Advertisement

American Journal of Clinical Dermatology

, Volume 2, Issue 6, pp 353–365 | Cite as

Occupational Contact Dermatitis

Recognition and Management
  • Patrick KochEmail author
Therapy in Practice

Abstract

Occupational contact dermatitis (OCD) represents 90 to 95% of all occupational dermatoses. The incidence rate of OCD is estimated to be around 0.5 to 1.9 cases per full-time worker per year. However, epidemiologic data are lacking and incidence is probably underestimated, especially in the US. Over the past 20 years, OCD has been the most frequently reported occupational disorder to German social insurance institutions.

Critical factors in the management of OCD are recognition of clinical features, knowledge of allergens and irritants present in different occupational fields, knowledge of suitable protection, interpretation of patch test results, and awareness of medicolegal aspects. Management of OCD should be carried out by dermatologists and patch test clinics in cooperation with physicians specialized in industrial medicine.

Individuals at high risk of OCD are hairdressers, dental laboratory technicians, other healthcare workers, construction industry workers, metal workers, leather and shoe manufacturers, florists and gardeners, and bakers, caterers, confectioners and cooks.

Keywords

Contact Dermatitis Allergic Contact Dermatitis Irritant Contact Dermatitis Dental Technician Contact Urticaria 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Rycroft R.J.G. Occupational contact dermatitis. In: Rycroft R.J.G., Menné T., Frosch P.G. Textbook of Contact Dermatitis. 2nd ed. Berlin: Springer Verlag, 1995: 343–400Google Scholar
  2. 2.
    Diepgen T.L., Coenraads P.J. The epidemiology of occupational contact dermatitis. Int Arch Occup Environ Health 1999; 72: 496–506PubMedCrossRefGoogle Scholar
  3. 3.
    Mathias C.T., Morrison J.H. Occupational skin diseases, United States: results from the Bureau of Labor Statistics Annual Survey of Occupational Injuries and Illnesses, 1973 through 1984. Arch Dermatol 1988; 124: 1519–1524PubMedCrossRefGoogle Scholar
  4. 4.
    Van der Walle H.B. Dermatitis in hairdressers (II). Management and prevention. Contact Dermatitis 1994; 30: 265–270PubMedCrossRefGoogle Scholar
  5. 5.
    Uter W., Pfahlberg A., Gefeller O., et al. Hand dermatitis in a prospective-followed cohort of hairdressing apprentices: final results of the POSH study. Contact Dermatitis 1999; 41: 280–286PubMedCrossRefGoogle Scholar
  6. 6.
    Bjórkner B. Plastic materials. In: Rycroft R.J.G., Menné T., Frosch P.G. Textbook of contact dermatitis. 2nd ed. Berlin: Springer Verlag, 1995: 537–572Google Scholar
  7. 7.
    Schnuch A., Lehmacher W. Zur epidemiologischen Überwachung des Kontaktekzems/Darstellung des Projektes Informationsverbund Dermatologischer Kliniken (IVDK) in Anlehnung an die Guidelines for Evaluating Surveillance Systems des Center of Disease Control (CDC). Dermatosen 1992; 40: 177–189Google Scholar
  8. 8.
    Uter W., Gefeller O., Schwanitz H.J. Occupational dermatitis in hairdressing apprentices: early onset of irritant skin damage. Curr Probl Dermatol 1995; 23: 49–55PubMedGoogle Scholar
  9. 9.
    Straube M., Uter W., Schwanitz H.J. Occupational allergic contact dermatitis from thiolactic acid contained in ‘ester-free’ permanent-waving solutions. Contact Dermatitis 1996; 34: 229–230PubMedCrossRefGoogle Scholar
  10. 10.
    Fisher A.A. Contact dermatitis from food additives and dyes. In: Rietschel R.L., Fowler J.F., editors. Fisher’s contact dermatitis. 4th ed. Baltimore (PA): Williams & Wilkins, 1995: 693Google Scholar
