某铸钢厂工人职业性接触性皮炎患病调查

对某铸钢厂工人职业性接触性皮炎患病原因进行调查,结果发现皮炎的发生与使用的钢水结晶器保护渣的刺激和未采取正确的个人防护以及高温等因素有关。经采取相应的防护措施后,职业性接触性皮炎患病得到有效的控制。     

职业性皮肤病——职业性接触性皮炎

职业性皮肤病是指在劳动生产过程中接触某些化学、物理、生物等职业性有害因素引起的皮肤及其附属器官的疾病。 皮肤是人体最大的器官，覆盖人体的表面，是同外界环境接触的第一道防线，也是生产性有害因素首先接触的器官。根据国外资料，职业性皮肤病约占职业病总数的50％～70％。我国尚未见完整的统计。据上海医科大学华山医院皮肤科对近300家工厂、40多种行业的调查发现，几乎各工种均有职业性皮肤病发生，其中石油、焦油化工、合成树脂、橡胶、电镀、制药、玻璃纤维、涂料等行业发病尤为普遍；中国疾病预防控制中心职业卫生与中毒控制所曾对某化工厂接触氟苯类化合物的工人进行氯痤疮的发病调查，结果发现，患病率达62．6％：这说明职业性皮肤病直接危害劳动人民的身体健康，影响了工农业的生产和建设。随着我国各行各业的不断兴起、各种新型农药的开发和使用，增加了职业性危害，所以，目前除了加强对心脏病、糖尿病等的预防和诊治外，还应对职业性皮肤病予以足够重视。[编者按]     

职业性光接触性皮炎一起的调查分析

2006年9月4日我县某铁路装卸队经营部12名工人发生一起原因不明的急性皮肤病，疾病预防控制中心接到报告后立即组织相关业务人员赶赴现场进行调查，现将结果报告如下。     

氰化物接触人群职业性接触性皮炎流行病学调查

目的探讨氰化物接触人群职业性接触性皮炎的发病特点和影响因素,为皮炎诊治和预防提供科学依据。方法采用随机分层整群抽样的方法,选择某石油化工企业接触氰化物的工人429人为调查对象,以问卷与医学检查相结合的形式,对调查对象进行横断面流行病学调查。内容包括一般情况、职业接触史、防护措施、发病情况及诊治经过等。结果氰化物接触人群职业性接触性皮炎患病率为30.8%,明显高于非氰化物接触人群皮炎患病率(χ2=6.46,P<0.05)。发病部位以暴露部位或直接接触氰化物部位为主。致病原以两种或两种以上氰化物混合物为主。车间氰化物浓度高、工作时间长以及手工操作的工种患病率较高。发病以7—9月份炎热夏季为主。单因素分析结果显示,年龄、工种、手套防护对氰化物职业性接触性皮炎发病的影响有统计学意义(P<0.05);非条件logistic回归分析显示,佩戴手套是氰化物职业性接触性皮炎发病的保护性因素。结论降低工作场所温度、采取有效的卫生防护措施和加强职业卫生知识培训,是预防职业性接触性皮炎发生的有效措施。     

职业性光接触性皮炎

简述了职业性光接触性皮炎的致病因素与机制、发病与危害、临床表现、治疗与预防。     

石化行业职业性接触性皮炎调查分析及其试点干预

目的 调查石化行业工作职业性接触性皮炎特点及发病原因.方法 对石化行业工作进行了现场调查,并进行试点干预.结果 职业性接触性皮炎患病率为13.11%,皮炎的发生与化学物质接触、未采取正确的个人防护措施有关.结论 采取正确的防护措施,可有效控制石化行业职业性接触性皮炎的发生.     

职业性接触性皮炎的诊断和防治

职业性接触性皮炎是指在劳动或作业环境中直接或间接接触具有刺激或致敏作用的职业性有害因素引起的皮肤急、慢性炎症性改变。它是职业性皮肤病中最常见的一种类型,据统计,约占整个职业性皮肤病的80～90%,是影响工人劳动的重要职业危害之一。因此,在开展职业性皮肤病防治研究工作中一向被认为     

玻璃纤维作业工人职业性接触性皮炎调查

选择玻璃纤维作业工人189名为观察组,非玻纤作业工人120名为对照组,进行皮肤科检查和斑贴试验,结果玻纤作业工人接触性皮炎患病率51．3％,明显高于对照组（P＜0．01）。     

The epidemiology of occupational contact dermatitis

Occupational contact dermatitis (OCD) ranks first of all occupational diseases in many countries. The incidence rate is believed to be around 0.5–1.9 cases per 1000 full-time workers per year. Epidemiological studies play an important role in observing disease trends, analysing risk factors, and monitoring the effect of preventive measures. In this review article the lack of truly epidemiologic data on OCD and the difficulties of those studies are illustrated. The following issues are highlighted: case ascertainment and bias, the distribution of allergic and irritant contact dermatitis in the working population, the interrelationship between exogenous (allergens, irritants) and endogenous factors, the prognosis, the social and economic impact, and the need for intervention studies. Received: 26 January 1999 / Accepted: 24 April 1999     

