Screening survey of ocular, nasal, respiratory and skin symptoms in manicurists in Poland.

OBJECTIVES: Manicurists are exposed to various chemicals in nail and skin care products and may develop ocular, nasal, respiratory or skin adverse reactions to them. To investigate the occurrence of ocular, nasal, respiratory and skin problems among manicurists and to identify their causal factors, particularly allergic etiology and occupational origin. MATERIAL AND METHODS: Manicurists employed in beauty salons in the central region of Poland were invited to fill in the questionnaire and undergo medical examination, skin prick tests with common aeroallergens, patch tests with European Baseline Series and (Meth)Acrylates Series-Nails and spirometry. RESULTS: In the questionnaire adverse nasal symptoms were reported by 70%, ocular - by 58%, respiratory - by 42%, hand eczema - by 43% of manicurists. In the medical interview, the frequency of those complaints was lower: nasal ones - 41%, ocular - 24%, cough - 18%, hand skin dryness - 20%, hand eczema - 6%. Cough and hand skin dryness occurred significantly more frequently than in the case of controls. Contact allergy was found for 41% of manicurists and 35% of controls. The prevalence of nickel sensitization was high in both groups (38% and 27%, respectively). Only 3 manicurists reacted to (meth)acrylates. The frequency of atopic diseases was similar in compared groups. Irritant nasal and respiratory reactions were significantly more prevalent among manicurists (nasal - 18% vs. 2%, p < 0.01; respiratory - 18% vs. 1%, p < 0.001). Work-related nasal irritant reactions were finally diagnosed for 19%, ocular ones - for 13%, respiratory - for 18% and within hand skin - for 23% of manicurists. CONCLUSIONS: The frequency of workattributed irritant mucosal and skin symptoms among manicurists is high. Exposure to acrylates is an important source of mucosal irritant reactions while occlusive gloves cause irritation of hand skin. The prevalence of nickel allergy among Polish females is high. Int J Occup Med Environ Health 2017;30(6):887-896.

ESSCA results with the baseline series, 2002-2012: p-phenylenediamine.

BACKGROUND: Allergic contact dermatitis caused by p-phenylenediamine (PPD) is common among all age groups and both sexes. Monitoring of prevalence and intensity of sensitization is important. OBJECTIVE: To evaluate contact allergy to PPD in Europe, and to compare reaction intensities in different European regions. METHODS: Data collected by the European Surveillance System on Contact Allergies (ESSCA) network between 2002 and 2012 from 12 European countries were analysed regarding prevalence, grading of positive reactions to PPD, and relevance. RESULTS: A total of 99 926 PPD-positive patients from 63 departments were included for analysis. The overall (2002-2012) prevalence of PPD sensitization in Europe is ∼4%. Stratified for country, the highest overall standardized prevalence was found in Lithuania, and the lowest in Slovenia. The prevalence of PPD sensitization did not decline over the years. In the southern European countries, higher numbers of strong and extremely strong reactions were registered. The clinical relevance of PPD sensitization varied from half to three-quarters. CONCLUSION: The prevalence of PPD sensitization has not changed over time. Strong and extremely strong patch test reactions are seen more often in the South, probably because of the higher number of PPD-containing hair dye products.

ESSCA results with the baseline series, 2009-2012: rubber allergens.

BACKGROUND: Allergic contact dermatitis caused by rubber allergens is common, and causes significant patient morbidity. Contemporary data are important to allow appropriate preventive measures and identification of contact allergy trends. OBJECTIVES: To describe the pattern of patch test reactivity to rubber allergens, including those in the European baseline series. METHODS: Data collected by the European Surveillance System on Contact Allergies (ESSCA) network between 2009 and 2012 from 12 European countries were analysed. RESULTS: Contact allergy to thiuram mix declined over the studied time period, with an overall prevalence of 1.87%. The prevalence of allergy to carba mix was 2.29%, and was significantly increasing. Prevalence rates of sensitization to other rubber allergens were largely unchanged. Statistical analysis with the MOAHLFA index confirmed the strong links between rubber allergy and occupational hand dermatitis. CONCLUSIONS: Changing patterns of allergy to rubber additives have been identified. Inclusion of carba mix in the European baseline series may be appropriate.