  11. 11.
    Frosch P.J., Burrows D., Camarasa J.G., et al. Allergic reactions to a hairdressers’ series: results from 9 European centres. Contact Dermatitis 1993; 28: 180–183PubMedCrossRefGoogle Scholar
  12. 12.
    Van der Walle H.B., Brusveld V.M. Latex allergy among hairdressers. Contact Dermatitis 1995; 32: 177–178PubMedCrossRefGoogle Scholar
  13. 13.
    Freeman S., Lee M.S. Contact urticaria to hair conditioner. Contact Dermatitis 1996; 35: 195–196PubMedCrossRefGoogle Scholar
  14. 14.
    Estlander T., Rajaniemi R., Jolanki R. Hand dermatitis in dental technicians. Contact Dermatitis 1984; 10: 201–205PubMedCrossRefGoogle Scholar
  15. 15.
    Mürer A.J.L., Poulsen O.M., Roed-Petersen J., et al. Skin problems among Danish dental technicians. A cross-sectional study. Contact Dermatitis 1995; 33: 42–47PubMedCrossRefGoogle Scholar
  16. 16.
    Rustemeyer T., Frosch P.J. Occupational skin diseases in dental laboratory technicians. (I) Clinical pictures and causative factors. Contact Dermatitis 1996; 34: 125–133PubMedCrossRefGoogle Scholar
  17. 17.
    Fisher A.A. Contact dermatitis in health personnel. In: Rietschel R.L., Fowler J.F., editors. Fisher’s contact dermatitis. 4th ed. Baltimore (PA): Williams & Wilkins, 1995: 595Google Scholar
  18. 18.
    Kanerva L., Jolanki R., Estlander T. 10 years of patch testing with the (meth)acrylate series. Contact Dermatitis 1997; 37: 255–258PubMedCrossRefGoogle Scholar
  19. 19.
    Andersson T., Bruze M., Bjórkner B. In vivo testing of the protection of gloves against acrylates in dentin-bonding systems on patients with known contact allergy to acrylates. Contact Dermatitis 1999; 41: 254–259PubMedCrossRefGoogle Scholar
  20. 20.
    Peiler D., Rustemeyer Th., Pflug B., et al. Allergic contact dermatitis in dental laboratory technicians. Part II: major allergens and their clinical relevance. Dermatol Beruf Umwelt 2000; 48: 48–54Google Scholar
  21. 21.
    Hogan D.J. Contact dermatoses in healthcare workers. In: Menné T., Maibach H.I., editor. Exogenous dermatoses: environmental dermatitis. Boston: CRC Press, 1991: 389–400Google Scholar
  22. 22.
    Schnuch A., Uter W., Geier J., et al. Contact allergies in healthcare workers. Results form the IVDK. Acta Derm Venereol (Stockh) 1998; 78: 358–363CrossRefGoogle Scholar
  23. 23.
    Baur X., Allmers H., Raulf-Heimsoth M., et al. Naturlatex-Allergie. Empfehlungen der interdisziplinären Arbeitsgruppe. Allergologie 1996; 19: 248–251Google Scholar
  24. 24.
    Wilkinsson S.M., Burt R. Latex: a cause of allergic contact eczema in users of natural latex gloves. J Am Acad Dermatol 1998; 39: 36–42CrossRefGoogle Scholar
  25. 25.
    Wakelin S.H., Jenkins R.E., Rycroft R.J.G., et al. Patch testing with natural rubber latex. Contact Dermatitis 1999; 40: 89–93PubMedCrossRefGoogle Scholar
  26. 26.
    Fuchs Th., Meinert A., Aberer W., et al. Benzalkoniumchlorid — relevantes Kontaktallergen oder Irritans? Hautarzt 1993; 44: 699–702PubMedGoogle Scholar
  27. 27.
    Fisher, A.A. Antiseptics and disinfectants. In: Rietschel R.L., Fowler J.F., editors. Fisher’s Contact Dermatitis. 4th ed. Baltimore (PA): Williams & Wilkins, 1995: 194Google Scholar
  28. 28.
    De Groot A.C. Unwanted effects of cosmetics and drugs used in Dermatology. 2nd ed. Amsterdam: Elsevier, 1985: 522Google Scholar
  29. 29.
