[Information value of lipid peroxidation parameters in patients with occupational allergic dermatoses].

Evaluation of lipid peroxidation in patients with occupational allergic dermatoses revealed activation of free radical oxidation. Serum levels of diene conjugates and end products of free radical lipid peroxidation appeared to be informative parameters for assessing influences on body system and for estimating the disease severity and the individual protective means efficiency.

Principles and methodology for translation and cross-cultural adaptation of the Nordic Occupational Skin Questionnaire (NOSQ-2002) to Spanish and Catalan.

BACKGROUND: Occupational skin diseases are among the most frequent work-related diseases in industrialized countries. The Nordic Occupational Skin Questionnaire (NOSQ-2002), developed in English, is a useful tool for screening of occupational skin diseases. OBJECTIVES: To culturally adapt the NOSQ-2002 to Spanish and Catalan and to assess the clarity, comprehension, cultural relevance and appropriateness of the translated versions. METHODS: The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) principles of good practice for the translation and cultural adaptation of patient-reported outcomes were followed. RESULTS: After translation into the target language, a first consensus version of the questionnaire was evaluated in multiple cognitive debriefing interviews. The expert panel introduced some modifications in 39 (68%) and 27 (47%) items in the Spanish and Catalan version, respectively (e.g. addition of examples and definitions, reformulation of instructions and use of direct question format). This version was back translated and submitted to the original authors, who suggested a further seven and two modifications in the Spanish and Catalan versions, respectively. A second set of cognitive interviews were performed. A consensus version of both questionnaires was obtained after final modifications based on comments by the patients. CONCLUSIONS: The final versions of the Spanish and Catalan NOSQ-2002 questionnaires are now available at www.NRCWE.dk/NOSQ.

The hardening phenomenon in irritant contact dermatitis: an interpretative update.

Irritant contact dermatitis (ICD) is common and poses a significant problem in high-risk populations. In most cases, ICD resolves despite continued exposure in a process known as 'hardening', allowing individuals to continue with their work. Those who cannot clear ICD develop chronic ICD, which is a significant source of emotional, physical, and financial distress for affected individuals. While hardening is well known among labourers and clinicians, its mechanism remains to be elucidated. Much can be learned from the study of self-healing processes like the hardening phenomenon. This overview briefly documents the pathogenesis of ICD, focuses on the latest advances pertaining to the hardening phenomenon in ICD, and then highlights potential avenues of productive research. A better understanding of the 'hardening' process in the skin will hopefully lead to advances for the treatment of ICD.

The validity and reliability of the occupational contact dermatitis disease severity index.

BACKGROUND: The occupational contact dermatitis disease severity index (ODDI) was designed to assess the severity and importantly the functional disability caused by occupational contact dermatitis (OCD) of the hands in patients attending our occupational dermatology clinic. OBJECTIVES: To investigate the accuracy of the ODDI. PATIENTS/METHODS: Of 205 patients, 95 were assessed as having OCD of the hands. Content validity was assessed by content mapping and expert opinion. Construct validity was examined through comparing the ODDI against global clinical dermatology severity assessment (GCDSA). Intraobserver reliability, interobserver reliability, internal consistency, acceptability and convenience were also assessed. RESULTS: The ODDI was found to have content validity by the experts and was moderately correlated with GCDSA, supporting construct validity (Pearson's r = 0.54; P < or = 0.01). The ODDI was shown to be reliable with substantial agreement for both intraobserver reliability [intraclass correlation coefficient (ICC) = 0.62] and interobserver reliability (ICC = 0.75). Internal consistency within the ODDI was almost perfect (ICC = 0.94-0.99) and user survey showed the ODDI to be acceptable, easy and quick to use. CONCLUSIONS: The ODDI is a valid and reliable instrument to assess the severity and functional limitations caused by OCD, in patients who have had treatment or modified work duties, associated with some improvement of their dermatitis.

[Expert opinion on occupational skin diseases: a Munich statement regarding the Bamberg medical bulletin (Bamberger Merkblatt)]. / Begutachtung von Berufskrankheiten der Haut: Eine Münchner Stellungnahme zum Bamberger Merkblatt.

