接触冷烫精对理发员职业危害的调查

本文报道了对64名接触冷烫精的女理发员健康状况、月经和孕产情况的调查,以及8名理发员尿波动试验所见。结果表明,长期接触冷烫精的女理发员月经异常发生率高于对照人群;理发员尿液对TA_(100)菌株具有明显的诱变活性。认为与冷烫精中存在极易经皮侵入机体的巯基乙酸有关。     

Prevalence of occupational hand dermatitis in U.K. hairdressers

Prevalence of hand dermatitis was investigated in 60 U.K. hairdressing salons. Exposure variables and individual characteristics were examined for associations with prevalence. 38.6% of respondents reported prevalent hand dermatitis and 72.7% of prevalent cases reported interdigital symptoms. Trainee hairdressers reported an increased risk of hand dermatitis, (RR = 2.95, 95% CI = 1.13-7.66), as did those with < or =2 years in the profession (RR = 4.91, 95% CI = 1.09-22.22). There was a positive association between prevalence and frequent use of protective measures (p = 0.04), suggesting that use of protective measures may be a reaction to incidence rather than a precaution. Wet work was significantly associated with prevalence, and RR was increased in those who performed more frequent wet work, i.e., trainee hairdressers. Prevalence was far higher than suggested by the surveillance schemes in the U.K.     

Occupational respiratory symptoms in New Zealand hairdressers

BACKGROUND: A study of occupational respiratory symptoms in hairdressers was carried out in 26 salons in New Zealand. METHODS: A questionnaire was administered to 100 hairdressers and 106 office and shop workers, recording respiratory symptoms, demographic data, and smoking habits. Pulmonary function was measured before each shift. RESULTS: Hairdressers had a higher prevalence of asthma symptoms, diagnosed asthma, and asthma attacks in the previous 12 months, but these differences reduced markedly when adjusted for age, gender and smoking. Hairdressers had a significantly lower pulmonary function, even after adjustment for smoking, but this difference was entirely due to differences between hairdressers and office workers and there were no such differences between hairdressers and shop workers. CONCLUSIONS: The excess symptom prevalence in hairdressers was largely due to the high smoking rates. Mean pulmonary function was lower in hairdressers but this finding requires further study.     

Incidence of hand eczema in female Swedish hairdressers

Objective

To estimate the occurrence of hand eczema in hairdressers in Sweden.

Methods

The occurrence of hand eczema was estimated in a Swedish longitudinal retrospective cohort study including all female graduates from vocational schools for hairdressers from 1970 to 1995. A stratified sample from the general population acted as controls. A self‐administered questionnaire including questions on the occurrence of hand eczema, skin atopy, working periods and number of hair treatments performed per week was sent to the participants. Incidence rate ratios (IRRs) of hand eczema were estimated.

Results

The incidence rate of hand eczema in hairdressers was 23.8 cases/1000 person‐years, whereas in hairdressers who were aged <25 years it was 37.1/1000 person‐years. The corresponding IRR for hairdressers compared with controls was 2.5 (95% confidence interval (CI) 2.2 to 2.8), and that for younger hairdressers was 3.1 (95% CI 2.6 to 3.5). The mean age at onset of hand eczema was 21.6 years for hairdressers and 21.2 years for controls. The 1‐year prevalence of hand eczema was 18.0% for hairdressers and 12.1% for controls. A large number of hair treatments involving exposure to skin irritants and sensitisers were reported. The incidence rate of hand eczema was higher among individuals with a history of childhood eczema, both for hairdressers and for controls, giving an (age‐adjusted) IRR of 1.9 and 2.2, respectively. The attributable fraction of hand eczema from skin atopy was 9.6%. A synergistic effect of skin atopy and hairdressing was found on the occurrence of hand eczema. The relative excess risk due to interaction was 1.21 (95% CI 0.21 to 2.21; p = 0.01).