    Schnuch A., Geier J., Uter W., et al. Patch testing with preservatives, antimicrobials and industrial biocides. Results from a multicentre study. Br J Dermatol 1998; 138: 467–476PubMedCrossRefGoogle Scholar
  30. 30.
    Olivieri J., Eigenmann P.A., Hauser C. Severe anaphylaxis to a new disinfectant: polyhexanide, a chlorhexidine polymer. Schweiz Med Wochenschr 1998; 128: 1508–1511PubMedGoogle Scholar
  31. 31.
    Autegarden J.E., Pecquet C., Huet S., et al. Anaphylactic schock after application of chlorhexidine to unbroken skin. Contact Dermatitis 1999 Apr; 40 (4): 215PubMedCrossRefGoogle Scholar
  32. 32.
    Snellman E., Rantanen T. Severe anaphylaxis after a chlorhexidine bath. J Am Acad Dermatol 1999; 40: 771–772PubMedCrossRefGoogle Scholar
  33. 33.
    Majoie I.M.L., Van Ginkel C.J.W. The biocide iodopropynyl butylcarbamate (IPBC) as an allergen in cutting oils. Contact Dermatitis 2000; 43: 238–240PubMedGoogle Scholar
  34. 34.
    Bryld L.E., Agner T., Rastogi S.C., et al. Iodopropynyl butylcarbamate: a new contact allergen. Contact Dermatitis 1997; 36: 156–158PubMedCrossRefGoogle Scholar
  35. 35.
    Pazzaglia M., Tosti A. Allergic contact dermatitis from iodo-2-propynylbutylcarbamate in a cosmetic cream. Contact Dermatitis 1999; 41: 290PubMedCrossRefGoogle Scholar
  36. 36.
    Rustemeyer T., Pilz B., Frosch P.J. Kontaktallergien in medizinischen Berufen. Hautarzt 1994; 45: 834–844PubMedCrossRefGoogle Scholar
  37. 37.
    Le Coz C.J., Coninx D., Van Rengen A., et al. An epidemic of occupational contact dermatitis from an immersion oil for microscopy in laboratory personnel. Contact Dermatitis 1999; 40: 79–83CrossRefGoogle Scholar
  38. 38.
    Fisher A.A. Paresthesia due to contactants. In: Rietschel R.L., Fowler J.F., editors. Fisher’s contact dermatitis. 4th ed. Baltimore (PA): Williams & Wilkins, 1995: 547Google Scholar
  39. 39.
    Fisher A.A. Contact dermatitis and reactions to metals. In: Rietschel R.L., Fowler J.F., editors. Fisher’s contact dermatitis. 4th ed. Baltimore (PA): Williams & Wilkins, 1995: 829Google Scholar
  40. 40.
    Avnstorp C.H. Risk factors for cement eczema. Contact Dermatitis 1991; 25: 81–88PubMedCrossRefGoogle Scholar
  41. 41.
    Koch P. Brûlures, nécroses et ulcérations cutanées dues au ciment. Ann Dermatol Vénéréol 1996; 123: 832–836PubMedGoogle Scholar
  42. 42.
    Condé-Salazar L., Gonzalez de Domingo M.A., Guimaraens D. Sensitization to epoxy resin systems in special flooring workers. Contact Dermatitis 1994; 31: 157–160PubMedCrossRefGoogle Scholar
  43. 43.
    Jolanki R., Estlander T., Kanerva L. Occupational contact dermatitis and contact urticaria caused by epoxy resins. Acta Derm Venereol (Stockh) 1987; 134: 90–94Google Scholar
  44. 44.
    Geier J., Brehler R., Eck E., et al. Berufsspezifische Epikutantestung bei Maurern und Angehórigen verwandter Berufe. Dermatosen 1999; 47: 29–33Google Scholar
  45. 45.
    De Boer E.M., Van Ketel W.G., Bruynzeel D.P. Dermatoses in metal workers. (I). Irritant contact dermatitis. Contact Dermatitis 1989; 20: 212–218PubMedCrossRefGoogle Scholar
  46. 46.
    Weidenbach T., Rakoski J. Gehäuftes Auftreten von dyshidrosiformen Handekzemen durch eine Öl-in-Wasser-Emulsion bei Metallarbeitern. Dermatosen 1985; 33: 121–124Google Scholar
  47. 47.
    Koch P. Kontaktallergien bei Metallarbeitern. Berufliche und allergologische Relevanz der Epikutantestung bei 17 Patienten. Dermatosen 1996; 44: 62–67Google Scholar
  48. 48.
    De Boer E.M., Van Ketel W.G., Bruynzeel D.P. Dermatoses in metal workers. (II). Allergic contact dermatitis. Contact Dermatitis 1989; 20: 280–286PubMedCrossRefGoogle Scholar
