Allergies in India: an analysis of 3389 patients attending an allergy clinic in Mumbai, India

A total of 3389 consecutive patients attending the allergy clinic over a period of 5 years (2003-2007) were analysed by the same physician. Males outnumbered females ie, 53.05% versus 46.95%.; 89.17% of the patients were adults and 10.83% were children. More than 80% of the patients were young, below 40 years of age. Nasobronchial allergies viz, asthma, rhinitis or asthma with rhinitis formed the largest group of patients (76.9%). Total serum IgE levels were elevated in every patient (except in those with contact dermatitis). The highest levels of IgE were seen in patients with atopic dermatitis (mean 1615.47 IU/ml). The house dust mite, D farinae, showed the highest incidence (77.13%) of positive reactions. Positive reactions to foods (16.48%) were more than that reported in western countries, whereas positive reactions to pollen were comparatively low (8.61%). In the contact dermatitis group, nickel sulphate (38.5%) and Parthenium hysterophorus (36.5%) were the commonest allergens on patch testing. Penicillins, sulphonamides and non-steroidal anti-inflammatory drugs were the drugs most commonly found to cause allergic reactions in India. The incidence of atopy is estimated to be 28.96% in a randomised survey of the Indian population.     

某工厂生产和使用百菌清的劳动卫生初步调查研究

在粉状百菌清生产车间的五个不同地点,30次采样中最高值为 1.41mg/m~3 百菌清,均值为0.2mg/m~3;12次未能检出;制革车间空气中未检出百菌清。三年观察未发现车间工人有任何系统中毒性病变,主要损害为皮肤病变,表现为过敏性皮炎。皮肤接触是造成皮肤损害的主要途径,因而,必须注意有效的皮肤防护。     

Common environmental contact allergens in Singapore

Contact allergens produce three types of reactions. The commonest reaction is allergic contact dermatitis (ACD). The commonest contactants in Singapore causing ACD are, in decreasing order of importance, nickel, fragrances, neomycin, lanolin, colophony, flavine, rubber chemicals, paraphenylenediamine, clioquinol and chromates. Another type of allergic contact reaction is immunologic contact urticaria (ICU). ICU is an IgE mediated mechanisms. Contact allergens causing ICU in Singapore are proteinaceous foodstuffs and rubber latex products. Photoallergic contact dermatitis is occasionally seen in Singapore. The commonest agent is Musk Ambrette, a perfume fixature found in male colognes.     

Review of contact dermatitis for non-dermatologists

Contact dermatitis is common. Occupational contact dermatitis is one of the commonest occupational diseases. Allergic contact dermatitis to topical medications is frequent. This article provides an update on the two main types of contact dermatitis: irritant and allergic. The role of patch testing in evaluating patients is discussed and guidelines for treatment are given. Clinical features, prognosis, risk factors, and prevention are discussed.     

104例接触性皮炎与湿疹斑贴试验结果分析

目的:探讨广州番禺区皮炎湿疹类皮肤病常见的过敏原。方法:采用"瑞敏"斑贴试剂盒对104例接触性皮炎与湿疹患者进行过敏原检测。结果:常见的变应原阳性率由高到低依次为重铬酸钾(40.38%)、氯化钴(29.8%)、硫酸镍(26.92%)、甲醛(23.07%)。斑贴试验阳性患者83例(79.8%),其中男16例,阳性率66.7%(16/24),女67例,阳性率83.8%(67/80),且经统计学分析,男女阳性率比较差异无统计学意义(P>0.05)。其中对1种抗原过敏者35例(42.17%),对2种及2种以上抗原过敏者48例(57.83%)。结论:重铬酸钾、氯化钴、硫酸镍、甲醛是广州番禺区皮炎湿疹类皮肤病重要致敏原;皮炎湿疹的发病与接触物本身的理化性质和患者过敏体质有关,而与性别无关。     

Urticarial contact dermatitis in food handlers

OBJECTIVE: To show that prick testing (using fresh samples of the food suspected from the patient's history) and not only patch testing is the appropriate investigation in selected cases of hand dermatitis in patients who spend considerable time handling foods (for example, catering workers, cooks). SETTING: The Contact and Occupational Dermatitis Clinic at the Skin and Cancer Foundation, a tertiary referral centre in Sydney. PATIENTS: Fourteen patients with hand dermatitis present for an average of 6.17 years referred by dermatologists and occupational health physicians. INTERVENTIONS: Patch and prick tests were performed for each patient. RESULT: In all patients prick tests identified the food allergens. Seafood was the most common allergen giving positive results in 10 patients. Patch tests did not identify any of the food allergens. Of the 14 patients nine were followed up and seven of these had been forced to change their career direction. CONCLUSION: Prick testing is the appropriate investigation in selected cases for the diagnosis of urticarial contact dermatitis in food handlers.     

