[Evaluation of the standard application of Delphi in the diagnosis of chronic obstructive pulmonary disease caused by occupational irritant chemicals].

PubMed

Zhao, L; Yan, Y J

2017-11-20

Objective: To investigate the problems encountered in the application of the standard (hereinafter referred to as standard) for the diagnosis of chronic obstructive pulmonary disease caused by occu-pational irritant chemicals, to provide reference for the revision of the new standard, to reduce the number of missed patients in occupational COPD, and to get rid of the working environment of those who suffer from chronic respiratory diseases due to long-term exposure to poisons., slowing the progression of the disease. Methods: Using Delphi (Delphi) Expert research method, after the senior experts to demonstrate, to under-stand the GBZ 237-2011 "occupational irritant chemicals to the diagnosis of chronic obstructive pulmonary dis-ease" standard evaluation of the system encountered problems, to seek expert advice, The problems encoun-tered during the clinical implementation of the standards promulgated in 2011 are presented. Results: Through the Delphi Expert investigation method, it is found that experts agree on the content evaluation and implemen-tation evaluation in the standard, but the operational evaluation of the standard is disputed. According to the clinical experience, the experts believe that the range of occupational irritant gases should be expanded, and the operation of the problem of smoking, seniority determination and occupational contact history should be challenged during the diagnosis. Conclusions: Since the promulgation in 2011 of the criteria for the diagnosis of chronic obstructive pulmonary disease caused by occupational stimulant chemicals, there have been some problems in the implementation process, which have caused many occupationally exposed to irritating gases to suffer from "occupational chronic respiratory Diseases" without a definitive diagnosis.

Occupational Contact Dermatitis in North American Production Workers Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014.

PubMed

Warshaw, Erin M; Hagen, Solveig L; DeKoven, Joel G; Zug, Kathryn A; Sasseville, Denis; Belsito, Donald V; Zirwas, Matthew J; Fowler, Joseph F; Taylor, James S; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Maibach, Howard I; Mathias, C G Toby

Little is known about the epidemiology of contact dermatitis in production workers (PWs). 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. This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1998 to 2014. 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%). 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.

Occupational Contact Dermatitis in Mechanics and Repairers Referred for Patch Testing: Retrospective Analysis From the North American Contact Dermatitis Group 1998-2014.

PubMed

Warshaw, Erin M; Hagen, Solveig L; Sasseville, Denis; Maibach, Howard I; DeKoven, Joel G; Belsito, Donald V; Fowler, Joseph F; Zug, Kathryn A; Taylor, James S; Mathias, C G Toby; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Zirwas, Matthew J; Storrs, Frances J

Contact dermatoses are common in mechanic and repair occupations. This study aimed to (1) estimate the prevalence of occupationally related contact dermatitis among mechanics/repairers patch tested from 1998 to 2014 by the North American Contact Dermatitis Group, (2) characterize responsible allergens and irritants, and their sources, and (3) compare results among 3 occupational subgroups (mechanics, electrical/electronic, and other). A cross-sectional analysis of patients patch tested by the North American Contact Dermatitis Group between 1998 and 2014. Of 38,784 patients patch tested, 691 (1.8%) were mechanics/repairers. Male sex (93.5%) and hand involvement (59.5%) were common overall. Occupationally related skin disease was more prevalent among vehicle and mobile equipment mechanics/repairers (52.7%) and other mechanics/repairers (41.4%) than electrical/electronic equipment mechanics/repairers (21.3%). Overall, carba mix, thiuram mix, and methylchloroisothiazolone/methylisothiazolone were the most common occupation-related clinically relevant allergens. Gloves, automotive vehicles, solvents, oils, lubricants, and fuels were the most common sources of responsible allergens. Common occupationally related allergens included rubber accelerators and the preservative methylchloroisothiazolone/methylisothiazolone.

Jet Fuel-Associated Occupational Contact Dermatitis.

PubMed

Contestable, James J

2017-03-01

Occupational contact dermatitis is a ubiquitous problem. Sailors onboard U.S. Navy vessels are at high risk given the multitude of potential workplace exposures. Solvents, petrochemicals, and fuels are abundant and can cause irritant or allergic contact dermatitis. Symptoms of contact dermatitis can cause inability to work and, if chronic, may require a change in rating or job. Prevention of this issue requires patient education about the risks and correct personnel protective equipment. Even with preventative strategies in place, exposures and cases of contact dermatitis will occur. Treatment consists of topical steroids and immunomodulators, as well as barrier creams and emollients. The goal of treatment is to fully restore the skin's natural barrier and prevent further exposure. A classic case of jet fuel-associated contact dermatitis is reviewed. A literature review utilizing PubMed, Google Scholar, and Google Search was conducted to elucidate our understanding of this issue, current occupational health guidelines, preventative approaches, and treatments. This case report provides guidance and recommendations for providers who encounter contact dermatitis related to petrochemicals, such as jet fuel. The literature review revealed limited knowledge surrounding in vivo human skin effects of jet fuel, specifically JP-5. Even larger gaps were found in our understanding of, and guidelines for, protective modalities against jet fuel exposure and dermatitis. A case is presented to facilitate recognition of jet fuel contact dermatitis and guidance for treatment and prevention. Given our current limited knowledge and guidelines concerning protective equipment and skin protectants, multiple proposals for future studies are suggested. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Epidemiology of occupational contact dermatitis in a North Italian population.

PubMed

Lodi, A; Mancini, L L; Ambonati, M; Coassini, A; Ravanelli, G; Crosti, C

2000-03-01

Occupational contact dermatitis (OCD) is a very important skin disease both for its high frequency and for its social and economic implications. The aim of our work is to evaluate the epidemiology of occupational contact dermatitis in a north-Italian population and the possibility of a correct etiological diagnosis using the patch test standard series of GIRDCA (Italian Group of Resarch on Contact Dermatitis). We patch tested 1,565 out-patients affected by dermatitis with standard series GIRDCA and with other specific professional haptens. The manifestations were suspected of being of occupational origin by a dermatologist on the basis of clinical and anamnestic data. Of all the recorded professions we have considered only the more numerically significant: food industry, building industry, textile industry, employees, cleaners, hospital personnel, hairdressers, housewives, mechanics and metallurgists. Sixty-nine percent of contact dermatitis was found in women, the hairdressers had the greatest number of patients in the younger group (68.7% in the 11-20 years age group) and the textile industry workers in older group (100% in the 41-50 years age group). A positive allergological anamnesis emerged in 32.3% of allergic contact dermatitis. Irritant contact dermatitis (10.6%) was more frequent than allergic contact dermatitis (8.4%). The hands are the most common localization (94. 4%). The allergen with the highest frequency of positive reactions is p-phenylenediamine (25.3%). We discuss the frequency of positives to various groups of allergens in each profession and the principal means of contact. Because of the frequency of this type of occupational skin disease, we stress the importance of prevention. The standard series GIRDCA was found to be adequate for recognizing occupational contact dermatitis in most of our patients (74%).

Pustular irritant contact dermatitis caused by dexpanthenol in a child.

PubMed

Gulec, Ali Ihsan; Albayrak, Hulya; Uslu, Esma; Başkan, Elife; Aliagaoglu, Cihangir

2015-03-01

Pustular irritant contact dermatitis is rare and unusual clinic form of contact dermatitis. Dexpanthenol is the stable alcoholic analogue of pantothenic acid. It is widely used in cosmetics and topical medical products for several purposes. We present the case of 8-year-old girl with pustules over erythematous and eczematous areas on the face and neck. To the best of our knowledge, this is the first case reported that is diagnosed as pustular irritant contact dermatitis caused by dexpanthenol.

Evaluation of electric arc furnace-processed steel slag for dermal corrosion, irritation, and sensitization from dermal contact.

PubMed

Suh, Mina; Troese, Matthew J; Hall, Debra A; Yasso, Blair; Yzenas, John J; Proctor, Debora M

2014-12-01

Electric arc furnace (EAF) steel slag is alkaline (pH of ~11-12) and contains metals, most notably chromium and nickel, and thus has potential to cause dermal irritation and sensitization at sufficient dose. Dermal contact with EAF slag occurs in many occupational and environmental settings because it is used widely in construction and other industrial sectors for various applications including asphaltic paving, road bases, construction fill, and as feed for cement kilns construction. However, no published study has characterized the potential for dermal effects associated with EAF slag. To assess dermal irritation, corrosion and sensitizing potential of EAF slag, in vitro and in vivo dermal toxicity assays were conducted based on the Organisation for Economic Co-operation and Development (OECD) guidelines. In vitro dermal corrosion and irritation testing (OECD 431 and 439) of EAF slag was conducted using the reconstructed human epidermal (RHE) tissue model. In vivo dermal toxicity and delayed contact sensitization testing (OECD 404 and 406) were conducted in rabbits and guinea pigs, respectively. EAF slag was not corrosive and not irritating in any tests. The results of the delayed contact dermal sensitization test indicate that EAF slag is not a dermal sensitizer. These findings are supported by the observation that metals in EAF slag occur as oxides of low solubility with leachates that are well below toxicity characteristic leaching procedure (TCLP) limits. Based on these results and in accordance to the OECD guidelines, EAF slag is not considered a dermal sensitizer, corrosive or irritant. Copyright © 2014 John Wiley & Sons, Ltd.

Occupant-to-occupant contact injury in motor vehicle crashes.

PubMed

Viano, David C; Parenteau, Chantal S

2017-10-03

This is a descriptive study of the frequency and risk of occupant-to-occupant contact injury by crash type and occupant age. It focused on rear impacts because of a recent Senate inquiry. 1994-2013 NASS-CDS data were used to investigate the effects of occupant-to-occupant contact on the risk of serious-to-fatal injury (Abbreviated Injury Scale [AIS] 3+) by crash type and age group. NASS-CDS in-depth cases were analyzed to identify crash circumstances for AIS 3+ occupant-to-occupant contact injury in rear crashes. Serious injury (AIS 3+) due to occupant-to-occupant contact was uncommon. It represented only 0.84% of all AIS 3+ injury for all age groups. The overall risk of AIS 3+ occupant-to-occupant contact injury was 0.042 ± 0.007%. The highest incidence was in side impacts (69.8%) followed by rollovers (22.9%). Occupant-to-occupant contact injury risk was lower in rear impacts than in other crash types, at 0.0078 ± 0.0054%. The highest risk of AIS 3+ injury with occupant-to-occupant was for the <9-year-old age group when compared to other age groups for all crash types. The risk was 0.051 ± 0.026%, representing 2.69% of all AIS 3+ injury in the <9-year-old age group. Only 4.2% of AIS 3+ occupant-to-occupant contact injury occurred to children <9 years old in rear impacts. The corresponding injury risk was lowest in rear impacts, at 0.014 ± 0.014%%, when compared to other crash types. The analysis of in-depth NASS-CDS cases of occupant-to-occupant contact injury in children< 9 years old involved in rear impacts identified very severe collisions in older model vehicles with deformation of the occupant compartment and yielding front seats as main factors for the contact injury. Front seat occupants injuring rear-seated children was not identified in the in-depth NASS-CDS cases. AIS 3+ occupant-to-occupant contact injury occurs primarily in side impacts and rollovers. Most contact injury is to adults (89.4% incidence). Occupant-to-occupant contact injury to

Managing Occupational Irritant Contact Dermatitis Using a Two-Step Skincare Regimen Designed to Prevent Skin Damage and Support Skin Recovery.

PubMed

von Grote, Erika C; Palaniswarmy, Kiruthi; Meckfessel, Matthew H

2016-12-01

Occupational irritant contact dermatitis (ICD) affecting the hands is a common and difficult-to-manage condition. Occupations that necessitate contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing elevate the risk of ICD. Management strategies that do not adequately prevent accumulated damage and repair skin, can develop into chronic dermatoses which negatively impact work productivity and quality of life. A 2-step skin-care regimen (Excipial Daily Protection Hand Cream (EP) and Excipial Rapid Repair Hand Cream (ER), Galderma Laboratories, L.P.) has been developed as a daily-use management strategy to protect and repair vulnerable hands. The protective barrier cream is formulated with aluminum chlorohydrate and designed for pre-exposure application to enhance the skin's natural protective barrier and minimize excessive moisture while wearing protective gloves. The repair cream, a lipid-rich formulation, is intended for post-exposure application to rehydrate and facilitate the skin's natural healing process. The results of 3 clinical studies highlighted in this review demonstrate how the use of a 2-step skin-care regimen offers a greater protective effect against ICD than the use of barrier cream alone, and also how the formulation of the barrier cream used in these studies helps minimize the occlusion effect caused by gloves and does not interfere with the antibacterial efficacy of an alcohol-based hand sanitizer. This 2-step skin-care regimen is effectively designed to manage and minimize the risk of ICD development in a variety of patients and provides clinicians an additional tool for helping patients manage ICD. J Drugs Dermatol. 2016;15(12):1504-1510.

Occupational Contact Dermatitis in the Canadian Aircraft Industry: A 25-Year Retrospective Study.

PubMed

Loranger, Camille; Moreau, Linda; Sasseville, Denis

2018-03-24

Aircraft building exposes workers to irritant and sensitizing products. The aim of this article was to study occupational dermatoses among aircraft workers over 25 years. The files of aerospace workers referred between 1990 and 2015 were extracted from the database of the McGill University Health Centre contact dermatitis clinic. These were subdivided according to demographics, type of work, patch testing results, and final diagnosis. Of 305 workers, 58% were 40 years or younger; one third were women. Onset of dermatitis varied from 2 months to 25 years, but 120 cases (39%) occurred during the first 3 years. Fifty-one percent of the cases involved assemblers, and 27% were composite material technicians, which were overrepresented as they constitute 10% of the workforce. Of the 305 workers, 152 suffered from allergic contact dermatitis, and 96 had irritant contact dermatitis. Of those with allergic contact dermatitis, 124 reacted to epoxy-based workplace products, but only 48 had positive patch tests to commercially available epoxy allergens. More than 60% of the cases of epoxy allergy would have been missed without testing with workplace products.

Tandem Repeated Irritation Test (TRIT) Studies and Clinical Relevance: Post 2006.

PubMed

Reddy, Rasika; Maibach, Howard

2018-06-11

Single or multiple applications of irritants can lead to occupational contact dermatitis, and most commonly irritant contact dermatitis (ICD). Tandem irritation, the sequential application of two irritants to a target skin area, has been studied using the Tandem Repeated Irritation Test (TRIT) to provide a more accurate representation of skin irritation. Here we present an update to Kartono's review on tandem irritation studies since 2006 [1]. We surveyed the literature available on PubMed, Embase, Google Scholar, and the UCSF Dermatology library databases since 2006. The studies included discuss the tandem effects of common chemical irritants, organic solvents, occlusion as well as clinical relevance - and enlarge our ability to discern whether multiple chemical exposures are more or less likely to enhance irritation.

[Occupational allergic "march". Rapid evolution of contact dermatitis to ammonium persulfate into airborne contact dermatitis with rhinitis and asthma in a hairdresser].

PubMed

Poltronieri, Anna; Patrini, L; Pigatto, P; Riboldi, L; Marsili, Chiara; Previdi, M; Margonari, M; Marraccini, P

2010-01-01

Hairdressers are exposed to irritants and allergenic compounds that may cause contact dermatitis, rhinitis and asthma. In this paper we describe the case of a female, age 33 years, who developed contact dermatitis after 10 years of exposure to ammonium persulfate. After 7 months of progressively extensive and persistent skin lesions, respiratory symptoms appeared that were related to the occupational exposure (on-off test). SIDAPA and specific occupational patch test for hairdressers and occupational challenge with ammonium persulfate were performed. Clinical parameters of inflammation, ECP (eosinophil cationic protein) and exhaled nitric oxide (FeNO) were detected before and after the specific bronchial challenge. The patch test was positive to ammonium persulfate (++), and bronchial challenge for ammonium persulfate showed a significant late response (FEV1 decrease--33%). Both FeNO and ECP showed a significant increase after 24 hours. Dermatitis, urticaria and angioedema occurred on the uncovered skin due to airborne contact. Topic steroids and anti-histaminic drugs resolved the clinical symptoms. Bronchial challenge is, in fact, considered to be the gold standard for the diagnosis of occupational asthma, although new inflammatory parameters can contribute to the diagnosis and can be useful for monitoring after a specific inhalation test with occupational agents. The described case summarizes the evolution from contact dermatitis to inhalation allergy, suggesting the occurrence of an allergic "march" for occupational allergy.

[Main Causes of Occupational Allergic Contact Dermatitis: A Three Year Study in the Center of Portugal].

PubMed

Pestana, Catarina; Gomes, Raquel; Pinheiro, Vítor; Gouveia, Miguel; Antunes, Isabel; Gonçalo, Margarida

2016-08-01

Allergic contact dermatitis, along with irritant contact dermatitis and immediate contact reactions, contact urticarial, are the most frequent dermatological occupational disease, but seldom reported to the National authorities. We performed a 3-year retrospective study at the allergology section in the Dermatology Clinic of the University Hospital of Coimbra to evaluate the main occupations diagnosed as occupational allergic contact dermatitis, most common allergens and the effect of the modification of the work station in the evolution of the disease. During 2012 - 2014 among the 941 patch tested patients, 77 (8.2%) were diagnosed with occupational allergic contact dermatitis, with 169 positive patch tests related to occupational exposure, 55 detected within the baseline and 114 in complementary test series. In most cases allergic contact dermatitis involved the hands (88.3%), main professional activities were nail estheticians and hairdressers due to the manipulation of (meth)acrylates, the most common allergen in the study. After the diagnosis, 27.3% abandoned the work, 23.4% changed the work station, 49% avoided exposure to the responsible allergen. Contact dermatitis resolved in 39% of the patients, improved in 39% but had no change in the remaining 22%. This study, although including only patients from the center of Portugal, evaluates a large sample of patients with different occupations studied with a larger variety of allergens. Apart from classical allergens and professions responsible for occupational allergic contact dermatitis that we found in lower numbers (thiuram mix, paraphenylenodiamine, chromium and cobalt in health care workers, hairdressers and in the building industry), (meth)acrylates tested outside the European and Portuguese Baseline Series were the main cause of occupational allergic contact dermatitis, namely in nail estheticians. Methylisothiazolinone, the second more frequent occupational contact allergen in the present study was

Occupational contact dermatitis in the UK: a surveillance report from EPIDERM and OPRA.

PubMed

Meyer, J D; Chen, Y; Holt, D L; Beck, M H; Cherry, N M

2000-05-01

Since February 1993 the EPIDERM surveillance scheme has collected data on occupational skin disease from consultant dermatologists in the UK. Reporting by occupational physicians to the scheme began in May 1994 and was superseded in January 1996 by the Occupational Physicians Reporting Activity (OPRA). The schemes currently receive reports on incident cases from 244 dermatologists and 790 occupational physicians. An estimated total of 9937 cases of contact dermatitis reported by dermatologists was calculated from surveillance data; 8129 contact dermatitis cases were estimated from reports by occupational physicians. The annual incidence of occupational contact dermatitis from dermatologist reports was 6.4 cases per 100,000 workers and 6.5 per 100,000 from reports by occupational physicians, an overall rate of 12.9 cases per 100,000 workers. Manufacturing industries account for the greatest number of cases seen by both sets of reporting physicians, with health care employment second. Reports from dermatologists also indicate high rates of dermatitis in the personal service industries (mainly hairdressers and barbers) and in agriculture. With the exception of an increase in cases seen in nurses in both schemes, the numbers and proportions of cases of contact dermatitis within occupations have remained fairly constant over the 6-year reporting period. Agents accounting for the highest number of allergic contact dermatitis cases were rubber (23.4% of allergic cases reported by dermatologists), nickel (18.2), epoxies and other resins (15.6), aromatic amines (8.6), chromium and chromates (8.1), fragrances and cosmetics (8.0), and preservatives (7.3). Soaps (22.0% of cases), wet work (19.8), petroleum products (8.7), solvents (8.0), and cutting oils and coolants (7.8) were the most frequently cited agents in cases of irritant dermatitis. The national scope of the data, together with the parallel structure by which both dermatologists and occupational physicians report

Occupational dermatitis in health care workers evaluated for suspected allergic contact dermatitis.

