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2001

CIS 02-660 Saad A., Besher S., Ammar N., Emam H.
Therapeutic effects of Nigella sativa on occupational contact dermatitis
Nigella seeds have known anti-allergic effects in traditional medicine. The therapeutic effects of Nigella sativa powdered in the form of capsules, lipoidal matter extract and the aqueous alcoholic extract of nigella seeds in the form of two ointments were studied in 50 male volunteers aged between 25 and 55 years suffering from chronic occupational contact dermatitis. Blood picture, IgE and natural killer (NK) cells were recorded before and after two weeks of therapy. Treatment with lipoidal extract ointment, alcoholic extract ointment and powdered seed capsules led to complete recovery of the eczematous lesions in 89%, 46%, and 63%, respectively. Clinical improvement by these three treatments was statistically significant, while placebos achieved no significant improvement. NK cell fraction was significantly augmented in treated groups. No harmful effects on the liver and the kidney functions were found.
Central European Journal of Occupational and Environmental Medicine, 2001, Vol.7, No.1, p.26-38. Illus. 42 ref.

CIS 02-814 Uter W., Schnuch A., Geier J., Pfahlberg A., Gefeller O.
Association between occupation and contact allergy to the fragrance mix: A multifactorial analysis of national surveillance data
To assess the role of occupational risk factors for fragrance contact allergy (FCA), data from all 57,779 patch-tested patients in the centres of the Information Network of Departments of Dermatology between January 1992 and December 1998 were analysed. It was found that the proportion of patients with FCA varied greatly between different occupational groups from 2.5% to 17.4%, the highest occupational risk of FCA beeing associated with work as a masseur or physiotherapist, foundry operator, potter or glass worker, or geriatric nurse. Non-occupational factors that influenced risk of FCA included atopy, female sex, several sites, in particular the axillae, and age. Occupations with a high risk of FCA were identified as targets of preventive action, namely the substitution of scented products with fragrance-free substances such as skin disinfectants, cleaning solutions or personal care products.
Occupational and Environmental Medicine, June 2001, Vol.58, No.6, p.392-398. 23 ref.

CIS 02-674 Park H., Sprince N.L., Whitten P.S., Burmeister L.F., Zwerling C.
Farm-related dermatoses in Iowa male farmers and wives of farmers: A cross-sectional analysis of the Iowa farm family health and hazard surveillance project
Agricultural workers are exposed to a variety of hazards that increase their risk of dermatitis. Nevertheless, the prevalence, patterns, and risk factors for dermatitis have not been well characterized among farmers in the United States. The prevalence and risk factors for dermatitis among 382 male farmers and 256 wives of farmers in Iowa were assessed using a cross-sectional study design. From 1992 to 1994, data on potential risk factors and dermatitis were collected. The results showed that 9.6% of male farmers and 14.4% of wives of farmers reported dermatitis during the previous 12-month period. In multivariable models, a history of allergy (odds ratio (OR), 8.2) was strongly associated with dermatitis among male farmers. Among wives of farmers, some college education (OR, 3.4) and exposure to petroleum products (OR, 3.1) were associated with dermatitis. These results can be used to undertake preventive efforts in controlling farm work related exposures.
Journal of Occupational and Environmental Medicine, Apr. 2001, Vol.43, No.4, p.364-369. Illus. 19 ref.

CIS 02-805 Aryal B.K., Khuder S.A., Schaub E.A.
Meta-analysis of systemic sclerosis and exposure to solvents
Although systemic sclerosis is a rare disease, incidence rates have increased recently in the United States. This study investigated the association between systemic sclerosis and exposure to solvents. A Medline search of articles published between 1966 and 2000 dealing with solvent exposure and systemic sclerosis identified eight studies that met inclusion criteria of the meta-analysis. The studies included seven case-control studies and one cohort study published between 1989 and 1998. A series of meta-analyses of studies on systemic sclerosis and solvent exposure were performed for all studies and for the subset of case-control studies. A random effect model was used to calculate a combined estimator of relative risk. The combined estimator of relative risk for all studies was 2.91. The combined estimator of relative risk for the seven case-control studies was 3.14. In conclusion, a statistically significant increased relative risk for all studies and for case-control studies suggests that exposure to organic solvent may be a risk factor for developing systemic sclerosis.
American Journal of Industrial Medicine, Sep. 2001, Vol.40, No.3, p.271-274. 25 ref.

CIS 02-800 Tsunoda T., Kaniwa M.A., Shono M.
Allergic contact dermatitis from a perinone-type dye C.I. Solvent Red 179 in spectacle frames
A 61-year-old Japanese woman developed itchy scaly erythema over the ears where the earpieces of her spectacle frames touched. She had worn the spectacles for 2 years and the eruption appeared after 1 year. She showed a positive patch test reaction to scrapings of red-violet earpieces. Her skin lesions subsided after she changed the red-violet earpieces to colorless ones. She had no history of contact allergy to hair dyes, plastics or other spectacles. According to the producer of spectacles, components of the coloring agent were Solvent Red 179 and 151. Further patch tests were performed with the coloring agent and dyes. Positive reactions were obtained to Solvent Red 179 and Solvent Orange 60. She was negative to Solvent Red 151.
Contact Dermatitis, Sep. 2001, Vol.45, No.3, p.166-167. Illus. 1 ref.

CIS 02-799 Wrangsjö K., Swartling C., Meding B.
Occupational dermatitis in dental personnel: Contact dermatitis with special reference to (meth)acrylates in 174 patients
Between 1995 and 1998, 174 dental personnel were referred as patients to the Department of Occupational and Environmental Dermatology, Stockholm. Hand eczema was diagnosed in 109 patients. 77 had positive reactions to substances in the standard series and 44 to substances exclusive to the dental series. 24 patients had positive reactions to (meth)acrylates, the majority with reactions to several test preparations. The most frequent allergens besides (meth)acrylates were nickel, cobalt, palladium, fragrance mix, colophonium and thiuram mix. Allergy to natural rubber latex was diagnosed in 14 patients. In conclusion, irritant hand dermatitis was the dominant diagnosis. Contact allergy to (meth)acrylate was seen in 22% of the patch tested patients, with reactions to 3 predominant test substances.
Contact Dermatitis, Sep. 2001, Vol.45, No.3, p.158-163. 21 ref.