2007年清远市接触职业病危害因素在岗职工体检结果与分析

目的了解清远市2007年接触职业病危害因素在岗职工的职业健康情况,分析当前职业健康检查存在的主要问题及解决措施。方法按职业健康检查项目进行在岗职业健康检查。结果3175名接触职业病危害因素在岗工人中,检出1837人一项或一项以上结果异常,异常检出率为57.83%。接触粉尘作业人员中检出9人不宜从事粉尘作业,占接触粉尘作业人数的0.71%。接触噪声作业人员中检出噪声职业禁忌证24人,占接触噪声作业人数的2.08%。接触铅作业人员中检出铅观察对象9例,占铅作业人数的10.00%。接触有毒化学物作业人员中血常规异常共24例,占接触有毒化学物人数的7.43%;变态反应性皮肤病12例,占接触有毒化学物人数的3.71%。检出异常情况以高仟伏胸片、肺功能、听力、血常规、尿铅检查为主;清远市的主要职业危害因素为粉尘、化学毒物和噪声。结论清远市面临的职业健康问题十分严峻,必须做好主要职业病危害因素的监测,加强职业健康监护和做好职业病三级预防工作,并且加大宣传力度提高工人及企业的职业病防范意识。     

斑贴试验检测职业性接触性皮炎变应原

目的探讨东莞地区职业性接触性皮炎的主要致病因素,了解其常见的接触性变应原。方法采用斑贴试验试剂盒对每例患者进行斑贴试验。结果300例患者中有167例至少对一种物质过敏,总阳性率为55．67％,阳性率较高的几种变应原依次为：硫酸镍104例（34．67％）,甲醛42例（14．00％）,重铬酸钾30例（10．00％）。结论东莞地区职业性接触性皮炎主要变应原为三种化学物质,调查结果有助于临床指导该疾病的预防和治疗。     

过敏性皮肤病接触变应原分析

目的分析过敏性皮肤病病人接触变应原特点。方法采用瑞典进口斑贴试验试剂盒对40例过敏性皮肤病病人进行斑贴试验。结果40例病人中阳性者25例,阳性率为62.5%。阳性率较高的过敏原依次为:硫酸镍、对苯二胺、芳香混合物、重铬酸钾、甲醛,斑贴阳性的病种有面部皮炎、湿疹、接触性皮炎、荨麻疹、瘙痒症。结论过敏性皮肤病临床表现为多种形态,过敏原主要为日常生活类物质,易于被医、患双方所忽视,临床医师须引起足够的重视。     

105例皮炎、湿疹类皮肤病斑贴试验的结果分析

目的探讨斑贴试验在寻找皮肤科常见疾病病因方面的应用。方法对门诊2008年4月-2009年10月确诊为皮炎、湿疹类皮肤病的105例患者进行斑贴试验,并对各组间结果进行分析比较。结果 105例患者出现一项及以上阳性的87例,总阳性率82.86%;其中接触性皮炎阳性率27/33例（81.81%）,过敏性皮炎阳性率18/25例（72%）,湿疹阳性率18/24例（75%）,面部复发性皮炎阳性率10/16例（62.5%）,神经性皮炎阳性率2/4例（50%）,脂溢性皮炎阳性率1/3例（33.33%）;阳性率最高的物质为重铬酸钾为21/105（20%）,其次为硫酸镍19/105（18.1%）、硫柳汞9/105（7.6%）。结论本研究证实在湿疹、皮炎类皮肤病的发生、发展中,接触性过敏原起着重要的作用,斑贴试验是目前多种皮肤病病因诊断的重要方法之一。     