[Preservatives as important etiologic factors of allergic contact dermatitis]. / Konserwanty jako istotne czynniki etiologiczne alergicznego kontaktowego zapalenia skóry.

BACKGROUND: Preservatives present in cosmetics and other industrial products can cause allergic contact dermatitis. The aim of the study was to assess the frequency of allergy to selected preservatives in consecutive patients examined due to contact dermatitis in the Nofer Institute of Occupational Medicine, Lódz, and to establish whether individuals sensitized to formaldehyde react simultaneously to formaldehyde releasers. MATERIAL AND METHODS: A group of 405 patients (308 females and 97 males) was examined in 2011-2013. In all participants patch tests with a series of 13 preservatives (paraben mix, formaldehyde, Quaternium 15, chloromethylisothiazolinone/methylisothiazolinone mix, methyldibromoglutaronitrile, diazolidinyl urea, imidazolidinyl urea, DMDM hydantoin, 2-bromo-2-nitropropane-1,3-diol, iodopropynyl butylcarbamate, benzalkonium chloride, sodium metabisulfite, produced by Chemotechnique Diagnostics, Sweden) were performed. RESULTS: Of the 405 patients 74 (including 52 females) showed positive results of patch tests. Contact allergy to at least 1 preservative was noted in 47 (11.6%) patients, including 34 (11%) females and 13 (13.4%) males. Methylisothiazolinone proved to be the most frequent sensitizer--4.7% (5.2% females, 3.1% males) while parabens, 2-bromo-2-nitropropane-1,3-diol and imidazolidinyl urea (0.2%) were found to be the least frequent. Fourteen (3.4%) participants, 10 women and 4 men, were allergic to formaldehyde and/or formaldehyde releasers. In 11 (78.6%) of them monovalent hypersensitivity was observed. In 13 (3.2% of the examined group) patients allergy to preservatives might have been of occupational origin. CONCLUSIONS: Preservatives, particularly isothiazolinones, are significant causal factors of allergic contact dermatitis, including occupational cases. Individuals sensitized to formaldehyde may react simultaneously to formaldehyde releasers, however, such reactions are relatively rare.

Occupational allergic and irritant contact dermatitis in workers exposed to polyurethane foam.

OBJECTIVES: To evaluate sensitization to chemicals present in work environment after an outbreak of contact dermatitis in workers of vehicle equipment factory, exposed to polyurethane foam, based on 4,4'-diphenylmethane diisocyanate (MDI). MATERIAL AND METHODS: From among 300 employees, 21 individuals reporting work-related skin and/or respiratory tract symptoms underwent clinical examination, patch testing, skin prick tests, spirometry and MDI sIgE measurement in serum. Patch tests included isocyanates series, selected rubber additives, metals, fragrances, preservatives, and an antiadhesive agent. RESULTS: Clinical examination revealed current eczema in the area of hands and/or forearms in 10 workers. Positive patch test reactions were found in 10 individuals, the most frequent to diaminodiphenylmethane and 4-phenylenediamine (7 persons). Reactions to an antiadhesive agent were assessed as irritant (5 workers). Except for sensitization to common aeroallergens, no significant abnormalities were found in the remaining tests. Occupational allergic contact dermatitis was diagnosed in 7 workers, irritant contact dermatitis in 10 and coexisiting allergic and irritant contact dermatitis in 3 workers. CONCLUSIONS: In workers manufacturing products from polyurethane foam, attention should be paid to the risk of developing contact dermatitis. Skin problems in our study group were attributable probably to insufficient protection of the skin.

[Isothiazolinones as causal factors of contact allergy epidemics in the 20th and 21st centuries]. / Izotiazolinony jako przyczyna epidemii alergii kontaktowej XX i XXI wieku.