Conclusion

Hairdressers are highly exposed to skin‐damaging substances. The self‐reported incidence of hand eczema was substantially higher in female hairdressers than in controls from the general population and than that found previously in register‐based studies. For many individuals, onset of hand eczema occurs early in life. Only about 10% of the hand eczema cases among hairdressers would be prevented if no one with skin atopy entered the trade.There are about 19 000 hairdressers in Sweden, of whom 80–90% are women and most are self‐employed, working in small salons. Hand eczema is a well‐known problem in occupations that involve largely manual work, particularly in combination with long periods of wet exposure and skin contact with chemicals. Hairdressing includes extensive wet work, which can cause irritant contact dermatitis. Many hair cosmetics such as hair colourings, permanent wave solutions and bleaches can also cause contact allergy. Previous studies on the occurrence of hand eczema in hairdressers give a cumulative prevalence of 17–42%.^1,2 A high prevalence (24–70%) and incidence rate (152–328 cases/1000 person‐years) of hand eczema have been found among apprentice hairdressers.^3,4,5 The only studies presenting incident rates of hand eczema in active hairdressers are based on registers of industrial injuries, which report incidences of 5.6–9.7/1 000 person‐years.^6,7 Registers of occupational skin diseases probably underestimate the actual occurrence of disease owing to under‐reporting.⁸ The objective of this study was to estimate the incidence of hand eczema and occupational skin exposure in female hairdressers using a self‐administered questionnaire.     

Occupational dermatoses in composite production

In a plant that produces fiber-resin composite by impregnation of cellulose fibers with phenol-formaldehyde and melamine-formaldehyde resins, a new technique was introduced that resulted in problems in the handling of uncured products. Many workers suffered dermatitis on areas of exposed skin. A primary investigation found that some workers had an occupationally related skin disease with contact allergy to work materials. We undertook a survey of occupational dermatoses, based on a questionnaire, clinical examination, and patch test with a standard series and a series of products and chemicals representing the work environment. Eighty-eight workers participated in the clinical investigation. In six workers, contact allergy to phenol-formaldehyde resin was seen, and in five workers, contact allergy to melamine-formaldehyde resin was noted. Two workers were allergic to both resins. Occupational dermatitis was diagnosed in nine of 88 (10.2%) workers. In this article, we discuss possible preventive measures for avoiding occupational dermatitis.     

青霉素制造过程中发生的职业性皮肤病

本文报告上海某制药厂生产青霉素过程中发生的职业性皮肤病。1964年及1987年分别调查357及193人,发病数分别为242(67.8%)及65(33.7%)人,所见皮损以皮炎湿疹最多,其他有接触性荨麻疹、瘙痒症、手掌角化皲裂、指间浸渍擦烂、甲沟炎及色素异常等。其中皮炎湿疹及手掌角化皲裂,1987年较1964年明显减少(P<0.001)。斑试结果显示甲醛、普鲁卡因、乙醇、青霉素为皮炎的主要致病因素。     

Risk of hand dermatitis among hairdressers versus office workers

OBJECTIVES: The risk of irritant skin damage associated with hairdressing was estimated with the individual occupational exposure and other relevant factors having been taken into consideration. METHODS: A cohort of 2352 hairdressing and 111 office apprentices was prospectively followed for the duration of their vocational training (3 years), 3 examinations having been made and 3 years of recruitment having been used [1992 (hairdressers only), 1993, 1994] in 15 vocational training schools in northwest Germany. The information of the final follow-up examination was used for the analysis. RESULTS: A multifactorial analysis taking several (constitutional) risk factors, which were unevenly distributed between the 2 groups, into account revealed a significantly increased risk for hairdressers when compared with office workers (odds ratio approximately 4.0) with a marked decline in the most recently recruited (1994) apprentice group. Other significant factors increasing the dermatitis risk were (i) low ambient absolute humidity, (ii) young age, and (iii) a certain higher range of "atopy score". If the individual profile of occupational exposure among hairdressers was also considered, unprotected wet work of more than 2 hours per day was found to be a significant risk factor. CONCLUSIONS: Good skin protection, as operationalized in the present study, can diminish, but not eliminate, the risk of occupational irritant hand dermatitis among hairdressers.     