CIS 02-848 Perrenoud D., Gallezot D., van Melle G.
The efficacy of a protective cream in a real-world apprentice hairdresser environment
The aim of this study was to compare the protective action of a new barrier cream and that of its vehicle in the context of hand irritation of apprentice hairdressers caused by repeated shampooing and exposure to hair-care products. This was a double-blind crossover study comparing the barrier cream (containing aluminium chlorohydrate 5% as active ingredient) against its vehicle alone. The efficacy of the creams was evaluated taking into account the clinical scores by researchers, biometric measurements and subjective opinions of the participants. An analysis of variance was performed considering the order of application, degree of atopy, and reported number of shampoos. Very little difference in efficacy between the protective cream and its vehicle was observed. However, the presence of aluminium chlorohydrate in the protective cream was shown to have a positive effect against work-related irritation. The participants rated the cosmetic qualities of the creams to be as important as their real protective and hydrating properties, an important factor in compliance issues.
Contact Dermatitis, Sep. 2001, Vol.45, No.3, p.134-138. Illus. 23 ref.

CIS 02-300 Allmers H.
Wearing test with two different types of latex gloves with and without the use of a skin protection cream
Among 72 subjects reporting symptoms indicating Type I hypersensitivity reactions to natural rubber latex (NRL) gloves, 44 (60%) had a positive prick test to NRL. They underwent wearing tests using 2 types of NRL gloves with high and low allergen contents. Gloves with a high allergen content caused positive skin reactions in 47% of SPT-positive subjects. After application of a skin protection cream, the frequency of positive skin responses in wearing tests decreased to 30% in prick-test-positive subjects. The gloves with low allergen caused hypersensitivity with and without skin protection cream in 2 cases (5%) of the prick-test-positive. No prick-test-negative subjects showed any urticaria during the glove-wearing test. The study demonstrates that high allergen contents in latex gloves frequently elicit skin responses in NRL-sensitized subjects. Hand skin cream may hamper the uptake of allergens from gloves, thus decreasing allergic reactions.
Contact Dermatitis, Jan. 2001, Vol.44, No.1, p.30-33. Illus. 16 ref.

CIS 02-185 Aplin C.G., Lovell C.R.
Contact dermatitis due to hardy primula species and their cultivars
It is widely believed that of all the Primula species to cause allergic contact dermatitis, P. obconica is the most likely culprit, particularly in Northern Europe. Other species are rarely implicated, probably as a consequence of under-reporting. Moreover, cutaneous reactions to other hardy Primula species and cultivars are milder and may be associated with a state of tolerance after repeated handling. 462 questionnaires were sent out to Auricula and Primula growers and 316 replies were returned with data on 320 growers. 84 out of a total of 320 (26.25%) attributed a cutaneous reaction to Primula species, whereas 236 (73.75%) reported no reaction. Of the 84 who reported reactions, 48 suspected P. auricula, 34 P. obconica, 10 P. vulgaris, 5 P. allionii, 3 P. marginata and 2 P. forrestii. 19 believed that they had reacted to 2 or more species of Primula. The study suggests that Primula species other than P. obconica may elicit dermatitis more frequently than previously recorded.
Contact Dermatitis, Jan. 2001, Vol.44, No.1, p.23-29. Illus. 18 ref.

CIS 02-209 Leino T.
Epidemiology of skin and respiratory diseases among hairdressers
Results of five epidemiologic studies of skin and respiratory disorders among hairdressers are presented. The studies focused on the working conditions in salons, the perceived health of the hairdressers, the prevalence, incidence and risk of skin and respiratory symptoms and diseases among hairdressers, and the risk and causes of leaving the profession. Physical conditions and chemicals in the ambient air were measured in 20 hairdressing salons. Health data were obtained by questionnaire, phone interviews and medical examinations. It was found that hairdressing salons meet Finnish indoor air criteria. High peak concentrations of certain chemicals during hair treatments cause discomfort and ill health to hairdressers and should be controlled, for example with local exhaust ventilation. Hairdressers have an increased risk of developing asthma and chronic bronchitis. Ammonium persulfate caused most of the occupational skin and respiratory diseases.
Finnish Institute of Occupational Health, Publication Office, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland, 2001. 124p. Illus. 287 ref.

CIS 02-327 Kieć-Świerczyńska M., Kręcisz B.
Occupational allergic contact dermatitis in hairdressers due to glutaraldehyde
Two cases of female hairdressers allergic to glutaraldehyde are described. A non atopic 26-year-old woman developed erythema with papules on the hands and face after 4 months' work in a hairdressing salon. She used glutaraldehyde-containing disinfectants for scissors, combs and hairbrushes. A 46-year-old woman worked for 28 years as a hairdresser. She reported dyspnoea, cough attacks and rhinostenosis. For 8 years, she had episodes of erythema with papules on the hands and face, accompanied by pruritus. The disinfectants used contained glutaraldehyde, glyoxal and quaternary ammonium compounds. Patch tests were done with the standard series, the hairdressers series and with 0.2% glutaraldehyde. Both patients reacted positively to glutaraldehyde, which should now be looked for in hairdressers.
Contact Dermatitis, Mar. 2001, Vol.44, No.3, p.185-186. 10 ref.

