Legislation helps prevention

One of the most difficult things in Occupational Health is show that preventive measures really have impact on the incidence of work-related disease. In an interesting study by Jill Stocks et al. data of the registries for occupational diseases in the UK are used to study the influence of European legislation on reducing chromate exposure in cement. They found a steeper decline in allergic contact dermatitis attributed to chromate than for other types of allergic contact dermatitis after introduction of the legislation.

S J Stocks, R McNamee, S Turner, M Carder, R M Agius Has European Union legislation to reduce exposure to chromate in cement been effective in reducing the incidence of allergic contact dermatitis attributed to chromate in the UK? Occup Environ Med2012;69:150-152

Filed under: Allergies, Chemical agents, Skin, legislation, Occupational diseases, prevention, Skin

Work-related skin problem in restaurant, catering and fast-food personnel

To determine the prevalence and risk factors for contact dermatitis and burns among restaurant, catering and fast-food outlet (FFO) staff, workers were interviewed and then clinical examination and patch and/or prick tests were conducted in selected individuals.

65 from 335 (19%) had occupational dermatitis or burns and contact dermatitis was the commonest diagnosis. All 35 workers had irritant contact dermatitis (ICD). The 3-month period prevalence for burns was 6% (20 workers)

The adjusted prevalence rate ratios of risk factors for ICD were 2.78 (95% CI 1.36–5.72) for frequent hand washing >20 times per day, 3.87 (95% CI 1.89–7.93) for atopy and 2.57 (95% CI 1.21–5.47) for contact with squid.

Occupational dermatoses in restaurant, catering and fast-food outlets in Singapore
Teo, S., Teik-Jin Goon, A., Siang, L. H., Lin, G. S., Koh, D.
Occupational Medicine 2009 59(7):466-471

Filed under: Occupational diseases, Irritant contact dermatitis, Skin

More skin and respiratory problems in professional cleaners

Indoor professional cleaners and other building workers (OBW) completed a questionnaire to compare rash and respiratory symptoms  and examine workplace factors such as training, protective equipment and work tasks.

The prevalence of rash was significantly higher in the cleaners compared to the OBW. For male cleaners, 21% (86/413) versus 11% (13/115) of OBW (P < 0.05). The rashes experienced by the cleaners were more likely to be on their hands and worse at work.

Cleaners washed their hands significantly more often than OBW. Cleaners with a rash were less likely to have received workplace training regarding their skin and were more likely to find the safety training hard to understand.

Cleaners with a rash within the past year were significantly more likely to have work-related asthma symptoms than cleaners without a rash (P < 0.001).

Cutaneous and respiratory symptoms among professional cleaners
Carrie B. Lynde, Maya Obadia, Gary M. Liss, Marcos Ribeiro, D. Linn Holness and Susan M. Tarlo Occupational Medicine 2009 59(4):249-254

Filed under: Asthma, Occupational exposure, Skin, Asthma, Cleaners, Skin

Sunlight exposure and skin cancer

Recent research shows that it is very difficul to separate the effects of occupational and recreational solar UVR exposure (sunlight exposure); therefore the results of this review should be interpreted with caution. However, it is clear that solar UVR exposure does induce skin cancer. Protective measures should be taken in an attempt to reduce the burden of occupational skin cancer in Great Britain.

Solar ultraviolet radiation and skin cancer
Charlotte Young, Mathematical Sciences Unit, Health and Safety Laboratory, Harpur Hill, Buxton, Derbyshire SK17 9JN, UK

Filed under: Occupational cancer, Occupational cancer, Skin, UV

Notification of occupational skin diseases

Notification of occupational skin diseases by dermatologists in The Netherlands

T. M. Pal, N. S. de Wilde, M. M. van Beurden, P. J. Coenraads2 and D. P. Bruynzeel

A voluntary surveillance scheme with dermatologists provides valuable data about the distribution of OCD in risk professions and the causal agents. However, it has certain limitations in assessing trends in incidence. Active medical surveillance in populations at risk should be encouraged not only to improve secondary prevention but also to obtain more reliable information about the incidence of OCD.

Filed under: Reporting OD's, Reporting, Skin

Malignant melanoma: gaps in our knowledge

Open access article: Melanoma: What Are the Gaps in Our Knowledge by Jonathan Rees PLoS Medicine

A short introduction:

Cutaneous malignant melanoma (MM) falls into two main groups, based on aetiology. First, a small minority of patients have acral MM, in which the disease occurs on the palms and soles. Acral melanomas are therefore not believed to be causally related to UVR, and their aetiology remains a mystery. They will not be discussed further in this article. By contrast, more than 90% of MM occurs on non-acral sites and is thought to be caused by UVR [2,4].

The evidence for such causality comes from a variety of fields. MM is most common in those with pale skin, which has a relative lack of melanin, a substance that blocks photons from penetrating deeply into skin. African people with very dark skin are hundreds of times less sensitive to the harmful effects of UVR than white Northern Europeans.

Even within white Northern European populations, MM rates vary in relation to more subtle degrees of difference in sun sensitivity. Those with red hair, pale skin, and a tendency to freckle are about three times more likely to develop MM than those without these three features. The dramatically elevated rate of MM in those with European ancestry in Australia is therefore what we would expect: susceptibility of the host coupled with enhanced environmental exposure leads to a high disease risk.

Given that we know the major host and environmental factors that lead to non-acral malignant melanomas, one might think that we know enough to reduce the incidence of MM.

But our ability to change people’s behaviour so that they reduce their exposure to UVR remains limited. In addition, as our knowledge of MM has increased, so has the incidence of disease. Puzzling gaps therefore remain in our knowledge of the aetiology of non-acral melanomas. So what important things do we not know?

Interested? You can find the article by clicking the link:

Open access article: Melanoma: What Are the Gaps in Our Knowledge by Jonathan Rees PLoS Medicine

 

Filed under: Occupational cancer, Occupational exposure, Skin, UV

New Evidence Based guideline on work-related latex allergy

In the UK, on the website on Health at Work, the NHS Plus (a network of NHS occupational health (OH) departments across England, supplying quality services to non-NHS employers in the industry, commerce and public sector, with a focus on small and medium sized enterprises), has published a series of evidence based guidelines on occupational health subjects:

• Anxiety
• Back Pain
• Chicken pox in pregnancy
• Chronic fatigue
• Common mental health problems
• Depression
• Dermatitis
• Diving
• Occupational Asthma
• Return to work
• Workplace smoking.

The most recent one is on latex: Latex allergy: occupational aspects of management

The full document and leaflets for employees, employers and healthcare professionals are now available as a pdf files. Hard copies will also be available soon.

Filed under: Allergies, Occupational exposure, EBM, Skin