PubMed

Kadivar, Salmon; Belsito, Donald V

2015-01-01

Contact dermatitides occur commonly among health care workers (HCWs). To contrast the atopic status and incidence, location, and final diagnosis of skin diseases afflicting HCWs versus non-HCWs (NHCWs) evaluated for suspicion of allergic contact dermatitis (ACD); and among the population diagnosed with ACD, to compare the incidence and occupational relatedness of allergens found in HCWs with the rates observed in NHCWs. Between July 1, 1994, and May 30, 2014, 2611 patients underwent patch testing by the senior author. Of these, 165 were classified as HCWs based on their primary occupation. Statistical analysis was done using a χ test. Health care workers were more likely than NHCWs to be women and to have hand dermatitis. Women, but not men, HCWs suffered more irritant contact dermatitis. Health care workers had significantly more work-related ACD, especially to formaldehyde, quaternium-15, 2-bromo-2-nitropropane-1,3-diol, cocamide diethanolamine (DEA), thiuram mix, carba mix, thimerosal, benzalkonium chloride, glutaraldehyde, and bacitracin. Only patients suspected of having ACD were tested. Our population was geographically limited to metropolitan Kansas City, MO and metropolitan New York, NY. Health care workers suffer more from occupational ACD, especially of the hands, than do NHCWs, including to allergens not present on available standard allergen series.

Occupational Contact Dermatitis in North American Print Machine Operators Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014.

PubMed

Warshaw, Erin M; Hagen, Solveig L; Belsito, Donald V; DeKoven, Joel G; Maibach, Howard I; Mathias, C G Toby; Zug, Kathryn A; Sasseville, Denis; Zirwas, Matthew J; Fowler, Joseph F; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Taylor, James S

Little is known about the epidemiology of contact dermatitis (CD) in print machine operators (PMOs). The aims of this study were to estimate the prevalence of CD and characterize clinically relevant and occupationally related allergens among PMOs undergoing patch testing. This was a retrospective cross-sectional analysis of the North American Contact Dermatitis Group data from 1998 to 2014. Of 39,332 patch-tested patients, 132 (0.3%) were PMOs. Among PMOs, most were male (75.0%) and white (92.4%). The majority were printing press operators (85.6%). The most frequent sites of dermatitis were hands (63.6%), arms (29.5%), and face/scalp (24.2%). More than half had an occupationally related skin condition (56.1%). Final diagnoses were most commonly allergic CD (58.3%) and irritant CD (33.3%). Cobalt (20.8%), carba mix (12.5%), thiuram mix (8.3%), and formaldehyde (8.3%) were the most frequent occupationally related allergens. The top allergen sources included inks (22.9%), gloves (20.8%), and coatings/dye/copy/photographic chemicals (14.6%). Allergic CD, irritant CD, and involvement of exposed body areas were common among PMOs. Common allergens included rubber accelerators, metals, and preservatives.

Wound-Related Allergic/Irritant Contact Dermatitis.

PubMed

Alavi, Afsaneh; Sibbald, R Gary; Ladizinski, Barry; Saraiya, Ami; Lee, Kachiu C; Skotnicki-Grant, Sandy; Maibach, Howard

2016-06-01

To provide information from a literature review about the prevention, recognition, and treatment for contact dermatitis. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify signs and symptoms of and diagnostic measures for contact dermatitis.2. Identify causes and risks for contact dermatitis.3. Select appropriate treatment for contact dermatitis and its prevention. Contact dermatitis to wound care products is a common, often neglected problem. A review was conducted to identify articles relevant to contact dermatitis.A PubMed English-language literature review was conducted for appropriate articles published between January 2000 and December 2015.Contact dermatitis is both irritant (80% of cases) or allergic (20% of cases). Frequent use of potential contact allergens and impaired barrier function of the skin can lead to rising sensitization in patients with chronic wounds. Common known allergens to avoid in wound care patients include fragrances, colophony, lanolin, and topical antibiotics.Clinicians should be cognizant of the allergens in wound care products and the potential for sensitization. All medical devices, including wound dressings, adhesives, and bandages, should be labeled with their complete ingredients, and manufacturers should be encouraged to remove common allergens from wound care products, including topical creams, ointments, and dressings.

Contact allergy: an update.

PubMed

Ljubojević Hadžavdić, Suzana; Pustišek, Nives; Žužul, Kristina; Švigir, Alen

2018-06-01

Contact allergies are common cause of eczema in all age groups and are one of the most common causes of occupational disability. Contact dermatitis (CD) can be divided into irritant and allergic contact dermatitis. Distinguishing between irritant and allergic triggers of CD by clinical and histologic examinations can be challenging. The approach to patients with CD should consist of a detailed (work and leisure) history, skin examination, patch tests with allergens based on history, physical examination, education on materials that contain the allergen and adequate therapy and prevention.

Carriers of filaggrin gene (FLG) mutations avoid professional exposure to irritants in adulthood.

PubMed

Bandier, Josefine; Ross-Hansen, Katrine; Carlsen, Berit C; Menné, Torkil; Linneberg, Allan; Stender, Steen; Szecsi, Pal B; Meldgaard, Michael; Thyssen, Jacob P; Johansen, Jeanne D

2013-12-01

Loss-of-function mutations in the filaggrin gene (FLG) are associated with xerosis, atopic dermatitis, and early onset of hand eczema. Irritant exposure is a risk factor for occupational hand eczema, and FLG mutations increase the risk of occupational irritant contact dermatitis on the hands in hospital cohorts. It is unknown whether FLG mutations affect the level of irritant exposure. To evaluate whether exposure to occupational irritants was dependent on FLG mutations, atopic dermatitis, and age at hand eczema onset. Randomly chosen Danish adults completed a questionnaire on general health and occupational exposures. Genotyping for FLG mutations (R501X, 2282del4, and R2447X) and patch testing were performed. Overall, 38.7% of subjects reported present or previous occupational exposure to irritants. Among individuals who reported hand eczema onset before entering their work life, 50.6% (45/89) of FLG non-mutation carriers became exposed to irritants, as compared with 28.6% (4/14) of heterozygous and 0% (0/6) of homozygous mutation carriers (p = 0.006). Avoidance was conspicuous among mutation carriers reporting childhood hand eczema and atopic dermatitis (odds ratio 0.08, 95% confidence interval 0.01-0.65). Carriers of FLG mutations who have had hand eczema onset in childhood avoid occupational exposure to irritants; the association is most marked with homozygous mutation status combined with atopic dermatitis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Irritant contact dermatitis due to ammonium bifluoride in two infant twins.

PubMed

Toledo, Fernando; Silvestre, Juan Francisco; Cuesta, Laura; Bañuls, José

2013-01-01

Ammonium bifluoride is one of the most corrosive acids that may produce severe chemical burns when in contact with skin. This hazardous chemical is widely used in household products. We report two pediatric cases of irritant contact dermatitis after exposure to a rust remover, which contained ammonium bifluoride. © 2011 Wiley Periodicals, Inc.

Barrier function and natural moisturizing factor levels after cumulative exposure to a fruit-derived organic acid and a detergent: different outcomes in atopic and healthy skin and relevance for occupational contact dermatitis in the food industry.

PubMed

Angelova-Fischer, Irena; Hoek, Anne-Karin; Dapic, Irena; Jakasa, Ivone; Kezic, Sanja; Fischer, Tobias W; Zillikens, Detlef

2015-12-01

Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin. The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers. The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels. In the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups. Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Black-spot poison ivy dermatitis. An acute irritant contact dermatitis superimposed upon an allergic contact dermatitis.

PubMed

Hurwitz, R M; Rivera, H P; Guin, J D

1984-08-01

A black spot in the epidermis over a blister of poison ivy dermatitis is an uncommon finding. Four patients with the phenomenon are described. Histologic and histochemical studies were made on biopsy material and the blackish deposit on the skin surface was compared with black deposits in and on leaves of the species of poison ivy. This examination revealed a yellow, amorphous substance on the stratum corneum of the lesions and a similar substance in and on leaves of the poison ivy plant, Toxicodendron radicans ssp. negundo. Associated with the pigmentary deposits there were distinct changes of acute irritant contact dermatitis superimposed upon allergic contact dermatitis. Our findings support the view that the black material is the oleoresin of the plant, and that this substance behaves both as an irritant and an allergen.

Is dermatitis palmaris sicca an irritant contact dermatitis?

PubMed

Chen, Fu-Juan; Liu, Zhen; Zhou, Ying; Chen, Yong-Hua; Fan, Yi-Ming

2013-01-01

Dermatitis palmaris sicca (DPS) is a common dry-fissured palmar dermatitis in Asian women. It may be an irritant contact dermatitis, but the immunophenotype of the cells in its infiltrate is unknown. The aim of this study was to evaluate the role of inflammatory cells in the pathogenesis of DPS. Patch testing was done in 68 patients with DPS, 87 subjects with hand eczema, and 31 healthy subjects. Immunophenotyping of cutaneous inflammatory cells was performed in 8 patients with DPS, 10 subjects with hand eczema, and 8 healthy individuals. Positive patch rates were higher in patients with DPS and those with hand eczema compared with healthy controls, but strong positive (++ or +++) reactions in DPS were fewer compared with hand eczema. Density of CD3, CD4, CD8, and CD68 cells in skin lesions of DPS and hand eczema was significantly higher than that in normal skin. Sparse CD20 cells were present only in hand eczema. Compared with hand eczema, the number of CD3, CD8, CD68, and dermal CD1a cells decreased, but epidermal CD1a cells and CD4/CD8 ratio increased in DPS. The absolute lack of CD20 cells and relative scarcity of dermal CD8 and CD1a cells in skin lesions might be insufficient to induce contact hypersensitivity, so DPS may be an irritant but not allergic contact dermatitis.

Occupational protein contact dermatitis.

PubMed

Barbaud, Annick; Poreaux, Claire; Penven, Emmanuelle; Waton, Julie

2015-01-01

Occupational contact dermatitis is generally caused by haptens but can also be induced by proteins causing mainly immunological contact urticaria (ICU); chronic hand eczema in the context of protein contact dermatitis (PCD). In a monocentric retrospective study, from our database, only 31 (0.41%) of patients with contact dermatitis had positive skin tests with proteins: 22 had occupational PCD, 3 had non-occupational PCD, 5 occupational ICU and 1 cook had a neutrophilic fixed food eruption (NFFE) due to fish. From these results and analysis of literature, the characteristics of PCD can be summarized as follows. It is a chronic eczematous dermatitis, possibly exacerbated by work, suggestive if associated with inflammatory perionyxix and immediate erythema with pruritis, to be investigated when the patient resumes work after a period of interruption. Prick tests with the suspected protein-containing material are essential, as patch tests have negative results. In case of multisensitisation revealed by prick tests, it is advisable to analyse IgE against recombinant allergens. A history of atopy, found in 56 to 68% of the patients, has to be checked for. Most of the cases are observed among food-handlers but PCD can also be due to non-edible plants, latex, hydrolysed proteins or animal proteins. Occupational exposure to proteins can thus lead to the development of ICU. Reflecting hypersensitivity to very low concentrations of allergens, investigating ICU therefore requires caution and prick tests should be performed with a diluted form of the causative protein-containing product. Causes are food, especially fruit peel, non-edible plants, cosmetic products, latex, animals.

Smoking, environmental tobacco smoke and occupational irritants increase the risk of chronic rhinitis.

PubMed

Hisinger-Mölkänen, Hanna; Piirilä, Päivi; Haahtela, Tari; Sovijärvi, Anssi; Pallasaho, Paula

2018-01-01

Allergic and non-allergic rhinitis cause a lot of symptoms in everyday life. To decrease the burden more information of the preventable risk factors is needed. We assessed prevalence and risk factors for chronic nasal symptoms, exploring the effects of smoking, environmental tobacco smoke, exposure to occupational irritants, and their combinations. In 2016, a postal survey was conducted among a random population sample of 8000 adults in Helsinki, Finland with a 50.5% response rate. Smoking was associated with a significant increase in occurrence of chronic rhinitis (longstanding nasal congestion or runny nose), but not with self-reported or physician diagnosed allergic rhinitis. The highest prevalence estimates of nasal symptoms, 55.1% for chronic rhinitis, 49.1% for nasal congestion, and 40.7% for runny nose, were found among smokers with occupational exposure to gases, fumes or dusts.Besides active smoking, also exposure to environmental tobacco smoke combined with occupational exposure increased the risk of nasal symptoms. Smoking, environmental tobacco smoke, and occupational irritants are significant risk factors for nasal symptoms with an additive pattern. The findings suggest that these factors should be systematically inquired in patients with nasal symptoms for appropriate preventive measures. (192 words).

Occupational skin hazards and prevalence of occupational skin diseases in shoe manufacturing workers in Indonesia.

PubMed

Febriana, Sri Awalia; Soebono, Hardyanto; Coenraads, Pieter-Jan

2014-02-01

Shoe manufacturing workers are exposed daily to an extensive range of potential physical and chemical occupational hazards. Shoe manufacturing in Indonesia is one of the industrial sectors that has shown sustained growth amongst the newly industrialized countries (NICs). In this study, we investigated the possible potential exposure of the workers to physical and occupational hazards and determined the prevalence of occupational skin diseases at a shoe manufacturing factory in Indonesia. A cross-sectional study on the observation of the working process and an inventory and risk assessment of exposure to the chemicals used. Classification of chemicals as potential sensitizers/irritants and qualitative assessments of these chemicals were done. Workers were examined and interviewed using the Nordic Occupational Skin Questionnaire-2002/LONG. The risk of Occupational skin diseases (OSD) at the shoe factory was mainly related to the exposure of the workers' skin to potential physical and chemical hazards in hot and humid environmental conditions. From a total of 514 workers, 8.5 % reported current OSD and 4.8 % reported a history of OSD. Occupational skin diseases were diagnosed in 29 % of the workers by dermatologists and 7.6 % had an occupational contact dermatitis (OCD). Of the 39 workers with contact dermatitis, 33 consented to being patch tested, 14 (3 %) workers showed a positive results and considered as having an occupational allergic contact dermatitis (OACD) and 25 (4.9 %) had an occupational irritant contact dermatitis (OICD). We observed a repeated and prolonged exposure of the workers to numerous physical and chemical skin hazards at this factory.

[Characterization of severe acute occupational poisoning accidents related to irritating gases in China between 1989 and 2003].

PubMed

Du, Xie-Yi; Zhang, Min; Wang, Huan-Qiang; Li, Tao; Wang, Hong-Fei; Chen, Shu-Yang; Zhang, Shuang; Qin, Jian; Ji, Li-Ying

2006-12-01

To analyze severe acute occupational poisoning accidents related to irritating gases reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies. The data from the national occupational poisoning case reporting system were analyzed with descriptive methods. (1) There were 92 severe acute occupational poisoning accidents related to asphyxiating gases during 15 years, which showed that there were 14.5 accidents occurred each year. Forty types of chemicals were reported to cause poisoning accidents directly. On average, there were 14.5 persons poisoned and 0.8 persons died of poisoning in each event. The number of death of poisoning reached 7 in most of the severe accidents. Chlorine was the main irritating gas resulting in poisoning accidents according to the number of accidents, cases and death. (1) The severe acute occupational poisoning related to irritating gases are more dangerous than others because of it is involved in more cases in each accident. (2) The accidents have concentricity in the certain types of chemicals, industries and jobs, and should be focused on control. (3) It is important to develop the program about early warning and forecast and the first aid.

Bioassays to evaluate non-contact spatial repellency, contact irritancy, and acute toxicity of permethrin-treated clothing against nymphal Ixodes scapularis ticks.

PubMed

Eisen, Lars; Rose, Dominic; Prose, Robert; Breuner, Nicole E; Dolan, Marc C; Thompson, Karen; Connally, Neeta

2017-10-01

Summer-weight clothing articles impregnated with permethrin are available as a personal protective measure against human-biting ticks in the United States. However, very few studies have addressed the impact of contact with summer-weight permethrin-treated textiles on tick vigor and behavior. Our aim was to generate new knowledge of how permethrin-treated textiles impact nymphal Ixodes scapularis ticks, the primary vectors in the eastern United States of the causative agents of Lyme disease, human anaplasmosis, and human babesiosis. We developed a series of bioassays designed to: (i) clarify whether permethrin-treated textiles impact ticks through non-contact spatial repellency or contact irritancy; (ii) evaluate the ability of ticks to remain in contact with vertically oriented permethrin-treated textiles, mimicking contact with treated clothing on arms or legs; and (iii) determine the impact of timed exposure to permethrin-treated textiles on the ability of ticks to move and orient toward a human finger stimulus, thus demonstrating normal behavior. Our results indicate that permethrin-treated textiles provide minimal non-contact spatial repellency but strong contact irritancy against ticks, manifesting as a "hot-foot" effect and resulting in ticks actively dislodging from contact with vertically oriented treated textile. Preliminary data suggest that the contact irritancy hot-foot response may be weaker for field-collected nymphs as compared with laboratory-reared nymphs placed upon permethrin-treated textile. We also demonstrate that contact with permethrin-treated textiles negatively impacts the vigor and behavior of nymphal ticks for >24h, with outcomes ranging from complete lack of movement to impaired movement and unwillingness of ticks displaying normal movement to ascend onto a human finger. The protective effect of summer-weight permethrin-treated clothing against tick bites merits further study. Published by Elsevier GmbH.

Occupational contact dermatitis caused by D-limonene.

PubMed

Pesonen, Maria; Suomela, Sari; Kuuliala, Outi; Henriks-Eckerman, Maj-Len; Aalto-Korte, Kristiina

2014-11-01

Limonene is widely used as a fragrance substance and solvent in cleansing products. Oxidized limonene is a frequent contact allergen among consumers of cosmetics, personal care products, and scented household cleaning products. Less is known about the sources of occupational exposure and occupational contact dermatitis caused by limonene. To report 14 patients with occupational contact allergy to limonene. The patients were examined in 2008-2013. An in-house preparation of oxidized limonene was patch tested as 3% and 5% in petrolatum from 2008 to August 2010, and after this as 3%, 1% and 0.3% pet. From 2012 onwards, a commercial test substance of limonene hydroperoxides was also used. We assessed the patients' occupational and domestic exposure to limonene. Occupational limonene allergy was observed in workers who used limonene-containing machine-cleaning detergents and hand cleansers, and in workers who used limonene-containing surface cleaners and dishwashing liquids similar to those used by consumers. In 3 cases, the occupational limonene allergy resulted from work-related use of limonene-containing, leave-on cosmetic products. Limonene is a frequent occupational sensitizer in hand cleansers and cleaning products. Occupational limonene contact allergy may also be caused by exposure to cosmetic products scented with limonene. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational dermatitis in hairdressers - influence of individual and environmental factors.

PubMed

Carøe, Tanja K; Ebbehøj, Niels E; Agner, Tove

2017-03-01

Hairdressers are at risk of developing occupational contact dermatitis because of their intense contact with wet work in combination with chemicals. To perform an analysis of a cohort study of hairdressers with occupational contact dermatitis recognized in the period 2006-2011, focusing on individual and environmental factors associated with the disease. The study was a descriptive, register-based survey including all hairdressers with recognized occupational contact dermatitis in Denmark in the period January 2006 to September 2011. Data were obtained from the Danish National Board of Industrial Injuries. The study comprised 381 patients (373 women and 8 men). The median age was 25 years, 64.8% were apprentices, and 35.2% were fully trained hairdressers. The prevalence of atopic dermatitis was 36.0%, and was significantly higher among apprentices than among fully trained hairdressers (44.9% and 19.4%, respectively) (p < 0.001). Of the patients, 48.3% had their dermatitis recognized as occupational irritant contact dermatitis, 46.7% had their dermatitis recognized as as occupational allergic contact dermatitis or combined allergic and irritant contact dermatitis, and 5.0% were recognized as having occupational contact urticaria. The low median age, the high percentages of atopic dermatitis in apprentices and the fact that more apprentices than fully trained hairdressers had recognized occupational contact dermatitis underlines the importance of early prevention. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effectiveness of interventions for preventing occupational irritant hand dermatitis: a quantitative systematic review.

