Work-related Contact Dermatitis Research Articles

How Allergists Can Perform an Occupational History in Every Patient

The occupational history is often neglected in the routine evaluation of new patients with asthma, chronic rhinitis or dermatologic complaints. Such omissions are inadvertent because work related conditions are often not prioritized. There also may be lack of awareness of the scope of respiratory or cutaneous allergens capable of inducing occupational asthma (OA) or work-related contact dermatitis. Evidence exists suggesting that the occupational history is often neglected among primary care physicians and specialists. Failure to diagnose OA in a timely fashion by identifying occupational sources of exposure, for example, may result in unnecessary morbidity in workers whose exposure is not modified. In this commentary, we propose a brief intake survey to be administered to all patients coming to an allergy practice to quickly screen for possible work-related respiratory symptoms and another for occupational dermatitis. This would require minimal physician time and could be self-administered at the initial encounter and incorporated into the medical record. A positive response to either surveys should trigger a more detailed evaluation by the allergy specialist. More detailed approaches for stepwise clinical evaluation of the worker suspected of OA and contact dermatitis are discussed.

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%).

Trends in occupational and work-related contact dermatitis attributed to nickel, chromium and cobalt in the UK: findings from The Health and Occupation Research network 1996-2019.

Occupational exposure to metals such as nickel, chromium and cobalt can be associated with contact dermatitis, which can adversely affect an individual's health, finances and employment. Despite this, little is known about the incidence of metal-related occupational contact dermatitis over prolonged periods of time. To investigate the medically reported trends in the incidence of work-related contact dermatitis attributed to nickel, chromium and cobalt in the UK. Incidence and trends in cases of occupational contact dermatitis caused by nickel, chromium or cobalt between 1996 and 2019 (inclusive), reported to the EPIDERM surveillance scheme, were investigated and compared with trends in the incidence of occupational contact dermatitis attributed to agents other than the aforementioned metals. A sensitivity analysis restricting the study cohort to cases attributed to only one type of metal was also conducted. Of all cases reported to EPIDERM during the study period, 2374 (12%) were attributed to nickel, chromium or cobalt. Cases predominantly comprised females (59%), with a mean (SD) age (males and females) of 38 (13) years. Cases were most frequently reported in manufacturing, construction, and human health and social activity industries. The most frequently reported occupations were hairdressing, and sales and retail (assistants, cashiers and checkout operators). The highest annual incidence rate of contact dermatitis was observed in females (2.60 per 100 000 persons employed per year), with the first and second peak seen in those aged 16-24 and ≥ 65 years, respectively. A statistically significant decrease in the incidence of occupational contact dermatitis attributed to metals over the study period was observed for all occupations (annual average change -6.9%, 95% confidence interval -7.8 to -5.9), with much of the decrease occurring between 1996 and 2007. Similar findings were obtained in the sensitivity analyses. Over a period of 24 years, there has been a statistically significant decline in the incidence of metal-related occupational contact dermatitis in the UK. This could be attributed not only to improvements in working conditions, which have reduced metal exposure, but could also be due to the closure of industries in the UK that might have generated cases of contact dermatitis owing to metal exposure.

Work-related contact dermatitis: interest of an occupational medicine approach in the clinical pathway

Work-related contact dermatitis is frequent and might reduce the professional activity. Through the presentation of a clinical situation and its handling, this article shows the added value of an occupational medicine intervention. This procedure integrating a field observation has shown useful solutions after the medical handling and the maintenance of employment, although they were not always where we expected them.

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

ObjectiveThis 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...

FACTORS RELATED TO COMPLAINTS OF CONTACT DERMATITIS AMONG MOTORCYCLE MECHANICS IN THE SOUTH AND NORTH KEMBANGAN AREAS, JAKARTA IN 2021

Background: Occupational contact dermatitis is an inflammation of the skin caused by materials found in the work environment. Purpose: To determine the factors associated with Complaints of Occupational Contact Dermatitis among Motorcycle Workshop Workers in the Kelurahan Kembangan Selatan and Kembangan Utara, Jakarta in 2021. Method: This research is a descriptive-analytic study with a cross-sectional study design. The population of this research is motorcycle repair workers in the southern and northern Kembangan villages amounted 78 workers. The sample in this study amounted to 35 samples of workshop workers with Quota sampling technique. The method of collecting data from the source of information used is in the form of primary data using measuring instruments in the form of questionnaires and observation sheets. Result: The proportion of workers who complained of work-related contact dermatitis were 13 workshop workers (37.1%). Conclusion: Based on the results of statistical tests, it is known that the variable associated with occupational contact dermatitis is the age (p-value 0.004) and working period (p-value 0.005) with complaints of occupational contact dermatitis in motorcycle repair workers in the Kembangan Selatan and Kembangan Utara sub-districts, meanwhile not related between length of contact (p-value 0.282), personal hygiene (p-value 0.689) and the use of PPE (p-value 0.519) with complaints of occupational contact dermatitis in motorcycle repair workers in the Kembangan Selatan and Kembangan Utara areas, Jakarta.

