Occupational contact urticaria

Occupational contact urticaria (OCU) refers to those immediate contact reactions caused by exposure to substances in the work environment. Contact urticaria is common in occupational settings [11], and its prevalence should be expected to increase because of workers increasing exposure to a variety of industrial materials. 

Contact urticaria usually clears spontaneously repeated exposure may produce dermatitis (eczema). In addition, it may be associated with allergic contact dermatitis (type-IV hypersensitivity), von Krogh and Maibach [4] tested 67 patients for immediate and delayed hypersensitivity, and 22 (33%) developed a positive delayed response subsequent to the initial wheal-and-flare reaction. The responsible agents were food products, rubber latex, cinnamic aldehyde, para-aminodiphenylamine, ethylaminobenzoate, ammonium persulfate, teak, epoxy resin and lemon perfume. They suggested that the term contact dermatitis of immediate and delayed type be used for patients exhibiting both types of reactions in the test situation, whether the initial reaction is uncharacteristic, urticarial or vesicular [4]. 

Not only contact urticaria may produce dermatitis, but immediate contact reactions aggravating chronic dermatitis have been reported [2, 4, 6,12]. A previous irritant contact dermatitis produced by the working environment may predispose one not only to allergic contact dermatitis but also to immediate contact 

Stage 2 Generalized urticaria Cutaneous and extracutaneous reactions 

Stage 3 Rhinoconjunctivitis Orolaryngeal symptoms Bronchial asthma 

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Yokota, K. et al., Occupational contact urticaria caused by airborne methylhexahydroph-thalic anhydride, Ind. Health, 39, 347, 2001. 

Ale, S.I. andMaibach, H.1.2000. Occupational contact urticaria. In Handbook of Occupational Dermatology, L., Kanerva, P., Eisner, J.E., Wahlberg, and H.I. Maibach, Eds., pp. 200-216. Springer-Verlag, Berlin, Heidelberg, New York. 

Allergic contact dermatitis (18) and occupational contact urticaria (19) have also been reported. 

Ouirce S, Tabar AI, Olaguibel JM, Cuevas M. Occupational contact urticaria syndrome caused by globe artichoke Cynara scolymus). J Allergy Chn Immunol 1996 97(2) 710-11. 

Kanerva L, Jolanki R, Toikkanen J, Esdander T (1997) Statistics on occupational contact urticaria. In Amin S, Lahti A, Maibach HI (eds) Contact urticaria syndrome. CRC Press, Boca Raton, pp 57-69... 

Hytonen M, Vanhanen M, Keskinen H, et al. (1994) Pharyngeal edema caused by occupational exposure to cellulasa enzyme. AUergy 49 782-784 Kanerva L, Vanhanen M, Tupasela O (1998) Occupational contact urticaria from cellulase enzyme. Contact Dermatitis... 

Carino M, Cassano N, et al. (1997) Occupational contact urticaria from paprika. Contact Dermatitis 37 135 Lovell CR, Rycroft RJG (1984) Contact urticaria from winged bean Psophocarus tetragonolobus). Contact Dermatitis 10 314-315... 

Jovanovic M, Oliwiecki S, Beck M (1992) Occupational contact urticaria from beef associated with hand eczema. Contact Dermatitis 27 188-189... 

Goranson K (1981) Occupational contact urticaria to fresh cow and pig blood in slaughtermen. Contact Dermatitis 7 281-282... 

Epstein S (1948) Milker s eczema. J Allergy 19 333-341 Kanerva L, Susitaival P (1996) Cow dander - the most common cause of occupational contact urticaria in Finland. Contact Dermatitis 35 309-310... 

Occupational contact urticaria and type I sensitization caused by gerbera. Contact Dermatitis 38 118-120... 

Kauppinen K (1980) Occupational contact urticaria provoked by mouse liver. Contact Dermatitis 6 444-445 Rudzki E, Rebandel P, Rogozinski T (1981) Contact urticaria from rat tail, guinea pig, streptomycin and vinyl pyridine. Contact Dermatitis 7 186-188... 

Miyahara H, Koga T, Imayama S, Hori Y (1993) Occupational contact urticaria syndrome from cefotiam hydrochloride. Contact Dermatitis 29 210-211 Schena D, Barba A, Costa G (1996) Occupational contact dermatitis due to cisplatin. Contact Dermatitis 34 2320-2321... 

In Finland, occupational contact urticaria (including protein contact dermatitis) has been classified as a separate occupational skin disease since 1989 and, accordingly, statistical data are available (Kanerva et aL 1995b, 1996b Kanerva and Brisman 1997). 

The Most Common Causes of Occupational Contact Urticaria... 

Table 1 gives a ranking list of the most common causes of occupational contact urticaria. The three most common causes are (1) cow dander, (2) natural rubber latex, and (3) flour, grains, feed and other foodstuffs. These three groups n = 985) comprised 82% of all cases of occupational contact urticaria during a 7-year period n = 1205). Contact urticaria from cow dander and natural rubber latex, as well as the total number of cases of contact urticaria, is much more common in women than in men (Kanerva et al. 1995b, 1996b). 

Occupational Contact Urticaria Caused by Low-Molecular-Weight Chemicals... 

Farmers experienced the greatest number of occupational contact urticaria cases in Finland (Table 3). Other risk occupations were animal attendants, bakers, nurses, chefs, cooks, cold-buffet managers, dental... 

The prevalence of occupational contact urticaria during a 5-year period per 100,000 employed workers is given in Table 4. Bakers, food-processing workers, dental assistants, veterinary surgeons, domestic animal attendants, farmers, chefs, cooks, cold-buffet managers and dairy workers had the highest prevalence (Table 4). 

Ten occupations with the highest risk of developing occupational contact urticaria and protein contact dermatitis, and their causes, are given in Table 6. Bakers and confectioners farmers butchers and sausage makers plastic product workers, and physicians were the five occupations with the highest risk (Table 6). 

Table 1. The causes of occupational contact urticaria and protein contact dermatitis during a seven-year period (1990-1996 1205 cases), according to the Finnish Register of Occupational Diseases...

Table 3. Occupations with the greatest number of cases of occupational contact urticaria in Finland during a 5-year period (n = 815)...

Table 2. Occupational contact urticaria caused by low-molecular-weight chemicals during 1990-1996...

Kanerva L, Toikkanen J, Jolanki R, Estlander T (1996b) Statistical data on occupational contact urticaria. Contact Dermatitis 35 229-233... 

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