Occupational skin diseases (OSDs) often have considerable medical and occupational consequences. Previous data on prognostic factors have been derived from studies with fairly small sample sizes.
To determine the medical and occupational outcome in 1048 patients diagnosed with OSD at the Finnish Institute of Occupational Health and to identify the prognostic risk factors for the continuation of OSD.
Patients examined in 1994-2001 filled out a follow-up questionnaire 6 months after the diagnosis. Data on atopy, contact allergies, and occupation were analysed.
Six months after the diagnosis the skin disease had healed in 27% of the patients. The OSD had cleared up in 17% of those with no changes at work, and in 34% of those who had changed their job/occupation. The best clearing had occurred in the patients with contact urticaria (35%), whereas the healing of allergic (27%) and irritant (23%) contact dermatitis was similar. The risk factors for continuing occupational contact dermatitis (OCD) were no changes in work, age > 45 years, food-related occupations, respiratory atopy, and male sex.
The healing of OSD was associated with discontinuation of the causative exposure. A change in work and the presence of easily avoidable work-related allergies were associated with a good prognosis.
Databases for monitoring patients with contact dermatitis have become indispensable for managing a constantly increasing variety of products which cause allergic and toxic dermatitis. As a result of collaboration between the Department of Dermatology and Department of Information Technology, Ullevål Hospital, we now have developed a database for registering patients with occupational dermatitis. The programming tool is DataEase, which contains files for the patients' personal data, site of the dermatitis, results of tests and diagnosis.
Octylisothiazolinone is a biocide that has been reported as a moderate, but rare contact allergen.
To investigate the occurrence of octylisothiazolinone contact allergy and allergic contact dermatitis diagnosed and registered in the Allergen Bank at Odense University Hospital during the past 20 years. Octylisothiazolinone has been used for targeted testing only.
All octylisothiazolinone-patch test results registered in the Allergen Bank between January 1992 and February 2012 were analyzed.
A total of 20 out of 648 patients patch tested with octylisothiazolinone had positive reactions. The majority of the patients (90%) with relevant sensitizations to octylisothiazolinone had been exposed in occupational settings and most patients were painters.
Routine patch testing with sesquiterpene lactone (SL) mix, supplemented with Compositae mix (CM) and other Compositae extracts and allergens where appropriate, was evaluated over an 8-year period. 190 of 4386 patients tested (4.3%) were Compositae-sensitive, 143 females (mean age 51.5 years) and 47 males (mean age 55 years), and 83% of reactions considered clinically relevant. 22% were suspected of occupational sensitization/dermatitis. 62% had a contact allergy to 2 or more compounds, most often to nickel, fragrance and colophonium. SL mix detected 65%, CM 87% of Compositae-allergic patients, and the overall detection rate with both mixes was 93%. Few irritant reactions and no cases of clear-cut active sensitization were recorded with the mixes, but our results emphasize the importance of differentiating late-appearing reactivation reactions from patch test sensitization. The weakly positive CM reactions could reflect some irritancy, but as they were associated with fragrance and/or colophonium allergy to a higher degree than weakly positive SL mix reactions, they probably represented cross-reactions. In conclusion, the detection rate with SL mix was high enough to support its continued use as a screening mix and it was very well and rather safely supplemented by aimed testing with CM.
AIMS: Health problems associated with indoor environments have been reported and discussed extensively during the past few decades, not least in Sweden. There is, however, great uncertainty concerning the background prevalence of the symptoms in question. The main objective of the present study was to investigate the prevalence of general, mucosal, and skin symptoms in the Swedish population. METHODS: A survey comprising 3,000 randomly selected Swedes, age 18-64, was carried out. The survey addressed 25 symptoms, principally general, mucosal, and skin symptoms. A number of other areas were covered and individual data registered at Statistics Sweden were added. The response rate was 70% (2,154 cases). RESULTS: The prevalence of symptoms in the Swedish population was found to accord with results in studies based on different kinds of samples. Women reported significantly more single symptoms, as well as sets of symptoms, than men. There was no clear connection between age and symptoms. The prevalence of symptoms was slightly lower among employees compared with non-workers. Office workers did not report symptoms related to "sick building syndrome" (SBS) more frequently than employees not working in offices. SBS symptoms, skin symptoms, and symptoms similar to those reported by individuals with "electric hypersensitivity" were significantly more prevalent among employees with extensive VDU usage. CONCLUSIONS: The prevalence of reported health complaints accords with that which has been found in previous studies. The background prevalence reported here can serve as a reference for further studies. The high prevalence of symptoms among individuals with extensive VDU usage gives cause for further studies.
