Computer-related skin diseases

The use of computers has increased vastly, occupationally as well as for private use, and in the last decade, a number of reports have been published in which skin problems are ascribed to the (intensive) use of computers. Not only irritant or mechanically induced contact dermatitis has been reported but also allergic contact dermatitis. As this appears to be a new group of occupational dermatoses, we present a brief overview of these cases, and aetiologic factors are discussed.     

Epidemiology of occupational skin disease in Singapore 1989-1998

This is an epidemiologic study of occupational skin disease in Singapore. All patients diagnosed with occupational dermatoses in the National Skin Centre, Singapore, over the 10-year period 1989-1998 were studied retrospectively. Irritant contact dermatitis was found to be more common than allergic contact dermatitis. The major sources of occupational dermatitis in Singapore were the metal/engineering, building/construction, electrical/electronics and transport industries. The main irritants were detergents/wet work, solvent and oil/grease. The main allergens were chromate, rubber chemicals and nickel. We concluded that the main sources of occupational skin disease and main allergens in Singapore had remained the same compared to a similar study of occupational skin diseases in 1984-85. Weak irritants are still the predominant causes of occupational irritant contact dermatitis, though the main irritants have changed compared to the previous study, where cutting fluids, cement and solvent were the most common irritants.     

Increase in occupational skin diseases of dental personnel

Occupational diseases of dentists and dental nurses were compiled from the Finnish Register of Occupational Diseases. The cases were recorded during 3 3-year observation periods, namely 1982-1984, 1986-1988, and 1992-1994 (i.e., 9 observation years). The relative risk of developing occupational allergic contact dermatitis in different occupations was calculated from the statistics of the years 1986-1991, and was expressed as the age-standardized rate ratio (SRR). During the 9 observation years, the majority of registered occupational diseases of dentists and dental nurses were skin diseases (221/312; 70.8%), followed by occupational repetitive strain injuries (61/312; 19.6%) and occupational respiratory diseases (20/312; 6.4%). The incidence rate (IR) for allergic contact dermatoses/10,000 workers (contact urticaria included) increased from 26 (95% confidence interval (CI) 16-40) in 1982-1984 to 79 (95%, CI 64-97) in 1992-1994. The IR/10,000 of allergic contact dermatoses increased especially for dentists, from 5.4 (95% CI 0.7-19) in 1982 to 67 (95% CI 45-95) in 1992-1994. The increase of the IR/10,000 dental nurses was smaller: from 43 (95%, CI 26-66) in 1982-1984 to 87 (95% CI 67-111) in 1992-1994. There was no increase in the IR/10,000 cases of irritant dermatoses. The most common causes of allergic contact dermatitis were plastics, disinfectants and antimicrobials, rubber chemicals, and mercury/mercury salts. The most common causes of irritant contact dermatitis were detergents, wet and dirty work, plastic chemicals and antimicrobials. Currently, Finnish dentists have the highest risk and dental nurses have the 4th highest risk of any occupation for developing occupational allergic contact dermatitis: the risk was 6.4-fold (SRR 6.4) in dentists and 6.1-fold in dental nurses, as compared to the general working population. It is evident that safer acrylics and protective gloves, better product declarations and material safety data sheets, as well as more information about protective measures, including non-touch working techniques, are needed.     

Occupational skin diseases in Singapore 2003-2004: an epidemiologic update

In this 2-year retrospective epidemiologic study of occupational skin disease in Singapore, there were 125 patients with occupational contact dermatitis. The mean age of patients was 33.8 years, with a male to female ratio of 5.3:1. Irritant contact dermatitis made up 62.4% of all cases, whereas allergic contact dermatitis constituted 37.6%. Wet work/detergents, oil/grease and solvents remained the 3 commonest irritants. There was also a significant increase in representation of workers from the food/catering industry in our study.     