  49. 49.
    Geier J., Lessmann H., Schumacher T.H., et al. Vorschlag für die Epikutantestung bei Verdacht auf Kontaktallergie durch Kühlschmierstoffe. Dermatosen 2000; 48: 232–236Google Scholar
  50. 50.
    Haudrechy P., Foussereau J., Mantout B., et al. Nickel release from nickel-plated metals and stainless steels. Contact Dermatitis 1994; 31: 249–255PubMedCrossRefGoogle Scholar
  51. 51.
    Mancuso G., Reggiani M., Berdondini R.M. Occupational dermatitis in shoemakers. Contact Dermatitis 1996; 34: 17–22PubMedCrossRefGoogle Scholar
  52. 52.
    Podmore P. Shoes. In: Rycroft R.J.G., Menné T., Frosch P.G. Textbook of Contact Dermatitis. 2nd ed. Berlin: Springer Verlag, 1995: 522Google Scholar
  53. 53.
    Koch P., Nickolaus G., Geier J. Kontaktallergien bei Lederherstellern, Lederverarbeitern und in der Schuhindustrie. Fünfjahresanalyse auf der Grundlage von Daten des Informationsverbundes Dermatologischer Kliniken (IVDK). Dermatosen 1996; 44: 257–262Google Scholar
  54. 54.
    Paulsen E., Søgaard J., Andersen K.E. Occupational dermatitis in Danish gardeners and greenhouse workers. (I). Prevalence and possible risk factors. Contact Dermatitis 1997; 37: 263–270PubMedCrossRefGoogle Scholar
  55. 55.
    Merrick C., Fenney J., Clark E.C., et al. A survey of skin problems in floristry. Contact Dermatitis 1991 Apr; 24 (4): 306PubMedCrossRefGoogle Scholar
  56. 56.
    Paulsen E., Stahl Skov P., Andersen K.E. Immediate skin and mucosal symptoms from pot plants and vegetables in gardeners and greenhouse workers. Contact Dermatitis 1998; 39: 166–170PubMedCrossRefGoogle Scholar
  57. 57.
    Mitchell J.C., Dupuis G. Allergic contact dermatitis from sesquiterpenoids of the Compositae family of plants. Br J Dermatol 1971; 84: 139–150PubMedCrossRefGoogle Scholar
  58. 58.
    Lamminpää A., Estlander T., Jolanki R., et al. Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 1996; 34: 330–335PubMedCrossRefGoogle Scholar
  59. 59.
    Paulsen E., Andersen K.E. Occupational dermatitis in a Danish dermatology department in 1 year. (II). Clinical features in patients with Compositae allergy. Contact Dermatitis 1993; 29: 195–201PubMedCrossRefGoogle Scholar
  60. 60.
    Fisher A.A. Toxicodendron plants and spices. In: Rietschel R.L., Fowler J.F., editors. Fisher’s contact dermatitis. 4th ed. Baltimore (PA): Williams & Wilkins, 1995: 488Google Scholar
  61. 61.
    Murphy G.M., White I.R., Hawk J.L.M. Allergic airborne contact dermatitis to Compositae with photosensitivity — chronic actinic dermatitis in evolution. Photodermatol Photoimmunol Photomed 1990; 7: 38–39PubMedGoogle Scholar
  62. 62.
    Green C., Ferguson J. Sesquiterpene lactone mix is not an adequate screen for Compositae allergy. Contact Dermatitis 1994; 31: 151–153PubMedCrossRefGoogle Scholar
  63. 63.
    Lepoittevin J.P., Tomb R. Sesquiterpene lactone mix is not an adequate screen for Compositae allergy. Contact Dermatitis 1995; 32: 254PubMedCrossRefGoogle Scholar
  64. 64.
    Paulsen E., Søgaard J., Andersen K.E. Occupational dermatitis in Danish gardeners and greenhouse workers. (III). Compositae-related symptoms. Contact Dermatitis 1998; 38: 140–146PubMedCrossRefGoogle Scholar
  65. 65.
    White I.R. Photopatch testing. In: Rycroft R.J.G., Menné T., Frosch P.G. Textbook of Contact Dermatitis. 2nd ed. Berlin: Springer Verlag, 1995: 297Google Scholar
  66. 66.
    Bruynzeel D.P., De Boer E.M., Brouwer E.J., et al. Dermatitis in bulb growers. Contact Dermatitis 1993; 29: 11–15PubMedCrossRefGoogle Scholar