The Bamberg medical bulletin (Bamberger Merkblatt) is intended to assure as an anticipated expert opinion an objective as possible assessment of the sequels of an occupational disease. However, the Bamberg medical bulletin is not suitable for this task in form and content. In case of an allergic contact dermatitis recognized under No. 51 01 in appendix 1 of the German ordinance on occupational diseases the disadvantage for the insured person consists mainly in the live-long existing change of the immune system and not as much in the intensity of the skin condition triggered by a new exposure to the allergen. The prerequisite for compensation imposed by the regulator, i.e. that the skin condition must be so severe as to have forced the affected individual to refrain from all activities which led or could lead to the development, aggravation or recurrence of the condition, is in its function as a typing sign widely unnecessary in the case of an allergic occupational dermatosis. The omission of all activities which led or could lead to the development, aggravation or recurrence of the condition imposed on the affected individual by the regulator has to be taken in account for the calculation of the reduction in earning capacity in the Bamberg medical bulletin. The Bamberg medical bulletin is by no means an anticipated expert opinion. Even as a qualified experience it urgently needs a revision which might be done with, but not governed by, the statutory occupational accident insurance. Our critical scientific comments do not absolve the medical evaluator from the responsibility to consider existing recommendations as the Bamberg medical bulletin. Our aim is to initiate a process leading to an appropriate judgement of the sequels of an occupational skin disease in each individual case.

Occupational dermatoses.

PURPOSE OF REVIEW: All terms referring to job-related (occupational) rashes are clearly defined. Ranking as the second most common occupational disorder, the importance of occupational dermatoses is illustrated. RECENT FINDINGS: 90-95% of occupational dermatoses result from a contact-type dermatitis. Until recently, 4/5 cases were believed to be of the irritant, rather than allergic type of contact dermatitis, however, with more extensive patch testing, more than half the cases were found to be allergic. SUMMARY: The direct causes of occupational dermatoses: chemical, mechanical, physical, and biological in nature are presented. The implications of assigning the degree and type of occupational dermatoses are explained. Workmans compensation is based on a no-fault arrangement, stating that unrestricted treatment and compensation is allowable only when negligence on the part of the employer is proven. Employee benefits are then determined by the duration and degree of disability sustained - all of which becomes litigational. Predisposing host factors, i.e. intellectual ability, anatomic site, atopy, skin pigmentation, age of skin, and immunosuppression (by disease or medication) are usually ignored. Environmental factors at the workplace must be considered conducive to occupational diseases. The full spectrum of irritant contact dermatitis is discussed with examples of each described. Allergic contact dermatitis and patch testing - the gold standard for identification of putative allergens is extensively discussed. Differentiating irritant contact dermatitis from allergic contact dermatitis is elucidated. The other non-contact type skin reactions are briefly mentioned.

An investigation of the effect of prolonged glove wearing on the hand skin health of dental healthcare workers.

OBJECTIVES: Glove wearing during patient treatment has been central to dental surgery infection control for over 15 years. However, little is known about the cutaneous effects of glove wearing on the hands of dental healthcare workers (DHCWs). The objective of this project was to assess the hand skin health of DHCWs before and after wearing gloves of two types and to compare this with a control group of non-DHCWs. METHODS: Following a mailing to all dentists in the West of Scotland, 50 DHCWs who wore gloves during dental treatment procedures for a minimum of 8h daily for at least 4 days per week were invited to participate in the project. The control group comprised 25 subjects who did not routinely use surgical or examination gloves. Hands were assessed by clinical examination and by transepidermal water loss at baseline, 1 month and 3 months. RESULTS: Of the 50 DHCWs, 26 wore a non-powdered latex glove (Microtouch Powder-free: Johnson and Johnson, Arligton, TX, US), and 24 wore a nitrile glove (Hartalega SDN BHD, Malaysia) from the time of the baseline examination until the 3-month examination. No differences were observed in hand skin health between the control group and the DHCWs at baseline, nor between those wearing the latex or nitrile gloves during the 3 month period of the study. CONCLUSION: It is concluded that the hand skin health of the DHCWs examined were no different from those of a control group of non-DHCWs, and that the wearing of the two types of gloves used in the 3 month study had no significant effect.

The effect of the working environment on occupational skin disease development in workers processing rockwool.

