; 846 workers (93%). The mean age of the group was 38.53 years. Out of these, 267 veterinarians and associated workers (29.3%) were found to have skin lesions. Of the 267 cases, 165 (61.80%) had non-infectious lesions, while the rest had 102 (38.20%) had infectious skin diseases. The main non-infectious lesions included friction-related disorders, eczemas, pigmentary disorders, papulosquamous disorders, and many others; while the infectious lesions were of fungal, bacterial, viral, and parasitic etiology. Fungal infections, eczemas, and melasma were more common in them, indicating an occupational etiology.Conclusion:A huge group of skin diseases was seen in veterinarians and veterinary workers, with some diseases showing an occupational nature. To reduce the burden of skin diseases in this particular group, proper prevention measures need to be instituted at work places by veterinary governing bodies of the state.

Patch Test Results from an Occupational and Contact Dermatitis Clinic in a Tertiary Care Hospital of Southern India: A Retrospective Study.

Occupational contact dermatitis, accounting for 95% of cases of occupational dermatoses, is the most common occupational skin disease. To find out the various allergens in different occupational and environmental settings causing contact allergy, from our patients presented with contact dermatitis. It was a retrospective study from the data in hospital outpatient register over one year period, which includes patients with age ranging from 11 years to 73 years. Patch test was done with total of 24 allergens from Indian standard battery and Indian standard series and with materials suspected to cause contact allergy. Result was expressed in terms of percentage. Contact dermatitis constitutes about 0.75% of total dermatological cases in our Dermatology Outpatient Department. A total of 358 contact dermatitis were included in this study with M:F ratio 2.25:1 and majority of the cases in the age group of 26-55 years. Out of 358 cases, 157 cases were positive to at least one allergen. Building construction workers constitute about 35.75% (128 cases) of total contact dermatitis cases, among which potassium dichromate (39 out of 57) is the most common allergen, followed by nickel (31) and cobalt (28). In other occupations, contact allergy to parthenium, hair dye, foot wear, paint, kum-kum, turmeric, detergents and cosmetics were also present in significant number and none was positive for vegetables, dettol, kerosene and native medication. This study gives an idea about the common occupation and population who are prone to develop contact dermatitis in our environmental setting and also about the most common sensitizers involved in various occupation and environment.