The Eastern European experience on occupational skin diseases. Make underreporting an issue?

Moldovan, Horațiu; Voidăzan, Septimiu; John, Swen-Malte; Weinert, Patricia; Moldovan, Geanina; Vlasiu, M.A.; Szász, Zsuzsánna Ágnes; Ţiplica, George‐Sorin; Szasz, Simona; Marin, A; Sălăvăstru, Carmen

doi:10.1111/jdv.14315

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…Additionally, in an unprecedented effort, WHO is currently conducting together with the International Labour Organisation (ILO) a global disease burden assessment of occupational sUVR‐inflicted skin cancers . Many of the reasons for the gross underreporting of occupational skin cancers may be the same as extensively discussed recently in a large survey regarding the lack of notifications of work‐related contact dermatitis in various south and east European countries, including bureaucratic hurdles, time‐consuming forms, high workloads and no availability of financial incentives for doctors and patients . Furthermore, at least in Italy, as it happens for other occupational diseases, usually the majority of cases are reported by occupational physicians, but skin cancers often appear when persons are in their retirement age, so that they have no access to the workers’ health surveillance performed by these doctors …”

Section: Discussionmentioning

confidence: 85%

“…9 Many of the reasons for the gross underreporting of occupational skin cancers may be the same as extensively discussed recently in a large survey regarding the lack of notifications of work-related contact dermatitis in various south and east European countries, including bureaucratic hurdles, time-consuming forms, high workloads and no availability of financial incentives for doctors and patients. 33 Furthermore, at least in Italy, as it happens for other occupational diseases, usually the majority of cases are reported by occupational physicians, but skin cancers often appear when persons are in their retirement age, so that they have no access to the workers' health surveillance performed by these doctors. 12 Other possible explanations of this large underreporting may be related to the roles and relations of the employers and employees in the companies, and are a common problem for all the occupational diseases.…”

Section: Discussionmentioning

confidence: 99%

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Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy

Gobba

Modenese

John

2019

Acad Dermatol Venereol

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Background Solar UV radiation (sUVR) is one of the main carcinogen exposures in occupational settings, and UV‐induced skin cancers are the most frequent tumours in fair‐skinned individuals worldwide. Objectives According to this premise, we should expect a high number of occupational skin cancers reported to the national workers’ compensation authorities each year, also considering that the incidence of skin cancers has been constantly increased in recent years Methods We examined the data on reported non‐melanoma skin cancers (NMSC) and actinic keratoses (AK) to the Italian National Workers Compensation Authority (INAIL) from 2012 to 2017, and we compared the number of reported skin cancers for outdoor workers with the expected numbers, obtained from currently available NMSC incidence rates for the Italian population applied to the occupational sUVR‐exposed workers estimated with the CAREX methodology in Italy in 2005. Results The cases of NMSC reported each year to INAIL in Italy are 34 per year on average, while for AK the mean number of reported cases is of only 15/year. We estimated a number of expected NMSC cases in Italy for solar UV‐exposed workers ranging between 432 and 983, representing a proportion between reported vs. expected skin cancers of only 3.5–6.2%. Conclusions Our study clearly shows that occupational skin cancers in Italy are largely underreported, and, accordingly, urgent initiatives should be taken to raise appropriate awareness to the problem of occupational sUVR‐induced skin cancers, so that adequate preventive measures can be implemented rapidly.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy

Gobba

Modenese

John

2019

Acad Dermatol Venereol

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“…Despite representing a significant economic burden for the public health system, occupational skin diseases are still not adequately taken care of at national and European level, due to lack of awareness among patients, physicians and regulators, insufficient and inadequate safety and health legislation, patients' fear of job loss, as well as lack of time and motivation [28]. Work-related exposures in agriculture are extremely complex and difficult to measure, while diseases from the spectrum of eczema are hard to differentiate and frequently overlap.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for work-related eczema and urticaria among vocational students of agriculture

Śpiewak¹,

Góra-Florek²,

Horoch³

et al. 2017

Ann Agric Environ Med.

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Introduction and objective. Farmers are at high risk of occupational skin diseases which may start already during vocational training. This study was aimed at identification of risk factors for work-related skin diseases among vocational students of agriculture. Materials and method. The study involved 440 students (245 males, 195 females aged 17-21 years) in 11 vocational schools which were at least 100 km from each other. The protocol included a physician-managed questionnaire and medical examination, skin prick tests, patch tests, total IgE and Phadiatop. Logistic regression model was used for the identification of relevant risk factors. Results. Work-related dermatoses were diagnosed in 29 study participants (6.6%, 95%CI: 4.3-8.9%): eczema in 22, urticaria in 14, and co-existence of both in 7 students. Significant risk factors for work-related eczema were: history of respiratory allergy (OR=10.10; p<0.001), history of eczema (itchy rash) provoked by wet work and detergents before entering the school (OR=5.85; p<0.001), as well as history of contact dermatitis to metals, rubber or cosmetics prior to inscription (OR=2.84; p=0.016), and family history of any skin disease (OR=2.99; p=0.013). Significant risk factors for work-related urticaria were: history of allergic rhinitis and asthma prior to inscription (OR=7.29; p=0.006), positive skin prick tests to work place allergens (OR=4.65; p=0.002) and to environmental allergens (OR=3.79; p=0.009), and positive Phadiatop test (OR=3.61; p=0.013). Conclusions. Work-related skin diseases are common among vocational students of agriculture. Atopy, past history of asthma, allergic rhinitis, and eczema (either atopic, allergic or irritant) are relevant risk factors for work-related eczema and urticaria in young farmers, along with family history of any skin disease. Positive skin prick tests seem relevant, especially in the case of urticaria. Asking simple, aimed questions during health checks while enrolling students into agricultural schools would suffice to identify students at risk for work-related eczema and urticaria, giving them the chance for selecting a safer profession, and hopefully avoiding an occupational disease in the future.

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“…In Germany, powdered natural rubber latex (NRL) gloves were banned and technical regulations on the use of low-allergen, powder-free NRL were implemented resulting in a steady decline of reported cases of suspected NRL allergy. [25][26][27][28] [21][22][23] Voss et al 24 demonstrate how the underlying health care and insurance systems and procedures affect disease notification, patient management and compensation of OSD cases.…”

Section: Political Systemmentioning

confidence: 99%

“…These might also affect underreporting of OSD cases which is a huge and common problem in many European countries. [25][26][27][28]…”

Section: Political Systemmentioning

confidence: 99%

The implementation of knowledge dissemination in the prevention of occupational skin diseases

Wilke

Bollmann

Cazzaniga

et al. 2017

Acad Dermatol Venereol

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Systematic knowledge dissemination is important to make OSD prevention more effective and to close the gap between research and practice. This study provides guidance to identify stakeholders, strategies and dissemination channels for systematic knowledge dissemination which need to be adapted to country-specific structures, for example the social security system and healthcare systems. A key for successful knowledge dissemination is building linkages among different stakeholders, building strategic partnerships and gaining their support right from the inception phase of a project.

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The Eastern European experience on occupational skin diseases. Make underreporting an issue?

Cited by 14 publications

References 22 publications

Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy

Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy

Risk factors for work-related eczema and urticaria among vocational students of agriculture

The implementation of knowledge dissemination in the prevention of occupational skin diseases

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