Our examinations involved 259 workers (46 females and 213 males) manufacturing insulation matting of rockwool and phenol-formaldehyde resin. The control group included 529 people. All of the subjects were patch-tested. The age-adjusted relative risk was used as a measure for evaluating the increase in the incidence of dermatitis and allergy to metals. An atomic absorption method was used to determine metal content in rockwool. Dermatitis was found in every fourth subject examined, oil acne in every tenth subject; 7.3% of the subjects examined were found to be allergy-positive to nickel, 6.9% to chromium, 5.0% to cobalt, 3.1% to formaldehyde, 1.5% to phenol-formaldehyde resin, 0% to phenol. Out of the 39 subjects examined twice (in 1988 and 1990), 5 were found to be allergy-positive to nickel during the second examination. A statistically significant increase in the risk of incidence of occupational dermatitis and allergy to nickel and cobalt was found in people producing insulation products made of rockwool. The latter material was found to contain 200 ppm chromium, 88 ppm nickel and 29 ppm cobalt.

A descriptive profile of eczema in a tertiary dermatological referral centre in Singapore.

A retrospective study of 25,448 new cases of patients with various types of eczemas seen over a two-year period (1989-1990) was conducted. This represented 34.1% of new cases (74,589) seen at the Centre. The M:F ratio was 1:1. Occupational and ethnic distribution did not differ from that of the total outpatient population. 67% were endogenous eczema. Among the endogenous eczema, the majority (70%) were either non-specified endogenous eczema, hand and feet eczema or atopic dermatitis. 13.7% were contact dermatitis. Of these, 50% were non-specified contact dermatitis, 39% were irritant contact dermatitis and 11% were allergic contact dermatitis. Unskilled workers (19.1%) and housewives (12%) had the highest proportion for contact dermatitis. Exfoliative dermatitis (0.5% of all eczemas) was commonest among the elderly (68.3%) and Malays (19.7%). The prevalence of endogenous eczema had increased sharply from 31% in 1973 to 67% in 1989/90. In contrast, the proportion of exogenous eczemas over all eczemas seen has decreased from 48% to 15.4% (1973 to 1989/90).

Infection control in South African oral hygiene practice.

OBJECTIVE: The aim was to gain information about the practice of infection control in oral hygiene practice. METHODS: A questionnaire based on OSHA and CDC guidelines was submitted to oral hygienists who attended a refresher course followed by a second posted questionnaire seeking information about hand hygiene practice. The questions were directed to observance of personal protection by oral hygienists and the application of procedures required for infection control in the surgery. RESULTS: 87.5% wore face masks but the proper use of facial protection, overcoats and disposable overcoats was reported by fewer than 50%. A total of 97% wore gloves and 88% changed gloves between patients. Skin reactions to gloves were reported by 26%. Only 7% had not been vaccinated against hepatitis B. The correct procedures for sterilising equipment and instruments were carried out by fewer than 50%, and 57% of participants wanted an improvement of infection control arrangements in their workplace. CONCLUSION: It is concluded that a need exists for proper practice of infection control by oral hygienists which can be remedied by interceptive and preventive education and peer pressure.

Occupational dermatosis.

Occupational Dermatosis is described as any alteration in the skin, mucosa or annexes that is directly or indirectly caused, conditioned, maintained or aggravated by agents present in the occupational activity or work environment. The authors of the present study describe the importance of the topic and the epidemiology and etiopathogeny of the main forms of occupational dermatoses: allergic and irritative contact dermatitis, phytodermatitis, acne (elaioconioses and chloracne), keratosis, cancers, foreign body granuloma, infections, onychias, and ulcerations. Clinical findings of occupational dermatosis are presented in relation to various professions. Laboratory tests used to diagnose this condition are analysed, with special emphasis on patch testing, which is the gold standard. Information about the treatment and prevention of this disorder is provided. Collective and individual measures, especially regarding the proper use of individual protection equipment for the prevention of occupational dermatosis, are detailed.

Occupational asthma and dermatitis induced by eugenol in a cleaner

No disponible

Hand dermatitis/eczema: current management strategy.