Chloromethylisothiazolinone (MCI) and methylisothiazolinone (MI) have been widely used as preservatives in cosmetics, household products and industrial products since the late 1970s. First cases of contact allergy to the MCI/MI combination were noted in 1980-1982 in Sweden. Then, a significant increase in the frequency of sensitization to these compounds was observed in many European centers. The increase has been stopped by the introduction of legislation on their maximum concentrations in consumer and industrial products in Europe and in some non-European countries. But approval of the use of MI alone without limits in industrial products (from 2000) and at a maximum concentration of 100 ppm in cosmetics (from 2005) resulted in an unprecedented increase in the number of individuals sensitized to this compound. Allergic contact dermatitis due to MI occurs in both adults and children. It is often manifested by severe symptoms, which may be also induced by airborne exposure. The most important sources of sensitization include cosmetic products and paints. To counteract the increasing problem of contact allergy epidemic to MI, the recommendations have been developed, suggesting the ban on the use of MI in "leave-on" cosmetics and maximum concentration of 15 ppm in "rinse-off" products. The recommendations are likely to be implemented in 2014.

[Impact of wet work on epidermal barrier (tewl and stratum corneum hydration) and skin viscoelasticity in nurses]. / Wplyw mokrego srodowiska pracy na wybrane parametry bariery naskórkowej (tewl i zawartosc wody w naskórku) oraz lepkosprezystosc skóry u pielegniarek.

BACKGROUND: Nurses are prone to develop hand eczema due to occupational exposure to irritants, including wet work. The aim of the study was to evaluate the impact of wet work on selected skin properties, reflecting epidermal barrier function--transepidermal water loss (TEWL) and stratum corneum hydration--and additionally skin viscoelasticity, in nurses. MATERIAL AND METHODS: Study subjects included 90 nurses employed in hospital wards. Measurements were carried out within the dorsal aspect of the dominant hand, using a Cutometer MPA 580 equipped with Tewameter TM 300 and Corneometer CM 825 (Courage & Khazaka, Germany) probes. Examina- tions took place on hospital premises. Similar measurements were performed in the control group of females non-exposed to irritants. RESULTS: In the examined group of nurses, mean TEWL was 15.5 g/h/m2 and was higher than in the control group (12.99 g/h/m2). After rejecting the extreme results, the difference between the groups proved to be statistically significant (p < 0.05). The mean value of stratum corneum hydration was lower in the examined group (37.915) compared with the control group (40.05), but the difference was not sta tistically significant. Also results of viscoelasticity assessment showed no significant differences between studied groups. CONCLUSIONS: The results of the assessment of skin biophysical properties show that wet work exerts a moderately adverse impact on skin condition. A higher TEWL value and a lower stratum corneum hydration in workers exposed to irritants reflect an adverse impact of these factors on the epidermal barrier function.

[Adverse cutaneous reactions induced by exposure to woods]. / Niepozadane reakcje skórne spowodowane kontaktem z materialem drewnianym.

Various adverse cutaneous reactions may occur as a result of exposure to wood dust or solid woods. These include allergic contact dermatitis, irritant contact dermatitis and, more rarely, contact urticaria, photoallergic and phototoxic reactions. Also cases of erythema multiforme-like reactions have been reported. Contact dermatitis, both allergic and irritant, is most frequently provoked by exotic woods, e.g. wood of the Dalbergia spp., Machaerium scleroxylon or Tectona grandis. Cutaneous reactions are usually associated with manual or machine woodworking, in occupational setting or as a hobby. As a result of exposure to wood dust, airborne contact dermatitis is often diagnosed. Cases of allergic contact dermatitis due to solid woods of finished articles as jewelry or musical instruments have also been reported. The aim of the paper is to present various adverse skin reactions related to exposure to woods, their causal factors and sources of exposure, based on the review of literature.

[Manicurists and pedicurists - occupation group at high risk of work-related dermatoses]. / Manikiurzystki i pedikiurzystki jako grupa zawodowa o istotnym ryzyku dermatoz zwiazanych z prac.

In recent years occupational skin and respiratory diseases have been more and more frequently diagnosed in small production and service enterprises. The awareness of occupational exposure and its possible health effects among their workers and employers is not sufficient. Beauty salons, in addition to hairdressers and beauticians, frequently employ manicurists and pedicurists. The workers often happen to perform various activities interchangeably. the health status of beauty salons workers has rarely been assessed. The most numerous reports concern hairdressers. In this occupational group, the occurrence of skin lesions induced by wet work and frequent allergy to metals, hair dyes and bleaches and perm solutions has been emphasized, while information about health hazards for being a manicurist or pedicurist in beauty salons is seldom reported. The aim of this paper is to present professional activities (manicure and pedicure, methods of nail stylization), occupational exposure and literature data on work-related adverse health effects in manicurists and pedicurists. Wet work and exposure to solvents, fragrances, resins, metals, gum, detergents may cause skin disorders (contact dermatitis, urticaria, angioedema, photodermatoses), conjunctivitis, anaphylaxis, respiratory tract diseases, including asthma. The discussed occupations are also associated with the increased incidence of bacterial (particularly purulent), viral and fungal infections and cancer.