CIS 02-299 Uter W., Geier J, Lessmann H., Hausen B.M.
Contact allergy due to disperse blue 106 and disperse blue 124 in German and Austrian patients, 1995 to 1999
Between 1995 and 1999, 1,986 patients were tested with a textile dye series containing Disperse Blue (DB) 106 and 124, and since 1997 also with a mix of both. 86 patients (4.3%) reacted positively to DB 106 and/or DB 124; with good concordance between the 2 allergens, and the single allergens and the mix. In contrast, the concordance between DB 106 and p-phenylenediamine, as well as between DB 124 and p-aminoazobenzene, was poor. Some 70% of positive reactions to DB 106 and DB 124 were clinically relevant. Furthermore, a significant increase in the proportion of DB 106/124-positive patients among those tested was found from 1995 to 1999. Hence, DB 106 and DB 124 are important allergens deserving close monitoring. The use of a mix of DB 106 and DB 124 seems justified in view of the close chemical similarity of the compounds. If possible, the presence of these allergens in individual textiles should be checked with thin-layer or column chromatography.
Contact Dermatitis, Mar. 2001, Vol.44, No.3, p.173-177. 19 ref.

CIS 02-314 Funke U., Faratsch M., Diepgen T.L.
Incidence of work-related hand eczema during apprenticeship: First results of a prospective cohort study in the car industry
A total of 2078 apprentices in the Audi automobile company in Germany were investigated at the start of their apprenticeship and systematically followed up over a 3-year period for occupational contact dermatitis. The 1-year cumulative incidence of hand eczema was 9.2% in metalworkers, 8.8% in other blue-collar workers, and 4.6% in white-collar apprentices, while the 3-year cumulative incidence was 15.3%, 14.1% and 6.9% respectively. Among women, the cumulative incidence was higher than in men (1-year incidence 10.1% versus 8.3%; 3-year incidence 16.1% versus 13.6%). In some occupations, such as in cooks, tool mechanics, milling cutters and painters, the incidence was significantly higher than expected. Within the first six months of apprenticeship, there was a particularly high rate of hand eczema, which then declined and remained steady at a lower rate over the 2nd and the 3rd years. Suggested preventive measures include reducing exposures and offering special medical advice to high-risk groups.
Contact Dermatitis, Mar. 2001, Vol.44, No.3, p.166-172. Illus. 12 ref.

CIS 02-298 Geukens S., Goosens A.
Occupational contact allergy to (meth)acrylates
Among 13,833 patients suspected of contact dermatitis examined during the years 1978-1999, occupational contact allergy to acrylates and methacrylates was diagnosed in 31 patients. The three most common sensitizers were ethylene glycol dimethacrylate (17 positive patch tests), 2-hydroxyethyl methacrylate (14 positive tests) and triethyleneglycol dimethacrylate (6 positive tests). The aim of this report was to identify the occupations and industries responsible for occupational sensitization to acrylates and methacrylates. 14 of the 31 patients worked in the dental sector, where acrylate- or methacrylate-containing dental prostheses and dental composites would appear to be mainly responsible for allergy to acrylates and methacrylates. An increase in skin problems related to the growing use of acrylates or methacrylates is clearly shown by the data.
Contact Dermatitis, Mar. 2001, Vol.44, No.3, p.153-159. Illus. 27 ref.

CIS 02-204 Skin cancer - Detection, reporting and compensation
Cancers de la peau - Comment les repérer, les déclarer, les faire reconnaître, les faire indemniser [in French]
Contents of this booklet describing the compensation system for occupational skin cancer in France: introduction and general considerations on occupational cancers; reporting procedures; occupational activities having possibly given rise to exposures to agents known to cause skin cancer (arsenic, tars, coal combustion products, crude oil-derived mineral oils, ionizing radiation) as well as the corresponding compensation systems. It duplicates the section of the general booklet on the compensation of occupational cancers in France (see CIS 02-201) applicable specifically to skin cancer.
Ligue nationale contre le cancer, 14 rue Corvisart, 75013 Paris, France, 2001. 13p.

CIS 01-1649
Health and Safety Executive
Sun protection
Exposure to ultraviolet (UV) radiation from the sun can cause skin damage including sunburn, blistering, skin ageing, and in the long term can lead to skin cancer. This leaflet is aimed at employers or managers responsible for persons working outdoors for most of the day. It contains advice on reducing the health risks from UV radiation, which include staying fully-clothed, wearing a hat with a brim that covers the ears and back of the neck, using solar creams, drinking water to prevent dehydration and regularly checking the skin for any unusual moles or spots.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, Apr. 2001. 6p. Illus. 1 ref.

CIS 01-724
Health and Safety Executive
Assessing and managing risks at work from skin exposure to chemical agents
This booklet provides practical advice to employers on how to control skin exposure to chemical agents at the workplace. Main topics covered: legal requirements; skin action of chemical agents; health effects (irritant or allergic contact dermatitis; other skin diseases such as urticaria, loss of pigmentation, skin cancer; systemic effects); hazard identification: risk assessment (exposure pathways, skin exposure measurement, biological monitoring); risk management (exposure prevention or control, elimination or substitution of the harmful substance, engineering control, process modification, modification of working methods, personal protective equipment, skin care products); health surveillance; information and training. Appendix includes references to relevant legislation.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, Jan. 2001. iv, 28p. Illus. 44 ref. Price: GBP 8.00.

2000

CIS 03-391 Lonne-Rahm S., Andersson B., Melin L., Schultzberg M., Arnetz B., Berg M.
Provocation with stress and electricity of patients with "sensitivity to electricity"
A total of 24 patients with self-reported skin symptoms when exposed to electromagnetic fields were tested in a provocation study, together with 12 controls matched by age and sex. Both groups were exposed to 30-minute periods of high or low stress situations, with and without simultaneous exposure to electromagnetic fields from a visual display unit. Stress was induced by requiring the participants to react to a random sequence of flashing lights while simultaneously solving complicated mathematical problems. Blood samples were analysed for levels of the stress-related hormones and the expression of different peptides, cellular markers and cytokines. Skin biopsies were also analysed for the occurrence of mast cells. Patients reported increased skin symptoms when they knew or believed that the electromagnetic field was turned on. However, there were no differences under blind conditions. Inflammatory mediators and mast cells in the skin were not affected by the stress exposure or by exposure to electromagnetic fields.
Journal of Occupational and Environmental Medicine, May 2000, Vol.42, No.5, p.512-516. 30 ref.