  67. 67.
    Kanerva L., Estlander T., Jolanki R. Minimal alstroemeria exposure during skin testing causing an allergic contact dermatitis reaction. Eur J Dermatol 1994; 4: 616–617Google Scholar
  68. 68.
    Piirilä P., Keskinen H., Leino T., et al. Occupational asthma caused by decorative flowers: review and case reports. Int Arch Occup Environ Health 1994; 6: 131–136CrossRefGoogle Scholar
  69. 69.
    Julian C.G., Browers P.W. The nature and distribution of daffodil picker’s rash. Contact Dermatitis 1997; 37: 259–262PubMedCrossRefGoogle Scholar
  70. 70.
    Hausen B.M. Allergiepflanzen. Pflanzenallergene. Landsberg: Ecomed Verlag, 1988: 177–178Google Scholar
  71. 71.
    Ducombs G., Schmidt R.J. Plants and plant products. In: Rycroft R.J.G., Menné T., Frosch P.G. Textbook of Contact Dermatitis. 2nd ed. Berlin: Springer Verlag, 1995: 609–610Google Scholar
  72. 72.
    Kuligowski M.E., Chang A., Leemreize J.H.M. Allergic contact dermatitis from hydrangea: report of a 10th case. Contact Dermatitis 1992; 26: 269–270PubMedCrossRefGoogle Scholar
  73. 73.
    Hausen B.M. Allergiepflanzen. Pflanzenallergene. Landsberg: Ecomed Verlag, 1988: 146Google Scholar
  74. 74.
    Mark K.A., Brancaccio R.R., Soter N.A., et al. Allergic contact and photoallergic dermatitis to plant and pesticide allergens. Arch Dermatol 1999; 135: 67–70PubMedCrossRefGoogle Scholar
  75. 75.
    Tacke J., Schmidt A., Fartasch M., et al. Occupational contact dermatitis in bakers, confectioners and cooks. A population-based study. Contact Dermatitis 1995; 33: 112–117PubMedCrossRefGoogle Scholar
  76. 76.
    Bauer A., Kelterer D., Stadeler M., et al. The prevention of occupational hand dermatitis in bakers, confectioners and employees in the catering trades. Preliminary results of a skin prevention program. Contact Dermatitis 2001; 44: 85–88PubMedCrossRefGoogle Scholar
  77. 77.
    Morren M.A., Janssens V., Dooms-Goosens A., et al. Alpha-amylase, a flour additive: an important cause of protein contact dermatitis in bakers. J Am Acad Dermatol 1993; 29: 723–728PubMedCrossRefGoogle Scholar
  78. 78.
    Straube M., Szliska Ch., Schwanitz H.J. Allergene und Irritanzien im Bäckerhandwerk. Allergologie 1996; 19: 494–499Google Scholar
  79. 79.
    Acciai M.C., Brusi C., Francalanci S., et al. Allergic contact dermatitis in caterers. Contact Dermatitis 1993 Jul; 29 (1): 48PubMedCrossRefGoogle Scholar
  80. 80.
    Cronin E. Dermatitis of the hands in caterers. Contact Dermatitis 1987; 17: 265–269PubMedCrossRefGoogle Scholar
  81. 81.
    Mathias C.T. The cost of occupational skin diseases. Arch Dermatol 1985; 121: 322–324Google Scholar
  82. 82.
    Diepgen T.L., Schmidt A., Berg A., et al. Medizinische Hinweise für die berufliche Rehabilitation von hautkranken Beschäftigten. Dt Ärztebl 1995; 92: A31–A40Google Scholar
  83. 83.
    Frosch P.J., Kurte A. Efficacy of skin barrier creams. (IV). The repetitive irrritation test (RIT) with a set of 4 standard irritants. Contact Dermatitis 1994; 31: 161–168PubMedCrossRefGoogle Scholar
  84. 84.
    Frosch P.J., Schulze-Dirks A., Hoffmann M., et al. Efficacy of skin barrier creams. (II). Inefectiveness of a popular skin protector against various irritants in the repetitive irrritation test in the guinea pig. Contact Dermatitis 1993; 29: 74–77PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 2001

Authors and Affiliations

  1. 1.Department of DermatologyUniversity of SaarlandHomburg/SaarGermany

Personalised recommendations