PubMed

Papadatou, Zoi; Williams, Hector; Cooper, Kay

2018-06-01

The aim of this review was to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed here) in preventing occupational irritant hand dermatitis (OIHD) in wet workers, comparing each intervention to an alternative intervention or to usual care (workers' regular skin care regimen). The most significant occupational skin problem potentially encountered in wet work occupations is occupational dermatitis. When the skin comes into contact with hazardous substances at work, this can cause occupational dermatitis. Substances which may cause occupational dermatitis include cleaning products, organic solvents, metalworking fluids, cement, flour, adhesives, other chemicals and even certain plants. Occupational skin disease has adverse effects on quality of life and the long term prognosis for skin health is poor unless workplace exposures are addressed. To date, no systematic review has been undertaken to determine the effectiveness of interventions for the primary prevention of OIHD in wet workers. The review included any workers from healthcare (e.g. nurses, doctors and allied health professionals) and also people in different wet work occupations (e.g. hairdressers, florists, catering workers, metal workers) at similar risk of OIHD. Studies that assessed the following interventions in the primary prevention of OIHD in wet workers at the workplace and at home (before and after work) were included:Types of studies considered were experimental study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, and before and after studies. Primary outcome measures were OIHD incidence, and secondary outcome measures were product evaluation and change of occupation because of OIHD versus staying in the occupation. Published and unpublished literature in

Surgery-Related Contact Dermatitis: A Review of Potential Irritants and Allergens.

PubMed

Cook, Kevin A; Kelso, John M

Surgical procedures utilize an increasing number of medical products including antiseptics, anesthetics, gloves, suture materials, tissue adhesives, topical antibiotics, and bandages. Many of these products have irritant potential. Allergic contact dermatitis has also been reported. This review covers preoperative, operative, and postoperative exposures that may result in contact dermatitis. Testing with standard patch panels such as T.R.U.E. Test and the North American Contact Dermatitis Group 65 allergen series does not evaluate for all relevant contactants. A thorough understanding of potential exposures is vital to effectively evaluate a patient with surgery-related contact dermatitis. A systematic approach is needed to ensure that standard patch panels and supplementary patches adequately address each encountered contactant. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Clinical profile and quality of life of patients with occupational contact dermatitis from New Delhi, India.

PubMed

Bhatia, Riti; Sharma, Vinod K; Ramam, M; Sethuraman, Gomathy; Yadav, Chander P

2015-09-01

Data regarding occupational contact dermatitis (OCD) and its effect on quality of life (QOL) in India are limited. To evaluate patients with OCD and record the outcome of treatment. All patients with OCD were evaluated for severity of disease (by the use of physician global assessment) and its effect on QOL (by use of the Dermatology Life Quality Index) questionnaire) at the first visit and after 3 months of treatment. Among 117 patients with OCD, hand eczema was present in 81.2%. Positive patch test reactions were found in 76%. The most common allergens were Parthenium hysterophorus and potassium dichromate. The most frequent diagnosis was occupational allergic contact dermatitis (OACD) (57%), caused by farming and construction work, followed by occupational irritant contact dermatitis (OICD) (24%), caused by wet work. Severe psychosocial distress was recorded in 62.5% of patients. After 3 months of treatment, 83% improved significantly, and 54% had improvement in QOL. Farmers were most frequently affected, followed by construction workers and housewives. OACD was found at a higher frequency than OICD. The most frequent allergens were Parthenium hysterophorus in farmers, potassium dichromate in construction workers, and vegetables in housewives. OCD has a significant impact on QOL. Patch testing, in addition to standard treatment, improves the outcome considerably. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Contact irritant responses of Aedes aegypti Using sublethal concentration and focal application of pyrethroid chemicals.

PubMed

Manda, Hortance; Shah, Pankhil; Polsomboon, Suppaluck; Chareonviriyaphap, Theeraphap; Castro-Llanos, Fanny; Morrison, Amy; Burrus, Roxanne G; Grieco, John P; Achee, Nicole L

2013-01-01

Previous studies have demonstrated contact irritant and spatial repellent behaviors in Aedes aegypti following exposure to sublethal concentrations of chemicals. These sublethal actions are currently being evaluated in the development of a push-pull strategy for Ae. aegypti control. This study reports on mosquito escape responses after exposure to candidate chemicals for a contact irritant focused push-pull strategy using varying concentrations and focal application. Contact irritancy (escape) behavior, knockdown and 24 hour mortality rates were quantified in populations of female Ae. aegypti under laboratory conditions and validated in the field (Thailand and Peru) using experimental huts. Evaluations were conducted using varying concentrations and treatment surface area coverage (SAC) of three pyrethroid insecticides: alphacypermethrin, lambacyhalothrin and deltamethrin. Under laboratory conditions, exposure of Ae. aegypti to alphacypermethrin using the standard field application rate (FAR) resulted in escape responses at 25% and 50% SAC that were comparable with escape responses at 100% SAC. Significant escape responses were also observed at <100% SAC using ½FAR of all test compounds. In most trials, KD and 24 hour mortality rates were higher in mosquitoes that did not escape than in those that escaped. In Thailand, field validation studies indicated an early time of exit (by four hours) and 40% increase in escape using ½FAR of alphacypermethrin at 75% SAC compared to a matched chemical-free control. In Peru, however, the maximum increase in Ae. aegypti escape from alphacypermethrin-treated huts was 11%. Results presented here suggest a potential role for sublethal and focal application of contact irritant chemicals in an Ae. aegypti push-pull strategy to reduce human-vector contact inside treated homes. However, the impact of an increase in escape response on dengue virus transmission is currently unknown and will depend on rate of biting on human hosts prior

Occupational skin hazards from synthetic plastics.

PubMed

Tosti, A; Guerra, L; Vincenzi, C; Peluso, A M

1993-01-01

Epoxy and acrylic resins have numerous industrial applications but are also widely used in the household environment. These compounds are presently one of the most important sources of occupational contact dermatitis. Contact sensitization to epoxy resins is usually caused by the resin itself but hardeners or other additives, such as reactive diluents, plasticizers, fillers and pigments, can occasionally be responsible. Since completely cured epoxy resins are not sensitizers, epoxy resin sensitization is always due to the presence, in the final polymer, of uncured allergenic low molecular weight oligomers. Acrylates are now considered the fourth most common cause of contact sensitization due to resins. Unpolymerized monomers of acrylic compounds are known to be responsible for the contact allergy. Accelerators, inhibitors and catalysts, which are usually added to the acrylates to promote the polymerization process, can also sensitize. Both allergic and irritant contact dermatitis may be caused by exposure to epoxy or acrylic resins and their additives. Contact urticaria, allergic or irritant airborne contact dermatitis caused by volatile compounds, onychia and paronychia can also occur. From January of 1984 to May of 1992 we detected 39 cases of occupational allergic contact dermatitis to epoxy resin system substances and 11 cases of occupational contact sensitization to acrylic compounds. In our experience, the electronics industry as well as paint and glue related activities were the most important sources of epoxy sensitization. Dental materials and anaerobic sealants were found to be the most frequent acrylate sensitizers.

Contact allergy to preservatives in patients with occupational contact dermatitis and exposure analysis of preservatives in registered chemical products for occupational use.

PubMed

Schwensen, Jakob Ferløv; Friis, Ulrik Fischer; Menné, Torkil; Flyvholm, Mari-Ann; Johansen, Jeanne Duus

2017-05-01

The aim of the study is to investigate risk factors for sensitization to preservatives and to examine to which extent different preservatives are registered in chemical products for occupational use in Denmark. A retrospective epidemiological observational analysis of data from a university hospital was conducted. All patients had occupational contact dermatitis and were consecutively patch tested with 11 preservatives from the European baseline series and extended patch test series during a 5-year period: 2009-2013. Information regarding the same preservatives in chemical products for occupational use ('substances and materials') registered in the Danish Product Register Database (PROBAS) was obtained. The frequency of preservative contact allergy was 14.2% (n = 141) in 995 patients with occupational contact dermatitis. Patients with preservative contact allergy had significantly more frequently facial dermatitis (19.9 versus 13.1%) and age > 40 years (71.6 versus 45.8%) than patients without preservative contact allergy, whereas atopic dermatitis was less frequently observed (12.1 versus 19.8%). Preservative contact allergy was more frequent in painters with occupational contact dermatitis as compared to non-painters with occupational contact dermatitis (p < 0.001). This was mainly caused by contact allergy to methylisothiazolinone and contact allergy to formaldehyde. Analysis of the registered substances and materials in PROBAS revealed that preservatives occurred in several product categories, e.g., 'paints and varnishes', 'cleaning agents', 'cooling agents', and 'polishing agents'. Formaldehyde and isothiazolinones were extensively registered in PROBAS. The extensive use of formaldehyde and isothiazolinones in chemical products for occupational use may be problematic for the worker. Appropriate legislation, substitution, and employee education should be prioritized.

Occupational Airborne Contact Dermatitis From Proton Pump Inhibitors.

PubMed

DeKoven, Joel G; Yu, Ashley M

2015-01-01

Few published reports have described occupational contact dermatitis from proton pump inhibitor (PPI) exposure in the literature. We present an additional case of a 58-year-old male pharmaceutical worker with an occupational airborne allergic contact dermatitis to PPIs confirmed by patch testing. This is a novel report of workplace exposure to dexlansoprazole and esomeprazole PPIs with resultant clinical contact allergy and relevant positive patch test results to these 2 agents. A literature review of all previously reported cases of occupational contact dermatitis to PPI is summarized. The case also emphasizes the importance of even minute exposures when considering workplace accommodation.

Interventions for preventing occupational irritant hand dermatitis.

PubMed

Bauer, Andrea; Rönsch, Henriette; Elsner, Peter; Dittmar, Daan; Bennett, Cathy; Schuttelaar, Marie-Louise A; Lukács, Judit; John, Swen Malte; Williams, Hywel C

2018-04-30

Occupational irritant hand dermatitis (OIHD) causes significant functional impairment, disruption of work, and discomfort in the working population. Different preventive measures such as protective gloves, barrier creams and moisturisers can be used, but it is not clear how effective these are. This is an update of a Cochrane review which was previously published in 2010. To assess the effects of primary preventive interventions and strategies (physical and behavioural) for preventing OIHD in healthy people (who have no hand dermatitis) who work in occupations where the skin is at risk of damage due to contact with water, detergents, chemicals or other irritants, or from wearing gloves. We updated our searches of the following databases to January 2018: the Cochrane Skin Specialised Register, CENTRAL, MEDLlNE, and Embase. We also searched five trials registers and checked the bibliographies of included studies for further references to relevant trials. We handsearched two sets of conference proceedings. We included parallel and cross-over randomised controlled trials (RCTs) which examined the effectiveness of barrier creams, moisturisers, gloves, or educational interventions compared to no intervention for the primary prevention of OIHD under field conditions. We used the standard methodological procedures expected by Cochrane. The primary outcomes were signs and symptoms of OIHD developed during the trials, and the frequency of treatment discontinuation due to adverse effects. We included nine RCTs involving 2888 participants without occupational irritant hand dermatitis (OIHD) at baseline. Six studies, including 1533 participants, investigated the effects of barrier creams, moisturisers, or both. Three studies, including 1355 participants, assessed the effectiveness of skin protection education on the prevention of OIHD. No studies were eligible that investigated the effects of protective gloves. Among each type of intervention, there was heterogeneity concerning

Differential gene expression responses distinguish contact and respiratory sensitizers and nonsensitizing irritants in the local lymph node assay.

PubMed

Adenuga, David; Woolhiser, Michael R; Gollapudi, B Bhaskar; Boverhof, Darrell R

2012-04-01

Genomic approaches have the potential to enhance the specificity and predictive accuracy of existing toxicology endpoints, including those for chemical sensitization. The present study was conducted to determine whether gene expression responses can distinguish contact sensitizers (1-chloro-2,4-dinitrobenzene [DNCB] and hexyl cinnamic aldehyde [HCA]), respiratory sensitizers (ortho-phthalaldehyde and trimellitic anhydride [TMA]), and nonsensitizing irritants (methyl salicylate [MS] and nonanoic acid [NA]) in the local lymph node assay (LLNA). Female Balb/c mice received doses of each chemical as per the standard LLNA dosing regimen on days 1, 2, and 3. Auricular lymph nodes were analyzed for tritiated thymidine ((3)HTdR) incorporation on day 6 and for gene expression responses on days 6 and 10. All chemicals induced dose-dependent increases in stimulation index, which correlated strongly with the number of differentially expressed genes. A majority of genes modulated by the irritants were similarly altered by the sensitizers, consistent with the irritating effects of the sensitizers. However, a select number of responses involved with immune-specific functions, such as dendritic cell activation, were unique to the sensitizers and may offer the ability to distinguish sensitizers from irritants. Genes for the mast cell proteases 1 and 8, Lgals7, Tim2, Aicda, Il4, and Akr1c18 were more strongly regulated by respiratory sensitizers compared with contact sensitizers and may represent potential biomarkers for discriminating between contact and respiratory sensitizers. Collectively, these data suggest that gene expression responses may serve as useful biomarkers to distinguish between respiratory and contact sensitizers and nonsensitizing irritants in the LLNA.

The three moments of skin cream application: an evidence-based proposal for use of skin creams in the prevention of irritant contact dermatitis in the workplace.

PubMed

Hines, J; Wilkinson, S M; John, S M; Diepgen, T L; English, J; Rustemeyer, T; Wassilew, S; Kezic, S; Maibach, H I

2017-01-01

Contact dermatitis is one of the most common occupational diseases, with serious impact on quality of life, lost days at work and a condition that may be chronically relapsing. Regular prophylactic skin cream application is widely acknowledged to be an effective prevention strategy against occupational contact dermatitis; however, compliance rates remain low. To present a simple programme for skin cream application in the workplace with focus on implementation to drive down the rate of occupational irritant contact dermatitis, an expert panel of eight international dermatologists combined personal experience with extensive literature review. The recommendations are based on clinical experience as supported by evidence-based data from interventional studies. The authors identified three moments for skin cream application in the work place: (i) before starting a work period; (ii) after washing hands; and (iii) after work. Affecting behaviour change requires systematic communications, monitoring and reporting, which is proposed through Kotter's principles of organizational change management. Measurement tools are provided in the appendix. Interventional data based on application of this proposal is required to demonstrate its effectiveness. © 2016 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

Occupational allergic contact dermatitis caused by epoxy chemicals: occupations, sensitizing products, and diagnosis.

PubMed

Aalto-Korte, Kristiina; Pesonen, Maria; Suuronen, Katri

2015-12-01

Epoxy products are among the most common causes of occupational allergic contact dermatitis. Diglycidyl ether of bisphenol A resin (DGEBA-R) is the most important sensitizer in epoxy systems. To describe patients with occupational allergic contact dermatitis caused by epoxy products. Patients with allergic reactions to epoxy chemicals were chosen from test files (January 1991 to June 2014). Only patients with occupational contact allergy to some component of epoxy resin systems were included. We analysed patch test results, occupation, symptoms, and exposure data. We found a total of 209 cases with occupational contact allergy to epoxy chemicals. The largest occupational groups were painters (n = 41), floor layers (n = 19), electrical industry workers (n = 19), tile setters (n = 16), and aircraft industry workers (n = 15). A total of 82% of the patients reacted to DGEBA-R. Diagnosis of the DGEBA-R-negative patients required testing with m-xylylenediamine, N,N'-tetraglycidyl-4,4'-methylenedianiline, 1,4-butanediol diglycidyl ether, 2,4,6-tris-(dimethylaminomethyl)phenol, diglycidyl ether of bisphenol F resin, N,N'-diglycidyl-4-glycidyloxyaniline, isophoronediamine, 4,4'-diaminodiphenylmethane, diethylenetriamine, and cresyl glycidyl ether. The hands/upper extremities were most commonly affected (69%), but facial symptoms were also frequent (60%). Allergic contact dermatitis caused by to epoxy products cannot always be diagnosed by the use of commercial test substances. Workplace products need to be tested. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Tandem repeated application of organic solvents and sodium lauryl sulphate enhances cumulative skin irritation.

PubMed

Schliemann, Sibylle; Schmidt, Christina; Elsner, Peter

2014-01-01

The objective of our study was to investigate the tandem irritation potential of two organic solvents with concurrent exposure to the hydrophilic detergent irritant sodium lauryl sulphate (SLS). A tandem repeated irritation test was performed with two undiluted organic solvents, cumene (C) and octane (O), with either alternating application with SLS 0.5% or twice daily application of each irritant alone in 27 volunteers on the skin of the back. The cumulative irritation induced over 4 days was quantified using visual scoring and non-invasive bioengineering measurements (skin colour reflectance, skin hydration and transepidermal water loss). Repeated application of C/SLS and O/SLS induced more decline of stratum corneum hydration and higher degrees of clinical irritation and erythema compared to each irritant alone. Our results demonstrate a further example of additive harmful skin effects induced by particular skin irritants and indicate that exposure to organic solvents together with detergents may increase the risk of acquiring occupational contact dermatitis. © 2014 S. Karger AG, Basel.

Head impact contact points for restrained child occupants.

PubMed

Arbogast, Kristy B; Wozniak, Samantha; Locey, Caitlin M; Maltese, Matthew R; Zonfrillo, Mark R

2012-01-01

Head injuries are the most common injuries sustained by children in motor vehicle crashes regardless of age, restraint, and crash direction. For rear seat occupants, the interaction of the subject with the seat back and the vehicle side interior structures has been previously highlighted. In order to advance this knowledge to the development of countermeasures, a summary of vehicle components that contributed to these injuries is needed. Therefore, the objective of this study was to create a contact map of the vehicle interior for head and face injuries to rear-seated restrained children in front crashes. The Crash Injury Research and Engineering Network (CIREN) was queried for rear-seated, restrained child occupants (age 0-15 years) in forward-facing child restraints, booster seats, or lap and shoulder belts who sustained an AIS2+ head and/or face injury in a frontal motor vehicle crash. Cases were analyzed to describe injury patterns and injury causation scenarios. A contact point map was developed to summarize the vehicle components related to injury causation of the head/face injury. Twenty-one cases met the combined inclusion and exclusion criteria. Seven of the child occupants were restrained in forward-facing child restraints, 2 in belt-positioning booster seats, and 12 in lap and shoulder belts. There were 28 head and 17 facial injuries. For left rear occupants, the most common contact point was the pillar in front of the occupant's seat row; that is, B-pillar for second-row occupants, indicating a leftward kinematics. For right rear occupants, due to differences in crash dynamics, the most common contact point location was the passenger's seat back, suggesting that these occupants moved predominantly forward. Contact points associated with head/face injury for restrained children 0 to 15 years in frontal crashes have been delineated. In a majority of the cases, the head/face injury was the most severe injury and severe injuries to other body regions were

Exploration and comparison of in vitro eye irritation tests with the ISO standard in vivo rabbit test for the evaluation of the ocular irritancy of contact lenses.

PubMed

Yun, Jun-Won; Hailian, Quan; Na, Yirang; Kang, Byeong-Cheol; Yoon, Jung-Hee; Cho, Eun-Young; Lee, Miri; Kim, Da-Eun; Bae, SeungJin; Seok, Seung Hyeok; Lim, Kyung-Min

2016-12-01

In an effort to explore the use of alternative methods to animal testing for the evaluation of the ocular irritancy of medical devices, we evaluated representative contact lenses with the bovine corneal opacity and permeability test (BCOP) and an in vitro eye irritation test using the three-dimensionally-reconstructed human corneal epithelium (RhCE) models, EpiOcular™ and MCTT HCE™. In addition, we compared the obtained results with the ISO standard in vivo rabbit eye irritation test (ISO10993-10). Along with the positive controls (benzalkonium chloride, BAK, 0.02, 0.2, and 1%), the extracts of 4 representative contact lenses (soft, disposable, hard, and colored lenses) and 2 reference lenses (dye-eluting and BAK-coated lenses) were tested. All the lenses, except for the BAK-coated lens, were determined non-irritants in all test methods, while the positive controls yielded relevant results. More importantly, BCOP, EpiOcular™, and MCTT HCE™ yielded a consistent decision for all the tested samples, with the exception of 0.2% BAK in BCOP, for which no prediction could be made. Overall, all the in vitro tests correlated well with the in vivo rabbit eye irritation test, and furthermore, the combination of in vitro tests as a tiered testing strategy was able to produce results similar to those seen in vivo. These observations suggest that such methods can be used as alternative assays to replace the conventional in vivo test method in the evaluation of the ocular irritancy of ophthalmic medical devices, although further study is necessary. Copyright © 2016. Published by Elsevier Ltd.