CIS 02-1156 Occupational skin diseases
Occupational skin diseases are notifiable under the Singapore Factories Act (CIS 91-703) and Workmen's Compensation Act (CIS 00-602). This information leaflet describes the common causes of occupational skin diseases (chemical, physical, mechanical, biological) and the corresponding preventive measures, including the responsibilities of management and of employees.
Ministry of Manpower, Occupational Health Department, 18 Havelock Road #05-01, Singapore 059764, Republic of Singapore, [c2000]. 8p. Illus.

CIS 02-1452 Vandersmissen G., Moens G., Vranckx R., de Schryver A., Jacques P.
Occupational risk of infection by varicella zoster virus in Belgian healthcare workers: A seroprevalence study
The presence of varicella zoster virus (VZV, chickenpox) antibodies was investigated in health care personnel in Belgian hospitals. The prevalence of VZV seropositivity was 98.5%. Seronegative workers were significantly fewer among nursing than among non-nursing staff. Because of this low overall susceptibility, VZV infection seems not to be an important occupational risk among healthcare workers. A negative history of chickenpox had no value as a predictor of susceptibility in adults.
Occupational and Environmental Medicine, Sep. 2000, Vol.57, No.9, p.621-626. Illus. 28 ref.

CIS 02-683 John S.M., Uter W., Schwanitz H.J.
Relevance of multiparametric skin bioengineering in a prospectively-followed cohort of junior hairdressers
To study the association between anamnestic and clinical findings, and multiparametric skin bioengineering data (transepidermal water loss (TEWL), microcirculation, capacitance, pH, sebum, temperature), hairdresser apprentices were prospectively followed for 3 years. Of the 66 apprentices, 19 developed moderate or severe dermatitis ("cases"), 32 had minimal skin changes and 15 were unaffected. Neither the atopy score nor the bioengineering parameters were significantly associated with the development of dermatitis. However, there was a significant increase in TEWL within the first year of training among "cases". Results show that work-related monitoring of basal biophysical skin-functions could become useful in the secondary prevention of occupational dermatitis. Further work is still required to develop a predictive tool for pre-employment counseling in wet work based on a combination of clinical and relevant non-invasive bioengineering parameters.
Contact Dermatitis, Sep. 2000, Vol.43, No.3, p.161-168. Illus. 23 ref.

CIS 02-849 Shaffer M.P., Belsito D.V.
Allergic contact dermatitis from glutaraldehyde in health-care workers
Glutaraldehyde is the disinfectant of choice for sterilizing medical and dental equipment, but is known to induce allergic contact dermatitis. In a 5-year study, 468 patients were patch tested to glutaraldehyde. Health-care workers were more than eight times more likely to be allergic to glutaraldehyde than non-health-care workers. Allergic contact dermatitis from glutaraldehyde often causes persistent dermatitis, which frequently forces patients to leave their jobs. Until a less sensitizing disinfectant is developed, it is in the best interest of those in health-care professions and other professions exposed to glutaraldehyde to reinforce occupational hygiene standards with respect to the limitation of exposure, in particular through improved methods of barrier protection.
Contact Dermatitis, Sep. 2000, Vol.43, No.3, p.150-156. 23 ref.

CIS 02-662 Goon A.T.J., Goh C.L.
Epidemiology of occupational skin disease in Singapore 1989 - 1998
All patients diagnosed with occupational skin diseases in the National Skin Centre, Singapore, between 1989 and 1998 were studied retrospectively. Irritant contact dermatitis was found to be more common than allergic contact dermatitis. The major sources of occupational dermatitis were the metalworking and engineering, building and construction, electrical and electronics, and transport industries. The main irritants were detergents and wet work, solvents, and oils and greases. The main allergens were chromate, rubber chemicals and nickel. That the main sources of occupational skin disease and main allergens were the same as those found in a similar study of occupational skin diseases in 1984-85. Weak irritants are still the predominant causes of occupational irritant contact dermatitis.
Contact Dermatitis, Sep. 2000, Vol.43, No.3, p.133-136. 3 ref.

CIS 02-818 Murphy R., Gawkrodger D.J.
Occupational latex contact urticaria in non-health-care occupations
Three case reports of latex contact urticaria are presented, involving workers in non-health-care occupations: a ceramic tiler, a car cleaner and a automobile mechanic. All three wore gloves at work. All tested positive to natural latex rubber patch and prick tests.
Contact Dermatitis, Aug. 2000, Vol.43, No.2, p.111. 6 ref.

CIS 02-661 Meding B.
Differences between the sexes with regard to work-related skin disease
In most countries, reports of skin disease are more frequent for women than for men. Epidemiological studies of hand eczema also show that women, in particular young women, are more often affected than men. Experimental studies of skin irritation have not confirmed differences between the sexes; thus, the higher prevalence of irritant contact dermatitis among women is most likely due to exposure. The most common type of hand eczema is irritant contact dermatitis, which is often caused by wet work encountered in many female-dominated occupations such as hairdressing, catering, cleaning and health-care. These occupations are also high-risk occupations for hand eczema. Nickel allergy is the most common contact allergy, which is most frequent in young women through contact with jewelry, and in 30-40% of cases gives rise to hand eczema. Preventive efforts should aim at reducing wet exposure.
Contact Dermatitis, Aug. 2000, Vol.43, No.2, p.65-71. Illus. 41 ref.