Occupational issues of irritant contact dermatitis

Occupational irritant contact dermatitis (ICD), a non-immunological cutaneous inflammatory response to a workplace substance, comprises a major portion of occupational dermatoses in industrialized societies, resulting in considerable social and economic implications. The sheer morphological variety of ICD presents a diagnostic and classification challenge; ideotypes identified to date include acute, chronic and cumulative irritant dermatitis, delayed acute irritant dermatitis, irritant reaction, pustular irritant dermatitis, suberythematous irritation, sensory irritation, friction dermatitis and airborne dermatitis. Hand dermatitis is the most frequent manifestation of occupational ICD. This article reviews the various types of ICD, the epidemiological data available to date, risk factors, pathophysiology, diagnosis and management of ICD, emphasizing occupational issues.Paper presented at the Occupational Skin Care Management State-of-the-Art Conference, 1–3 September 2000, Zurich     

Occupational protein contact dermatitis with type I allergy to different kinds of meat and vegetables

Objective: Even though occupational protein contact dermatitis is not an uncommon finding in occupational dermatology, reports about multiple sensitizations are rare. High-molecular-weight substances such as proteins can pass the epidermis only if it is damaged and cause a sensitization. In a high percentage of cases, atopic dermatitis might be the cause of this damage but cannot be regarded as the only cause. An interesting case is presented that was carefully worked up. Methods: Scratch, intracutaneous, and prick or prick-to-prick tests with native occupational allergens were performed as single tests. The patient was patch-tested with the European Standard Series. The determination of allergen-specific IgE was performed by ImmunoCAP. The results were subdivided into six classes. In addition, oral provocations with relevant allergens were performed. Results: The skin tests showed positive type I allergies to beef, lamb, horse, and pork meat, to pork and horse blood as well as to rye and wheat flour, raw potato, and pasta. Weak positive reactions could be found for fowl, duck, goose, and turkey in intracutaneous testing. The ImmunoCAP showed elevated specific IgE values for pork meat, raw potato, and rye and wheat flour. The oral provocation did not show any systemic or skin change. Conclusions: This case report demonstrates how an initial case of contact urticaria turns into protein contact dermatitis. It shows that the diagnosis can be made by means of scratch or prick tests with native occupational allergens. The determination of allergen-specific IgE by ImmunoCAP might be helpful, but a negative result does not exclude protein contact dermatitis. Received: 26 August 1997 / Accepted: 14 November 1997     

广东150例职业性三氯乙烯药疹样皮炎病例的职业流行病学调查

目的阐明职业性三氯乙烯(TCE)药疹样皮炎职业流行病学特征,为其防治与研究提供资料。方法用专用调查表对广东省1988～2001年发病的150例职业性TCE药疹样皮炎病例进行回顾性调查,同时收集这些发病事故的调查资料,用Excel建立数据库,SPSS10.0进行统计处理。结果这组病例的临床表现和发病特点与药疹皮炎极其相似,表现为剥脱性皮炎、重症多形红斑、大疱性表皮坏死松解症或多形红斑。其发病均因接触TCE,但与接触浓度无明显关系;潜伏期均小于3个月;××市3年调查,接触TCE新工人的发病率仅为0.045%;激素治疗有效,病后再接触可再发病,斑贴试验阳性等。引起发病的TCE含量在95%以上,产地也不同,全分析未发现相同杂质;全部病例没有发现接触甲醛、甲胺磷等能引起药疹样皮炎的化学品;大部分病例发疹前2个月没有服过任何药物;美国和日本等地已有21例相似的病例报道。因接触TCE的新工人多和临床医师和管理人员提高了对本病的认识,使广东多发。结论本组病例都由职业性接触TCE引起,与药疹样皮炎相似,属免疫增强损伤。称为“职业性TCE药疹样皮炎”;其流行病学特点均与职业性TCE接触明显相关。     

Occupational contact dermatitis in a gender perspective: North East Italian data 1996-2016

Background:Occupational contact dermatitis (OCD) ranks high among occupational diseases in Europe, but little is known as regards OCD and jobs in a gender perspective.Objectives:To evaluate sex prevalence of OCD according to occupational sectors and agents involved. 27381 patients (1996–2016) with suspected irritant/allergic contact dermatitis (ICD-ACD) were evaluated in North-Eastern Italy. Each patient underwent: a standardized questionnaire, a dermatologist/occupational physician evaluation and a patch test.Results:Females were younger at diagnosis (35.2 ± 11.6 years vs 37.7 ± 12.6 in males, p< 0.001) and had a lower ICD prevalence (OR 0.58, C.I. 95% 0.51 - 0.66, p < 0.001). Job categories most involved differed between sexes, with highest rank for healthcare professionals in females and machinery mechanics and filters for males. In females ACD percentage was higher in all job categories.Conclusions:OCD characteristics differ between sexes, according to intrinsic and extrinsic factors. Use of personal care products, housekeeping products and outdoor work activities may account for different sensitization profiles.     

