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FS10.2Occupational contact dermatitis in health care workers
Authors:Vera  Mahler   T Bruckner  A Schmidt  T L Diepgen
Affiliation:University of Erlangen, Erlangen, Germany; University of Heidelberg, Heidelberg, Germany; Occupational Medicine Nüremberg, Nüremberg, Germany
Abstract:Objectives: Occupational skin diseases (OSDs) account for a large number of occupational diseases in Europe. Population‐based epidemiological studies concerning certain occupations (e.g. Health care workers), however, are missing. Aim of our study was to analyse the reports of OSD in Health care workers (HCW) in the register of OSDs of Northern Bavaria and to assess the annual incidence in this occupational group in relationship to the total employed population in Northern Bavaria. Further, we investigated the spectrum of sensitizations with and without occupational relevance in this group. Methods: A total of 5285 cases of OSD were assessed prospectively and registered from 1990–1999. Data of total employment were provided by the German Federal Employment office. Results: A total of 3097 cases were confirmed as OSD in 24 occupational groups, of which 482 were confirmed in the group of HCW. The average annual incidence of OSD in this group accounted for 7.3 per 10,000 workers. In 1990 the incidences in this occupational group accounted for 11.4%, in 1999 for 5.0% per 10,000 workers with highest incidences in younger age groups. In the evaluated health care workers from the register of OSD in Northern Bavaria 54%(n = 260) had irritant and 51%(n = 244) had allergic contact dermatitis including 19%(n = 89) who suffered from both. Of the 482 HCW 13% had occupational relevant Type IV allergy to glutaraldehyde, 12% to thiurams, 6% to nickel (II) sulfate, 4% to formaldehyde or fragances, respectively, 2% to thimerosal, potassium (II) chloride, chloromethyl‐isothiazolone and p‐phenylendiamine (free base) each. Conclusions: HCW belong to the occupational groups at exceedingly high risk for OSD. Higher frequencies of OSD occur in younger age groups. Irritant and allergic contact dermatitis are equally common causes of OSD in HCW. Sensitization to certain allergens (e.g. glutaraldehyde, thiurams and latex) are most often of occupational relevance, whereas others although frequently found (e.g. sensitization to nickel‐II‐sulfate, cobalt‐II‐chloride, fragance‐mix) rarely are of occupational relevance.
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