Allergy to orthopedic metal implants - a prospective study.

OBJECTIVES: Evaluation of the allergenic properties of the metal knee or hip joint implants 24 months post surgery and assessment of the relation between allergy to metals and metal implants failure. MATERIALS AND METHODS: The study was conducted in two stages. Stage I (pre-implantation) - 60 patients scheduled for arthroplasty surgery. Personal interview, dermatological examination and patch testing with 0.5% potassium dichromate, 1.0% cobalt chloride, 5.0% nickel sulfate, 2.0% copper sulfate, 2.0% palladium chloride, 100% aluminum, 1% vanadium chloride, 5% vanadium, 10% titanium oxide, 5% molybdenum and 1% ammonium molybdate tetrahydrate were performed. Stage II (post-surgery) - 48 subjects participated in the same procedures as those conducted in Stage I. RESULTS: Stage I - symptoms of "metal dermatitis" were found in 21.7% of the subjects: 27.9% of the females, 5.9% of the males. Positive patch test results were found in 21.7% of the participants, namely to: nickel (20.0%); palladium (13.3%); cobalt (10.0%); and chromium (5.9%). The allergy to metals was confirmed by patch testing in 84.6% of the subjects with a history of metal dermatitis. Stage II - 10.4% of the participants complained about implant intolerance, 4.2% of the examined persons reported skin lesions. Contact allergy to metals was found in 25.0% of the patients: nickel 20.8%, palladium 10.4%, cobalt 16.7%, chromium 8.3%, vanadium 2.1% Positive post-surgery patch tests results were observed in 10.4% of the patients. The statistical analysis of the pre- and post-surgery patch tests results showed that chromium and cobalt can be allergenic in implants. CONCLUSIONS: Metal orthopedic implants may be the primary cause of allergies. that may lead to implant failure. Patch tests screening should be obligatory prior to providing implants to patients reporting symptoms of metal dermatitis. People with confirmed allergies to metals should be provided with implants free from allergenic metals.

Tissue reaction to the nickel implants in the guinea pigs.

OBJECTIVES: The aim of the study was the assessment of local tolerance to nickel implants during 9 months observation in guinea pigs sensitized to nickel before implantation and non-sensitized ones. MATERIALS AND METHODS: Three groups of guinea pigs were included in the study: 10 sensitized to nickel by the guinea pig maximization test; 10 previously non-sensitized and 10 in control group. In 20 animals (except control group) the nickel implants were inserted in the muscle of the back. After 9 months of observation, the animals were patch-tested with 5% nickel sulfate. Also percentage of eosinophils in peripheral blood was examined. Next, the tissue surrounding the implant and skin from the area of patch tests were collected for the histological examination. RESULTS: In 70% of previously sensitized animals, the patch test confirmed the sensitivity to nickel. In 60% of previously non-sensitized animals, a positive reaction to nickel occurred. The results of patch tests in control group were negative. Percentage of eosinophils in peripheral blood was fourfold higher in animals sensitized to nickel than in control group. In histological examination, in the tissue surrounding the implant a dissimilarity concerning the intensity of cellular infiltration was observed between animals previously allergic and non-allergic to nickel. In the 2 of 10 previously sensitized guinea pigs quite severe inflammatory reactions in the inside of connective tissue capsule were noted which may indicate a local allergic reaction. The histological images of skin collected from the positive patch test site corresponded with the typical allergic contact dermatitis. CONCLUSIONS: Nickel implants may cause primary sensitization to nickel. The nature of the histological changes in the tissues around the implants in guinea pigs sensitized to nickel may correspond to an allergic reaction. The examination of percentage of eosinophils in blood of guinea pigs may be useful in assessing the allergenic activity of metal alloys containing nickel.