Occupational acne

Oil acne is the most common form of occupational acne and is most commonly observed in workers employed in the machine tooling trades. Others affected may include auto, airplane and truck mechanics petroleum refiners and rubber workers. The incidence of oil acne has declined in recent years because of decreased use of pure cutting oils and improved industrial and personal hygiene practices (Kokelj 1992). 

Tropical acne may result from exposure to excessively hot or humid environments and, when such exposure is required in the performance of the patient s job, may be considered to be a form of occupational acne. Tropical acne has been observed most commonly in soldiers stationed in tropical climates, but variants may result from chronic exposure to other hot and/or humid environments as can be found in foundries (Mathias 1994). 

Knox JM, Dinehart SM, et al. (1986) Acquired perforating disease in oil field workers. J Am Acad Dermatol 14 605-611 Kokelj F (1992) Occupational Acne. Clin Dermatol 10 213-217 Litt JZ (1974) McDonald s acne. Arch Dermatol 110 956 Longnecker MP, Rogan WJ, Lucier G (1997) The human health effects of DDT (dichlorodiphenyltrichloroethane) and PCBs (polychlorinated biphenyls) and overview of organochlorines in public health. Ann Rev Public Health 18 211-44 Mathias CGT (1994) Occupational Dermatoses. In Zenz C, Dickerson OB, Horvath EP (eds) Occupational medicine, 3rd edn. Mosby, St. Louis, pp 93-131 McDonough AJ, Gawkrodger DJ, Walker AE (1993) Chloracne-study of an outbreak with new clinical observations. Clin Exp Dermatol 18 523-525... 

Omohundro C, Taylor JS (1998) Occupational acne. In English JSC (ed) A colour handbook of occupational dermatology. Manson, London, pp 121-134... 

Polybrominated Biphenyls. As discussed in Section 3.2.1.2, results from a medical history survey study of workers in a PBB manufacturing plant and a nonexposed group of Wisconsin farm residents indicated an association between occupational exposure to PBBs and the occurrence of acne (Chanda et al. 1982). 

The VER lifetime of the doorway vibration in ACN is quite short. It was estimated to be <5 ps (46). This estimate was obtained by molecular thermometry. As discussed above, the occupation number of C-H stretching excitations produced by the laser is 0.02. Since about one half of the C-H stretch excitation energy ( 1500 cm-1) is transferred to the doorway vibration at 379 cm-1, about 4 quanta of doorway excitations will be produced in the first 5 ps due to C-H stretch decay. If the doorway vibration were long-lived (i.e., if Ti > 5 ps), then the doorway... 

Many industrial accidents involving malfunctioning reaction vessels used to manufacture chlorinated phenols or phenoxy herbicides have exposed more than 1300 workers to shortterm, high-level doses of the dioxins that occur as contaminants of these substances. Exposures have frequently been associated with acne-like skin lesions, dermatitis, altered liver enzyme concentrations, pulmonary deficiency, numbness, nausea, headache, hearing loss, sleep disturbance, tiredness, sexual dysfunction, depression, and appetite loss. Populations exposed to dioxin-contaminated materials through non-occupational sources - including (hoxin-contaminated soils in Missouri, a trichlorophenol reactor explosion in Italy, dioxin-containing herbicide in Viemam, and assorted laboratory accidents - have all experienced similar effects. 

Benzoyl peroxide is used mainly in acne treatment and is an irritant. Allergic contact dermatitis to this compound is not infrequent. Eaglstiein (1968) reported two cases. The sensitization rate has been estimated to be 1 %-2.5%. In a human maximization test, 76% became sensitized (Leyden and Kligman 1977). Crossreactions to benzoic acid and related compounds were not found. The drug has been advocated for treatment of chronic leg ulcers. Eight of 16 patients showed positive patch tests to 2% benzoyl peroxide after 6 weeks of leg ulcer treatment with 10% benzoyl peroxide (Jensen et al. 1980). Patients sensitized to benzoyl peroxide may be at risk in certain occupations (e.g., baking and the plastics industry). 

Occupational and environmental acne is a variety of acne venenata, resulting from various chemical exposures and from a variety of environmental, physical and mechanical factors, usually encountered in the workplace but occasionally seen in non-occupational settings. The eruption may be mild, involving localized exposure or covered areas of the body, or severe, explosive and disseminated with the involvement of almost every follicular orifice. Additionally, chloracne almost always represents a cutaneous sign of systemic exposure to highly toxic chemicals. Occupational and environmental acne is separated into oil acne, coal-tar acne, acne cosmetica, acne aestivalis, acne mechanica, tropical acne and chloracne. This listing is not exhaustive but serves as a useful paradigm and includes the most common causes. 

Acne aestivalis is a rare, infrequently described, generally, non-occupational eruption, which can also affect performing artists. Typically, it affects women in the age range of 25-40 years and involves the cheeks, sides of the neck, chest, shoulders and upper arms. Typical lesions are erythematous, round, hard, small papules comedones and pustules are absent or scarce. Lesions involute in the fall without scar formation. Acne aestivalis responds to topical retinoic acid but not to antibiotics (Hjorth et al. 1972). 