CIS 02-373 Crepy M.N.
Occupational skin diseases caused by cutting fluids
Dermatoses professionnelles aux fluides de coupe [in French]
Cutting fluids are in widespread use for lubrication and cooling during machining operations. The most common occupational skin diseases caused by cutting fluids include dermatitis from contact with aqueous fluids, whose use is growing. Contents of this practical data sheet aimed at occupational physicians: classification; composition; effects on skin; epidemiology; diagnosis at workplace; confirmation of diagnosis in specialised medical institutions; prognosis; prevention and treatment; compensation of occupational diseases caused by exposure to cutting fluids.
Documents pour le médecin du travail, 3rd Quarter 2000, No.83, p.295-304. 61 ref.

CIS 02-312 Berndt U., Hinnen U., Iliev D., Elsner P.
Hand eczema in metalworker trainees - An analysis of risk factors
The present study, as part of PROMETES (Swiss Prospective Metal Worker Eczema Study), was performed to examine risk factors for the development of occupational hand dermatitis in metal-worker trainees. Since this disease is very common, a high standard of preventive measures is necessary, especially for persons with an endogenous disposition for the development of eczema. Within the cohort of 201 healthy young men, 47 (23%) showed at least mild signs of hand eczema at within the 2.5 year observation period. Various occupational and domestic exposures, skin protection behaviour, regeneration time, and smoking habits, as well as atopic disposition, were studied with regard to their influence on the skin condition of the metalworker trainees. The important risk factors for the development of hand eczema included atopic disposition, mechanical factors as possible irritants to the epidermal barrier, and an insufficient amount of skin recovery time, supporting a cumulative sub-irritant effect on the skin, possibly leading to irritant contact dermatitis.
Contact Dermatitis, Dec. 2000, Vol.43, No.6, p.327-332. Illus. 12 ref.

CIS 01-1706 Livesley E., Rushton L.
Health and Safety Executive
The prevalence of occupational dermatitis amongst printers in the Midlands
The objectives of this project were to quantify the extent of dermatitis in the printing industry, identify links between dermatitis and particular processes and activities, and to formulate proposals for reducing occupational dermatitis in this industry. Questionnaires were addressed to 2,600 workers in the graphics, paper and media sector, with a response rate of 62%, 41% of whom reported a skin complaint at some time and 26% a current skin problem on the hand. Prevalence was highest among persons involved in printing (49%). 45 subjects with self-reported current dermatitis and 60 controls were subjected to medical examination. It was estimated that for 26 (68%) cases, irritant contact dermatitis was caused by occupational factors. It was also found that many existing guidelines were not being properly implemented within the printing industry.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2000. vi, 74p. Illus. 33 ref. Price: GBP 15.00.

CIS 01-1715 Crepy M.N.
Occupational skin diseases of hairdressers
Dermatoses professionnelles des coiffeurs [in French]
Occupational skin diseases affecting hairdressers are frequent, appear precociously and are often wrongly diagnosed. Contents of this information note on occupational allergy and dermatology: epidemiology; causative factors (occupational risk factors, endogenous factors); diagnosis at the place of work (clinical forms, differential diagnosis, inspection of the workplace, spot tests); confirmation of the diagnostic in a specialised facilities (allergy studies of eczema and contact urticaria); prognosis; prevention; workers' compensation.
Documents pour le médecin du travail, 1st Quarter 2000, No.81, p.61-68. Illus. 77 ref.

CIS 01-1482 Rühl R., Hadrich D.
Fighting against skin diseases due to exposure to cement
Gegen Hautschäden durch Zement [in German]
Cement-induced skin diseases (cement dermatitis) constitute an important occupational issue in a number of countries. The high alkalinity of cement and the abrasion of hands when working with cement are the causes of cement-induced chemical and irritating dermatitis. These two factors are also the precursors of allergies to chromates which result from chromate compounds included in cement. Leather gloves do not ensure protection from alkalinity. The most efficient measure to reduce skin diseases due to cement is to lower the proportion of chromate compounds in cement. Statistics from Denmark and Finland show a decline of cement-induced chromate sensitivity after the proportion of chromate compounds in cement was lowered as a result of new regulations.
Bundesarbeitsblatt, 2000, No.2, p.18-21. Illus. 7 ref.

CIS 01-1530 Ahlén C., Mandal L.H., Johannessen L.N., Iversen O.J.
Survival of infectious Pseudomonas aeruginosa genotypes in occupational saturation diving environment and the significance of these genotypes for recurrent skin infections
Occupational saturation divers suffer from various skin disorders, of which skin infections are the most serious and frequent. Pseudomonas aeruginosa is the microbe most often isolated. P.aeruginosa isolates from 292 skin infections in operational saturation divers and about 800 isolates from occupational saturation diving systems have been collected during the period 1986 to 1998. 472 P.aeruginosa isolates have been genetically analyzed, of which 181 originate from skin infections in divers. 97 different P.aeruginosa genotypes have been defined. Some of these genotypes are solely found from skin infections, some solely from the saturation environment and about 25% were found both from infections and from the saturation environment. Eight frequent infectious genotypes are shown to be present over several years, both in infections and in the saturation environment. The study suggests that skin infections in occupational saturation divers are commonly caused by environmental strains and not by diver-to-diver contagion.
American Journal of Industrial Medicine, May 2000, Vol.37, No.5, p.493-500. Illus. 10 ref.

CIS 01-1152 Gallo R., Cozzani E., Brusati C., Guarrera M.
Ewe milker's hand dermatitis
Case study of a non atopic 25-year-old Sardinian shepherd with recurrent hand dermatitis. Three months after having started sheep breeding, he developed an itchy, fissured hand dermatitis which lasted for the whole lambing and milking season. The eczema was exacerbated by the activity of milking the ewes and partially cleared in summer. Patch testing was negative. After applying wet ewe wool on the palm for 20 minutes, whealing was visible at the site of application.
Contact Dermatitis, June 2000, Vol.42, No.6, p.361-362. Illus. 6 ref.