Irritant-induced asthma.

PubMed

Labrecque, Manon

2012-04-01

To describe the recent insights into the definition, causes, natural outcome, and key elements of irritant-induced asthma (IIA) management. IIA is a subtype of occupational asthma without immunologic sensitization and includes the typical reactive airway dysfunction syndrome (RADS) and a more gradual form called not-so-sudden IIA, when onset of asthma follows repeated low-dose exposure to irritants. The World Trade Center tragedy brought new insight in the understanding of IIA, suggesting that it can exhibit a prolonged interval between exposure and recognition of clinical symptoms and disease. Dimethyl sulfate has been recently reported to cause RADS and repeated diesel exhaust exposure to cause not-so-sudden IIA in patients who worked in a bus garage. Cleaning workers who are exposed to a large variety of irritants and sensitizers are especially at risk of occupational asthma and IIA. IIA includes RADS and not-so-sudden IIA. Outcome of IIA is as poor as occupational asthma with sensitization. Treatment of IIA does not differ from standard asthma treatment, but high-dose vitamin D could be assessed further for possible therapeutic benefit.

Occupational contact sensitization in female geriatric nurses: Data of the Information Network of Departments of Dermatology (IVDK) 2005-2014.

PubMed

Schubert, S; Bauer, A; Molin, S; Skudlik, C; Geier, J

2017-03-01

Geriatric nurses (GN) have a high risk of occupational contact dermatitis (OCD), with chronic irritant contact dermatitis predominating. However, allergic contact dermatitis is an important issue as well. Little is known whether the relevant occupational allergen spectrum reported in the 1990s, including fragrances, preservatives, rubber chemicals and ingredients of surface disinfectants to be the most common sensitizers in GN, is still valid. To monitor the current allergen spectrum in GN with OCD and verify the validity of the patch test recommendations (baseline-, preservative-, ointment base-, rubber-, disinfectant, series and fragrances) in GN with suspected OCD given by the German Contact Dermatitis Research Group (DKG). Retrospective analysis of IVDK data (2005-2014) of 743 female GN with OCD, in comparison to 695 GN without OCD. GN with OCD reacted significantly more frequently to both fragrance mixes, hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC), thiuram mix, zinc diethyldithiocarbamate and mercaptobenzothiazole than GN without OCD. Reactions to MDBGN, methylchloroisothiazolinone/methylisothiazolinone and oil of turpentine occurred substantially, but not significantly more frequently among GN with OCD. The latter may be due to former use of a special alcoholic liniment in geriatric care. Among material from the patients' workplaces, tetrazepam was a frequent allergen, due to dust exposure from pill crushing. Furthermore, occupationally used protective gloves, body care products as well as surface disinfectants were often tested positively. The general allergen spectrum in GN with OCD is unchanged, so the DKG patch test recommendations are still valid. Prevention of occupational sensitization should focus on fragrance-free hygiene and body care products, usage of accelerator-free protective gloves and avoidance of drug dust exposure. © 2016 European Academy of Dermatology and Venereology.

Occupational contact dermatitis due to essential oils.

PubMed

Trattner, Akiva; David, Michael; Lazarov, Aneta

2008-05-01

Allergic contact dermatitis induced by the occupational use of products containing essential oils has not been studied comprehensively. The aim of the present report was to describe the characteristics, diagnosis, and outcome of 5 patients with occupational contact dermatitis because of essential oils attending our outpatient dermatology clinics over a 2-year period. These patients are added to the 11 cases reported thus far in the literature. The research shows that for proper diagnosis, patch tests with the standard series and the fragrance series should be performed, in addition to tests with the specific oils to which the patients were exposed. Patients should be instructed to avoid the allergens identified. Sensitization to essential oils has important implications for the occupational future of affected individuals.

[Type IV contact allergies in the food processing industry: an update].

PubMed

Bauer, A; Schubert, S; Geier, J; Mahler, V

2018-06-01

The food sector is one of the high-risk areas for occupational irritative and allergic contact eczema. The present work provides an overview of the main allergens as well as sensitization frequencies and risk in various food industry occupations. The literature on type IV sensitization in the food sector is summarized. The relative risk of developing a work-related eczema in food processing is increased by more than 3 times. The comparison group was calculated on the basis of the proportion of documented cases in the IVDK (Informationsverbund Dermatologischer Kliniken) network per 100,000 working persons in relation to the average of the years 2005 and 2010. For this purpose, the average risk of all patients was set as reference to 1. Bakers, pastry chefs, cooks and meat and fish processors are mainly affected. In addition to irritant contact eczema, allergic contact eczema and protein contact dermatitis often occur. Leading haptens (main allergens) are rubber ingredients, but also disinfectants and compositae. Only a few contact allergens are responsible for the majority of job-relevant sensitizations in the food industry.

Occupational skin diseases in Czech healthcare workers from 1997 to 2009.

PubMed

Machovcová, A; Fenclová, Z; Pelclová, D

2013-04-01

The healthcare sector ranked in second place among economic sectors in the Czech Republic, with about 11.4 % of all occupational diseases in 2009. Skin diseases constituted about 20 % of all occupational diseases. The aim of this study was to analyze the causes and trends in allergic and irritant-induced skin diseases in the healthcare sector. The data concerning occupational skin diseases (Chapter IV of the Czech List of Occupational Diseases, non-infectious skin illnesses) in the healthcare sector were analyzed from the Czech National Registry of Occupational Diseases from 1997 until 2009. The trends in the total counts and most frequent causes were evaluated. During the past 13 years, a total of 545 skin diseases were acknowledged in healthcare workers. Allergic contact dermatitis was diagnosed in 464 (85 %), irritant contact dermatitis in 71 (13 %) and contact urticaria in 10 subjects (2 %). Ninety-five percent of the patients were females. The overall incidence in individual years varied between 1.0 and 2.9 cases per 10,000 full-time employees per year. Disinfectants were the most frequent chemical agents causing more than one third of all allergic skin diseases (38 %), followed by rubber components (32 %) and cleaning agents (10 %). A general downward trend of diagnosed cases of occupational skin diseases in heath care workers in the Czech Republic over the past 13 years was demonstrated.

An update on airborne contact dermatitis: 2001-2006.

PubMed

Santos, Raquel; Goossens, An

2007-12-01

Reports on airborne dermatoses are mainly published in the context of occupational settings. Hence, in recent years, dermatologists and also occupational physicians have become increasingly aware of the airborne source of contact dermatitis, resulting mainly from exposure to irritants or allergens. However, their occurrence is still underestimated, because reports often omit the term 'airborne' in relation to dust or volatile allergens. For the present update, we screened the journals 'Contact Dermatitis' (July 2000 to December 2006); 'Dermatitis', formerly named 'American Journal of Contact Dermatitis'; 'La Lettre du Gerda' (January 2000 to December 2006); and also included relevant articles from other journals published during the same period. This resulted in an updated list of airborne dermatitis causes.

Acute toxicity and primary irritancy of alkylalkanolamines.

PubMed

Ballantyne, B; Leung, H W

1996-12-01

The acute handling hazards of several alkylalkanolamines were determined by investigating their potential acute toxicity and primary irritancy. Materials studied were N-methylethanolamine (MEA), N, N, -dimethylethanolamine (DMEA), N, N, -dimethylisopropanolamine (DMIPA), N-methyldiethanolamine (MDEA), and tertbutyldiethanolamine (BDEA). All these alkylalkanolamines were of comparable acute peroral toxicity in the rat (LD50 range 1.48-2.83 ml/kg). By 24 h occluded epicutaneous contact in the rabbit, MEA, DMEA and DMIPA were of moderate acute percutaneous toxicity (LD50 range 1.13-2.0 ml/kg), MDEA was of slight acute percutaneous toxicity (LD50 male 9.85 ml/kg, female 10.90 ml/kg), and BDEA of intermediate toxicity (LD50 6.4 ml/kg). Due to differences in vapor pressure the acute vapor exposure toxicity of the alkylalkanolamines to rats varied; MEA, MDEA and BDEA were of a low order of acute toxicity, and DMIPA was moderately toxic with an LT50 of 3.2 h for a saturated vapor atmosphere exposure. A 4 h-LC50 (rat combined sex) of 1461 ppm was determined for DMEA. All alkylalkanolamines studied, except MDEA, were moderately to markedly irritating and caused variable degrees of skin corrosivity; MDEA caused only transient minor skin irritation. In accord with the skin irritancy results, the eye irritancy from 0.005 ml MEA, DMEA, DMIPA and BDEA was severe, and that from MDEA was slight. Exposure to these compounds has implications for occupational health procedures.

Chromate and amine contact allergies in workers manufacturing precast concrete elements.

PubMed

Mowitz, Martin; Zimerson, Erik; Hauksson, Inese; Pontén, Ann

2016-12-01

Five workers from a plant manufacturing concrete wall panels and beams were referred to our department because of suspected occupational dermatitis. When patch tested, 3 workers reacted to potassium dichromate. Four workers reacted to ethylenediamine dihydrochloride, without any obvious exposure. Owing to the high proportion of workers with recent-onset skin disease, an investigation of all workers at the plant was initiated. To investigate the prevalence of occupational dermatitis and contact allergy in the workers at the plant. All 24 workers at the plant underwent a clinical investigation and were patch tested. Four cases of allergic occupational contact dermatitis and 3 cases of irritant occupational contact dermatitis were diagnosed. Contact allergy to potassium dichromate was found in 4 workers. All 4 also reacted to ethylenediamine dihydrochloride and/or amines that were present as additives in the cement. Chromate contact allergy can still be found in concrete workers, despite the legislation regulating the amount of hexavalent chromium (chromate) in cement. Occupational contact allergy to amines can be found in workers exposed to cement and concrete, so amines should be tested in these workers. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A survey of plants responsible for causing irritant contact dermatitis in the Amathole district, Eastern Cape, South Africa.

PubMed

Otang, Wilfred M; Grierson, Donald S; Afolayan, Anthony J

2014-11-18

Potentially harmful plants grow almost everywhere, hence, it is not practical to eradicate them all. However, a basic understanding of adverse cutaneous reactions and the common plants that cause each type can enable vulnerable individuals to discover the source of their dermatitis and thus prevent re-exposure. The aim of this study therefore, was to document the plants responsible for irritant contact dermatitis (ICD) in the Eastern Cape, along with their respective irritants and clinical presentations. Study participants (161) in 12 locations were selected by convenient sampling with particular focus on local people who regularly interact with plants or plant products. Interview questions were focused on the local names of plants that contain irritating chemicals and physical characteristics that cause ICD. Forty four plant species distributed in 24 families and 34 genera were reported as causative agents of irritant contact dermatitis. Herbs constituted 67.35%, trees 24.49% and shrubs 8.16%. Mechanical ICD was reported to be caused by 23 species, closely followed by chemical ICD (20 species) and mechanico-chemical ICD (6 species). Species with the highest frequency of citations were Allium cepa, Acacia karroo, Capsicum annuum, Citrus limon and Zea mays. The most representative families were Euphorbiaceae (for chemical ICD), Urticaceae (for mechanico-chemical ICD), Fabaceae and Rutaceae for mechanical ICD. Most of the classes of chemical compounds identified as being responsible for chemical ICD were restricted to plants of specific genera such as the diterpenes in Euphorbia spp., disulphides in Allium spp., terpenes in Citrus spp. and isothiocyanates in Brassica spp. Thorns and hairs were reported for causing Mechanical ICD in 6 plant species each, including widely cultivated plants such as Acacia karoo and Citrus reticulata. Irritant contact dermatitis is a common cutaneous disorder in individuals exposed to plants in the Eastern Cape, especially among workers

Efficacy of dexpanthenol in skin protection against irritation: a double-blind, placebo-controlled study.

PubMed

Biro, Kathrin; Thaçi, Diamant; Ochsendorf, Falk R; Kaufmann, Roland; Boehncke, Wolf-Henning

2003-08-01

Dexpanthenol is popular in treating various dermatoses and in skin care, but few controlled clinical trials have been performed. We investigated the efficacy of dexpanthenol in skin protection against irritation in a randomized, prospective, double-blind, placebo-controlled study. 25 healthy volunteers (age 18-45 years) were treated for the inner aspect of both forearms with either Bepanthol Handbalsam containing 5% dexpanthenol or placebo x2 daily for 26 days. From day 15-22, sodium lauryl sulfate (SLS) 2% was applied to these areas x2 daily. Documentation comprised sebumetry, corneometry, pH value and clinical appearance (photographs). 21 volunteers completed the study, 3 were excluded because of non-compliance and 1 experienced a non-study-related, severe, adverse event. Only corneometry yielded a statistically significant difference, with decreased values following SLS challenge at the placebo sites (P < 0.05). Intraindividual comparisons showed superior results at the dexpanthenol-treated sites in 11 cases and in only 1 case at the placebo site. 6 volunteers experienced an irritant contact dermatitis, with more severe symptoms at the placebo site in 5 cases. In conclusion, dexpanthenol exhibits protective effects against skin irritation. The initiation of a study to evaluate the efficacy of dexpanthenol in preventing irritant occupational contact dermatitis under real workplace conditions is validated.

AIRBORNE CONTACT DERMATITIS – CURRENT PERSPECTIVES IN ETIOPATHOGENESIS AND MANAGEMENT

PubMed Central

Handa, Sanjeev; De, Dipankar; Mahajan, Rahul

2011-01-01

The increasing recognition of occupational origin of airborne contact dermatitis has brought the focus on the variety of irritants, which can present with this typical morphological picture. At the same time, airborne allergic contact dermatitis secondary to plant antigens, especially to Compositae family, continues to be rampant in many parts of the world, especially in the Indian subcontinent. The recognition of the contactant may be difficult to ascertain and the treatment may be even more difficult. The present review focuses on the epidemiological, clinical and therapeutic issues in airborne contact dermatitis. PMID:22345774

Effect of Skin Protection and Skin Irritation on the Internal Exposure to Carbon Disulfide in Employees of the Viscose Industry.

PubMed

Kilo, Sonja; Zonnur, Nina; Uter, Wolfgang; Göen, Thomas; Drexler, Hans

2015-10-01

Occupational exposure to carbon disulfide (CS2) leads to inhalative and dermal uptake and thereby to internal exposure. In order to prevent occupational contact dermatitis, gloves and skin protection creams are used at the workplace. The aim of the study was the evaluation of the influence of personal skin protection and irritation on the internal exposure to CS2 of employees in the viscose industry. One hundred and eighty-two male CS2-exposed employees were included in the study and were examined regarding working conditions, use of personal protective measures und skin status. Personal air monitoring and biological monitoring was performed and the 'relative internal exposure' (RIE, internal exposure in relation to external exposure) calculated. A multiple regression analysis calculated the influence of skin protection and irritation on CS2 uptake. Usage of skin protection creams and gloves (and both in combination) while working was associated with a significantly higher RIE indicating a higher dermal penetration of CS2. Equally, irritated skin and younger age was associated with a higher internal burden. Gloves and skin protection creams are useful for preventing occupational skin diseases. However, when handling skin-resorptive substances like CS2, they can increase internal exposure or skin irritation. Therefore, we recommend the careful consideration of benefits and risks of protective creams and gloves at the workplace. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Occupational contact allergic dermatitis in dentistry.

PubMed

Mikov, Ivan; Turkalj, Ivan; Jovanović, Marina

2011-06-01

Dental professionals may be at increased risk of developing occupational allergic diseases specially to methacrylates that can permeate protective disposable gloves. We presented a case of occupational allergic contact dermatitis in a 28-year-old dental technician. The patient had complained of itching and cracking of fingers for 6 months. The dermatitis improved over weekends. Skin erythema and scaling were present with primarily involvement of the fingertips. Patch testing with dental series gave positive vesicular reaction to methyl methacrylate. Follow-up after 6 months of allergen avoidance showed a complete regression of dermatitis. Methacrylates serve as bases for acrylic resins which are used in prosthetics. Methyl methacrylate as a small molecular acrylate can permeate thin protective disposable gloves. Using adequate personal protective equipment, like nitrile rubber gloves, is the most important preventive measure in this occupation. Health practitioners should recognize possible occupational hazards in dentistry and implement appropriate preventive measures to protect health of workers.

Diesel exhaust causing low-dose irritant asthma with latency?

PubMed

Adewole, Femi; Moore, Vicky C; Robertson, Alastair S; Burge, P S

2009-09-01

Diesel exhaust exposure may cause acute irritant-induced asthma and potentiate allergen-induced asthma. There are no previous reports of occupational asthma due to diesel exhaust. To describe occupational asthma with latency in workers exposed to diesel exhaust in bus garages. The Shield database of occupational asthma notifications in the West Midlands, UK, was searched between 1990 and 2006 for workers where diesel exhaust exposure was thought to be the cause of the occupational asthma. Those without other confounding exposures whose occupational asthma was validated by serial peak expiratory flow (PEF) analysis using Oasys software were included. Fifteen workers were identified with occupational asthma attributed to diesel exhaust. Three had validated new-onset asthma with latency. All worked in bus garages where diesel exhaust exposure was the only likely cause of their occupational asthma. Occupational asthma was confirmed by measures of non-specific reactivity and serial measurements of PEF with Oasys scores of 2.9, 3.73 and 4 (positive score > 2.5). The known non-specific irritant effects of diesel exhaust suggest that this is an example of low-dose irritant-induced asthma and that exposures to diesel exhaust in at least some bus garages are at a sufficient level to cause this.

Are You at Risk for Contact Dermatitis? | Poster

Cancer.gov

You probably don’t give much thought to hand health. Until something goes wrong, almost everyone takes for granted that these crucial appendages will continue working as they always have. But hand health is an important consideration, especially at work. According to the Centers for Disease Control and Prevention (CDC), allergic contact dermatitis and irritant contact dermatitis account for 15–20 percent of all reported occupational diseases, and they cost employers an estimated $1 billion each year in lost workdays and decreased productivity.

Occupational allergic contact dermatitis and patch test results of leather workers at two Indonesian tanneries.

PubMed

Febriana, Sri Awalia; Jungbauer, Frank; Soebono, Hardyanto; Coenraads, Pieter-Jan

2012-11-01

Tannery workers are at considerable risk of developing occupational contact dermatitis. Occupational skin diseases in tannery workers in newly industrialized countries have been reported, but neither the prevalence of occupational allergic contact dermatitis nor the skin-sensitizing agents were specifically examined in those studies. To assess the prevalence of occupational allergic contact dermatitis in Indonesian tanneries, identify the causative allergens, and propose a tannery work series of patch test allergens. A cross-sectional study in all workers at two Indonesian tanneries was performed to assess the prevalence of occupational contact dermatitis via a questionnaire-based interview and skin examination. Workers with occupational contact dermatitis were patch tested to identify the causative allergens. Occupational contact dermatitis was suspected in 77 (16%) of the 472 workers. Thirteen (3%) of these 472 workers were confirmed to have occupational allergic contact dermatitis. Potassium dichromate (9.2%), N,N-diphenylguanidine (5.3%), benzidine (3.9%) and sodium metabisulfite (2.6%) were found to be the occupationally relevant sensitizers. The sensitization pattern showed some differences from the data in studies reported from other newly industrial countries. We compiled a 'tannery work series' of allergens for patch testing. A number of these allergens may also be considered for patch testing in patients with (leather) shoe dermatitis. © 2012 John Wiley & Sons A/S.

Extended documentation for hand dermatitis patients: Pilot study on irritant exposures.

