Contact Dermatoses in Metal Workers

Abstract

We studied 150 metal workers occupationally exposed to metals and metalworking fluids (MWFs) to determine the prevalence and nature of contact dermatitis. 150 office workers were used as non-exposed control group. Questionnaires were administered to evaluate occupational and non-occupational exposure. All subjects underwent a dermatological examination and patch-testing with standard allergen series and MWFs used in the plant. Twenty-eight metal workers (18.6 %) presented minor skin disorders involving the hands (vs. only 2% of the controls), ten (6.6%) had major disorders (similar to the figure for the control group -5.4%), and 112 (74.8%) had no lesions, as opposed to 92.6% of the control group. Positive patch tests were found in ten metal workers: eight had major skin disorders (six to nickel, cobalt and chromium, one to nickel and cobalt, one to nickel) and the remaining two were asymptomatic (one positive for nickel and chromium, one for nickel). Among the controls there were three cases of positivity, all among asymptomatic subjects. Patch tests with MWFs were negative. The prevalence of dermatoses among the metal workers was significantly higher than that of controls (p < 0.01), and all cases of allergy in this group were provoked by metals themselves. In spite of the high level of automation currently used in the metal industry, the prevalence of occupational diseases among metal workers remains high. The most common disorders are those involving the skin, in most cases dermatitis provoked by contact with metalworking fluids (MWFs) and metals themselves. MWFs are oils or oil-based emulsions used for lubricating and cooling the cutting edge of tools, elimination of metal chips and refinishing the surface of the final product. The neat, or insoluble, oils used during the first part of this century, have been almost completely replaced by oil-in-water emulsions (l). The composition of these fluids is complex, and they often contain a number of additives (e.g., emulsifiers, preservatives, corrosion inhibitors, biocides, antifoaming agents, hard-water stabilizers, dyes, fragrances) (2). They may also contain contaminant metals such as nickel (3), chrome (4) or cobalt (5) that leak into the oil during use. All of the above substances can be irritants and / or sensitizers (6, 7), provoking various types of cutaneous symptoms mainly on the hands and arms.A few attempts have been made to determine the actual prevalence of dermatoses among metal workers (6,8) 0394-6320 (2000)

Self‐reported skin symptoms in metal workers

“…It is possible that some of those with severe symptoms had already left their work prior to the present study. The 1‐year prevalence of HD among metal workers in this study was higher than in machine‐tool operators in a Swedish cross‐sectional study (15), whereas current eczema was reported less frequently than what was found in 2 other cross‐sectional studies on machinists (16, 22). In the report by Sprince et al (16), the risk of dermatitis was associated with the use of semisynthetic MWF versus the use of soluble oil MWF.…”

A survey of occupational hand eczema in Denmark

“…Nickel allergy from work tools and metalworking were frequent causes in both sexes. It has been shown that nickel in significant amount may be released from tools (15) and metalworkers are known to have an increased risk of nickel allergy (16, 17). In a recent study of OSD comprising mainly hand eczema cases, nickel was found to be the most common sensitizer, but showing an occupational relevance in only 11% of the cases sensitized (9).…”

Lymphocyte subset changes in blood and gastrointestinal mucosa after oral nickel challenge in nickel‐sensitized women

“…Nickel is a ubiquitous metal present in many items and objects, thus favouring sensitization. It has been reported that about 10-15% of women and 2-3% of men living in industrialized countries are nickel sensitive (1)(2)(3) and may develop allergic contact dermatitis. Contact with nickel occurs through the skin and/or gastrointestinal mucosa by the ingestion of certain foods.…”