A Qualitative Study to Identify Characteristics of a Desirable Training Program for Prevention of Occupational Skin Disease.

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. To understand workers' experiences and preferences for workplace training and barriers and facilitators to training. 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. 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. These findings can help to shape more effective workplace training programs for skin protection.

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

Skin-specific training experience of workers assessed for contact dermatitis.

Contact dermatitis is a common and preventable work-related disease. Skin-specific training may be effective for preventing occupational contact dermatitis, but little information is available regarding actual workplace training and its effectiveness. To describe workplace skin-specific training among workers with suspected contact dermatitis. Patch test patients being assessed for suspected contact dermatitis at an occupational health clinic in Toronto, Canada, completed a questionnaire on training experiences, workplace characteristics, exposures and skin protection practices. Of 175 patients approached, 122 (71%) workers completed questionnaires. Many (80%) had received general occupational health and safety and hazardous materials training (76%). Fewer (39%) received skin-specific training. Of those with work-related contact dermatitis, 52% did not receive skin-specific training. Skin-specific training was commonly provided by health and safety professionals or supervisors using video, classroom and online techniques. Content included glove use, exposure avoidance and hand washing information. Workers that received skin-specific training found it memorable (87%), useful (85%) and common sense in nature (100%). This study indicates gaps in workplace training on skin disease prevention for workers with contact dermatitis. Workers perceived skin-specific training to be useful. Understanding worker training experiences is important to prevention programme development and reducing work-related skin disease.

Protection when under attack

We get under the skin of work-related contact dermatitis – the most common form of skin disease in the dental team

Prevention of Occupational Contact Dermatitis

This article reviews the scientific research concerning occupational contact dermatitis and the related methods of prevention. The information provided herein clarifies some difficulties involved in the confirmation of diagnoses and creating strategies for prevention. Occupational skin diseases, most of which are contact dermatitis arising from exposure to a culpable agent, constitute more than 35% of all work-related disorders. Contact dermatitis can be classified as either the irritant or the unfavorably allergic type. Each type has an alternate pathogenesis, while the clinical presentation is the same. Once the hazardous elements that cause work-related contact dermatitis are identified, the dermatitis can be controlled in some patients. However, in other patients, it can be chronic and disabling. Failure to follow the outlined preventive programs will lead to high rates of occupational contact dermatitis.

S1 guideline on occupational skin products: protective creams, skin cleansers, skin care products (ICD 10: L23, L24)--short version.

Job-related hand dermatitis heads up the list of reported occupational diseases. So-called skin products - understood to mean protective creams, skin cleansers and skin care products - are used for the primary and secondary prevention of job- related hand dermatitis. In the interests of evidence-based medicine, the only preventive measures and/or occupational skin products that should be used are those whose potential uses and efficacy are underpinned by scientific research. To this end, the Arbeitsgemeinschaft für Berufs- und Umweltdermatologie e.V. (Working Group for Occupational and Environmental Dermatology, ABD) of the DDG (German Dermatological Society) and the Deutsche Gesellschaft für Arbeits- und Umweltmedizin (German Society for Occupational and Environmental Medicine, DGAUM) have summed up the latest scientific findings and recommendations in the updated guideline. The benefit of the combined application of protective creams and skin care products in the primary and secondary prevention of work-related contact dermatitis has been widely confirmed by recent clinical-epidemiological studies. The guideline clearly explains the necessity of demonstrating the efficacy of protective creams and cleansing products by means of in vivo methods in the sense of repetitive applications. Transferable standardised testing systems designed to examine the irritation potential and thus the compatibility of occupational skin cleansers and the reduction of irritation by protective skin creams have now been developed and validated by multicentre studies for skin protection creams and cleansers. The status of the current assessment of the safety of occupational skin products is also summarised.

Cases of occupational dermatitis and asthma in beauticians that were reported to The Health and Occupation Research (THOR) network from 1996 to 2011.