Occupational contact dermatitis in nurses with hand eczema

Occupationally related dermatitis is a common problem in nurses, who are exposed to a wide variety of allergenic and irritant substances. In a group of 44 nurses with hand dermatitis (40 female, 4 male), 18 were thought to have a predominantly allergic contact dermatitis, 15 an irritant dermatitis, 7 other form of eczema, 3 atopic dermatitis and one pompholyx. 10 of the 15 irritant cases were diagnosed as occupational. Of the 18 patients with allergic contact dermatitis, the allergens were thought to be occupationally relevant in 8 cases. In 6 of these 8 the dermatitis was due to natural rubber latex (3) or other rubber chemicals (3). 2 had additional evidence of immediate-type hypersensitivity to natural rubber latex (one was patch test allergic to latex, the other to thiuram mix). Natural rubber latex allergy, both delayed and immediate, is a significant problem, and nurses at risk should be tested for both types of hypersensitivity, as well as being patch tested to standard, rubber and medicaments series.     

A study of dermatitis in the lacquerware industry

Contact dermatitis from lacquer has been documented. The causative agent is a resin from a lacquer trees that induce either irritation or sensitization. Thai and Japanese lacquer trees 2 distinct species hut are both members of the Anacardiaceae family. We report 3 eases of contact dermatitis from Thai lacquer resin. Observation and study of the lacquer plantation and working process at the factory were made to elucidate the aetiology of the dermatitis.     

Occupational dermatoses among fibreglass-reinforced plastics factory workers

Fibreglass-reinforced plastics (FRP) factory workers are at high risk of developing occupational dermatoses because of their exposure to many chemicals used in the manufacture of plastics as well as to glass fibre or dust. Patch tests were carried out on 29 workers involved in FRP manufacturing processes where unsaturated polyester (UP) resin was used, to investigate the causes of their skin problems. Of the 22 workers who reported experiencing skin problems, 16 showed positive results to at least 1 chemical, including 6 cases of multiple sensitivity. 2 showed positive reactions to UP base resin, 6 to cobalt chloride, 5 to benzoyl peroxide (BPO), 4 to methyl ethyl ketone peroxide (MEKPO), 2 to para-tertiary butyl catechol (PTBC), 1 to styrene and 1 to formaldehyde. After taking into account their exposures and reported causes by questionnaires and their patch test results, 7 cases were diagnosed as allergic contact dermatitis (ACD) due to chemicals, 3 as irritant contact dermatitis (ICD) due to chemicals, and 3 as dermatitis due to mechanical irritation (MI) from glass fibre or dust, as well as 9 as ACD and/or MI. 18 of the total of 29 subjects (62.1%), including 2 workers without a history of skin problems, were sensitized to at least 1 chemical. Cobalt, peroxides, PTBC and UP base resin were the common causes of ACD.     

Hand dermatitis in the pottery industry

Irritant hand dermatitis has long been recognized in the pottery industry. In our series, among workers handling glaze, sensitization to chromate was common and allergy to other metals and to biocides also occurred. Allergy to oil additives was found in mould makers. Whilst irritant hand dermatitis does occur, allergy to metals and biocides should be looked for in workers handling glazes, and allergy to oil additives in mould makers.     

Prediction of irritancy in the human skin irritancy model and occupational setting

It is of great importance to find ways to lower the incidence of chronic irritant contact dermatitis. In this process, it is crucial to have insight in the factors that can predict irritancy. This review offers a survey of recent findings in the field of skin irritancy testing, discussed in the context of renowned, older work. Extrinsic and intrinsic factors that may determine the outcome of irritancy testing in the human skin model are considered. In recent decades, there has been increasing interest in factors influencing the development of occupational dermatitis by means of prospective cohort studies. This promising new area of investigation is discussed separately.     

Factors associated with skin irritation of the hands experienced by general dental practitioners

Practising dental surgeons are now wearing gloves for longer periods of time than any other comparable group. As part of a study to assess dentists' attitudes to cross-infection, a questionnaire was sent to 1950 randomly selected general dental practitioners in England and Wales, with information being requested concerning the incidence of skin irritation of the hands considered to be associated with glove wearing. The response to the questionnaire was 61%, with 29% of respondents indicating that they had experienced skin irritation. A strong association was identified between pattern of glove wearing and incidence of skin irritation, with routine glove wearers being more likely to suffer skin irritation than occasional glove wearers. Female respondents were also more likely to have experienced skin irritation than male respondents. No association was identified between reported incidence of skin irritation and practising arrangements, years since graduation and number of years of glove wearing.