Occupational skin diseases

Occupational skin diseases are ranked among the top five occupational diseases in many countries.[1]

Contact Dermatitis due to irritation is inflammation of the skin which results from a contact with an irritant.[2] It has been observed that this type of dermatitis does not require prior sensitization of the immune system. There have been studies to support that past or present atopic dermatitis is a risk factor for this type of dermatitis.[3] Common irritants include detergents, acids, alkalies, oils, organic solvents and reducing agents.[4]

Clinical manifestations of the contact dermatitis are also modified by external factors such as environmental factors (mechanical pressure, temperature, and humidity) and predisposing characteristics of the individual (age, sex, ethnic origin, preexisting skin disease, atopic skin diathesis, and anatomic region exposed.[5]

Another occupational skin disease is glove-related hand urticaria, believed to be caused by repeated wearing and removal of the gloves. It has been reported as an occupational problem among the health care workers. The reaction is caused by the latex or the nitrile present in the gloves.[6]

Types

The acute form of this dermatitis develops on exposure of the skin to a strong irritant or caustic chemical. This exposure can occur as a result of accident at a workplace . The irritant reaction starts to increase in its intensity within minutes to hours of exposure to the irritant and reaches its peak quickly. After the reaction has reached its peak level, it starts to heal. This process is known as decrescendo phenomenon.[7] The most frequent potent irritants leading to this type of dermatitis are acids and alkaline solutions.[8] The symptoms include redness and swelling of the skin along with the formation of blisters.

The chronic form occurs as a result of repeated exposure of the skin to weak irritants over long periods of time.[9]

Prevention

Prevention measures include avoidance of the irritant through its removal from the workplace or through technical shielding by the use of potent irritants in closed systems or automation, irritant replacement or removal [10] and personal protection of the workers. Low quality evidence exists for the effectiveness of certain therapies and their ability to specifically prevent hand skin irritation in the workplace. The limited evidence that does exist suggests that moisturizers used alone or in combination with a barrier cream can result in a clinically beneficial effect in the long or short-term primary prevention of occupational irritant hand dermatitis.[11]

References
  1. Kanerva's Occupational Dermatology. ISBN 978-3-642-02035-3.
  2. Chew, Ai-Lean; Maibach, Howard I. (18 June 2006). Irritant Dematitis. ISBN 978-3-540-31294-9.
  3. Coenraads, P. J.; Diepgen, T. L. (1998-02-01). "Risk for hand eczema in employees with past or present atopic dermatitis". International Archives of Occupational and Environmental Health. 71 (1): 7–13. doi:10.1007/s004200050243. ISSN 0340-0131. PMID 9523243. S2CID 24878837.
  4. Elsner, P. (1994-07-01). "Irritant dermatitis in the workplace". Dermatologic Clinics. 12 (3): 461–467. doi:10.1016/S0733-8635(18)30149-9. ISSN 0733-8635. PMID 7923942.
  5. Safety, Government of Canada, Canadian Centre for Occupational Health and. "Dermatitis, Irritant Contact : OSH Answers". www.ccohs.ca. Retrieved 2016-03-25.
  6. Glove-related hand urticaria: an increasing occupational problem amongst health care workers. Hawkey S, Abdul Ghaffar S.
  7. Dermatotoxicology. ISBN 978-0849397738.
  8. Eichmann, A.; Amgwerd, D. (1992-05-05). "[Toxic contact dermatitis]". Schweizerische Rundschau für Medizin Praxis = Revue Suisse de Médecine Praxis. 81 (19): 615–617. ISSN 1013-2058. PMID 1589676.
  9. Dahl, M. V. (1988-01-01). "Chronic, irritant contact dermatitis: mechanisms, variables, and differentiation from other forms of contact dermatitis". Advances in Dermatology. 3: 261–275. ISSN 0882-0880. PMID 3152823.
  10. handbook of occupational dermatology.
  11. Bauer A, Rönsch H, Elsner P, Dittmar D, Bennett C, Schuttelaar MA, Lukács J, John S, Williams HC. Interventions for preventing occupational irritant hand dermatitis. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD004414. DOI: 10.1002/14651858.CD004414.pub3
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