Beauticians are exposed to many potential allergens in their occupation. To identify the sources of occupational skin and respiratory disease reported in beauticians, with an emphasis on acrylate chemicals, and to investigate the trends over time. We used the Health and Occupation Research (THOR) database to identify occupational disease in beauticians between 1996 and 2011. Trend analysis was carried out to look for any change in the allergens reported over this period. In total, 257 cases of contact dermatitis (CD) in beauticians were identified, which were associated with 502 suspected agents. The most frequently cited source of allergic CD was acrylate chemicals. The trend analysis showed a small average annual percentage increase in work-related CD in beauticians for all agents (1.1%; 95% CI -2.5 to 4.9). There was a small decrease in cases in which acrylates were not cited (-1.7%; 95% CI -5.9 to 2.7), and a statistically significant increase when acrylates were cited (7.4%; 95% CI 0.9 to 14.4). There were 11 cases of occupational asthma. We found an increase in cases of occupational dermatitis associated with acrylates in beauticians over a 15-year period, and describe other causes of occupational dermatitis.

Health Care Services Use by Workers with Work-Related Contact Dermatitis

There is little information in the literature regarding the use of health care services by workers with occupational contact dermatitis. The objective of the study was to describe the use of health care services by workers with occupational contact dermatitis. One hundred workers with hand dermatitis were enrolled and observed for 6 months after assessment at St. Michael's Hospital (Toronto, ON, Canada). Information was collected at the time of diagnosis and 6 months after the assessment. Questionnaires were administered to collect information about clinical presentation and the use of health services. A diagnosis of occupational contact dermatitis was made for 78 of the workers. By the time of assessment at the Occupational Health Clinic at St. Michael's Hospital, almost all of the workers had seen their family doctor for their skin problem, and 71% had seen a dermatologist. Although family doctors and dermatologists asked the workers to identify their occupation, they rarely asked about workplace exposures, and the physicians provided minimal advice about job change or modification on return to work. During the 6 months following diagnosis, 62% of the workers saw their family physicians in follow-up, but rarely was advice about job change or modification provided at these follow-up visits. This descriptive information suggests that there are gaps in health services for patients with work-related skin disease and that there is a need for refinement of the delivery of health services related to occupational disease. A redesign of the occupational health care delivery system to address these issues and an evaluation of new models seem appropriate.

Allergic contact dermatitis from dicyclohexylmethane-4,4'-diisocyanate.

From August 1999 to April 2001, there was an outbreak of severe eczema at a factory manufacturing medical equipment. A glue, mainly based on the isocyanate dicyclohexylmethane-4,4'-diisocyanate (DMDI), was suspected as being the cause of the problem. 16 workers with recent episodes of eczema were patch tested with a standard series, an isocyanate series and work material. The latter consisted of, among other things, the glue, DMDI, and an amine, dicyclohexylmethane-4,4'-diamine (DMDA), which is formed when DMDI reacts with water. 13 patients reacted to DMDI, 9 to 1,6-hexamethylenediisocyanate (HDI) and 4 to isophoronediisocyanate (IPDI), all of which are aliphatic isocyanates. None reacted to the aromatic isocyanates, diphenylmethane-4,4'-diisocyanate (MDI) or toluenediisocyanate (TDI). One explanation for this pattern could be that aromatic diisocyanates are more reactive than the aliphatic ones and that, therefore, they are inactivated before penetrating the skin. 5 patients reacted to DMDA and 5 to 4,4'-diaminodiphenylmethane (MDA). Concurrent reactions to DMDA and or MDA with DMDI could be due to cross-reactivity. The positive reactions to MDA could also be a marker of MDI exposure. Yet another patient, investigated in 1997 with suspected work-related contact dermatitis from the glue, is described. She, however, showed no positive reactions to any isocyanates.

Survey of symptoms, respiratory function, and immunology and their relation to glutaraldehyde and other occupational exposures among endoscopy nursing staff

OBJECTIVESTo find the nature and incidence of symptoms experienced by a large sample of hospital endoscopy nurses. To find whether nurses in endoscopy units develop asthma under current working conditions...