Can simultaneous contact allergies to phenyl glycidyl ether and epoxy resins of the bisphenol A/F-types be explained by contamination of the epoxy resins?
Simultaneous contact allergies to epoxy resins based on diglycidyl ether of bisphenol A (DGEBA-R) or epoxy resins of the bisphenol F-type and the reactive diluent phenyl glycidyl ether (PGE) have been reported. The reason might be cross-reactivity, exposure to an epoxy resin system with PGE as a component, or contamination by PGE in the epoxy resin.
To study contamination by PGE, 20 commercial epoxy resins were analysed for the presence of PGE. To study contact allergy to PGE and its relation to epoxy resins by inserting PGE in the standard series.
Among 2227 patients, 7 reacted to PGE. Of 23 (30%) patients, 7 with contact allergy to DGEBA-R and 7/19 (37%) with contact allergy to an epoxy resin of the bisphenol F-type reacted to PGE. All 7 patients with contact allergy to PGE reacted both to the DGEBA-R and to the epoxy resin of the bisphenol F-type. PGE was found in 90% of the investigated resins. The amounts of PGE ranged between 0.004% w/w and 0.18% w/w.
Most probably, the presence of PGE as a contaminant in epoxy resins is of minor importance for the sensitization, but possibly the contamination of PGE might elicit contact dermatitis in individuals with a high reactivity to PGE.
Studies on the prevalence of hand dermatitis in construction painting are rare. Our aim was to study the painters' chemical exposure and the prevalence of self-reported skin symptoms on hands and forearms. A cross-sectional questionnaire survey was conducted on 1000 Finnish male construction painters and 1000 carpenters (response rates 60.6% and 60.4%, respectively). We used 2 definitions for symptom-based hand dermatitis (liberal > or = 2 symptoms and strict criteria > or = 3) and logistic regression analysis, adjusted with age and atopy. Painters reported more symptoms of hand dermatitis than carpenters (12-month prevalence 22.5% and 14.2%, P
The combined diagnosis of allergic and irritant contact dermatitis in a retrospective cohort of 1000 consecutive patients with occupational contact dermatitis.
The diagnosis of combined allergic and irritant contact dermatitis is an accepted subdiagnosis for hand dermatitis, and it is often considered in a patient with contact dermatitis, a positive and relevant patch test result, and wet work exposure. We therefore hypothesize that it is arbitrary for wet work exposure to be taken into consideration in a patient with newly diagnosed relevant contact allergy. Furthermore, an overestimation of the diagnosis will probably occur if the criteria for wet work exposure are applied correctly, as many occupations have an element of wet work.
To find the statistically expected number of combined allergic and irritant contact dermatitis cases in 1000 patients, and to evaluate the diagnostic criteria for the diagnosis.
One thousand consecutive patients with occupational contact dermatitis from a hospital unit in Denmark were assessed.
The expected number of cases with the diagnosis of combined allergic and irritant contact dermatitis was 0.33%, as compared with the observed number of 6.4%. Females occupied in wet occupations were often diagnosed with combined allergic and irritant contact dermatitis (p
Protein contact dermatitis is a frequent disorder among hand eczema patients who have occupational food contact. Knowledge about the consequences of having protein contact dermatitis is lacking.
To investigate the consequences of having occupational skin disease on the hands resulting from food handling, with a focus on protein contact dermatitis.
One hundred and seventy-eight patients who were identified as having skin disease related to occupational food exposure and who answered a questionnaire concerning the consequences of their skin disease were included in the study. The patients were consecutively examined at Gentofte Hospital, Denmark between 2001 and 2010.
Seventy-five per cent of patients with protein contact dermatitis had to wear gloves at work, and 62.5% reported sick leave lasting for >3 weeks, as compared with 60.2% and 30%, respectively, of the patients with other occupational food-related hand dermatoses (p = 0.02). Sixty-two per cent and 43%, respectively, had to change job because of skin problems (p = 0.02). Atopic dermatitis was equally common in the two groups.
We found that the patients with protein contact dermatitis experienced more severe and frequent consequences than patients with other food-related hand dermatoses.