138例面部复发性皮炎的斑贴试验及临床分析

目的通过斑贴试验及问卷调查探讨面部复发性皮炎的可能致病因素及潜在规律。方法对138例面部复发性皮炎患者进行问卷调查和斑贴试验,48 h和96 h后分别观察结果。结果 138例患者除2例患者因对所有试剂及试验材料过敏而剔除外,有99例斑贴试验阳性,占受试者的72.79%,其中对1种变应原阳性者24例(24.24%),对2种阳性者33例(33.33%),对3种阳性者22例(22.22%),对4种及4种以上阳性者20例(20.20%),阳性发生率较高的前6位过敏原依次为甲醛、硫酸镍、重铬酸钾、卡巴混合物、硫柳汞、对苯类。阳性率与年龄、性别相关,与化妆品的使用无明显相关性。结论面部复发性皮炎的发生与接触变应原关系密切,斑贴试验是指导面部复发性皮炎治疗的一个有力手段。     

215例接触性皮炎斑贴试验结果及新致敏原筛查

对215例门诊接触性皮炎及59例非接触性皮炎患者做斑贴试验。结果列前四位的致敏原分别是0．1％硫柳汞、5％硫酸镍、7％芳香混合物、1％甲醛。这4种致敏原在手部、躯干四肢、面部和脐周的患病率差异有统计学意义（P〈0．01）,提示0．1％硫柳汞主要引起面部、手部、躯干及四肢皮炎,5％硫酸镍主要引起脐周和躯十及四肢皮炎,7％芳香混合物主要引起手部、躯干及四肢、面部皮炎,1％甲醛主要引起面部皮炎;乙酸戊酯、松香水的斑贴试验浓度分别为20％、25％。     

Occupational Dermatoses in Ontario, 1955 to 1962

In Ontario in 1962, with a compensationeligible labour force of 1,814,000, 10 out of each 1000 workers received compensation for some occupational dermatosis, as defined here; 36 out of each 1000 workers received compensation for some cause. Contact dermatitides made up 5042 of 7448 cases of occupational disease for which compensation and/or medical aid was paid in 1955 and 1956. In eight years, 1955 to 1962 (inclusive), of a total of 534,557 “compensation only” cases, 7023 received payment for contact dermatitis. The average yearly cost of compensation of a worker with a contact dermatitis was estimated at $1113; the annual total cost, at $900,000. The average cost of an occupational dermatosis was $368; the annual total cost, $10 million. Occupational dermatoses account for almost one-third of all compensation costs. The cost of “medical aid only” is excluded from all of these estimates. In contact dermatitis, primary irritants (chemicals) are still the main causative agents. Skin sensitizers, the epoxy resins particularly, have become more prominent in recent years. There is no all-purpose barrier cream or protective clothing. Proper personal hygiene remains the most effective preventive agent in industry.     

1 129 例疑诊过敏性接触性皮炎患者斑贴试验分析

目的:分析解放军总医院皮肤科2005年7月~2006年7月1 129例疑诊过敏性接触性皮炎(ACD)患者斑贴试验结果,明确临床常见变应原及各种变应原和性别的关系,为本地区ACD的防治及斑贴试验变应原的选择提供依据。方法:用改良的欧洲标准变应原系列对疑诊ACD患者进行斑贴试验,并对结果作统计学处理。结果:1 129例受试者中,阳性反应747例,阳性反应率较高的变应原依次是:硫酸镍、硫柳汞、重铬酸钾、芳香混合物、甲醛,阳性反应率较低的变应原有:秋兰姆混合物、硫氢基混合物、咪唑烷基尿素、溴硝丙二醇。女性患者对硫酸镍的阳性反应比男性患者高,而男性患者对卡巴混合物的阳性反应比女性患者高,其差异有统计学意义(P<0.001)。结论:硫酸镍、硫柳汞、重铬酸钾、芳香混合物、甲醛是本地区ACD的常见变应原。男女患者对硫酸镍和卡巴混合物的反应存在差异。斑贴试验用于寻找ACD患者的可疑致病原因安全有效。     

某镍镉电池厂职业病危害因素的调查

目的:调查某镍镉电池厂职业病危害因素,为预防和减少职业病的危害提供依据。方法:参照相关国家标准和规范对某镍镉电池企业进行职业卫生调查和作业场所职业病危害因素检测,较为全面反映镍镉电池企业存在职业病危害因素的种类、分布、浓度、人员接触情况。结果:该镉镍电池企业存在镉、镍、甲苯、二甲苯等职业病危害;镉粉尘超标严重;73.3%监测点空气中镉及其化合物短时间接触浓度超过国家职业卫生标准;个别测定点和作业岗位噪声强度超过85dB(A);NaOH、KOH,苯、二甲苯、溶剂汽油等化学有害因素浓度均未超过国家职业卫生标准。结论:该镍镉电池厂生产作业场所存在较严重的镉粉尘污染,个别测定点和作业岗位噪声强度超过85dB(A),应采取积极有效的防治对策。     