PubMed

Uter, Wolfgang; Bauer, Andrea; Bensefa-Colas, Lynda; Brans, Richard; Crépy, Marie-Noëlle; Giménez-Arnau, Ana; Larese Filon, Francesca; Ljubojević Hadžavdić, Suzana; Pesonen, Maria; Schuttelaar, Marie L; Wilkinson, Mark; Lidén, Carola

2018-05-30

Irritant exposure may be a contributory cause or the sole cause of (occupational) hand dermatitis. However, the documentation of irritant exposures in clinical practice is not standardized. To examine the feasibility and usefulness of a form with different items addressing both occupational and non-occupational irritant exposures in a semiquantitative way. Between May 2016 and May 2017, successive patients with work-related hand dermatitis, irrespective of aetiology, were examined in 9 specialized European departments. Department-specific investigation was supplemented with the above proforma. The results were recorded by use of an anonymized secured online documentation system in a pilot study. Altogether, 193 patients were included; 114 females and 79 males, with a mean age of 40 years (range 18-68 years). The most common occupational group comprised healthcare workers (n = 35); occupational exposure of the hands to gloves, dusts and water without detergents of >2 hours/day was seen in 54.5%, 24.4% and 24.3% of patients, respectively. Non-occupational exposures rarely exceeded 2 hours/day. It is hoped that the set of descriptors will offer a basis for (clinical) epidemiological studies assessing the role of irritant exposures in occupational hand dermatitis, and to support a high level of quality and consistency in daily patient care. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Ulcerative contact dermitis caused by premixed concrete (cement burns)].

PubMed

Ancona Alayón; Aranda Martínez, J G

1978-01-01

Cement dermatitis manifests clinically as a chronic dermatitis of irritative character, due to its alkaline nature and as allergic contact dermatitis produced by sensitization to chromium and cobalt occurring as trace elements. the present report deals with a mason without previous dermatitis, presenting bullae, ulcers and necrosis in lower limbs, short time after incidental contact at work, with premixed concrete. The clinical manifestations, such as short evolution, clear limitation to sites in close contact with concrete, negativity to standard patch testing and good prognosis with early treatment, are mentioned. The acute irritant nature of the disease is clear, in opposition to the classical manifestations of cement dermatitis. The need of studies of the chemical properties of this material including pH, alkalinity and the possible roll of additives employed, is part of the strategy for prevention of occupational dermatitis in the building trade, which should include also, information of hazards and proper training in their trade.

Effectiveness of interventions for preventing occupational irritant hand dermatitis: a quantitative systematic review protocol.

PubMed

Papadatou, Zoi; Cooper, Kay; Klein, Susan; MacDuff, Colin; Steiner, Markus

2016-10-01

The objective of this quantitative systematic review is to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed) in preventing occupational irritant hand dermatitis (OIHD) in wet workers. These interventions will be compared to an alternative intervention or to usual care (workers regular skin care regime). The specific review question is: "What is the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions in preventing OIHD in wet workers?"

Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014.

PubMed

Higgins, Claire L; Palmer, Amanda M; Cahill, Jennifer L; Nixon, Rosemary L

2016-10-01

Healthcare workers (HCWs) are at risk of developing occupational skin disease (OSD). To ascertain the causes of OSD in Australian HCWs in a tertiary referral clinic. A retrospective review was performed of patients assessed at the Occupational Dermatology Clinic in Melbourne from 1993 to 2014. Of 685 HCWs assessed in the clinic over a period of 22 years, 555 (81.0%) were diagnosed with OSD. The most common diagnosis was irritant contact dermatitis (ICD) (79.1%), followed by allergic contact dermatitis (ACD) (49.7%). Natural rubber latex allergy was also relatively frequent (13.0%). The major substances causing ACD were rubber glove chemicals (thiuram mix and tetraethylthiuram disulfide), preservatives (formaldehyde, formaldehyde releasers, and isothiazolinones), excipients in hand cleansers, which are hard-to-avoid weak allergens, and antiseptics. ACD caused by commercial hand cleansers occurred more frequently than ACD caused by alcohol-based hand rubs (ABHRs). Occupational ICD was mostly caused by water/wet work and hand cleansers, and environmental irritants such as heat and sweating. Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Genes Interacting with Occupational Exposures to Low Molecular Weight Agents and Irritants on Adult-Onset Asthma in Three European Studies

PubMed Central

Rava, Marta; Ahmed, Ismail; Kogevinas, Manolis; Le Moual, Nicole; Bouzigon, Emmanuelle; Curjuric, Ivan; Dizier, Marie-Hélène; Dumas, Orianne; Gonzalez, Juan R.; Imboden, Medea; Mehta, Amar J.; Tubert-Bitter, Pascale; Zock, Jan-Paul; Jarvis, Deborah; Probst-Hensch, Nicole M.; Demenais, Florence; Nadif, Rachel

2016-01-01

Background: The biological mechanisms by which cleaning products and disinfectants—an emerging risk factor—affect respiratory health remain incompletely evaluated. Studying genes by environment interactions (G × E) may help identify new genes related to adult-onset asthma. Objectives: We identified interactions between genetic polymorphisms of a large set of genes involved in the response to oxidative stress and occupational exposures to low molecular weight (LMW) agents or irritants on adult-onset asthma. Methods: Our data came from three large European cohorts: Epidemiological Family-based Study of the Genetics and Environment of Asthma (EGEA), Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults (SAPALDIA), and European Community Respiratory Health Survey in Adults (ECRHS). A candidate pathway–based strategy identified 163 genes involved in the response to oxidative stress and potentially related to exposures to LMW agents/irritants. Occupational exposures were evaluated using an asthma job-exposure matrix and job-specific questionnaires for cleaners and healthcare workers. Logistic regression models were used to detect G × E interactions, adjusted for age, sex, and population ancestry, in 2,599 adults (mean age, 47 years; 60% women, 36% exposed, 18% asthmatics). p-Values were corrected for multiple comparisons. Results: Ever exposure to LMW agents/irritants was associated with current adult-onset asthma [OR = 1.28 (95% CI: 1.04, 1.58)]. Eight single nucleotide polymorphism (SNP) by exposure interactions at five loci were found at p < 0.005: PLA2G4A (rs932476, chromosome 1), near PLA2R1 (rs2667026, chromosome 2), near RELA (rs931127, rs7949980, chromosome 11), PRKD1 (rs1958980, rs11847351, rs1958987, chromosome 14), and PRKCA (rs6504453, chromosome 17). Results were consistent across the three studies and after accounting for smoking. Conclusions: Using a pathway-based selection process, we identified novel genes potentially involved

Resident Rounds: Part III - Case Report: Betel Quid Induced Irritant Contact Dermatitis of the Hand.

PubMed

Mathieu, Regine J; Cheraghi, Nikoo; Russo, Marian A

2016-06-01

Betel quid is a drug used in Far East Asia, India, and the South Pacific. The habit of betel quid chewing is widely reported to cause oral cancer and tooth and gum disease. However, skin disease due to betel quid use is underreported. We report a case of irritant contact dermatitis to betel quid components in a 35-year-old male betel quid user who presented for evaluation of a persistent rash on his fingertips.

Contact allergens and irritants in household washing and cleaning products.

PubMed

Magnano, Michela; Silvani, Simonetta; Vincenzi, Colombina; Nino, Massimiliano; Tosti, Antonella

2009-12-01

Household cleaning products often contain potential allergens and irritants but allergic contact dermatitis from these products in general consumers is rarely reported in the literature. The purpose of this study was to evaluate the presence of irritants and allergens as indicated on the labels or on the product information found on the website of household cleaning products marketed in Italy. We examined the labels and the product information of 291 liquid household washing and cleaning products, including 43 washing-up liquids, 63 laundry detergents, 61 fabric conditioners, 47 spray detergents, and 77 hard surface cleaning products. We obtained the data from the product information found on the websites for 263 products and directly on the product packages for 28 products. For each product we specifically recorded the presence of surfactants, preservatives, and fragrances listed in Annex III of Directive 76/768/EEC. The websites of two Italian brands do not respect EU regulations as they provide product information only with bar codes of the products. Preservatives and fragrances are the main allergens declared in the label of household cleaning products with methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) listed in 35.7% and limonene in 43.6% of the products. Surfactants were listed in 16.5% of the studied products. Our study shows that household cleaning products in Italian market contain several allergens, particularly preservatives and fragrances. For consumers, at least in Italy, it may not be easy to retrieve product information from the website for two widely sold brands. The information had to be taken from the actual package.

Bronchial asthma and COPD due to irritants in the workplace - an evidence-based approach

PubMed Central

2012-01-01

Background Respiratory irritants represent a major cause of occupational obstructive airway diseases. We provide an overview of the evidence related to irritative agents causing occupational asthma or occupational COPD. Methods We searched MEDLINE via PubMed. Reference lists of relevant reviews were also screened. The SIGN grading system was used to rate the quality of each study. The modified RCGP three-star system was used to grade the body of evidence for each irritant agent regarding its causative role in either occupational asthma or occupational COPD. Results A total of 474 relevant papers were identified, covering 188 individual agents, professions or work-sites. The focus of most of the studies and the predominant diagnosis was occupational asthma, whereas occupational COPD arose only incidentally. The highest level assigned using the SIGN grading was 2+ (well-conducted systematic review, cohort or case–control study with a low risk of confounding or bias). According to the modified RCGP three-star grading, the strongest evidence of association with an individual agent, profession or work-site (“**”) was found for 17 agents or work-sites, including benzene-1,2,4-tricarboxylicacid-1,2-anhydride, chlorine, platinum salt, isocyanates, cement dust, grain dust, animal farming, environmental tobacco smoke, welding fumes or construction work. Phthalic anhydride, glutaraldehyde, sulphur dioxide, cotton dust, cleaning agents, potrooms, farming (various), foundries were found to be moderately associated with occupational asthma or occupational COPD (“*[+]”). Conclusion This study let us assume that irritant-induced occupational asthma and especially occupational COPD are considerably underreported. Defining the evidence of the many additional occupational irritants for causing airway disorders will be the subject of continued studies with implications for diagnostics and preventive measures. PMID:23013890

Epoxy-based production of wind turbine rotor blades: occupational dermatoses.

PubMed

Pontén, A; Carstensen, O; Rasmussen, K; Gruvberger, B; Isaksson, M; Bruze, M

2004-06-01

Occupational dermatoses were investigated in a factory producing rotor blades for wind turbines by an epoxy-based process. In a blinded study design, 603 workers were first interviewed and thereafter clinically examined. Based on a history of work-related skin disease, clinical findings of dermatitis, or both, 325 (53.9%) of the workers were patch tested with a specially profiled occupational patch-test series and the European standard patch-test series. Calculated on all investigated workers, 17.1% of the workers were diagnosed with occupational dermatoses caused by work. Occupational allergic contact dermatitis was found in 10.9% of the workers. The estimated frequency of irritant contact dermatitis caused by work was 6.1%. Dermatitis on the hands was associated with contact allergy to epoxy resin (P = 0.017). The number of days on leave before the clinical examination was negatively associated with the presence of dermatitis (P = 0.001). Among workers employed 7-12 months, the frequency of occupational contact allergy was higher than that among workers employed for

Hand eczema and occupational contact allergies in healthcare workers with a focus on rubber additives.

PubMed

Hamnerius, Nils; Svedman, Cecilia; Bergendorff, Ola; Björk, Jonas; Bruze, Magnus; Engfeldt, Malin; Pontén, Ann

2018-06-20

Hand eczema (HE) in healthcare workers (HCWs) is common. Besides wet work, healthcare work also implies exposure to contact allergens. To assess HE and contact allergy related to occupational exposures in HCWs. In a cross-sectional study, 311 HCWs with HE within the preceding 12 months and a control group of 114 HCWs without HE were investigated with the baseline series and a special patch test series based on substances found in the gloves, soaps, alcoholic hand disinfectants and hand creams provided at the hospitals. Contact allergy to rubber additives was significantly more common in HCWs with HE (6%) than in HCWs without HE (1%, P = .02). The corresponding percentages for fragrances were 11% and 3%, respectively (P = .004). Occupational HE was found in 193 of 311 (62%) HCWs. Of these, 22 of 193 (11%) had occupational allergic contact dermatitis, including 17 with glove-related rubber contact allergy. Contact allergy to diphenylguanidine was as common as contact allergy to thiurams. Occupational contact allergy to rubber additives was significantly associated with sick-leave related to HE. Contact allergy to rubber additives in medical gloves is the most common cause of occupational allergic contact dermatitis in HCWs. Aimed patch testing with relevant rubber additives is mandatory when HE in HCWs is investigated. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Skin irritability to sodium lauryl sulfate is associated with increased positive patch test reactions.

PubMed

Schwitulla, J; Brasch, J; Löffler, H; Schnuch, A; Geier, J; Uter, W

2014-07-01

As previous observations have indicated an inter-relationship between irritant and allergic skin reactions we analysed data of synchronous allergen and sodium lauryl sulfate (SLS) patch tests in terms of a relationship between SLS responsiveness and allergic patch test reactions. To analyse differences in terms of allergen-specific and overall reaction profiles between patients with vs. those without an irritant reaction to SLS. Clinical data of 26 879 patients patch tested from 2008 to 2011 by members of the Information Network of Departments of Dermatology were analysed. After descriptive analyses, including the MOAHLFA index, the positivity ratio and the reaction index, a negative binomial hurdle model was adopted to investigate the correlation between SLS reactivity and positive patch test reactions. Men, patients aged ≥ 40 years and patients with an occupational dermatitis background were over-represented in the SLS-reactive group. Patients with an irritant reaction to SLS showed a higher proportion of weak positive reactions, as well as more questionable and irritant reactions to contact allergens than patients not reactive to SLS. The risk of an additional positive patch test reaction increased by 22% for SLS-reactive patients compared with those who were SLS negative. The marked association between SLS reactivity and the number of positive reactions in patch test patients may be due to nonspecific increased skin reactivity at the moment of patch testing only. However, increased SLS reactivity could also be due to longer-lasting enhanced skin irritability, which may have promoted (poly-)sensitization. Further studies, for example with longitudinal data on patients repeatedly patch tested with SLS and contact allergens, are necessary. © 2014 British Association of Dermatologists.

Occupational Skin Diseases in the San Francisco Bay Area

PubMed Central

Gellin, Gerald A.; Wolf, C. Richard; Milby, Thomas H.

1970-01-01

From answers by one-third of the practicing dermatologists in the San Francisco Bay Area to a questionnaire on occupational skin diseases, contact dermatitis due to irritants and sensitizers was found to rank first. Poison oak, which is the leading reported cause on “Doctor's First Report of Work Injury” received by the California Department of Industrial Relations, was sixth on the list of the survey, trailing solvents, cleansing agents, petroleum products and epoxy resins. A history of atopic dermatitis was often noted in current cases of occupational diseases of the skin. Avoidance of exposure or limiting the contact with pathogenic substances—through engineering changes, observation of working conditions by physicians, education of workers—appeared to be the best preventive measures. PMID:4255687

Occupations at risk of developing contact allergy to isothiazolinones in Danish contact dermatitis patients: results from a Danish multicentre study (2009-2012).

PubMed

Schwensen, Jakob F; Menné, Torkil; Andersen, Klaus E; Sommerlund, Mette; Johansen, Jeanne D

2014-11-01

In recent years, the prevalence of contact allergy to isothiazolinones has reached epidemic levels. Few studies have presented data on occupations at risk of developing contact allergy to isothiazolinones. To present demographics and examine risk factors for sensitization to methylisothiazolinone (MI), methylchloroisothiazolinone (MCI) in combination with MI and benzisothiazolinone (BIT) in Danish dermatitis patients. A retrospective epidemiological analysis of data from three Danish hospitals departments was conducted. All patients consecutively patch tested with MI, MCI/MI and BIT between 2009 and 2013 were included. MI contact allergy showed a significantly increased trend in prevalence from 1.8% in 2009 to 4.2% in 2012 (p < 0.001). Females with facial dermatitis mainly drove the increase in 2012. Adjusted logistic regression analysis showed that MI sensitization was significantly associated with occupational exposures, hand and facial dermatitis, age > 40 years, and the occupational groups of tile setters/terrazzo workers, machine operators, and painters. MCI/MI contact allergy was significantly associated with the following high-risk occupations: painting, welding (blacksmiths), machine operating, and cosmetology. The occupational group of painting was frequent in the group of patients with BIT contact allergy. Several high-risk occupations for sensitization to isothiazolinones exist. Regulation on the allowed concentration of isothiazolinones, and especially MI, in both consumer products and industrial products is needed. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational contact dermatitis in blue-collar workers: results from a multicentre study from the Danish Contact Dermatitis Group (2003-2012).

PubMed

Schwensen, Jakob F; Menné, Torkil; Veien, Niels K; Funding, Anne T; Avnstorp, Christian; Østerballe, Morten; Andersen, Klaus E; Paulsen, Evy; Mørtz, Charlotte G; Sommerlund, Mette; Danielsen, Anne; Andersen, Bo L; Thormann, Jens; Kristensen, Ove; Kristensen, Berit; Vissing, Susanne; Nielsen, Niels H; Thyssen, Jacob P; Johansen, Jeanne D

2014-12-01

Blue-collar workers have a high risk of occupational contact dermatitis, but epidemiological studies are scarce. To investigate allergic contact dermatitis in blue-collar workers with dermatitis registered by the Danish Contact Dermatitis Group. A retrospective analysis of patch test data from 1471 blue-collar workers and 1471 matched controls tested between 2003 and 2012 was performed. A logistic regression was used to test for associations. The blue-collar workers often had occupational hand dermatitis (p < 0.001). Atopic dermatitis was less commonly observed among blue-collar workers (19.6%) than among controls (23.9%) (p = 0.005). Allergens with a statistically significant association with the occupational group of blue-collar workers were epoxy resins, methyldibromo glutaronitrile, 2-bromo-2-nitro-1,3-propanediol, potassium dichromate, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI). The following occupations were additionally identified as risk factors for contact sensitization to MCI/MI and MI, epoxy resins, and potassium dichromate, respectively: painting, construction work, and tile setting/terrazzo work. Contact allergy is a major problem among blue-collar workers. The data indicate a healthy worker effect among blue-collar workers diagnosed with dermatitis, as blue-collar workers were diagnosed significantly less often with atopic dermatitis than were controls. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Irritant contact dermatitis caused by needle-like calcium oxalate crystals, raphides, in Agave tequilana among workers in tequila distilleries and agave plantations.

PubMed

Salinas, M L; Ogura, T; Soffchi, L

2001-02-01

It was found that needle-like calcium oxalate crystals, raphides, are found abundantly in all tissues of Agave tequilana plants; thus, 1 droplet (0.03 ml) of juice pressed from leaves contains 100-150 crystals, 30-500 microm in length, sharpened at both ends. In tequila distilleries, 5/6 of the workers who handle the agave stems have experienced the characteristic irritation. In contrast, only 1/3 of workers in agave plantations who harvest agave plants, complain of the irritation. It is confirmed that all the irritation suffered in both distilleries and plantations takes place at bodily locations where the plants come into contact with the worker's skin in the course of their work.

Contact Eczema Caused by True Teak (Tectona Grandis)

PubMed Central

Krogh, H. K.

1962-01-01

An epidemiological study of occupational contact eczema in a furniture factory is presented. The localization, distribution, and clinical features of the skin lesions were characteristic of contact eczema caused by a sensitizing or irritating dust. True teak—Tectona grandis—was the cause of the skin condition. That teak is a fairly potent sensitizer and also contains primary irritants is fully confirmed by the present study. About half the employees who were heavily exposed to teak dust suffered from eczema and/or severe itching. Only 8% of those with slight exposure to teak dust experienced skin symptoms. Patch tests with native teak dust moistened with water were applied on 10 “controls” and 112 workers who were exposed to teak in various working procedures. Moistened teak dust produced toxic reactions in 20·5%, while native teak dust did not have primary irritant effects and was, therefore, considered to be the substance of choice for patch testing; 18·7% of the workers showed an allergic skin reaction to native teak dust. The diagnosis of allergic contact eczema was made in 12·5%, and 6·2% were considered to have latent allergy. Primary irritant (contact) eczema was considered to be present in four individuals who had experienced acute, transitory, eczematous eruptions during the hot part of the summer when they perspired freely. In these cases the patch test to native teak dust was negative. Desensitization or “hardening” was observed in four workers. In most cases the skin lesions were not severe enough to cause sickness absence. The cause of the relatively high percentage of sensitization to teak among the workers in the factory is discussed. The importance of suitable prophylactic measures is stressed. PMID:14459786

Povidone-iodine induced post-surgical irritant contact dermatitis localized outside of the surgical incision area. Report of 27 cases and a literature review.

