Prognosis of occupational contact dermatitis

This chapter reviews reports on the prognosis of occupational contact dermatitis. Factors that may affect the prognosis of occupational contact dermatitis include atopy, job change, the age of the patient, the nature of irritants and allergens, and the nature of the occupation. 

Association of Atopy and Prognosis of Occupational Contact Dermatitis... 

Nethercott J, Holness L (1994) Disease outcome in workers with occupational skin disease. J Am Acad Dermatol 30 569-574 Pryce DW, Irvine D, English JSC, et al. (1989) Soluble oil dermatitis a follow-up study. Contact Dermatitis 21 28-35 Rosen RH, Freeman S (1993) Prognosis of occupational contact dermatitis in New SouA Wales, Australia. Contact Dermatitis 29 88-93... 

It is well documented that prognosis in chromium dermatitis is probably worse than in any other form of dermatitis. Burrows (1972) found that a very small percentage were clear after 10-15 years. Halbert et al. (1992) confirmed this, and Hogan et al. (1990), in a review of the prognosis of occupational contact dermatitis of the hands, again confirmed the poor prognosis in chromate dermatitis. 

Shah M, Lewis FM, Gawkrodger DJ (1996) Prognosis of occupational hand dermatitis in metalworkers. Contact Dermatitis 34 27-30... 

The causes of chronicity from occupational contact dermatitis are usually multifactorial. Most studies indicated that allergic contact dermatitis is less likely to lead to chronicity than irritant contact dermatitis. The risk factor for chronicity of dermatitis in patients with contact dermatitis appears to be determined by the type or causes of contact dermatitis, the presence of atopy, and job change. The prognosis of contact dermatitis appears to be better in recent years. This improvement could be due to better understanding of the nature and causes of occupational contact dermatitis, availability of better diagnostic procedures and better health education, and preventive measures against occupational contact dermatitis. 

Halbert AR, Gebauer KA, Wall LM (1992) Prognosis of occupational chromate dermatitis. Contact Dermatitis 27 214-219... 

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... 

In Singapore, the prognosis of occupational allergic and irritant contact dermatitis for patients who ceased to be exposed was better then those who continued exposure to the contactants. The overall clearance rates for patients who ceased exposure and continued exposure were 73% and 69%, respectively. The clearance rates for allergic contact dermatitis were 71% (ceased exposure) and 74% (continued exposure), respectively, and for irritant contact dermatitis were 74% and 68%, respectively (Chia and Goh 1991). 

A personal history of atopy appears to significantly affect the prognosis of patients with occupational contact dermatitis. Rosen reported that the clearance... 

Chia SE, Goh CL (1991) Prognosis of occupational dermatitis in Singapore Worker. Am J Contact Dermat 2 105-109... 

Measures of the public health importance of a disease include the absolute number of cases, the incidence rate, the prevalence (rate), the economic impact of the disease, and the prognosis and preventability of the disease.65 Contact dermatitis is the most common occupational and environmental skin disease. Epidemiologic data show that contact dermatitis comprises 90 to 95% of all occupational skin diseases. 

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... 

Goh CL (1995) Noneczematous contact reactions. In Rycroft RJG, Menne T, Frosch PJ (eds) Textbook of contact dermatitis. Springer, Berlin Heidelberg New York, pp 221-236 Goh CL (1997) Prognosis of contact and occupational dermatitis. Clin Dermatol 15 655-659... 

Chia et al. observed that occupational irritant dermatitis from cement and acids/alkali tends to have a relatively better prognosis than other irritants, with all workers experiencing complete clearance of their dermatitis when they ceased contact with the irritant (Chia and Goh 1991). 

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). 

Occupational allergic contact dermatitis to chromates in cement has been reported to persist even upon avoidance of cement. Burrows reported that only 8% of his patients with cement dermatitis had clearance of their dermatitis after a 10- to 13-year follow-up (Burrows 1972). In Sydney, the prognosis from occupational allergic contact dermatitis from chromate was worse than those caused by other occupational allergens only less than 20% of such patients had clearance of their dermatitis over a 2- to 10-year follow-up period (Rosen and Freeman 1993). Another study from Perth, Australia, also reported poor prognosis from cement dermatitis, where 89% of cement workers with chromate allergy had persistent dermatitis when followed up over a period between 6 months and 9 years (Halbert et al. 1992). 

Therefore, although previous reports appear to suggest that occupational allergic contact dermatitis from chromate in cement is associated with poor prognosis, recent reports have indicated otherwise. This change could be attributed to reduction in exposure to chromates in cement among those affected through mechanisation of construction processes,... 

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