牡丹江地区156例皮炎湿疹类皮肤病斑贴试验变应原检测结果分析

目的探讨牡丹江地区皮炎湿疹类皮肤病的常见变应原及斑贴试验的临床应用,为疾病的预防和治疗提供依据。方法采用标准抗原系列对156例皮炎湿疹患者进行斑贴试验。结果 156例皮炎湿疹斑贴试验者中,有一项或一项以上阳性者113例,阳性率为72.4%。变应原阳性率位居前三位的分别是:硫酸镍、对苯二胺、芳香混合物。结论硫酸镍、对苯二胺、芳香混合物是牡丹江地区引起皮炎湿疹类皮肤病的主要变应原。     

浙江省某医院医务人员职业道德自评调查与分析

目的：了解医务人员在医德素质、医德类型及医德影响因素方面的自评情况,并采取针对性措施,提高医务人员职业道德。方法：自行设计医德素质评估表、医德类型评估表和医德影响因素评估表,对96名医务人员进行问卷调查。结果：医务人员医德素质自我评价均较好,但在对医德内涵的认识程度,对法律、法规、制度的掌握及交流沟通能力方面较为不足。医德类型普遍属于单纯医疗型（职业选择,从事医务工作）。市场经济的冲击、医德监督管理不到位及部份患者就诊道德差明显影响医德发展。结论：要想从根本上提高医务人员的职业道德水平,必须多环节配合：加强自身素质教育的环节、重视医患沟通环节、加强医德监督管理环节、呼吁政府干预环节、提升就诊道德环节。     

669例湿疹皮炎患者斑贴试验分析

目的探讨慢性湿疹和皮炎患者接触性致敏原及其特点。方法采用斑贴试验检查669例皮炎湿疹患者。结果 669例皮炎湿疹患者中斑贴试验阳性312例,其中对1种物质过敏164例,2种物质过敏78例,3种物质过敏44例,4种物质过敏19例,5种及以上物质过敏7例。其中以硫酸镍最高为17.19%,其余依次是氯化钴、重铬酸钾、芳香混合物、松香、对苯类、甲醛及对苯二胺。结论硫酸镍、氯化钴、重铬酸钾和芳香化合物是本地区湿疹皮炎患者重要的致敏原。     

An observational study on the effects of aviation turbine fuel and lubricants on the skin of Indian Air Force ground crew in flying stations

BackgroundGround crew of the Air Force routinely handle aviation turbine fuel (ATF) and lubricants and a need was felt to study the adverse effects of these substances on their skin so that remedial measures could be taken to prevent these adverse effects.MethodsA multi-centric, cross-sectional, observational study was performed at three Air Force flying stations. 109 ground crew members of the Indian Air Force (IAF) who were in direct contact with ATF and lubricants were screened for dermatological manifestations on exposed areas. History of atopy was elicited, systemic and dermatological examination done and occlusive patch testing carried out where indicated. Fungal infections were excluded by a potassium hydroxide mount.Results20 out of the 109 personnel (18.34%) were symptomatic in the form of mild irritant contact dermatitis. There was no case of allergic contact dermatitis. Only two cases showed an irritant reaction on patch testing. 65% of the symptomatic personnel were atopic. There was no predisposing trade or age group for adverse effects to ATF.ConclusionThis study revealed that contact with ATF is associated with only mild irritant contact dermatitis in exposed ground crew members of the IAF and atopy was a predisposing factor for susceptibility to the dermatitis.     

结核病职业暴露与风险防范

目的：探讨结核病职业暴露的危险因素与对策。方法：回顾我院1991～2010年结核病职业暴露发病案例,对职工发病率与发病者年龄、科室分布情况进行分析。结果：1991～2000年,255例研究对象中有16例医务人员感染结核杆菌,并发展成活动性结核病,发病率为6.27%。2001～2010年,325例研究对象中有5例医务人员感染结核杆菌,并发展成活动性结核病患者,发病率为1.54%。两个时间段发病率比较,差异具有统计学意义（P〈0.05）。结论：积极采取相关干预措施,可最大限度地预防结核病职业暴露的发生,降低职业病的发病率。