Contact laboratory technicians

The costs of an intervention have to be compared with the results of this intervention (Drummond et al. 2004). These results can be outputs, outcomes, and impacts (Fig. 2). An output is the direct result of a production process. Agents of production (resources) are transformed to generate a certain commodity or service (output). For instance, equipment, reagents, and the knowledge of a laboratory technician are used to perform a certain resistance test. Other examples of outputs are contacts, admissions, or prescriptions. 

In Pease v. Sinclair Refinery Co., a manufacturer of chemistry teachers demonstration kits offered one kit which contained sample tubes of different liquids, one of which was supposed to be kerosene. Unfortunately, since kerosene has the same physical appearance as water, the manufacturer substituted water for kerosene in the tube, perhaps in an effort to save costs. A severe injury occurred when the water was inadvertently mixed with a chemical which was explosive in the presence of water. The court held that the manufacturer should have foreseen that, in a chemistry classroom setting, a number of chemicals might come in contact with each other, most certainly with water. The court balanced the gravity of the possible harm - explosion, against what it viewed as the ease with which the manufacturer could have provided a warning. Compare the results in that case, however, with the Croteau v. Borden Co.f where a chemical manufacturer was held not liable to a laboratory technician for a failure to warn that if one of its chemicals was mixed with a wide variety of other chemicals an explosion might be produced. 

This appears to be relatively straightforward, but in fact can be rather complicated. In a large academic institution, the actual duties associated with a given job classification often become blurred over a period of time. For example, a job title of laboratory technician might appear to logically relate to chemical exposure, but the duties of the individual may have changed so that the job may never bring the individual into contact with chemicals at all. It is not possible to simply have the persoimel department list all persons in specific job classifications as professional staff or faculty in research areas. 

Not only workers normally in contact with domestic and farm animals but also explorers, surveyors, zoo attendants and laboratory technicians are at risk. Particular examples include T. verrucosum among farmers (or veterinarians) and their families and T. mentagrophytes among laboratory workers. Pet-shop and kennel workers are at risk from M. canis. Sportsmen and various categories of workers (e.g. miners) may contract T. rubrum infection (Wilkinson 1987). 

Agrup G, Sjostedt L (1988) Contact urticaria in laboratory technicians working with animals. Acta Derm Venereol 81 736-742... 

Le Coz C, Coninx D, Van Rengen A, El Aboubi S, El Bakali A, Goossens A (1998) An epidemic among laboratory technicians of occupational contact dermatitis from a reformulated immersion oil for microscopy. In Kanerva L, Lauerma A, Bjorkner F, Estlander T, Jolanki R, Hannuksela M (eds) Proceedings of the Fourth Congress of European Society of Contact Dermatitis People and Work, Research Reports 18,... 

Itchy rash-like eruptions on exposed skin areas in the factory workers who coat car badges with the resin have been reported within 1 week to 6 months of exposure to DMDI (White et al. 1983). The same was reported in workers of a glass-bottle factory, where DMDI was used to coat the bottles (Israeli et al. 1981), as well as in the workers of a PU-molding plant (Emmett 1976). Irritant dermatitis appearing in a laboratory technician within a few hours of contact with TDI and in a repair man have also been described (Rothe 1976). 

Causes of Contact Urticaria Found in Case Reports (see also Laboratory technicians)... 

Chemical laboratory technicians and associate laboratory workers are exposed to a great number of chemicals that cause irritant or allergic contact dermatitis, contact urticaria or skin burns. Laboratories that deal with biological specimens or laboratory animals, e.g., in hospitals, university clinical departments and pharmaceutical companies, share the hazards of chemistry laboratories however, human and animal tissue specimens, and laboratory animals contribute additional risks of contact urticaria and skin infections. Laboratory assistants are at greater risk of sensitization than workers in general. Also, the risk of skin infections is increased (Karjalainen et al. 1997)-... 

Cases of allergic contact dermatitis or contact urticaria in laboratory technicians or associate workers are frequently reported from histology or electron microscopy laboratories (Van Ketel 1979 Lindskov 1982 Tobler et al. 1990 Palmer and Rycroft 1993 Steinkraus and Hausen 1994 Wakelin et al. 1998) (see Chap. 164), or from film processing (White 1983 Liden 1984) (see details in Photographers). 

