Occupational hand eczema

Meding B, Swanbeck G. 1990. Occupational hand eczema in an industrial city. Contact Dermatitis 22 13-23. 

Bruze M (1993) Principles of occupational hand eczema. In Menne T, Maibach HI (eds) Hand eczema. CRC Press, Boca Raton FL, pp 165-178... 

The distinction between endogenous AD and dermatitis caused by external factors is often difficult. When the diagnosis of an occupational hand eczema is made, the diagnosis indicates that occupational exposure has been the major cause of dermatitis. In the case of an AD patient, the diagnosis of an occupational hand eczema requires that AD has been symptom free and hand eczema is seen to develop or deteriorate significantly in the working environment. Sometimes the dermatitis flares up so that the association is evident and the diagnosis of an occupational skin disease may be made. However, the practice of compensatory principles in this kind of case is variable in different countries (Bruze 1994) ... 

McSweeney EE, Arlt HG Jr, Russel J (eds) (1987) Tall oil and its uses, vol II. Pulp Chemicals Association, New York Meding B, Swanbeck G (1990) Occupational hand eczema in an industrial city. Contact Dermatitis 22 13-23 Meding B, Toren K, Karlberg A-T, et al. (1993) Evaluation of skin symptoms among workers at a Swedish paper mill. Am J Ind Med 23 721-728... 

The dynamics of the development of occupational hand eczema are not fully understood, but irritation and contact sensitivity, together with individual constitutional factors, influence its development. Theoretically, at least one of the triggering factors could be eliminated if the workers used individual preventive measures. Use of gloves, protective hand creams and hand washing were not found to influence the propensity for developing irritant cement eczema (Avnstorp 1991). Furthermore, no additional effect was found from individual preventive measures. The absence of influence from individual preventive measures could be explained by the possibility that the work processes are so hazardous that they overwhelm the protective effect. It could also be that the preventive initiatives were not conducted systematically or carefully enough. 

A metalworker with occupational hand eczema from cleansing parts broke out in response to chamomile tea, used to treat the rash [320]. 

Fig. 1. Occupational hand eczema in a silk-screen worker due to an emulsion containing (meth)acrylate derivatives...

Although most nickel sensitization results from nonoccupational exposures, nickel dermatitis was historically a problem in workplaces where there was a high risk of continuous contact with soluble nickel, eg, in electroplating (qv) shops. Improved personal and industrial hygiene has largely eliminated this problem. However, there are a few occupations involving wet nickel work, particularly where detergents faciUtate the penetration of skin by nickel, where hand eczema may occur (126). 

General principles of prevention of occupational asthma, rhinoconjimctivitis and dermatitis (e.g. hand eczema or contact dermatitis) should be published by national regulatory and advisory bodies. 

Nickel contact hypersensitivity has been documented extensively in both the general population and in a number of occupations in which workers were exposed to soluble nickel compounds. In several countries, it has been reported that 10-20% of the female population and about 1% of the male population show dermal sensitivity to nickel. Of these, 40-50% have vesicular hand eczema, which in some cases can be very severe and lead to loss of working ability. Oral nickel intake may aggravate vesicular hand eczema. Prostheses, or other surgical implants, made from nickel-containing alloys have been reported to cause nickel sensitization or to aggravate existing dermatitis. 

Table 3. Sick-leave, medical consultation due to work-related hand eczema in different occupational groups (modified according to Smit et al. 1993)...

Table 5. Reported 1-year prevalence of hand eczema in men and women in occupations according to a population-based study in Gothenburg (Sweden) (modified according Meding and Swan-beck 1990)...

Burrows D, Corbett JR (1977) Industrial dermatitis in Northern Ireland. Contact Dermatitis 3 145-150 Christensen OB (1982) Prognosis in nickel allergy and hand eczema. Contact Dermatitis 8 7-15 Coenraads PJ, Diepgen TL (1998) Risk of hand eczema in employees with past or present atopic dermatitis. Int Arch Occup Environ Health 71 7-13... 

Majoie IML, von Blomberg BME, Bruynzeel DP (1996) Development of hand eczema in junior hairdressers an 8-year followup study. Contact Dermatitis 34 243-247 Mathias CGT (1985) The cost of occupational skin disease. Arch Dermatol 121 332-334... 

Itschner L, Hinnen U, Eisner P (1996) Prevention of hand eczema in the metal-working industry Risk awareness and behaviour of metal worker apprentices. Dermatology 193 226-229 Kanerva L, Estlander T, Jolanki R (1988) Occupational skin disease in Finland. An analysis of 10 years of statistics from an occupational dermatology clinic. Int Arch Occup Environ Health 60 89-94... 

Estlander T, Jolanki R, Kanerva L (1994a) Allergic contact dermatitis from rubber and plastic gloves. In Mellstrom G, Wahiberg JE, Maibach HI (eds) Protective gloves for occupational use. CRC Press, Boca Raton, pp 221-239 Estlander T, Jolanki R, Kanerva L (1994b) Protective gloves. In Menne T, Maibach H (eds) Hand eczema. CRC Press, Boca Raton, pp 311-321... 

Kanerva L, Jolanki R, Toikkanen J, Tarvainen K, Estlander T (1995) Statistics on occupational dermatoses in Finland. In Eisner P, Maibach HI (eds) Irritant dermatitis. New clinical and experimental aspects. Curr Probl Dermatol 23 28-40 Kanerva L, Talvi A, Estlander T (1998) Occupational contact psoriasis. Eur J Dermatol 8 217-218 Lammintausta K, Kalimo K, Havu VK (1982) Occurrence of contact allergy and hand eczema in hospital wet work. Contact Dermatitis 8 84-90... 

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

Table 1. Change of occupation among atopic dermatitis patients according to Lammintausta et al. (1993). The initial and new occupations of 111 individuals are indicated. The reported prevdence of hand eczema (HE) in 955 atopic dermatitis patients with the same occupations is also shown (Rystedt 1986a)...

The reduction of the amount of wet work is the most important measure in prevention of occupational skin diseases, not only because wet work itself is irritant, but because many relevant allergens contact the skin during wet work. Furthermore, the concept of wet work is easily understood, and it is often not difficult to convince the management to reduce wet work by showing its effects on the frequency of hand eczema... 

Coenraads PJ (1983) Prevalence of hand eczema. Association with occupational exposure, especially in construction workers (M.D. thesis). University of Groningen, Groningen... 

Rystedt I (1985) Hand eczema and long-term prognosis in atopic dermatitis. Acta Derm Venereol Suppl (Stocldi) 117 1-59 Schubert H, Berova N, Czernielewski A, et al. (1987) Epidemiology of nickel allergy. Contact Dermatitis 16 122-128 Shah M, Lewis FM, Gawkrodger DJ (1996) Prognosis of occupational hand dermatitis in metalworkers. Contact Dermatitis 34 27-30... 

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