Tertiary prevention of occupational skin diseases: Prevalence of allergic contact dermatitis and pattern of patch test results

Abstract

Background Allergic contact dermatitis (ACD) is one of the most common occupational skin diseases (OSDs). Its prevalence and the causative allergens differ between occupations. Objectives To evaluate the prevalence of ACD and the pattern of patch test results of patients taking part in a tertiary individual prevention programme (TIP) for OSD in Germany. Patients and Methods In a retrospective cohort study, the data of 3411 TIP patients patch tested between 2007 and 2016 were analysed. Results In 2687 (78.8%) patients, work‐related skin disease was diagnosed, mostly hand dermatitis. The highest proportion of face dermatitis was seen in painters (8.1%). ACD was most common in painters (56.8%), hairdressers (45.8%), construction workers (31.5%), gardeners/florists (26.7%), and metalworkers (26.5%). On average, hairdressers had the youngest age (31.4 ± 12.6 years, P < 0.0001) and the shortest time in the profession prior to the TIP (mean 13.7 years). The pattern of patch test reactivity showed occupation‐specific differences related to work exposures. Conclusions Identification of occupational groups at risk for ACD and relevant allergens may help in the development and implementation of targeted prevention strategies. Our data suggest that there should be a particular focus on hairdressers and painters.

Occupational contact dermatitis in Triveneto: Analysis of patch test data of the North Eastern Italian Database from 1996 to 2016

“…Regarding the sites of occurrence, in agreement with previous studies, 3,8,51,59 we observed that OCD had a much higher proportion of hand involvement than non‐OCD (76.6% vs. 36.1%, OR 5.79; 95% CI 5.17–6.48), whereas leg and face dermatitis was rare. Among persons with OCD there were no significant differences regarding hand and leg localization between genders, whereas women had a significantly higher frequency of face dermatitis than men.…”

“…Regarding the diagnosis, we find that ACD is predominant in our population (56.5% vs 43.5%) with a slightly higher proportion, as compared to ICD, among individuals with OCD (OR 1.14; 95%CI 1.04–1.26). Generally, ICD is the most common type of CD reported in literature, accounting for 60–80% of all CD, while ACD accounts for the remaining 20–40%, 6,41,51 but the proportion may vary widely across studies, depending on the occupations that prevail and the hazards to which people are exposed, the centers that report cases, and differences in the diagnostic criteria 4,5,52,53 . In comparison, a previous Italian study from Sertoli et al found that ACD clearly predominates over ICD (64,4% vs 34,6%, respectively) 14 .…”

“…Considerable sex differences were observed in most of the industrial activities. In particular, cleaners, hairdressers, barbers and beauticians, and healthcare workers were confirmed as occupational categories with a highly female dominance, whereas construction workers were a strictly male category 9,51,57,64,65 …”

“…As already highlighted in several studies, even in our population, hairdressers were the youngest working category among those at high risk for OCD (mean age 27.1 ± 11.7 years). Probably the high amount of wet work and the exposure to strong sensitizers, especially during apprenticeship, results in an early onset of occupational dermatitis in this occupation 49,51,58 …”

Contact Allergy—Emerging Allergens and Public Health Impact

“…Awareness of workers is often underdeveloped, for instance, concerning contact with contaminated surfaces such as benches, clothing and tools [168]. Epoxy resin systems are known to cause face dermatitis [169] either via airborne contact or accidental exposure, e.g., in painters who are often sensitised to these (and to isothiazolinones which may also cause airborne ACD) [170].…”