Table 4. Differential diagnosis of various forms of occupational and environmental acne...

Bartolini R (1989) Acne. A summary of the occupational health concern. Canadian Centre for Occupation Health and Safety. Hamilton, Ontario. Report No. F89-iE i-7... 

Fisher A (1982) Leukoderma from bleaching creams containing 2% hydroquinone. Contact Dermatitis 8 272-273 Fisher A (1986) Acne venenata in black skin. Cutis 37 24-26 Fisher A (1994) Differential diagnosis of idiopathic vitiligo. Part III occupational leukoderma. Cutis 53 278-280 Fisher A (1995) Contact leukoderma (vitiligo) hyperpigmentation and discolorations from contactants. In Rietschel R, Fowler JJ (eds) Fisher s contact dermatitis, 4th edn. Williams Wilkins, Baltimore, pp 765-777... 

Ruxin TA, Taylor JS (1994) Other occupational dermatoses acne, pigmentary disorders, skin cancer, infection, reactions to temperature and humidity, scleroderma, and nail changes. In Hogan DJ (ed) Occupational skin disorders. Igaku-Shoin, New York, pp 89-103... 

Some examples of common additives are given which may be used as drugs themselves (such as benzoyl peroxide for acne), in the synthesis of drugs (dicyclohexyl carbodiimide) or as antioxidants in final products. Ethylene diamine is present in topical drugs and in aminophylline and is the allergen in the latter compound. Several cases of occupational contact dermatitis have been reported (Corazza et al. 

Depending on the type of product and exposition, several occupation-induced dermatoses may occur among workers in the pharmaceutical industry. They include irritation, contact allergy, photosensitivity, urticaria, acne venenata and, less frequently, fixed drug eruption and steroid rosacea (H. Degreef, personal communication), and even toxic epidermal necrolysis (as was the case with the transcutaneous absorption of an intermediary product in the synthesis of tetramisole, an anthelminthic drug Valsecchi et al. 1987). 

The effect of co-adsorbates such as alcohols and ACE was scrutinized by direct or sensitized excitation of ACN. In the direct excitation, the cisoid/transoid ratio was reduced from 8.78 with additives to 1.6 2.8 without additives. In the Rose Bengal sensitization, the ratio remained relatively constant at 0.34 0.61. Co-adsorption of alcohols increased ACN mobihty on the silica gel surface because of blocking of stronger binding sites and reduced the cisoid/transoid ratio because increased mobility by solvent molecules would be advantageous for dimerization from the T, state, rather than the S, state, over a longer time span. Moreover, the co-adsorbed alcohols would result in diminished formation of preferred pairs of ACN that would lead to cisoid-l from the S, state owing to the occupation of sites for pair formation by the co-adsorbate. When ACN is diluted with ACE as an inert counterpart, a hybrid pair of ACN with ACE that is unable to dimerize may be created, and therefore the cisoid/transoid ratio reflects the diffusional dimerization via the Tj state. 

Ramesh and Ramamurthy demonstrated a dependency of the cisoid/transoid ratio on the mean occupancy number (S), which refers to number of ACN molecules per micelle. Under constant concentration (0.05 M) of aqueous surfactant SDS, the cisoid/transoid ratio decreased with decrease of [ACN] that is, the ratio was 4.6, 4.6, 4.0, 3.6, 2.0, and 1.7 under S of 9.0, 7.0, 6.0, 3.0, 2.0, and 1.0, respectively. When cetyltrimethylammonium bromide (CTAB) was employed in place of SDS, the ratio decreased from 4.6 to 1.3 at S of ca. 9. These results can be interpreted as follows. With a decrease of [ACN], the S value decreases. Since the probability for formation of Sj-derived cisoid-l increases at high [ACN], cisoid-l is favored under conditions of high S. With a decrease of S, the probability for the S, state to encounter a ground state ACN prior to ISC to the Tj state decreases, and hence the cisoid/transoid ratio decreases. In CTAB micelles, the heavy atom effect of the bromide ion leads to promoted formation of T,-derived transoid-1, whereas in micelles with atoms hghter than bromine, the S,-derived cisoid-l predominates. 

Like other constrained media, supercages in zeolites can offer reactivity and selectivity for products in photochemical reactions that cannot be expected in homogeneous solutions. Ramamurthy et al. have undertaken photochemical reactions in dry cation-exchanged Y zeoHte (LiY, NaY, KY, RbY, CsY, TIY). On irradiation (X. > 300 nm) of ACN, formation of cisoid-l was favored in zeoHtes with lower atomic number metals (Li and Na) and with a higher occupancy number (S). The cisoid/transoid ratios in NaY and CsY, for example, were 25 and 4.2, respectively, at S = 0.5 and decreased to 22 and 2.8 at S = 0.25. It is apparent that a higher S value is favorable for formation of cisoid-l derived from the Sj state with a short Hfetime, while heavy atom cations accelerate ISC from the Sj to the Tj state of ACN in the cage. Transient absorption of the Tj state was observed at 470 nm with higher relative yield with the use of heavier cations. 

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