PubMed

Borrego, Leopoldo; Hernández, Noelia; Hernández, Zaida; Peñate, Yeray

2016-05-01

Povidone-iodine solution is an antiseptic that is used worldwide as surgical paint and is considered to have a low irritant potential. Post-surgical severe irritant dermatitis has been described after the misuse of this antiseptic in the surgical setting. Between January 2011 and June 2013, 27 consecutive patients with post-surgical contact dermatitis localized outside of the surgical incision area were evaluated. Thirteen patients were also available for patch testing. All patients developed dermatitis the day after the surgical procedure. Povidone-iodine solution was the only liquid in contact with the skin of our patients. Most typical lesions were distributed in a double lumbar parallel pattern, but they were also found in a random pattern or in areas where a protective pad or an occlusive medical device was glued to the skin. The patch test results with povidone-iodine were negative. Povidone-iodine-induced post-surgical dermatitis may be a severe complication after prolonged surgical procedures. As stated in the literature and based on the observation that povidone-iodine-induced contact irritant dermatitis occurred in areas of pooling or occlusion, we speculate that povidone-iodine together with occlusion were the causes of the dermatitis epidemic that occurred in our surgical setting. Povidone-iodine dermatitis is a problem that is easily preventable through the implementation of minimal routine changes to adequately dry the solution in contact with the skin. © 2015 The International Society of Dermatology.

Patch test results of the European baseline series among patients with occupational contact dermatitis across Europe - analyses of the European Surveillance System on Contact Allergy network, 2002-2010.

PubMed

Pesonen, Maria; Jolanki, Riitta; Larese Filon, Francesca; Wilkinson, Mark; Kręcisz, Beata; Kieć-Świerczyńska, Marta; Bauer, Andrea; Mahler, Vera; John, Swen M; Schnuch, Axel; Uter, Wolfgang

2015-03-01

Occupational contact dermatitis is one of the most common occupational diseases in Europe. In order to develop effective preventive measures, detailed and up-to-date data on the incidence, main causes and professions at risk of occupational contact dermatitis are needed. To describe the pattern of patch test reactivity to allergens in the European baseline series of patients with occupational contact dermatitis in different occupations. We analysed data collected by the European Surveillance System on Contact Allergy (ESSCA) network from 2002 to 2010, from 11 European countries. Allergens in the European baseline series associated with an at least doubled risk of occupational contact dermatitis include: thiuram rubber chemical accelerators, epoxy resin, and the antimicrobials methylchloroisothiazolinone/methylisothiazolinone, methyldibromo glutaronitrile, and formaldehyde. The highest risk of occupational contact dermatitis was found in occupations classified as 'other personal services workers', which includes hairdressers, nursing and other healthcare professionals, precision workers in metal and related materials, and blacksmiths, tool-makers and related trades workers. In the planning and implementation of measures aimed at preventing occupational contact dermatitis, the focus should be on the identified high-risk occupational groups and the most common occupational allergies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Occupational dermatitis in the agriculture-food industry environment].

PubMed

Tripodi, Dominique; Géraut, Christian

2002-09-01

The agricultural and food professions are those that touch agriculture, but also the restoration, the kitchens, and the employees of slaughterhouses. Various occupational skin diseases touch these salaried employees or craftsmen: eczemas or contact hives with plants or meats and fleshes of animals and all chemical substances that are added: pesticides, food additives and various preservatives. Irritation contact dermatitis or real skin burns are observed with housekeeping products imposed by the sanitary norms, increasingly powerful, but as increasingly caustic. Infectious illnesses transmitted from the animal to the man are sometimes observed especially among the breeders and employees of slaughterhouses.

In vivo skin penetration of macromolecules in irritant contact dermatitis.

PubMed

Abdel-Mottaleb, Mona M A; Lamprecht, Alf

2016-12-30

Recently, a selective preferential accumulation of polymeric nanoparticles (in the size range around 100nm) has been observed in the follicular system of dermatitis skin. The present investigation aimed at clearly investigating the effect of irritant contact dermatitis on the barrier permeability for colloidal systems below this size range, namely quantum dots and hydrophilic macromolecules. Irritant dermatitis was induced in mice and the penetrability of quantum dots (5nm) and hydrophilic dextran molecules has been tracked in both healthy and inflamed skin using confocal laser scanning microscopy. The selective accumulation of the quantum dots was clearly observed in inflamed skin while hydrophilic dextran behaved similarly in both healthy and inflamed skin. The therapeutic potential for the transdermal delivery of peptide drugs through inflamed skin has been also tested in rats. Results revealed that the transdermal permeation of insulin and calcitonin was not significantly enhanced in dermatitis compared to healthy skin. On the other side, permeation through stripped skin was significantly higher. However, the effect was limited and shorter compared to the SC injection where t min was 0.5h and 2h with a 70% and 46% reduction in blood glucose levels for the stripped skin and the SC injection respectively. Similarly, t min was 4h and 8h with area under the curve of 161±65% and 350±97% for the stripped skin and the SC injection respectively. In conclusion, the changes in skin permeability accompanied with skin inflammation did not affect its permeability to peptide drugs. Our findings also underline that experiments with the tape stripped skin model as a surrogate for inflamed skin can risk misleading conclusions due to significant difference of skin permeability between the tape stripped skin and inflamed skin. Copyright © 2016 Elsevier B.V. All rights reserved.

Macular pigmentation complicating irritant contact dermatitis and viral warts in Laugier-Hunziker syndrome.

PubMed

Bhoyrul, B; Paulus, J

2016-04-01

Laugier-Hunziker syndrome (LHS) is a rare acquired disorder characterized by macu-lar pigmentation of the lips and oral mucosa, with frequent longitudinal melanonychia. Involvement of other areas, such as the genitalia and fingers, has rarely been described. LHS is a benign condition with no known systemic manifestations. We report the case of a woman who developed melanotic macules on her fingers and elbow 16 years after the onset of pigmentation of her lips. This unusual feature of LHS in our patient was associated with irritant contact dermatitis and viral warts. Only two cases of an association with an inflammatory dermatosis have been reported previously in the literature. © 2015 British Association of Dermatologists.

Occupational Asthma

MedlinePlus

... The rate of occupational asthma varies within individual industries. Irritants in high doses that induce occupational asthma ... which is found in the petroleum or chemical industries. If you are exposed to any of these ...

Contact allergy to epoxy resin: risk occupations and consequences.

PubMed

Bangsgaard, Nannie; Thyssen, Jacob Pontoppidan; Menné, Torkil; Andersen, Klaus Ejner; Mortz, Charlotte G; Paulsen, Evy; Sommerlund, Mette; Veien, Niels Kren; Laurberg, Grete; Kaaber, Knud; Thormann, Jens; Andersen, Bo Lasthein; Danielsen, Anne; Avnstorp, Christian; Kristensen, Berit; Kristensen, Ove; Vissing, Susanne; Nielsen, Niels Henrik; Johansen, Jeanne Duus

2012-08-01

Epoxy resin monomers are strong skin sensitizers that are widely used in industrial sectors. In Denmark, the law stipulates that workers must undergo a course on safe handling of epoxy resins prior to occupational exposure, but the effectiveness of this initiative is largely unknown. To evaluate the prevalence of contact allergy to epoxy resin monomer (diglycidyl ether of bisphenol A; MW 340) among patients with suspected contact dermatitis and relate this to occupation and work-related consequences. The dataset comprised 20 808 consecutive dermatitis patients patch tested during 2005-2009. All patients with an epoxy resin-positive patch test were sent a questionnaire. A positive patch test reaction to epoxy resin was found in 275 patients (1.3%), with a higher proportion in men (1.9%) than in women (1.0%). The prevalence of sensitization to epoxy resin remained stable over the study period. Of the patients with an epoxy resin-positive patch test, 71% returned a questionnaire; 95 patients had worked with epoxy resin in the occupational setting, and, of these, one-third did not use protective gloves and only 50.5% (48) had participated in an educational programme. The 1% prevalence of epoxy resin contact allergy is equivalent to reports from other countries. The high occurrence of epoxy resin exposure at work, and the limited use of protective measures, indicate that reinforcement of the law is required. © 2012 John Wiley & Sons A/S.

Professional photosensitive eczema of fishermen by contact with bryozoans: disabling occupational dermatosis.

PubMed

Clin, Benedicte; Stosse-Guevel, Catherine; Marquignon, Marie-France; Verneuil, Laurence; Letourneux, Marc

2008-01-01

Eczema associated with bryozoans is a form of occupational dermatosis caused by a living animal, involving contact eczema, occasionally associated with photosensitivity and concerning fishermen on a quasi-elective basis. This affection can prove to be extremely disabling, frequently generating disastrous social consequences, since the eviction of the responsible allergen is very often synonymous to occupational reclassification, a measure which fishermen, highly attached to their profession, have great difficulty in accepting. Based on the description of three cases of photosensitive eczema associated with contact with the bryozoan, Alcyonidium gelatinosum, identified in fishermen from the English Channel coastline, we describe the characteristics and the specificities of this occupational dermatosis, then approach the issue of its prevention, which, unfortunately, remains limited.

Evaluation of sensory irritation of delta3-carene and turpentine, and acceptable levels of monoterpenes in occupational and indoor environment.

PubMed

Kasanen, J P; Pasanen, A L; Pasanen, P; Liesivuori, J; Kosma, V M; Alarie, Y

1999-05-28

The standard mouse bioassay was used for obtaining the RD50 (i.e., the concentration that causes a 50% decrease in respiratory frequency) and for estimating the irritation properties of d-delta3-carene (i.e., (+)-delta3-carene) and commercial turpentine. The chemicals studied possess mainly sensory irritation properties similar to the previously studied monoterpenes, pinenes. The irritation potency of d-delta3-carene (RD50 = 1345 ppm) was almost equal to that of d-pinenes. Thus, d-delta3-carene was about four times more potent as a sensory irritant than I-beta-pinene, whereas the difference with I-alpha-pinene was more marked; as a sensory irritant, I-alpha-pinene is almost inactive. Based on sensory irritation potency and physicochemical and structural properties of pinenes and delta3-carene, the potency of a closely related monoterpene, limonene, is discussed. For commercial turpentine, a mixture of monoterpenes (mainly d-delta3-carene, I-beta-pinene, alpha-pinenes, and limonenes), the RD50 (1173 ppm) was the same order of magnitude as those of d-pinenes and d-delta3-carene. Apparently, d-monoterpenes are responsible for the sensory irritation caused by turpentine. In the wood industry and in the indoor air of nonindustrial environments, monoterpenes are thought to be one of the causative agents for irritation symptoms. The occupational exposure limit (OEL) of turpentine (100 ppm in Finland and the United States) is also used for individual monoterpenes, excluding limonene. Using results from this and our previous study, proposed OELs and recommended indoor levels (RILs) for selected monoterpenes and turpentine were determined based on their RD50 values. According to our studies, the present OEL of turpentine (100 ppm; 560 mg/m3) in Finland and in the United States seems to be suitable only for I-pinenes. For d-monoterpenes and turpentine, an OEL about three times lower is suggested. Our results show that recommended indoor levels (RILs) for monoterpenes are high

[Occupational contact dermatitis in metal workers and gender effect].

PubMed

Filon, F Larese; Marzioti, G; Fortina, A Belloni; Peserico, A; De Toni, A; Corradini, M T; Carrabba, E; Fiorito, A

2007-01-01

Contact dermatitis is more frequent among women for anatomical reasons and for extraprofessional exposure to irritants and detergents during homeworks. In addition sensitisation to contact haptens is different in sexes. The aim of our work was to evaluate the association between patch test skin sensitizations and professional exposure to metals analyzing data for gender. Of the 15.217 patients patch tested for dermatitis, 678 were metalworkers. The statistical analysis revealed a significant association between dermatitis and sensitisation to nickel in professional exposed women (OR = 1.68; LC50% 1.11-6.50) while metal sensitisation (Cr.Ni and Co) was not relevant in men: for them a significant association between dermatitis and sensitisation was found to quaternium (OR = 3.91; LC95% 1.18-12.9), to mercaptobenzothiazole (OR = 2.69; LC50% 1.11-6.50) and to ethylendiamine dichloride (OR = 2.53; LC95% 1-6.41). The authors stress the need to evaluate patch test sensitisation considering gender effects.

Epoxy-based production of wind turbine rotor blades: occupational contact allergies.

PubMed

Pontén, Ann; Carstensen, Ole; Rasmussen, Kurt; Gruvberger, Birgitta; Isaksson, Marléne; Bruze, Magnus

2004-03-01

An industry producing rotor blades for wind turbines with an epoxy-based technology had experienced an increasing number of workers with dermatitis, among whom the frequency of occupational contact allergy (OCA) was suspected to be underestimated. To investigate the frequency of OCA by patch-testing with a specially profiled occupational patch test series. In a blinded study design, 603 workers were first interviewed and thereafter clinically examined. Based on a history of work-related skin disease, clinical findings of dermatitis, or both, 325 (53.9%) of the workers were patch-tested with an occupational patch test series and the European Standard patch test series. Of the 603 investigated workers, 10.9% had OCA and 5.6% had contact allergy to epoxy resin in the standard test series. Contact allergy to amine hardeners/catalysts was found in 4.1% of the workers. Among the workers with OCA, 48.5% reacted to work material other than epoxy resin in the European Standard patch test series. Approximately 50% of the workers with OCA would not have been detected if only the European Standard patch test series had been used.

Primary irritant and delayed-contact hypersensitivity reactions to the freshwater cyanobacterium Cylindrospermopsis raciborskii and its associated toxin cylindrospermopsin

PubMed Central

Stewart, Ian; Seawright, Alan A; Schluter, Philip J; Shaw, Glen R

2006-01-01

Background Freshwater cyanobacteria are common inhabitants of recreational waterbodies throughout the world; some cyanobacteria can dominate the phytoplankton and form blooms, many of which are toxic. Numerous reports in the literature describe pruritic skin rashes after recreational or occupational exposure to cyanobacteria, but there has been little research conducted on the cutaneous effects of cyanobacteria. Using the mouse ear swelling test (MEST), we sought to determine whether three toxin-producing cyanobacteria isolates and the purified cyanotoxin cylindrospermopsin produced delayed-contact hypersensitivity reactions. Methods Between 8 and 10 female Balb/c mice in each experiment had test material applied to depilated abdominal skin during the induction phase and 10 or 11 control mice had vehicle only applied to abdominal skin. For challenge (day 10) and rechallenge (day 17), test material was applied to a randomly-allocated test ear; vehicle was applied to the other ear as a control. Ear thickness in anaesthetised mice was measured with a micrometer gauge at 24 and 48 hours after challenge and rechallenge. Ear swelling greater than 20% in one or more test mice is considered a positive response. Histopathology examination of ear tissues was conducted by independent examiners. Results Purified cylindrospermopsin (2 of 9 test mice vs. 0 of 5 control mice; p = 0.51) and the cylindrospermopsin-producing cyanobacterium C. raciborskii (8 of 10 test mice vs. 0 of 10 control mice; p = 0.001) were both shown to produce hypersensitivity reactions. Irritant reactions were seen on abdominal skin at induction. Two other toxic cyanobacteria (Microcystis aeruginosa and Anabaena circinalis) did not generate any responses using this model. Histopathology examinations to determine positive and negative reactions in ear tissues showed excellent agreement beyond chance between both examiners (κ = 0.83). Conclusion The irritant properties and cutaneous sensitising potential of

Survey of Occupational Allergic Contact Dermatitis and Patch Test among Clothing Employees in Beijing.

PubMed

Chen, Yu-Xin; Gao, Bing-Ai; Cheng, Hai-Yan; Li, Lin-Feng

2017-01-01

Occupational population-based epidemiological data relating to occupational contact allergies in the Chinese clothing industry are limited. To investigate the prevalence of occupational allergic contact dermatitis (OACD) and to identify the causative allergens among clothing employees in China, a cross-sectional study was conducted in 529 clothing employees at 12 clothing factories in Beijing. All employees were subjected to an interview using self-administered questionnaire and skin examination, and those who were diagnosed with occupational contact dermatitis (OCD) were patch tested. In the present survey, we found that the overall 1-year prevalence of OACD among the clothing employees was 8.5%. The 1-year prevalence of OACD among workers (10.8%) was significantly higher than that among managers (3.2%). The lesions were primarily on the hands and wrists in workers, but the face and neck in managers. The major allergens were nickel sulfate and cobalt dichloride in workers and colophony and p -tert-butylphenol formaldehyde resin in managers. In conclusion, workers are at a higher risk of OACD compared with managers in the Chinese clothing industry. In addition to hand dermatitis in workers, airborne contact dermatitis on the face and neck should be also addressed in managers.

Contact Irritancy and Toxicity of Permethrin-Treated Clothing for Ixodes scapularis, Amblyomma americanum, and Dermacentor variabilis Ticks (Acari: Ixodidae).

PubMed

Prose, Robert; Breuner, Nicole E; Johnson, Tammi L; Eisen, Rebecca J; Eisen, Lars

2018-05-24

Clothing treated with the pyrethroid permethrin is available in the United States as consumer products to prevent tick bites. We used tick bioassays to quantify contact irritancy and toxicity of permethrin-treated clothing for three important tick vectors of human pathogens: the blacklegged tick, Ixodes scapularis Say (Acari: Ixodidae); the lone star tick, Amblyomma americanum (L.) (Acari: Ixodidae); and the American dog tick, Dermacentor variabilis (Say) (Acari: Ixodidae). We first demonstrated that field-collected I. scapularis nymphs from Minnesota were as susceptible as laboratory-reared nymphs to a permethrin-treated textile. Field ticks examined in bioassays on the same day they were collected displayed contact irritancy by actively dislodging from a vertically oriented permethrin-treated textile, and a forced 1-min exposure resulted in all ticks being unable to move normally, thus posing no more than minimal risk of biting, 1 h after contact with the treated textile. Moreover, we documented lack of normal movement for laboratory-reared I. scapularis nymphs by 1 h after contact for 1 min with a wide range of permethrin-treated clothing, including garments made from cotton, synthetic materials, and blends. A comparison of the impact of a permethrin-treated textile across tick species and life stages revealed the strongest effect on I. scapularis nymphs (0% with normal movement 1 h after a 1-min exposure), followed by A. americanum nymphs (14.0%), I. scapularis females (38.0%), D. variabilis females (82.0%), and A. americanum females (98.0%). Loss of normal movement for all ticks 1 h after contact with the permethrin-treated textile required exposures of 1 min for I. scapularis nymphs, 2 min for A. americanum nymphs, and 5 min for female I. scapularis, D. variabilis, and A. americanum ticks. We conclude that use of permethrin-treated clothing shows promise to prevent bites by medically important ticks. Further research needs are discussed.

Acute irritant threshold correlates with barrier function, skin hydration and contact hypersensitivity in atopic dermatitis and rosacea.

PubMed

Darlenski, Razvigor; Kazandjieva, Jana; Tsankov, Nikolai; Fluhr, Joachim W

2013-11-01

The aim of the study was to disclose interactions between epidermal barrier, skin irritation and sensitization in healthy and diseased skin. Transepidermal water loss (TEWL) and stratum corneum hydration (SCH) were assessed in adult patients with atopic dermatitis (AD), rosacea and healthy controls. A 4-h patch test with seven concentrations of sodium lauryl sulphate was performed to determine the irritant threshold (IT). Contact sensitization pattern was revealed by patch testing with European baseline series. Subjects with a lower IT had higher TEWL values and lower SCH. Subjects with positive allergic reactions had significantly lower IT. In AD, epidermal barrier deterioration was detected on both volar forearm and nasolabial fold, while in rosacea, impeded skin physiology parameters were observed on the facial skin only, suggesting that barrier impediment is restricted to the face in rosacea, in contrast with AD where the abnormal skin physiology is generalized. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational dermatoses from exposure to epoxy resin compounds in a ski factory.

PubMed

Jolanki, R; Tarvainen, K; Tatar, T; Estlander, T; Henriks-Eckerman, M L; Mustakallio, K K; Kanerva, L

1996-06-01

Of 22 workers in a ski factory, occupational allergic contact dermatitis was found in 8. 6 were sensitive to epoxy resin compounds, i.e., epoxy resins, hardeners or diluents, 1 to cobalt in glass-fiber reinforcements, and 1 to formaldehyde in a urea-formaldehyde glue and a lacquer. 4 workers had irritant contact dermatitis from epoxy resin compounds, lacquers, sanding dust, or glass-fiber dust. 3 had contact allergy from a new sensitizer, diethyleneglycol diglycidyl ether, in a reactive diluent. Immediate transfer of workers sensitized to epoxy resin from epoxy exposure prevents aggravation of their dermatitis and broadening of the sensitization to epoxy hardeners, diluents and other compounds.