Occupational dermal exposure to permanent hair dyes among hairdressers

Skin exposure to permanent hair dye compounds was assessed in 33 hairdressers using a previously evaluated hand rinse method. Hand rinse samples were collected from each hand before the start of hair dyeing, after application of the dye and after cutting the newly-dyed hair. Sixteen of the hairdressers did not use gloves during dye application, and none used gloves while cutting the dyed hair. The samples were analysed for pertinent aromatic amines and resorcinol (RES) using an HPLC method. 10 of 54 hair dye mixtures contained 1,4-phenylenediamine (PPD), 40 toluene-2,5-diaminesulphate (TDS), and 44 RES. After application of the hair dye, PPD was found in samples from 4 hairdressers, TDS in 12 and RES in 21. PPD was found in samples from 3 of the 17 hairdressers that used gloves during application of the hair dye, TDS in 5 and RES in 11. In the group that did not use gloves during the application of hair dye (n = 16) PPD was found in samples from 1 hairdresser, TDS in 7 and RES in 11. After cutting the dyed hair, PPD was found in samples from 5 hairdressers, TDS in 14 and RES in 20. Analysis of samples of newly-dyed hair cuttings revealed the presence of aromatic amines and/or RES in 11/12 samples. Our conclusion is that hairdressers' skin is exposed to allergenic compounds during hair dyeing. Exposure occurs from dye application, from cutting newly-dyed hair and from background exposure. The exposure loadings are in the level, where there is a risk of sensitization and/or elicitation of contact allergy (i.e. for PPD 22-939 nmol per hand). The glove use observed in this study was often improper, and was insufficient to prevent exposure. To reduce exposure, improved skin protection and work routines are important.     

Occupational hand infections

Prompt diagnosis and treatment of hand and upper extremity infections is imperative because they have the potential to be life threatening and pose a risk of functional impairment. Serious infections may result in prolonged hospitalization and resultant loss of productivity. The mainstay of treatment continues to be antibiotic therapy, heat, elevation, adequate surgical drainage, and débridement. Prompt specialty consultation should be obtained in cases in which there is a doubt about the diagnosis or when there is failure to improve in the face of seemingly appropriate treatment.     

Occupational asthma in hairdressers: results of inhalation tests with bleaching powder

Study objective: To analyze the extent to which the clinical diagnosis of bleach-induced asthma can be confirmed by laboratory tests and to determine the role of work-related exposure to bleaching powder in a group of hairdressers with respiratory complaints. Methods: The study population consisted of 55 female hairdressers who had regular contact with various hair products and a clinical history of job-related rhinitic and/or asthmatic symptoms. We divided the individuals into two groups: group I, with asthmatic symptoms (n=38), and group II, without asthmatic symptoms (control group, n=17). All subjects underwent immunological, pulmonary-function, and nonspecific bronchial provocation tests, and 46 study participants were subjected to a standardized bleaching-powder test in a designated chamber. Results: There were 13 positive responses to bleaching powder in the skin test, and 32 individuals showed positive bronchial responsiveness to acetylcholine; positive responses to the challenge with bleaching powder occurred in 9 women (22% of those tested). None of the women in group II reacted to bleaching powder. There was no significant difference between persons with a positive or a negative bronchial provocation test with regard to the evaluated parameters. Conclusions: In the diagnostic workup of hairdressers with work-related respiratory symptoms, bleaching powder is one of the products that need to be tested. As not every patient with an asthmatic response to bleaching powder shows a positive response to the acetylcholine challenge test, in doubtful cases a specific exposure test may be recommendable. Received: 29 January 1997 / Accepted: 9 June 1997     

Occupational dermatoses among workers in a porcelain manufacturing factory

The objectives of the present work are to determine the prevalence and risk factors of occurrence of occupational dermatoses among workers in a porcelain manufacturing factory. The study included 235 workers (132 males and 103 females). After history taking, dermatological examination was performed at the work place. Cases of contact dermatitis (CD) were patch tested using potassium dichromate 0.5%, Cobalt chloride 1% and Nickel sulphate 5% in petrolatum. Results showed that the prevalence of occupational dermatoses (OD) was 26.8% among exposed workers. The highest percentage of OD was found among workers in the decoration department. It represented 30.2% of all cases. CD was the commonest presentation among the studied group, it represented 27% of all cases of OD. Results of patch testing indicated that out of 17 cases of CD 12 cases (70%) were of the irritant variety and 5 cases (30%) were of the allergic type. The prevalence of OD was found to be affected by age, duration of work, type of exposure and daily bathing after work.