Erin M Warshaw1, Solveig L Hagen, Joel G DeKoven, Kathryn A Zug, Denis Sasseville, Donald V Belsito, Matthew J Zirwas, Joseph F Fowler, James S Taylor, Anthony F Fransway, Vincent A DeLeo, James G Marks, Melanie D Pratt, Howard I Maibach, C G Toby Mathias. 1. From the *HCMC Parkside Occupational and Contact Dermatitis Clinic; †Department of Dermatology, Minneapolis Veterans Affairs Medical Center; and ‡Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN; §Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; ∥Dartmouth-Hitchcock Medical Center, Lebanon, NH; ¶Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada; #Department of Dermatology, Columbia University, New York, NY; **Ohio State University, Columbus; ††University of Louisville, KY; ‡‡Department of Dermatology, Cleveland Clinic, OH; §§Associates in Dermatology, Fort Myers, FL; ∥∥Department of Dermatology, Keck School of Medicine at University of Southern California, Los Angeles; ¶¶Department of Dermatology, Pennsylvania State University, State College; ##Division of Dermatology, University of Ottawa, Ontario, Canada; ***Department of Dermatology, University of California, San Francisco; and †††Department of Dermatology, University of Cincinnati, OH.
Abstract
BACKGROUND: Little is known about the epidemiology of contact dermatitis in production workers (PWs). OBJECTIVE: The aims of this study were to estimate the prevalence of contact dermatitis and characterize clinically relevant and occupationally related allergens among North American PWs undergoing patch testing. METHODS: This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1998 to 2014. RESULTS: Of 39,332 patch-tested patients, 2732 (7.0%) were PWs. Among PWs, most were men (62.4%) and white (83.9%). A history of childhood eczema was uncommon (11.3%). Prevalent occupations included machine operators (27.3%); fabricators, assemblers, and hand-working occupations (16.8%); and precision metalworking occupations (16.1%). The most frequent sites of dermatitis were the hands (53.8%) and arms (29.4%), which were significantly more commonly affected compared with non-PWs (P < 0.0001). Occupationally related skin disease, allergic contact dermatitis, and irritant contact dermatitis were also significantly more common in PWs (49.9% vs 10.6%, 58.9% vs 53.7%, and 32.7% vs 25.7%, respectively; all Ps < 0.0001). Epoxy (15.3%), thiuram mix (8.3%), carba mix (8.1%), formaldehyde (6.3%), and cobalt (5.9%) were the most frequent occupationally related allergens. The top allergen sources included adhesives/glues (16.0%), metalworking fluids/cutting oils (6.8%), and coatings (6.3%). CONCLUSIONS: Production workers had a high rate of occupationally related skin disease, as well as irritant and allergic contact dermatitis. Involvement of exposed body areas was common. Frequently identified allergens included adhesives/glues, rubber accelerators, metals, and preservatives.
BACKGROUND: Little is known about the epidemiology of contact dermatitis in production workers (PWs). OBJECTIVE: The aims of this study were to estimate the prevalence of contact dermatitis and characterize clinically relevant and occupationally related allergens among North American PWs undergoing patch testing. METHODS: This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1998 to 2014. RESULTS: Of 39,332 patch-tested patients, 2732 (7.0%) were PWs. Among PWs, most were men (62.4%) and white (83.9%). A history of childhood eczema was uncommon (11.3%). Prevalent occupations included machine operators (27.3%); fabricators, assemblers, and hand-working occupations (16.8%); and precision metalworking occupations (16.1%). The most frequent sites of dermatitis were the hands (53.8%) and arms (29.4%), which were significantly more commonly affected compared with non-PWs (P < 0.0001). Occupationally related skin disease, allergic contact dermatitis, and irritant contact dermatitis were also significantly more common in PWs (49.9% vs 10.6%, 58.9% vs 53.7%, and 32.7% vs 25.7%, respectively; all Ps < 0.0001). Epoxy (15.3%), thiuram mix (8.3%), carba mix (8.1%), formaldehyde (6.3%), and cobalt (5.9%) were the most frequent occupationally related allergens. The top allergen sources included adhesives/glues (16.0%), metalworking fluids/cutting oils (6.8%), and coatings (6.3%). CONCLUSIONS: Production workers had a high rate of occupationally related skin disease, as well as irritant and allergic contact dermatitis. Involvement of exposed body areas was common. Frequently identified allergens included adhesives/glues, rubber accelerators, metals, and preservatives.