Ever since its inception a couple of centuries ago, hand dermatitis/eczema has been in the reckoning. Idiosyncrasies continued to loom large thereafter, till it acquired its appropriate position. Dermatitis/eczema are synonymous, often used to indicate a polymorphic pattern of the inflammation of the skin, characterized by pruritus, erythema and vesiculation. A spectrum delineated into acute sub-acute and chronic dermatitis of the hands. Pompholyx, recurrent focal palmer peeling, ring, wear and tear and fingertip eczema, apron, discoid eczema, chronic acral dermatitis, gut and patchy papulosquamous eczema are its clinical variants. Occupational dermatitis/eczema may be contributory. Etiological definitions are clinched by detailed history of exogenous and endogenous factors. However, scientific confirmation of the entity is through patch testing by using available antigens.

Patients with occupational contact dermatitis in Israel: quality of life and social implications.

One of the most common occupational diseases is skin disease caused as a result of contact with work-related materials or exacerbated by them. Although occupational-related skin disease is a common condition, it is not considered to be a serious one and, therefore, has not received satisfactory attention in the psycho-social literature or in the social work profession. In our study, 70 occupational contact dermatitis (OCD) patients were interviewed by telephone regarding psychological, social, economic, and subjective issues related to the disease. All patients reported to be affected in their daily living activities, self-image, economic status, and in their interpersonal relationships in the family. Our study seeks to highlight the problems of this population group and serve as a vehicle to facilitate patient's rights.

Osnabrueck hand eczema severity index--a study of the interobserver reliability of a scoring system assessing skin diseases of the hands.

An easy-to-use standardized instrument is needed for the clinical assessment of the severity of occupational hand eczema by dermatologists as well as occupational physicians. The Osnabrueck hand eczema severity index (OHSI) was developed for this purpose and the interobserver reliability investigated. The clinical severity was evaluated on the basis of the extension or clinical characteristics of six morphological characteristics. For the validation of the OHSI, hand eczema in 28 patients was investigated independently by one dermatologist and 2 occupational physicians. The agreement between the observers was determined by using kappa values, Kendall's coefficient of concordance, the intraclass correlation coefficient (ICC) and the 95% limits of agreement. The ICC for the total OHSI was 0.80 and the estimated limits of agreement (-3.6 and 3.0) were sufficiently small to expect that ratings according to OHSI performed by independent observers of different medical specialities should produce similar results. It could be demonstrated that the use of the OHSI is simple and practicable. The interobserver reliability for the summary score is good. OHSI seems a reliable tool for assessing the severity of occupational hand eczema.

Dermatoses ocupacionais / Occupational dermatosis

Dermatose ocupacional é qualquer alteração da pele, mucosa e anexos, direta ou indiretamente causada, condicionada, mantida ou agravada por agentes presentes na atividade ocupacional ou no ambiente de trabalho. Os autores referem a importância do tema, a epidemiologia e a etiopatogenia das principais dermatoses ocupacionais: dermatites de contato irritativas e alérgicas, fitodermatites, acnes (elaioconiose e cloracne), ceratoses, cânceres, granulomas de corpo estranho, infecções, oníquias e ulcerações. A clínica da dermatose ocupacional é apresentada em diferentes profissões. Analisam-se os exames laboratoriais pedidos nessas dermatoses, com especial destaque para testes de contato, que são o padrão ouro, e fornecem-se dados do tratamento e prevenção; quanto à prevenção da dermatose ocupacional, informam-se as medidas coletivas e individuais, especialmente, no que respeita ao uso adequado dos equipamentos de proteção individual.

Occupational Dermatosis is described as any alteration in the skin, mucosa or annexes that is directly or indirectly caused, conditioned, maintained or aggravated by agents present in the occupational activity or work environment. The authors of the present study describe the importance of the topic and the epidemiology and etiopathogeny of the main forms of occupational dermatoses: allergic and irritative contact dermatitis, phytodermatitis, acne (elaioconioses and chloracne), keratosis, cancers, foreign body granuloma, infections, onychias, and ulcerations. Clinical findings of occupational dermatosis are presented in relation to various professions. Laboratory tests used to diagnose this condition are analysed, with special emphasis on patch testing, which is the gold standard. Information about the treatment and prevention of this disorder is provided. Collective and individual measures, especially regarding the proper use of individual protection equipment for the prevention of occupational dermatosis, are detailed.