Contact Dermatitis in the Textile Industry: A Review of 72 Patients

Background: Occupational skin disease can cause significant morbidity in textile industry workers. Both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) have been reported. Objective: The purpose of this study was to characterize and determine the relative frequency of work-related ACD and ICD in textile workers. Methods: Seventy-two textile industry workers seen during a 5-year period were evaluated for possible work-related contact dermatitis. All patients underwent patch testing with a screening series. Many patients (70%), depending on occupational exposures, also underwent testing with a textile dye and finish series and additional patch tests of specific workplace materials. Results: Twenty-one patients (29%) were diagnosed as having a predominantly work-related ACD. Relevant allergens included textile dyes, textile finishes, and rubber allergens. Twenty-seven patients (38%) were diagnosed as having primarily a work-related ICD. Five patients (7%) were believed to have combined work-related ACD and ICD. Nineteen patients (26%) were believed to have purely non-work-related allergens, irritants, atopy, or other dermatoses as the major factors in their skin disease. The hands were the most common site of involvement. Of the 40 patients with occupational exposure to raw textile products, 36 (90%) had a work-related dermatitis and only 4 (10%) had a non-work-related dermatitis. Conclusion: In the 72 textile workers evaluated in our clinic, occupational exposures were an important cause of skin disease (74% in our series). Textile workers with job exposures to raw textile materials are at highest risk for work-related dermatitis. Textile industry workers with essentially no textile product exposure were more likely to have non-work-related dermatoses. ICD was only slightly more frequent than ACD. The hands were the most common site of involvement. Because relevant allergens (work-related and non-work-related) were more common than expected, we emphasize the importance of patch testing with standard screening allergens in the diagnostic evaluation of patients with dermatitis who work in the textile industry. In addition, textile dye and finish allergens should also be tested in this patient population, particularly those patients with any textile product exposure.

Contact dermatitis in the textile industry: a review of 72 patients

Background: Occupational skin disease can cause significant morbidity in textile industry workers. Both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) have been reported. Objective: The purpose of this study was to characterize and determine the relative frequency of work-related ACD and ICD in textile workers. Methods: Seventy-two textile industry workers seen during a 5-year period were evaluated for possible work-related contact dermatitis. All patients underwent patch testing with a screening series. Many patients (70%), depending on occupational exposures, also underwent testing with a textile dye and finish series and additional patch tests of specific workplace materials. Results: Twenty-one patients (29%) were diagnosed as having a predominantly work-related ACD. Relevant allergens included textile dyes, textile finishes, and rubber allergens. Twenty-seven patients (38%) were diagnosed as having primarily a work-related ICD. Five patients (7%) were believed to have combined work-related ACD and ICD. Nineteen patients (26%) were believed to have purely non-work-related allergens, irritants, atopy, or other dermatoses as the major factors in their skin disease. The hands were the most common site of involvement. Of the 40 patients with occupational exposure to raw textile products, 36 (90%) had a work-related dermatitis and only 4 (10%) had a non-work-related dermatitis. Conclusion: In the 72 textile workers evaluated in our clinic, occupational exposures were an important cause of skin disease (74% in our series). Textile workers with job exposures to raw textile materials are at highest risk for work-related dermatitis. Textile industry workers with essentially no textile product exposure were more likely to have non-work-related dermatoses. ICD was only slightly more frequent than ACD. The hands were the most common site of involvement. Because relevant allergens (work-related and non-work-related) were more common than expected, we emphasize the importance of patch testing with standard screening allergens in the diagnostic evaluation of patients with dermatitis who work in the textile industry. In addition, textile dye and finish allergens should also be tested in this patient population, particularly those patients with any textile product exposure.

Contact Dermatitis in the Textile Industry: A Review of 72 Patients

Background: Occupational skin disease can cause significant morbidity in textile industry workers. Both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) have been reported. Objective: The purpose of this study was to characterize and determine the relative frequency of work-related ACD and ICD in textile workers. Methods: Seventy-two textile industry workers seen during a 5-year period were evaluated for possible work-related contact dermatitis. All patients underwent patch testing with a screening series. Many patients (70%), depending on occupational exposures, also underwent testing with a textile dye and finish series and additional patch tests of specific workplace materials. Results: Twenty-one patients (29%) were diagnosed as having a predominantly work-related ACD. Relevant allergens included textile dyes, textile finishes, and rubber allergens. Twenty-seven patients (38%) were diagnosed as having primarily a work-related ICD. Five patients (7%) were believed to have combined work-related ACD and ICD. Nineteen patients (26%) were believed to have purely non-work-related allergens, irritants, atopy, or other dermatoses as the major factors in their skin disease. The hands were the most common site of involvement. Of the 40 patients with occupational exposure to raw textile products, 36 (90%) had a work-related dermatitis and only 4 (10%) had a non-work-related dermatitis. Conclusion: In the 72 textile workers evaluated in our clinic, occupational exposures were an important cause of skin disease (74% in our series). Textile workers with job exposures to raw textile materials are at highest risk for work-related dermatitis. Textile industry workers with essentially no textile product exposure were more likely to have non-work-related dermatoses. ICD was only slightly more frequent than ACD. The hands were the most common site of involvement. Because relevant allergens (work-related and non-work-related) were more common than expected, we emphasize the importance of patch testing with standard screening allergens in the diagnostic evaluation of patients with dermatitis who work in the textile industry. In addition, textile dye and finish allergens should also be tested in this patient population, particularly those patients with any textile product exposure.