CIS 01-1144 Queille-Roussel C., Graeber M., Thurston M., Lachapelle J.M., Decroix J., de Cuyper C., Ortonne J.P.
SDZ ASM 918 is the first non-steroid that suppresses established nickel contact dermatitis elicited by allergen challenge
SDZ ASM 918, a non-steroid selective cytokine-inhibitor developed for treatment of inflammatory skin diseases, has been shown to be effective in the treatment of atopic dermatitis and psoriasis. In this study, 2 SDZ ASM 918 cream formulations were tested for their efficacy to suppress nickel contact dermatitis induced by 48h challenge with 5% nickel sulfate in water patches in 66 healthy volunteers with previous positive patch tests to nickel. The established allergic contact dermatitis was treated for 12 days. Evaluation of erythema, induration and vesiculation was performed. SDZ ASM 918 formulations were significantly more effective than corresponding vehicles.
Contact Dermatitis, June 2000, Vol.42, No.6, p.349-350. 6 ref.

CIS 01-1151 Kanerva L., Alanko K., Pelttari M., Estlander T.
Occupational allergic contact dermatitis from Compositae in agricultural work
A 36-year-old non atopic man working as an agricultural substitute worker fir the past 12 years developed severe vesicular dermatitis on the back of his hands and milder dermatitis on his lower arms, upper chest and face. In his work, he had fed cattle with hay contaminated with weeds such as Compositae (Asteraceae), and had also been exposed to many agricultural chemicals. Away from work he was symptom-free. Patch tests with various Compositae showed a strong positive reaction. It was concluded that the patient had occupational allergic contact dermatitis from Compositae and it was recommended that he should change to a job where no exposure to such substances would occur.
Contact Dermatitis, Apr. 2000, Vol.42, No.4, p.238-239. Illus. 15 ref.

CIS 01-1067 Vermeulen R., Kromhout H., Bruynzeel D.P., de Boer E.M.
Ascertainment of hand dermatitis using a symptom-based questionnaire: Applicability in an industrial population
The applicability of a symptom-based questionnaire on hand dermatitis was assessed in a population of 224 rubber workers. Subsequently, 202 workers were examined by a dermatologist. The two different diagnostic tools used for assessing dermatitis resulted in dissimilar estimates of the prevalence of hand dermatitis, ranging from 6.9% to 38.1% of all workers. Using the medical evaluation as benchmark, moderate sensitivity and specificity (respectively 71.4% and 76.1%), low positive predictive value (18.2%) and high negative predictive value (97.3%) were observed for the classification based on the self-administered questionnaire. When evaluated against "first symptoms of dermatitis" the sensitivity decreased, while the specificity remained almost the same. The findings differ from the original questionnaire validation study among nurses. If questionnaires are to be used, validity studies have to be carried out to evaluate differences in perception of skin diseases between different occupational populations.
Contact Dermatitis, Apr. 2000, Vol.42, No.4, p.202-206. 20 ref.

CIS 01-1143 Bohn S., Niederer M., Brehm K., Bircher A.J.
Airborne contact dermatitis from methylchloroisothiazolone in wall paint. Abolition of symptoms by chemical allergen activation
Preservatives such as isothiazolinones in paints have been reported to cause airborne contact dermatitis. Cases from five patients who experienced acute dermatitis on air-exposed skin and respiratory symptoms after staying in recently painted rooms are reported. Kathon® (a mixture of methylchloroisothiazolinone and methylisothiazolinone) added as preservative to the wall paint was identified as the causative agent. In one person, symptoms rapidly disappeared after treatment of the painted walls with sodium bisulfite which leads to inactivation of the allergenic properties of Kathon®. Chemical analyses of the decorating paints used and experiments on emission and air concentration of Kathon® from a painted surface before and after inactivation by sodium bisulfite are also described.
Contact Dermatitis, Apr. 2000, Vol.42, No.4, p.196-201. Illus. 24 ref.

CIS 01-1164 Hatch K.L., Maibach H.I.
Textile dye allergic contact dermatitis prevalence
This article summarizes textile dye prevalence studies and makes recommendations for advancing knowledge about textile-dye sensitization. Prevalence data is provided by study and by dye. Most textile-dye prevalence studies having been conducted in Italy, dermatology teams are encouraged to conduct research in other countries, to include dyes for which the least prevalence data has been collected, to standardize the application and reading methods, and to verify the purity and the identity of dyes used for patch testing. Testing with pure dyes and other chemicals in dye formulations should provide insights into the proper choice of dye systems that will decrease sensitization.
Contact Dermatitis, Apr. 2000, Vol.42, No.4, p.187-195. 20 ref.

CIS 01-424 Röcher W.
Skin protection and care
Protección y cuidados de la piel [in Spanish]
Occupational skin diseases can be avoided if the employer adopts a plan of specific measures aimed at protecting the skin before work starts and providing proper care at the end of the working day. Such an approach has two advantages: it ensures that workers have a healthy skin, and it costs little in comparison with curative measures in the event of lesions. Following a brief introduction on the structure and functions of the skin, preventive measures to be adopted and various types of topics for skin care and protection are presented. Advice for implementing a skin protection plan within the enterprise is also included.
Mapfre seguridad, 3rd Quarter 2000, Vol.20, No.79, p.25-35. Illus.

CIS 01-494 Gala Ortiz G., Condé-Salazar L., Guimaraens D., de la Hoz C., Cuevas Agustin M.
Occupational protein contact dermatitis from fruits
Case description of an atopic 17-year-old male smoker, who had been working as a kitchen assistant for one year, handling various types of food, mainly fruit, potato, garlic and onion. Three months prior to consultation, he had developed pruritus on his hands which caused scratching. On examination, he had eczema on the fingers, backs of the hands and both wrists. He noted an increase in pruritus after handling fruits (mostly apples, oranges, pears and peaches), and vegetables (potatoes, garlic and onions). He also reported the appearance of weals on the wrists after handling melons. On prick-by-prick testing, positive reactions were obtained to a series of fruits. In a rub test, only peach skin was positive. Specific IgE was detected for profillin.
Contact Dermatitis, July 2000, Vol.43, No.1, p.43. 9 ref.