Systemic allergic contact dermatitis to fiberglass in a factory worker of wind turbine blades.

PubMed

Nogueira, Ana; Morais, Paulo; Cunha, Ana Paula; Azevedo, Filomena

2011-09-01

Fiberglass is extensively used due to its properties of thermal, acoustic and electrical insulation, and also to reinforce other materials such as plastics. Irritant contact dermatitis to fiberglass is a well established occupational dermatose and is due to penetration of small fragments in the cornified layer of the skin. On the other hand, allergic contact dermatitis (ACD) is rare and is more often triggered by sensitivity to the additives and resins used in the manufacture of fiberglass products. We report a case of ACD to fiberglass in a factory worker of fiberglass reinforced products.

Occupational skin disease in Victoria, Australia.

PubMed

Cahill, Jennifer L; Williams, Jason D; Matheson, Melanie C; Palmer, Amanda M; Burgess, John A; Dharmage, Shyamali C; Nixon, Rosemary L

2016-05-01

To describe the characteristics of patients with occupational skin disease (OSD) in a tertiary referral clinic in Victoria, Australia. A retrospective review was conducted of records from patients seen at the Occupational Dermatology Clinic in Melbourne, Australia between 1 January 1993 and 31 December 2010. Of the 2894 people assessed in the clinic during the 18-year period, 44% were women and 56% were men. In all, 2177 (75%) were diagnosed with occupational skin disease (OSD). Of the patients with a work-related skin condition, 45% (n = 979) were considered to be atopic. The most common diagnosis in those with OSD was irritant contact dermatitis (ICD) (44%), followed by allergic contact dermatitis (33%) and endogenous eczema (11%). Women were significantly more likely to have soaps and detergents (P < 0.001) and water/wet work (P < 0.001) as causes of their ICD than men. Men were significantly more likely to have oils and coolants (P < 0.001) and solvent exposures (P < 0.001) as causes of their ICD. Occupational groups with the highest incidence of OSD were the hair and beauty professions (70 per 100 000), followed by machine and plant operators (38 per 100 000) and health-care workers (21 per 100 000). We confirm the importance of occupational contact dermatitis as the most common cause of OSD, with ICD being the most common diagnosis. There are differences in the causes of ICD between our group of male and female workers. For the first time in Australia, rates of OSD in certain industries have been calculated. © 2015 The Australasian College of Dermatologists.

Survey of Occupational Allergic Contact Dermatitis and Patch Test among Clothing Employees in Beijing

PubMed Central

Chen, Yu-Xin; Gao, Bing-Ai; Cheng, Hai-Yan

2017-01-01

Occupational population-based epidemiological data relating to occupational contact allergies in the Chinese clothing industry are limited. To investigate the prevalence of occupational allergic contact dermatitis (OACD) and to identify the causative allergens among clothing employees in China, a cross-sectional study was conducted in 529 clothing employees at 12 clothing factories in Beijing. All employees were subjected to an interview using self-administered questionnaire and skin examination, and those who were diagnosed with occupational contact dermatitis (OCD) were patch tested. In the present survey, we found that the overall 1-year prevalence of OACD among the clothing employees was 8.5%. The 1-year prevalence of OACD among workers (10.8%) was significantly higher than that among managers (3.2%). The lesions were primarily on the hands and wrists in workers, but the face and neck in managers. The major allergens were nickel sulfate and cobalt dichloride in workers and colophony and p-tert-butylphenol formaldehyde resin in managers. In conclusion, workers are at a higher risk of OACD compared with managers in the Chinese clothing industry. In addition to hand dermatitis in workers, airborne contact dermatitis on the face and neck should be also addressed in managers. PMID:28396866

Occupational allergic contact dermatitis caused by sterile non-latex protective gloves: clinical investigation and chemical analyses.

PubMed

Pontén, Ann; Hamnerius, Nils; Bruze, Magnus; Hansson, Christer; Persson, Christina; Svedman, Cecilia; Thörneby Andersson, Kirsten; Bergendorff, Ola

2013-02-01

An increased frequency of occupational contact hand dermatitis among surgical operating theatre personnel has been noticed. To evaluate patients with occupational contact dermatitis caused by their rubber gloves, and to describe a method for analysing the content of the allergens in the gloves. Patch tests were performed with the baseline series, a rubber chemical series, and the patients' own gloves. A method for analysing 1,3-diphenylguanidine (DPG) and cetylpyridinium chloride in the gloves was developed. Contact allergy to thiuram mix was found in 8 of 16 patients, whereas 12 of 16 patients reacted to DPG. In 7 of 8 patients, contact allergy to cetylpyridinium chloride was found. In the patients' gloves, cetylpyridinium chloride and DPG were detected at higher concentrations on the inside of the gloves than on the outside. Most patients had worked for decades in their present occupations, but their hand dermatitis had only been present for months. Contact allergy to DPG in gloves has been disputed, but, in this study, we were able to confirm the presence of DPG and cetylpyridinium chloride in the causative gloves by using a modified method for the analysis. The presence of these chemicals in gloves caused an increase in occupational contact dermatitis in surgical operating theatre personnel. © 2012 John Wiley & Sons A/S.

Occupational dermatoses in restaurant, catering and fast-food outlets in Singapore.

PubMed

Teo, Sylvia; Teik-Jin Goon, Anthony; Siang, Lee Hock; Lin, Gan Siok; Koh, David

2009-10-01

The restaurant industry is a rapidly growing sector in Singapore and workers in this industry are trained in culinary skills but not on recognition of safety and health hazards and their control measures. Anecdotal clinical evidence has suggested an increased prevalence of occupational dermatoses among restaurant workers. To determine the prevalence and risk factors for contact dermatitis and burns among restaurant, catering and fast-food outlet (FFO) staff. Workers were interviewed and then clinical examination and patch and/or prick tests were conducted in selected individuals. In total, 335 of 457 workers (73% response) were interviewed and 65 (19%) had occupational dermatitis or burns and were examined. Of these, contact dermatitis was the commonest diagnosis, with a 12-month period prevalence of 10% (35 workers) and 3-month period prevalence of 8% (26 workers). All 35 workers had irritant contact dermatitis (ICD) and there were no cases of allergic contact dermatitis. The adjusted prevalence rate ratios of risk factors for ICD were 2.78 (95% CI 1.36-5.72) for frequent hand washing >20 times per day, 3.87 (95% CI 1.89-7.93) for atopy and 2.57 (95% CI 1.21-5.47) for contact with squid. The 3-month period prevalence for burns was 6% (20 workers). Ten workers had other occupational dermatoses such as work-related calluses, paronychia, heat rash and allergic contact urticaria to prawn and lobster. ICD and burns are common occupational skin disorders among restaurant, catering and FFO workers.

Irritant contact dermatitis from an ornamental Euphorbia.

PubMed

Worobec, S M; Hickey, T A; Kinghorn, A D; Soejarto, D D; West, D

1981-01-01

An ornamental succulent plant sold in many plant stores in the Chicago area has been identified as Euphorbia hermentiana Lem. Open and closed patch testing using undiluted latex from this species was performed on five Caucasian volunteers. Open testing on flexor forearms resulted in irritant follicular dermatitis, while closed testing to the flexor surfaces of both upper arms in each subject produced bullae and vesiculation with residual desquamation and hyperpigmentation. Dermatological signs persisted for over a week following latex application.

Occupant seating anthropometry: body ellipses and contact zones for side-impact protection research

NASA Astrophysics Data System (ADS)

Culver, Clyde C.; Viano, David C.

The study has developed an anthropometric description of seated occupants and determined body regions representing major paths in side-impact crashes. The study has identified five major body ellipses defining the head, shoulder, chest, abdomen and pelvis of seated occupants of various sizes, including the six-year-old child. Body contact zones have been determined for front-seated occupants. These templates provide information for the design of side interiors to improve occupant protection in side-impact crashes by load-transfer and energy-absorption characteristics of biocompatible interiors.

Contact Lens Risks

MedlinePlus

... Health and Consumer Devices Consumer Products Contact Lenses Contact Lens Risks Share Tweet Linkedin Pin it More ... redness blurred vision swelling pain Serious Hazards of Contact Lenses Symptoms of eye irritation can indicate a ...

Contact Dermatitis Associated With Skin Cleansers: Retrospective Analysis of North American Contact Dermatitis Group Data 2000-2014.

PubMed

Warshaw, Erin M; Goodier, Molly C; DeKoven, Joel G; Maibach, Howard I; Taylor, James S; Sasseville, Denis; Belsito, Donald V; Fowler, Joseph F; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Mathias, Toby; Zirwas, Matthew J; Zug, Kathryn A

There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000-2014. Of 32,945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3-4.5] for APT reaction and 10.0 [95% CI = 8.2-12.2] for ICD, respectively, P < 0.0001). As compared with those without APT reaction to SC, individuals with APT reaction had significantly higher frequencies of hand (RR = 2.4 [95% CI = 2.1-2.7]) and arm dermatitis (RR = 1.3 [95% CI = 1.1-1.6], P ≤ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2-7.3], P < 0.0001). More than 50 allergens were associated with SCs including quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3,5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.

Common Occupational Disorders: Asthma, COPD, Dermatitis, and Musculoskeletal Disorders.

PubMed

Bepko, Jennifer; Mansalis, Katherine

2016-06-15

An occupational illness is an event or exposure that occurs in the workplace that causes or contributes to a condition or worsens a preexisting condition. If an occupational disorder is suspected, a directed history should be taken with particular attention to establishing a temporal relationship of symptoms and exposure at work. Occupational asthma is the most prevalent occupational lung disorder in industrialized countries and presents with classic asthma symptoms (cough, difficulty breathing, chest tightness, wheezing). Occupational chronic obstructive pulmonary disease has been linked with exposure to nonspecific vapors, gases, dusts, fumes, and cigarette smoke. Occupational contact dermatitis is the most common dermal exposure. It can be caused by exposure to a variety of agents, including primary irritants or sensitizers, physical agents, mechanical trauma, and biologic agents. Occupational musculoskeletal disorders include many common repetitive injuries such as carpal tunnel syndrome and medial or lateral epicondylitis. Treatment of occupational disorders is generally the same as for nonoccupational disorders. Ideally, the exposure should be controlled to protect the worker. The impact of an occupational injury reaches beyond lost wages and can have a negative impact on quality of life.

Potential allergy and irritation incidents among health care workers.

PubMed

Alamgir, Hasanat; Yu, Shicheng; Chavoshi, Negar; Ngan, Karen

2008-07-01

This study describes the types, causes, and outcomes of potential irritation and allergy incidents among workers in British Columbia's health care industry. Data on occupation-induced allergy and irritation incidents were extracted from a standardized database using the number of productive hours obtained from payroll data as a denominator during a 1-year period from three British Columbia health regions. Younger workers, female workers, facility support service workers, laboratory assistants and technicians, and maintenance and acute care workers were found to be at higher risk for allergy and irritation incidents. Major causes of allergy and irritation incidents included chemicals, blood and body fluids, food and objects, communicable diseases, air quality, and latex. A larger proportion of chemically induced incidents resulted in first aid care only, whereas non-chemical incidents required more emergency room visits.

Asthma, chronic bronchitis, and exposure to irritant agents in occupational domestic cleaning: a nested case-control study.

PubMed

Medina-Ramón, M; Zock, J P; Kogevinas, M; Sunyer, J; Torralba, Y; Borrell, A; Burgos, F; Antó, J M

2005-09-01

Women employed in domestic cleaning are at increased risk for symptoms of obstructive lung disease, but the agents responsible are unknown. To investigate common tasks and products in occupational domestic cleaning in relation to respiratory morbidity. Case-control study in domestic cleaning women nested within a large population based survey of women aged 30-65 years; 160 domestic cleaning women with asthma symptoms, chronic bronchitis symptoms, or both and 386 without a history of respiratory symptoms were identified. Detailed exposures were evaluated for 40 cases who reported still having symptoms at the recruitment interview, and 155 controls who reported not having symptoms. All tasks performed and products used when cleaning houses were determined in a face-to-face interview. Lung function, methacholine challenge, and serum IgE testing were performed. Personal exposure measurements of airborne chlorine and ammonia were performed in a subsample. Associations between asthma, chronic bronchitis, and cleaning exposures were evaluated using multiple logistic regression analysis. Airborne chlorine (median level 0-0.4 ppm) and ammonia (0.6-6.4 ppm) were detectable during occupational domestic cleaning activities. Cases used bleach more frequently than controls; adjusted odds ratio (OR) for intermediate exposure was 3.3 (95% CI 0.9 to 11) and for high exposure 4.9 (1.5 to 15). Other independent associations included accidental inhalation of vapours and gases from cleaning agents and washing dishes. These associations were more pronounced for cases with asthma symptoms than for those with symptoms of chronic bronchitis, but were not related to sensitisation to common allergens. Asthma symptoms in domestic cleaning women are associated with exposure to bleach and possibly other irritant agents. The public health impact of the use of irritant cleaning products could be widespread since the use of these products is common both in the workplace and at home.

Allergic contact hobby dermatitis from turpentine.

PubMed

Barchino-Ortiz, L; Cabeza-Martínez, R; Leis-Dosil, V M; Suárez-Fernández, R M; Lázaro-Ochaita, P

2008-01-01

Turpentine is an oleoresin obtained from various species of pine. It contains a volatile oil (oil of turpentine) which is responsible for its properties and this is the form generally used. Opportunity for contact with turpentine is widespread. It is universally used as a solvent to dissolve and thin lacquers, varnishes and paints. It is also an ingredient in many liniments and cold remedies. Turpentine is regarded as both a local irritant and a sensitizer. Cases of allergic contact dermatitis in painters, mechanics, shoe repairers and home decorators have been reported. We report a case of a non-professional painter who developed a contact allergic dermatitis due to his exposure to turpentine while doing oil-painting as a hobby. Dermatitis is one of the biggest dangers of working with art materials and occupational contact dermatitis is often detected on the hands of the painters. Solvents are indispensable and turpentine is the most important and the traditional one used in oil-painting. Contact allergy to oil of turpentine was reported to have become rare in Europe but over the last few years, increased rates of turpentine sensitization have been reported.

Frequency-risk and duration-risk relations between occupational livestock contact and methicillin-resistant Staphylococcus aureus carriage among workers in Guangdong, China.

PubMed

Ye, Xiaohua; Liu, Weidong; Fan, Yanping; Wang, Xiaolin; Zhou, Junli; Yao, Zhenjiang; Chen, Sidong

2015-07-01

Increasing evidence indicates a strong association between occupational livestock contact and methicillin-resistant Staphylococcus aureus (MRSA) carriage. However, it remains unclear whether there are frequency-risk and duration-risk relations between occupational livestock contact and human MRSA carriage. A cross-sectional survey was conducted in Guangdong, China, using a multistage sampling method. Participants were interviewed and provided a nasal swab for S aureus analysis. All MRSA isolates were genotyped by multilocus sequence typing. The dose-response relation was examined using logistic regression models. Among the 1,860 participants, 1.4% of controls tested positive for MRSA (characterized as sequence type [ST] 59 and ST7), and 7% of workers with livestock contact tested positive for MRSA (characterized as ST9, ST59, and ST7). There was a 5.31 times increased risk of MRSA carriage corresponding to occupational livestock contact (odds ratio = 6.31; 95% confidence interval, 3.44-11.57) using no contact as reference. We found frequency and short-term duration of occupational livestock contact were associated with increased risk of MRSA carriage in a dose-response manner. These significant trends were observed consistently among workers with occupational pig contact. However, no long-term duration-risk increasing trend was observed for occupational livestock or pig contact. Our findings suggest that there may be dose-response relations between occupational livestock contact and human MRSA carriage. Nasal MRSA clonal complex 9 is not found in controls, but it is found in workers with livestock contact. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Evaluation of occupational allergic contact dermatitis and its related factors in Iran.

PubMed

Nassiri-Kashani, Mansour; Nassiri-Kashani, Mohammad Hassan; Ghafari, Mostafa

2016-01-01

Background: Occupational contact dermatitis, especially in hand, is one of the most common occupational disorders. The present study aimed at evaluating patients with occupational allergic contact dermatitis (ACD) caused by common allergens based on occupation type and disease history. Methods: This cross-sectional study aimed at evaluating the data of the patients with probable diagnosis of ACD in Center for Research and Training in Skin Diseases and Leprosy (CRTSDL) in Iran. In the present study, 946 patients were assessed from different regions of Iran. One hundred fifty-one cases with positive patch test and relevant exposure were entered into the study; data related to their occupation and disease activity history were evaluated and recorded. Then, factors related to disease activity history were assessed considering the occupational groups and common exposures. Results: Nickel sulphate was the most common allergen in the 151 patients. Disease activity was constant in 29.8% of the patients; it increased in 27.8%, and decreased just before doing the patch test in 42.4%. Of the patients, 52.3% were getting worse during the working days. Occupational groups were significantly different in age and gender. Disease duration was also different in the occupational groups (p=0.001). The least disease duration was observed in healthcare workers, and the most in service workers. Lesions in the foot were related to period of employment. In administrative work group, (teachers, technicians and housewives) disease activity was decreased in the most cases, while it was increased in most patients of service workers (p=0.086). Conclusion: The present study, similar to previous reports, revealed that nickel sulphate is the most common allergen in ACD cases. Moreover, it was found that the symptoms of disease activity remained constant or increased in a significant proportion of the cases during the working days. Therefore, these workers should seriously follow up on this matter

Occupational contact dermatitis caused by aniline epoxy resins in the aircraft industry.

PubMed

Pesonen, Maria; Suuronen, Katri; Jolanki, Riitta; Aalto-Korte, Kristiina; Kuuliala, Outi; Henriks-Eckerman, Maj-Len; Valtanen, Ilona; Alanko, Kristiina

2015-08-01

Tetraglycidyl-4,4'-methylenedianiline (TGMDA) is an aniline epoxy resin used in, for example, resin systems of pre-impregnated composite materials (prepregs) of the aircraft industry. Allergic contact dermatitis caused by TGMDA in prepregs has been described previously. To report on 9 patients with occupational allergic contact dermatitis caused by TGMDA in epoxy glues used in helicopter assembly. The patients were examined with patch testing at the Finnish Institute of Occupational Health in 2004-2009. The first patient was diagnosed by testing both components of two epoxy glues from the workplace, and was also tested with glue ingredients, including TGMDA. The following patients were tested with the glues and TGMDA. The resin parts of the glues were analysed for their epoxy compounds, including TGMDA. All of the patients had a patch test reaction to one or both of the resin parts of the TGMDA-containing glues. Eight of them had a strong allergic reaction to TGMDA, and one had a doubtful reaction to TGMDA. Two of the patients also had an allergic reaction to triglycidyl-p-aminophenol (TGPAP), another aniline epoxy resin, which was not present in the TGMDA-containing glues. In aircraft industry workers with suspected occupational dermatitis, aniline epoxy resins should be considered and patch tested as possible contact allergens. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational carprofen photoallergic contact dermatitis.

PubMed

Kerr, A C; Muller, F; Ferguson, J; Dawe, R S

2008-12-01

The nonsteroidal anti-inflammatory drug carprofen was used in humans in the 1980s, before its withdrawal due to adverse effects. It re-emerged for veterinary uses, for which it is still widely prescribed, in the 1990s. There has been one previous report published of photoallergic contact dermatitis (PACD) in a pharmaceutical factory worker exposed to carprofen. Investigation of carprofen as a cause of PACD in pharmaceutical factory workers presenting with facial dermatitis. Photopatch testing to carprofen dilutions in two pharmaceutical factory workers and three healthy volunteer controls using the European consensus methodology. This was followed by testing of eight further employees, referred by occupational health services, in the same factory. The index patient suspected a problem with carprofen and was found to have PACD to carprofen. The second patient presented with a widespread, although especially photoexposed site, dermatitis and was initially labelled as having an 'unclassified dermatitis'. Only subsequently was her exposure (indirect; she did not work in the packaging section of the factory like the first patient) to carprofen recognized and testing confirmed both contact allergy and PACD to carprofen. One of three healthy volunteer controls had an active photoallergy sensitization event to carprofen starting 10 days after photopatch testing. Three of eight factory employees subsequently referred because of skin problems had carprofen PACD. Carprofen is a potent photoallergen. These cases emphasize the importance of photopatch testing, and considering agents not included in standard series, when investigating patients presenting with a photoexposed site dermatitis.