Skin-conditioning products in occupational dermatology

Moisturizers are frequently used in the prevention of occupational contact dermatitis. This review discusses their chemistry and mode of action. Methods to prove their preventive efficacy are presented. In addition to pharmacological efficacy, subjective factors that influence application of the products and compliance come into play. In conclusion, moisturizers are only one element of skin-disease prevention at the workplace that should be viewed as a complex, inter-dependent system. The efficacy of the complete, integrated system of occupational skin care has to be proven.Paper presented at the Occupational Skin Care Management State-of-the-Art Conference, 1–3 September 2000, Zurich     

Secondary individual prevention of occupational skin diseases in health care workers,cleaners and kitchen employees: aims,experiences and descriptive results

OBJECTIVES: Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants' attitudes towards health) and medical aims (e.g. optimising diagnostic procedures, complementing individual therapy). METHODS: Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient's history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. RESULTS: In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. CONCLUSIONS: There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions.     

广州市职业健康监护和职业病发病状况分析

目的分析广州市职业健康监护工作和职业病发病的特点。方法对1993至2002年全市劳动卫生工作情况汇总资料进行职业健康监护和职业病发病状况的回顾性研究。职业健康监护体检资料按时间顺序每5年分一组，共分两组，即1993至1997年为第1组，1998至2002年为第2组。结果10年职业健康监护体检年平均受检率均在75％以上。第2组噪声听力损伤、观察对象、物理因素重点监护人员和粉尘、化学因素禁忌证人员明显高于第1组，差异有统计学意义（P〈0．01）。第1组新发慢性职业病共91例，第2组181例，两组发病率的差异有统计学意义（P〈0．05），其中化学中毒和噪声听力损伤的发病率上升明显，两组尘肺的发病率差异无统计学意义（P〉0．05）。10年共发生各类职业病581例，其中急性中毒309例，占53．18％，慢性职业病272例，占46．82％；慢性职业病中尘肺占16．70％，铅和苯化学中毒占16．87％。随着时间的推移，尘肺、化学因素中毒和总职业病患者发病工龄趋于年轻化，发病工龄也明显缩短，差异均有统计学意义（均P〈0．01）。结论广州市初步建立了一个较规范的职业健康监护体系。体检中检出的噪声职业性重点监护和粉尘、化学因素禁忌证人员明显上升；职业病发病明显上升，以急性职业中毒和尘肺、铅和苯中毒为主；慢性职业病患者发病年龄趋于年轻化，发病工龄缩短。     

Variability in transepidermal water loss of the skin: evaluation of a method to assess susceptibility to contact dermatitis in epidemiological studies

Summary Transepidermal water loss (TEWL) has been suggested to be a measure which can be used to identify subjects at risk for the development of contact dermatitis. Transepidermal water loss is high when the barrier function of the skin is impaired. It is assumed that subjects with a high TEWL have skin which is more permeable to substances causing contact dermatitis. The inter-individual and intra-individual variability of simultaneous TEWL measurements and TEWL measurements over a period of three weeks were estimated in healthy individuals. The intra-individual coefficient of variation (CV) of simultaneous measurements was 13.5%. The intra-individual coefficient of variation of the measurements on consecutive days was somewhat higher (15.1%). The intra-individual coefficients of variation were low compared to the inter-individual coefficients of variation. The results indicate that transepidermal water loss is a stable personal characteristic, which can be studied as a risk factor in epidemiologie studies on contact dermatitis.     

某化工厂3例职业性皮肤病的调查

目的调查某化工厂(生产左羟丙哌嗪)3例职业性皮肤病即"硬皮病"样改变的发生的原因。方法根据现场职业卫生调查情况、患者的病历资料及职业病诊断原则进行综合分析。结果病例均发生在产品左羟丙哌嗪预试验期间,因接触大量的苯胺及其化合物导致发生职业性硬皮病样综合征,病程迁延,彻底脱离致病环境者病情好转,严重者呈不可逆性倾向。正式投产运行后职业卫生管理完善,自动化程序提高,防护措施加强,未发生新的病例。结论结合患者的职业接触史及车间发病的情况和临床表现,并参考相关的资料,可以确认该化工厂发生的硬皮病样改变为苯胺及其化合物所致的职业性皮肤病——硬皮病。