CIS 01-493 Dawn G., Gupta G., Forsyth A.
The trend of nickel allergy from a Scottish tertiary referral centre
To analyse the change in trend of allergic contact dermatitis (ACD) from nickel in a specialized medical centre, 800 and 860 patients were patch tested in 1982 and 1997, respectively. The frequency of positive reactions to nickel was 16% in 1982 and 22% in 1997. The commonest age of onset in 1982 was in the 11-20 year age group while in 1997, this was 1 decade later. In 1997, a much higher female preponderance (F:M=13:1) was observed than in 1982 (F:M=6:1). The rate of atopy in patients with nickel ACD showed an increase from 23% in 1982 to 33% in 1997. Nickel was considered to be a contributory factor in 27% of patients in 1982 and 24% patients in 1997. The most common occupations were hairdressing in 1982 and nursing in 1997. In 1997 a massive increase in the number of patients showing positive reactions to other allergens in addition to nickel was observed. In both years, the hands were the main sites of involvement. However, in 1997 there was an increase in the number of patients presenting with face and neck involvement.
Contact Dermatitis, July 2000, Vol.43, No.1, p.27-30. Illus. 28 ref.

CIS 01-492 Sugiura M., Hayakawa R., Kato Y., Sugiura K., Ueda H.
4 cases of photocontact dermatitis due to ketoprofen
Four cases of photocontact dermatitis due to ketoprofen, a non-steroidal anti-inflammatory drug derived from propionic acid are reported. All 4 cases developped dermatitis on the areas where strips containing ketoprofen had been applied when exposed to sunlight. A skin biopsy was carried out to examine the amount of ketoprofen in the eruptive skin. Cross-reactions between tiaprofenic acid, suprofen and ketoprofen were highlighted by patch and photopatch testing. Vehicles of patients' medicaments were negative in all 4 cases. After covering their eruptions with sunblock creams for around 3 months the patients did not develop eruptions again.
Contact Dermatitis, July 2000, Vol.43, No.1, p.16-19. Illus. 11 ref.

CIS 01-505 Lindberg M., Silverdahl M.
The use of protective gloves and the prevalence of hand eczema, skin complaints and allergy to natural rubber latex among dental personnel in the county of Uppsala, Sweden
To evaluate the prevalence of acrylate allergy and natural rubber latex (NRL) allergy among dentists, dental nurses and dental hygienists were given a self-administered questionnaire. The most common problem among the 527 respondents was dry skin, fissures and/or itching of the hands. Of the 72 persons reporting to have suffered from hand eczema during the past 12 months, 41 were patch tested. In the patch-tested group, 9.8% reacted to one or more of the acrylates. In addition, 389 persons were tested for NRL allergy with the Pharmacia Upjohn CAP-RAST test, and of these, 7.2% were found to be positive. The prevalence of self-reported hand eczema and the number of positive CAP-RAST tests differed between the 3 occupations, with higher figures for the dentists. There was also a correlation between atopic eczema and hand eczema. Of those reporting skin symptoms, 67.7% associated them with the workplace and 28.8% with the use of gloves.
Contact Dermatitis, July 2000, Vol.43, No.1, p.4-8. 27 ref.

CIS 01-161 Wallenhammar L.M., Örtengren U., Andreasson H., Barregård L., Björkner B., Karlsson S., Wrangsjö K., Meding B.
Contact allergy and hand eczema in Swedish dentists
The occurrence of contact allergy, in particular in reaction to acrylates and methacrylates, was investigated. Certain consequences of hand eczema were evaluated by a questionnaire mailed to 3,500 Swedish dentists. Among respondents residing in three major cities, 14.9% reported hand eczema during the previous year and were invited to a clinical examination, including patch testing. 83% attended, among whom a diagnosis of hand eczema was confirmed in 94% of the cases. Irritant contact dermatitis was diagnosed in 67% and allergic contact dermatitis in 28%. On patch testing, 50% presented at least one positive reaction. The most frequent allergens were nickel sulfate, fragrance mix, gold sodium thiosulfate and thiuram mix. It is concluded that dentistry is a high-risk occupation for hand eczema, and that irritant contact dermatitis is most common. However, the prevalence of contact allergy to acrylates was below 1% in the population of responding dentists.
Contact Dermatitis, Oct. 2000, Vol.43, No.4, p.192-199. 31 ref.

CIS 01-253 Avenel Audran M., Hausen B.M., le Sellin J., Ledieu G., Verret J.L.
Allergic contact dermatitis from hydrangea - Is it so rare?
Eight cases of allergic contact dermatitis from the ornamental plant Hydrangea macrophylla observed in Angers, France, during a period of 15 years are reported and compared to other cases described in literature. Allergic contact dermatitis from hydrangeas appears to be an occupational dermatosis among nursery workers, presenting as a chronic eczema involving the hands and especially the first 3 fingers. Differential diagnosis from irritant contact dermatitis may be difficult. Patch tests with the stem as well as the leaf of hydrangeas gave strong positive reactions in all patients, and hydrangenol, the allergen of hydrangea, when tested, always also gave a positive reaction. Sensitization seems to occur after prolonged contact with the plant, which could explain the relative frequency in Angers, a city that provides almost 90% of hydrangea seedling production in France.
Contact Dermatitis, Oct. 2000, Vol.43, No.4, p.189-191. 15 ref.

CIS 00-1354 Gee M.R.
Dermatologic disease: Twenty-two year experience at the USAF aeromedical consultation service and review of other military and civilian experiences
The Aeromedical Consultation Service (ACS) is a U.S. Air Force tertiary referral service which evaluates aviators with complex medical problems and makes recommendations for their aeromedical disposition. This study reports the experience with dermatologic disease among aviators referred to the ACS over a 22-year period from 1975-1997. Fungal diseases were seen most frequently (14.5%). Five aviators were permanently disqualified from flying duties due to chronic urticaria. A review of other military and civilian experiences with dermatologic disease is also presented.
Aviation, Space, and Environmental Medicine, Mar. 2000, Vol.71, No.3, p.230-237. 34 ref.

