Irritant contact dermatitis, occupational exposures causing

Workers who continued with exposure to occupational irritants tend to have a poorer prognosis than those who cease exposure. For example, Chia et al. reported that about 60% of patients with occupational irritant dermatitis from solvents had persistent dermatitis when they continued to work with the solvents (Chia and Goh 1991). Some occupational irritants appear to cause less chronicity, e.g. irritant contact dermatitis from acids/alkali and cement appear to clear when proper preventive measures are introduced (Chia and Goh 1991). The report from Singapore showed that all workers with irritant contact dermatitis from cement had complete clearance of their dermatitis despite continuing to work with the irritant. Similarly, in Denmark, occupational irritant dermatitis from cement cleared in 80% of their workers despite the fact that they continued working at the same job (Avnstorp 1989). 

Construction workers risk occupational contact dermatitis from exposure to irritants, chromate, cobalt, rubber and epoxy. Nickel allergy, however, is not often discussed in relation to construction work (Coenraads et al. 1984). In construction workers it is often found together with allergy to chromate and/or cobalt, and nickel in cement has been proposed as a cause. However, nickel in cement exists mainly as insoluble salts (Wahlberg et al. 1977 Goh et al. 1986). 

Kanerva L, Bjorkner B, Estlander T, et al. (1996) Plastic materials occupational exposure, skin irritancy and its prevention. In van der Valk PGM, Maibach HI (eds) The irritant contact dermatitis syndrome. CRC Press, Boca Raton, pp 127-55 Kanerva L, Lauerma A, Estlander T, et al. (1996b) Occupational allergic contact dermatitis caused by photobonded sculptured nails and a review of (meth)acrylates in nail cosmetics. Am J Contact Dermat 7 109... 

Toxicology. Cobalt causes skin irritation, allergic contact dermatitis, and occupational asthma interstitial pulmonary fibrosis is associated with exposure to hard metal dust (tungsten and cobalt). 

MEKP has caused irritant dermatitis with direct contact only rarely has it caused allergic contact dermatitis from occupational exposure. ... 

Dermal and ocular exposures are the most common routes of exposure to captafol. Contact dermatitis has been reported after exposure to captafol. During occupational exposure, captafol has been reported to cause severe irritation of the respiratory tract, eye damage and other systemic effects. Oral ingestion of captafol is unlikely to cause acute poisoning. 

Trinitrotoluene (2,4,6-trinilrololueue, TNT [CAS 118-96-7]) Irritating upon direct contact. Stains tissues yellow. Causes sensitization dermatitis. Vapors irritating to the respiratory tract. May cause liver injury, methemoglobinemia (see p 261). Occupational overexposure associated with cataracts. Causes vasodilation, including coronary arteries. Headache and drop in blood pressure are common. Well absorbed by all routes. Tolerance to vasodilation can occur cessation of exposure may precipitate angina pectoris in pharmacologically dependent workers. See also nitrates, p 279. 

Allergic and irritant dermatitis (contact dermatitis) is overwhelmingly the most important cause of occupational skin diseases, which account for 15% to 20% of all reported occupational diseases. There is virtually no occupation or industry without potentitd exposure to the many diverse agents that cause allergic and irritant dermatitis. 

Since use of gloves can sometimes cause accidents, and the substitution of noxious products by less aggressive substances is sometimes not possible for technical or economical reasons, skin-care products play an important role in the prevention of occupational contact dermatitis. Preventive skin care at the workplace may be divided into pre-exposure protection by protective creams, removal of irritants by mild cleaning agents, and enhancement of barrier-function generation by emollients or moisturisers. More details are given in Chap. 62, Barrier Creams/Emollients,... 

Povidone-iodine is an iodophor. A 10% povidone-iodine solution contains 1% available iodine, but free iodine is at a concentration of 0.001%. Occupational exposure can cause irritant rather than allergic contact dermatitis in healthcare workers. 

Some persons are more susceptible to skin damage than others, particularly the young, those with soft, sweaty skin, the fair complexioned and those with poor personal hygiene. Occupational dermatitis can affect any part of the body, but the hands, wrists and forearms are most commonly involved. Damage to the skin may follow exposure to chemical and biological substances as well as physical agents. Dermatitis is of two kinds irritative and sensitising - the former is four times more common. Chemicals which cause irritative dermatitis include acids, alkalis, solvents, some metals and their salts. Their effect on the skin depends on the concentration and duration of exposure, and will affect most people in contact with them. At first the response may be minor, but it worsens with repeated contact. 

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