Kanerva et al. 1996). Natural rubber latex and laboratory animals are probably the most common causes of contact urticaria in the laboratory environment. Other types of noninfectious biological risk may include exposure to animal and plant proteins, e.g., flour, grains or feed, and decorative plants, and enzymes (Tarvainen et al. 1991). Contact urticaria from laboratory animals is more common in persons carrying out experiments with animals, e.g., laboratory technicians and chemists, than in those tending them. The former tasks involve more direct handling of the animals, their secretions, and their internal organs (Susitaival and Hannuksela 1997). 

Le Coz CJ, Caussade P, Bottlaender A (1998) Occupational contact dermatitis from methyl-ter-pyridine in a chemistry laboratory technician. Contact Dermatitis 38 214-215 Liden C (1984) Occupational dermatoses at a film laboratory. Contact Dermatitis 10 77-87... 

Wakelin SH, McFadden JP, Leonard JN, Rycroft RJG (1998) Allergic contact dermatitis from d-limonene in a laboratory technician. Contact Dermatitis 38 164-165 Wang M-T, Wenger K, Maibach HI (1997) Piperazine diacrylamide allergic contact dermatitis. Contact dermatitis 37 300 Warshaw TG (1988) Primary irritant effect of 3,4,5-trichloro-pyridazine. Contact Dermatitis 18 257-258 Weller R, Ormerod A (1996) Water tester s dermatitis due to a para-phenylenediamine derivative. Contact Dermatitis 34 138 White IR (1983) Allergic contact dermatitis from a colour film process chemical (PBAi). Contact Dermatitis 9 323-324 Wigger-Alberti W, Eisner P (1997) Occupational contact dermatitis due to pyritinol. Contact Dermatitis 37 91-92... 

In the pharmaceutical industry, people come into contact with both chemical intermediates and finished products. The risk of developing contact allergy is greatest for chemists and laboratory technicians, who are involved in research for new compounds, and for cleaning personnel and technicians in general, who are often less well protected than the workers in production units (Sherertz 1994). Pharmacists are also exposed to medications when preparing compounded formulations, and the conditions they work in are similar to those of medical personnel (Foussereau et al. 1982). 

Several cases of occupation-induced allergic contact dermatitis to these agents in chemists and laboratory technicians have been reported (Rycroft 1983 Goh 1984 Alomar 1987 Romaguera et al. 1988, 1990). Cross-sensitivity between ranitidine and its intermediary products does not always occur. 

Quirce S, Olaguibel JM, Garcia BE, Tabar AI (1993) Occupational airborne contact dermatitis due to benzoyl peroxide. Contact Dermatitis 29 165-166 Rustemeyer T, Frosch PJ (1996) Occupational skin diseases in dental laboratory technicians. (I). Clinical picture and causative factors. Contact Dermatitis... 

Ethylenediamine is used in numerous industrial processes as a solvent for casein or albumin, as a stabilizer in rubber latex and as a textile lubricant. It can be found in epoxy-resin hardeners, cooling oils, fungicides, and waxes. Contact dermatitis from ethylenediamine is almost exclusively due to topical medicaments. Occupational contact dermatitis in epoxy-resin systems is rather infrequent. Ethylenediamine can cross react with triethylenetetramine and diethylenetriamine. Ethylenediamine was responsible for sensitization in pharmacists handling aminophylline suppositories, in nurses preparing and administering injectable theophylline, and in a laboratory technician in the manufacture of aminophylline tablets. 

Methyl 2,3 epoxy 3-(4-methoxyphenyl)propionate is an intermediate product in the synthesis of diltiazem hydrochloride. Contact dermatitis was observed in several laboratory technicians. 

Rustemeyer T, Frosch PJ (1996) Occupational skin diseases in dental laboratory technicians. (I). Clinical picture and causative factors. Contact Dermatitis... 

Methyl-4,5-trimethyIene-4-isothiazoIin-3-one (MTI) is a biocide which induced contact dermatitis in a laboratory technician also sensitive to BIT. 

Pyridine is a solvent for many organic compounds and anhydrous metallic salts chemicals. Contained in Karl Fischer reagent, it induced contact dermatitis in a laboratory technician. 

PHENOXYBENZAMiNE HYDROCHLORIDE A woman laboratory technician developed acute allergic eczematous contact dermatitis of the hands and face, after contact with phenoxybenzamine hydrochloride (46 =). Patch tests with phenoxybenzamine 1% in aqua, carried out after the clinical dermatitis had subsided, were positive. This was followed by recurrence of the dermatitis at the original sites. Sensitization to this chemical was produced in guinea pigs. Crosssensitivity to related compounds may be due to the chloroethylamine moiety of the molecule. No cross-sensitivity was observed to the dichlorodiethylamine compound, although nitrogen mustard is known to be capable of contact sensitization. 

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