CIS 00-1409 Kanerva L., Alanko K., Estlander T., Jolanki R., Lahtinen A., Savela A.
Statistics on occupational contact dermatitis from (meth)acrylates in dental personnel
During 1975-1998, 630 cases of occupational dermatosis in dental personnel were reported to the Finnish Register of Occupational Diseases, 70.6% of which were allergic. The number of cases greatly increased during the last decade. No cases of acrylates or methacrylates allergy were reported in 1975-1981. During 1982-1998, 161 cases were reported, 87% being allergic. The largest annual number of occupational dermatoses from acrylates and methacrylates in dental personnel were reported in 1998.
Contact Dermatitis, Mar. 2000, Vol.42, No.3, p.175-176. Illus. 14 ref.

CIS 00-1406 Kanerva L., Alanko K.
Occupational allergic contact urticaria from maleic anhydride
A 32-year-old non-atopic process operator presented rhinitis, dyspnoea, conjunctivitis and whealing, the respiratory symptoms preceding the skin symptoms. He had worked as a carpenter and with cement, and for 3 years in a firm manufacturing polyester resin prior to onset. His job was to pour maleic anhydride granules from 25kg bags into a 1000kg vessel. He used a fresh-air helmet because of the dust. His skin symptoms were itchy wheals. Based on anamnestic data, prick tests, RASTs and a provocation test, it was concluded that the patient had occupational allergic IgE-mediated rhinoconjunctivitis and contact urticaria from maleic anhydride. Because of the risk of occupational asthma, he was advised not to continue his job.
Contact Dermatitis, Mar. 2000, Vol.42, No.3, p.170-172. 15 ref.

CIS 00-1456 Christensen L.P., Larsen E.
Direct emission of the allergen primin from intact Primula obconica plants
The allergen primin and its precursor miconidin were collected by dynamic headspace technique from the glasshouse plant Primula obconica Hance and quantified and identified by gas chromatography and gas chromatography-mass spectrometry. The primin concentrations in leaves/stems and flowers of P. obconica were 262µg and 531µg per g fresh plant material, respectively, whereas miconidin concentrations were 92µg per g fresh plant material in leaves and stems and 194µg per g fresh plant material in flowers. The amounts of primin released from unchopped leaves/stems and flowers were 65.3ng and 18.8ng per g fresh plant material per hour, respectively. Dynamic headspace analysis of intact P. obconica plants showed that primin is also directly emitted from undamaged plants, although in smaller concentrations, whereas miconidin was only emitted in minute amounts. The possibility that primin from P. obconica could be a potential airborne allergen and therefore a source of airborne contact dermatitis is discussed.
Contact Dermatitis, Mar. 2000, Vol.42, No.3, p.149-153. Illus. 24 ref.

CIS 00-1349 Kirkeskov Jensen L.K., Mikkelsen S., Pryds Loft I., Eenberg W.
Work-related knee disorders in floor layers and carpenters
To examine the relationship among knee-straining work, self-reported knee-complaints and physical signs of knee disorders, 133 floor layers, 506 carpenters and 327 compositors aged 26 to 72 years without previous acute knee traumas were surveyed in a cross-sectional study by means of a questionnaire. A random sample of the questionnaire responders, 67 floor layers, 127 carpenters and 101 compositors had independent double examinations for physical signs of knee disorders. Videotapes showed that knee-straining work constituted 56% of working time for floor layers, 26% for carpenters, and none for compositors. The prevalences of self-reported knee-complaints were positively associated with the amount of knee-straining work and were significantly different for the three trades. The clinical study showed a positive association for knee-straining work, hyperkeratosis and bursitis.
Journal of Occupational and Environmental Medicine, Aug. 2000, Vol.42, No.8, p.835-842. 37 ref.

CIS 00-803 Vanhanen M., Tuomi T., Tiikkainen U., Tupasela O., Voutilainen R., Nordman H.
Risk of enzyme allergy in the detergent industry
To assess the prevalence of enzyme sensitization in a detergent factory, 40 workers in manufacturing, packing and maintenance, and 36 non-exposed persons in the management and sales departments were subjected to skin prick and radioallergosorbent tests. Nine workers were sensitized to enzymes in the exposed group of 40, whereas none were sensitised in the non-exposed group. All the sensitized workers had symptoms at work; all had rhinitis and one had asthma. Airborne protease concentrations were generally <20ng/m³, but occasional peak values up to 80ng/m³ were detected in the packing and maintenance tasks, and high values of >1µg/m³ in the mixing area. Despite the use of encapsulated enzyme preparations, high enzyme concentrations in workplace air are possible, resulting in a higher risk of sensitization than expected.
Occupational and Environmental Medicine, Feb. 2000, Vol.57, No.2, p.121-125. 24 ref.

CIS 00-781 Franklin P.J., Goldenberg W.S., Ducatman A.M., Franklin E.
Too hot to handle: An unusual exposure of HDI in specialty painters
Between November 1993 and May 1994, seven painters and one boilermaker who were working at three different power plants were examined following complaints of asthma, dyspnoea or rash. At their respective work sites, hexamethylene diisocyanate (HDI) was applied to the hot surfaces of boilers that were shut down but not allowed sufficient time to cool. Consequently, these workers were exposed to volatile HDI and its thermal decomposition products. All of these workers underwent a complete physical examination, spirometry and methacholine challenge testing. All 8 workers complained of dyspnoea, while 4 of the 8 also complained of rash. On examination, 3 workers were methacholine challenge positive and 2 had persistent rash. At follow-up 4 years later, 5 workers still had to use inhalation medication and one had progressive asthma and dermatitis. All 8 workers, by the time of the follow-up, had gone through economic and occupational changes.
American Journal of Industrial Medicine, Apr. 2000, Vol.37, No.4, p.431-437. 39 ref.

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