Cutaneous irritancy of an ibuprofen medicated plaster in healthy volunteers.

PubMed

Maganji, Manisha; Connolly, Mark P; Bhatt, Aomesh

2018-04-01

To assess the irritation and contact sensitization potential of a 200 mg ibuprofen medicated plaster. This double-blind, phase-1 placebo controlled study had two phases; the induction phase to evaluate the irritant potential of continuous application of the plaster, and the challenge phase to assess contact sensitivity (allergy). The cumulative irritancy potential was evaluated using an adaptation of the Shelanski method. Healthy adults (≥18 years of age) (N = 210) were treated simultaneously with one ibuprofen medicated and one placebo plaster applied in a randomized fashion to either the left or right side of the lower back. During the induction phase, plasters were applied on Days 1, 3, 5, 8, 10, 12, 15, 17, and 19 and the final plaster removed on Day 22. At each scheduled visit plasters and applications sites were assessed for degree of adhesion and skin irritation (score of 1 = no irritation to 7 = strong reaction spreading beyond test sites), respectively. The challenge phase followed a two-week washout period. A plaster was applied on Day 36 for 48 h and assessment occurred on Days 38, 39, and 40. The mean cumulative irritation score during the induction phase was lower for the ibuprofen medicated plaster than the placebo plaster (0.32 vs. 1.23, respectively). Three (1.4%) subjects experience a dermal reaction of grade ≥3 for the ibuprofen medicated plaster compared with 27 (12.7%) for the placebo plaster. Following challenge with ibuprofen or placebo plasters, 12 subjects (6.2%) with the ibuprofen medicated plaster and four (2.2%) with the placebo plaster had skin reaction of assessment grade higher than the induction phase. One subject for the ibuprofen and two for the placebo plaster had reactions with grade >2. No subjects showed an increase in sensitization on Day 39 or 40 compared with Day 38. The findings indicate that the both the irritancy and contact sensitization of the ibuprofen medicated plaster is acceptable.

Association between occupation and contact allergy to the fragrance mix: a multifactorial analysis of national surveillance data

PubMed Central

Uter, W; Schnuch, A; Geier, J; Pfahlberg, A; Gefeller, O

2001-01-01

OBJECTIVES—To assess the role of potential (occupational) risk factors for fragrance contact allergy (FCA). Most studies assessing the range of contact sensitisation in various clinical populations found the fragrance mix, a good screening tool for the detection of FCA in general, to be one of the leading allergens. The role of occupational exposure to fragrances is, however, yet unclear.
METHODS—Firstly, crude analyses of the prevalence of FCA in various occupational fields including all 57 779 patients patch tested in the participating centres of the Information Network of Departments of Dermatology (IVDK) between January 1992 and December 1998. Secondly, a multifactorial Poisson regression analysis of these patients, including several potential risk factors.
RESULTS—(a) The proportion of patients with FCA varied greatly between different occupational groups from 2.5% to 17.4%, (b) the highest occupational risk of FCA was associated with work as a masseur or physiotherapist, metal furnace operator, potter or glass maker etc, or geriatric nurse, (c) non-occupational factors that influenced risk of FCA included atopy, female sex, several sites, in particular the axillae, and increasing age.
CONCLUSIONS—Occupations with a high risk of FCA were identified as targets of preventive action—that is, the substitution of scented products with fragrance free materials with which to work (skin disinfectants, cleaning solutions, personal care products) wherever possible.


Keywords: contact allergy; occupational risk factors; fragrances PMID:11351055

The role of biomaterials as occupational hazards in dentistry.

PubMed

Hensten-Pettersen, A; Jacobsen, N

1990-06-01

Many of the biomaterials and auxilliary products used in dentistry are chemically and biologically reactive and may be of concern in occupational safety programmes. Observations from 1936 to 1975 indicated that most occupational problems were related to skin contact with procaine, soaps, eugenol, iodine, formalin, phenol, and other disinfectants. Methyl methacrylate monomer was identified as an irritant and allergen in the later part of this period. Investigations from 1975 to 1985 indicated that disinfectants and detergents were still important causes of dermatoses, whereas reactions to procaine had been replaced by reactions to pantocaine. Furthermore, adverse reactions to methyl methacrylate monomer and to elastomeric impression materials had replaced the former iodine, tricresol and eugenol reactions. In recent studies the frequency of occupation-related dermatoses varied from 21 per cent to 43 per cent, depending on the prevailing material usage in the various specialties. Reactions to local anaesthetics seemed to have disappeared. Transient, irritative reactions of the eyes and airways have been observed, mostly associated with exposure to volatiles from resin-based materials, X-ray chemicals and cleansers. The occupational problems related to biomaterials in dentistry seem to have been fairly constant over the years, reflecting the type of materials in common use, and with dermatological disorders being a tenacious companion. Neuropathological conditions in dental technicians have been associated with prolonged exposure to vapours of methyl methacrylate monomer. The more recent extensive use of volatile resin-based materials, and the use of protective gloves seems to have created new problems that need to be investigated.

The irritation potential and reservoir effect of mild soaps.

PubMed

Lodén, Marie; Buraczewska, Izabela; Edlund, Fredrik

2003-08-01

Identification and reduction of external noxious factors is one key point in the strategy for the treatment and reduction of contact dermatitis. A wide variety of soaps on the market are claimed to be suitable for the use on sensitive skin due to their mildness. The aim of the present study was to illustrate possible differences in the irritation potential of 8 products and to investigate whether surfactant residues may form an irritant reservoir on the skin. The study was double-blind, randomized using healthy human volunteers. The inherent capacity of the products to induce irritation was determined using conventional patch test technique, whereas detection of potential surfactant residues on the skin was done using a methodology developed in the 1960s for detection of the corticosteroid reservoir in the stratum corneum. The method comprised the release of active substance from the stratum corneum reservoir by occlusion of the skin with an aluminium chamber, followed by evaluation of the biological response. In the present study, the soap-treated area was rinsed with water and then occluded. Instrumental measurements of the transepidermal water loss and superficial skin blood flow served as indicators of the injurious effects of the products. The results showed large differences in irritation potential between the products, and some of them demonstrated considerable damaging effect. Moreover, the study proved the presence of barrier-impairing residues on the skin after rinsing with water. Subclinical skin damage can make the skin vulnerable to further irritation and delay recovery of chronic irritant contact dermatitis.

Work-associated irritable larynx syndrome.

PubMed

Anderson, Jennifer A

2015-04-01

The purpose of this study is to review the relevant literature concerning work-associated irritable larynx syndrome (WILS), a hyperkinetic laryngeal disorder associated with occupational irritant exposure. Clinical symptoms are variable and include dysphonia, cough, dyspnoea and globus pharyngeus. WILS is a clinical diagnosis and can be difficult to differentiate from asthma. Treatment options for WILS include medical and behavioural therapy. Laryngeal-centred upper airway symptoms secondary to airborne irritants have been documented in the literature under a variety of diagnostic labels, including WILS, vocal cord dysfunction (VCD), laryngeal hypersensitivity and laryngeal neuropathy and many others. The underlying pathophysiology is as yet poorly understood; however, the clinical scenario suggests a multifactorial nature to the disorder. More recent literature indicates that central neuronal plasticity, inflammatory processes and psychological factors are all likely contributors. Possible mechanisms for WILS include central neuronal network plasticity after noxious exposure and/or viral infection, inflammation (i.e. reflux disease) and intrinsic patient factors such a psychological state. Treatment is individualized and frequently includes one or more of the following: environmental changes in the workplace, GERD therapy, behavioural/speech therapy, psychotherapy counselling and neural modifiers.

Occupational asthma due to formaldehyde.

PubMed Central

Burge, P S; Harries, M G; Lam, W K; O'Brien, I M; Patchett, P A

1985-01-01

Bronchial provocation studies on 15 workers occupationally exposed to formaldehyde are described. The results show that formaldehyde exposure can cause asthmatic reactions, and suggest that these are sometimes due to hypersensitivity and sometimes to a direct irritant effect. Three workers had classical occupational asthma caused by formaldehyde fumes, which was likely to be due to hypersensitivity, with late asthmatic reactions following formaldehyde exposure. Six workers developed immediate asthmatic reactions, which were likely to be due to a direct irritant effect as the reactions were shorter in duration than those seen after soluble allergen exposure and were closely related to histamine reactivity. The breathing zone concentrations of formaldehyde required to elicit these irritant reactions (mean 4.8 mg/m3) were higher than those encountered in buildings recently insulated with urea formaldehyde foam, but within levels sometimes found in industry. Images PMID:4023975

Screening occupational contact allergy to bisphenol F epoxy resin.

PubMed

Aalto-Korte, Kristiina; Suuronen, Katri; Kuuliala, Outi; Henriks-Eckerman, Maj-Len; Jolanki, Riitta

2014-09-01

Epoxy resins based on diglycidyl ether of bisphenol F (DGEBF) are widely used as such in applications requiring chemical resistance, and also together with diglycidyl ether of bisphenol A resin (DGEBA-R). Concomitant patch test reactions to DGEBA-R and DGEBF resin (DGEBF-R) are common. Previous studies have yielded conflicting results on the frequency of independent DGEBF-R contact allergies. To report the results of over 11 years of screening with DGEBF-R. An in-house test substance of DGEBF-R (Epikote 862) was tested in the baseline patch test series, first at 1% and later at 0.25%. Test files were screened for allergic reactions to DGEBF-R and DGEBA-R, and the clinical records of positively reacting patients were analysed for occupation and exposure. Among 1972 patients, 66 (3.3%) reacted to DGEBF-R and 96 (4.9%) to DGEBA-R. Independent DGEBF-R allergies were seen in 5 patients only, and independent DGEBA-R allergies in 35. Specific exposure to DGEBF-R was found in 26 patients. The main occupational fields were the aircraft industry, the electrical and sports equipment industry, boat building, painting/floor coating, tile setting, and pipe relining. Independent contact allergies to DGEBF-R were rare, and screening with it was not found to be useful. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational skin problems in construction workers.

PubMed

Shah, Kartik R; Tiwari, Rajnarayan R

2010-10-01

Construction workers handle cement which has constituents to produce both irritant contact dermatitis and corrosive effects (from alkaline ingredients, such as lime) and sensitization, leading to allergic contact dermatitis (from ingredients, such as chromium). The present study has been carried out among unorganized construction workers to find the prevalence of skin problems. The present cross-sectional study was conducted in 92 construction workers of Ahmedabad and Vadodara. All the workers were subjected to clinical examination after collection of information regarding demographic characteristics, occupational characteristics and clinical history on a predesigned proforma. Of them, 47.8% had morbid skin conditions. Frictional callosities in palm were observed in 18 (19.6%) subjects while 4 (4.3%) subjects had contact dermatitis. Other conditions included dry, fissured and scaly skin, infectious skin lesion, tinea cruris, lesion and ulcers on hands and/or soles. The skin conditions were common in the age group of 20-25 years, males, those having ≥1 year exposure and those working for longer hours. Half of the workers not using personal protective equipment had reported skin-related symptoms.

Occupational skin disease in the construction industry.

PubMed

Bock, M; Schmidt, A; Bruckner, T; Diepgen, T L

2003-12-01

Construction workers have a substantial risk of developing irritant and/or allergic contact dermatitis. Unfortunately, however, there is little population-based epidemiological data relating to occupational skin diseases (OSD) in the European construction industry that allow assessment of preventive measures. In this investigation, the yearly incidence rates and causes of OSD in the construction industry were analysed on the basis of our register in Northern Bavaria. From 1990 until 1999, all incidences of OSD in the construction industry were recorded prospectively. This enables the calculation of incidence rates of OSD in relation to the employed population in Northern Bavaria as recorded by the German Federal Employment Office. In the construction industry, a total of 335 OSD were registered. These comprise 9.0% of all OSD in the register. We classified them into four relevant groups: (A) tile setters and terrazzo workers (incidence per 10 000 employees = 19.9); (B) painters (7.8); (C) construction and cement workers (5.2); and (D) wood processors (2.6). The overall incidence was 5.1 per 10 000 employees over 10 years, which is a little below average for the entire register (6.7). Of these, 43.6% were at least 40 years old. Allergic contact dermatitis (61.5%) occurred more often than irritant contact dermatitis (44.5%). Potassium dichromate caused roughly half of all cases of sensitization found to be occupationally relevant in the construction industry (152 cases) followed by epoxy resin (40) and cobalt chloride (32). The results indicate that potassium dichromate is still the most important allergen in the construction industry of Northern Bavaria; there has been no significant decline during the 1990s. This contrasts with the Scandinavian countries, where the prevalence of potassium dichromate sensitization declined following the reduction of chromium VI levels resulting from the addition of ferrous sulphate to cement. Within the construction industry, tile

Enhanced expression of IL-8 in normal human keratinocytes and human keratinocyte cell line HaCaT in vitro after stimulation with contact sensitizers, tolerogens and irritants.

PubMed

Mohamadzadeh, M; Müller, M; Hultsch, T; Enk, A; Saloga, J; Knop, J

1994-12-01

To investigate the interleukin-8 production of keratinocytes after stimulation in vitro we have used various agents: (i) contact sensitizer (2,4-dinitrofluorobenzene, 3-n-pentadecylcatechol); (ii) tolerogen (5-methyl-3-n-pentadecylcatechol); (iii) irritant (sodium lauryl sulfate). Interleukin-8 gene expression was assessed by northern blot hybridization of the total cytoplasmic RNA extracted from subconfluent normal human keratinocyte cultures and the keratinocyte cell line HaCaT using a radiolabeled DNA probe specific for human interleukin-8. Interleukin-8 gene expression was markedly increased upon in vitro stimulation after 1-6 h with contact sensitizers, tolerogen and the irritant. In contrast, interleukin-8 production was not detectable in unstimulated normal human keratinocytes or the HaCaT keratinocyte cell line. These results suggest that the induction and production of interleukin-8 is a response to nonspecific stimuli and may play a critical role in the early response to immunogenic or inflammatory signals in man.

Occupational allergic contact dermatitis caused by coconut fatty acids diethanolamide.

PubMed

Aalto-Korte, Kristiina; Pesonen, Maria; Kuuliala, Outi; Suuronen, Katri

2014-03-01

Coconut fatty acids diethanolamide [cocamide diethanolamine (cocamide DEA)] is a surface-active derivative of coconut oil that is used in industrial, household and cosmetic products. Cocamide DEA contact allergy has been reported relatively seldom. To describe cocamide DEA-positive patients in an occupational dermatology clinic. We retrieved allergic reactions to cocamide DEA from test files, and studied the occupation, exposure, concomitant allergic reactions and diagnoses of the positive patients. Of the 2572 patients tested, 25 (1%) had an allergic reaction to cocamide DEA. Nineteen patients were occupational cases, and 11 worked in the metal industry. Hand cleansers constituted the main source of sensitization (n = 17). Other sources included two dishwashing liquids, one barrier cream, and one metalworking fluid. Three patients reacted to monoethanolamine and 2 to diethanolamine. Diethanolamine is an impurity of cocamide DEA, and can be found in cocamide DEA-containing products and in commercial patch test substances, which may explain some concomitant reactions. Cocamide DEA allergy is relatively common in patients with occupational hand dermatitis, and mainly derives from hand cleansers. However, exposure to detergents, metalworking fluids and barrier creams must also be taken into account. Concomitant reactions to ethanolamines are possible. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Protective effects of different marigold (Calendula officinalis L.) and rosemary cream preparations against sodium-lauryl-sulfate-induced irritant contact dermatitis.

PubMed

Fuchs, S M; Schliemann-Willers, S; Fischer, T W; Elsner, P

2005-01-01

In the present study, we evaluated the protective action of cream preparations containing seven different types of marigold and rosemary extracts in vivo in healthy volunteers with experimentally induced irritant contact dermatitis (ICD). Marigold and rosemary extracts in base cream DAC (Deutscher Arzneimittel-Codex = German Pharmaceutical Codex) were tested in a 4-day repetitive irritation test using sodium lauryl sulfate. The effect was evaluated visually and quantified by noninvasive bioengineering methods, namely chromametry and tewametry. When the test products were applied parallel to the induction period of ICD, a statistically significant protective effect of all cream preparations was observed by all methods. This effect, although not statistically significant, was superior to control by undyed marigold und faradiol ester-enriched extracts in chromametry and by dyed and undyed rosemary extracts in tewametry. The sequential treatment (postirritation) once a day for 5 days was without any effect. Thus, a protective effect of some marigold and rosemary extracts against ICD could be shown in the elicitation phase. Copyright (c) 2005 S. Karger AG, Basel.

(Meth)Acrylate Occupational Contact Dermatitis in Nail Salon Workers: A Case Series.

PubMed

DeKoven, Samuel; DeKoven, Joel; Holness, D Linn

Recently, many cases of acrylate-associated allergic contact dermatitis have appeared among nail salon workers. Common acrylate-containing products in nail salons include traditional nail polish, ultraviolet-cured shellac nail polish, ultraviolet-cured gel nails, and press-on acrylic nails. Nail salon technicians seen in the occupational medicine clinic in 2015 and 2016 were identified, and their patch test results and clinical features were summarized. Patch testing was done with the Chemotechnique (Meth)Acrylate nail series, and either the North American Standard series or the North American Contact Dermatitis Group screening series. Six patients were identified, all women, ages 38 to 58. Common presentations included erythematous dermatitis of the dorsa of the hands, palms, and forearms and fissures on the fingertips. Less common sites of eruptions included the periorbital region, cheeks, posterior ears, neck, sacral area, lateral thighs, and dorsa of the feet. All patients reacted to hydroxyethyl methacrylate, and 5 patients reacted to ethyl acrylate. Each patient also reacted to (meth)acrylates that are not found on either standard series, including ethyleneglycol dimethacrylate, 2-hydroxypropyl methacrylate, and 2-hydroxyethyl acrylate. The authors report 6 cases of allergic contact dermatitis to acrylates in nail technicians seen over the past year, representing a new trend in their clinic. These cases are reflective of a growing trend of nail technicians with allergic contact dermatitis associated with occupational (meth)acrylate exposure. Efforts to improve prevention are needed.

Assessment of the in vitro dermal irritation potential of cerium, silver, and titanium nanoparticles in a human skin equivalent model

EPA Science Inventory

AbstractDermal exposure to metals may res·ult in irritant contact dermatitis. This study examined the potential of metal nanoparticles to elicit irritant contact dermatitis in a human skin equivalent model (HSEM) derived from epidermal keratinocytes. These cultured cells form a m...

Prevention of experimentally induced irritant contact dermatitis by extracts of Isatis tinctoria compared to pure tryptanthrin and its impact on UVB-induced erythema.

PubMed

Heinemann, Christian; Schliemann-Willers, Sibylle; Oberthür, Christine; Hamburger, Matthias; Elsner, Peter

2004-05-01

Lipophilic extracts of Isatis tinctoria L. exhibit significant activity against several clinically relevant targets of inflammation. The alkaloid tryptanthrin was identified as one of the active principles in woad and characterised as a potent dual inhibitor of COX-2 and 5-LOX. Here, the anti-inflammatory efficacy of topical application of three different Isatis extracts and tryptanthrin was investigated in human volunteers. Two different models were used, namely the sodium lauryl sulphate (SLS)-induced irritant contact dermatitis (ICD) and UVB-induced erythema. Twenty healthy volunteers without any skin disease participated in the study. Cumulative irritant contact dermatitis was induced on test fields on the volunteers' backs by twice daily application of 0.5 % sodium lauryl sulphate over a period of four days. Half of the test fields were treated with the test substances during the eliciting phase, while the remaining test fields were treated over a period of 4 days after induction of dermatitis. In the second model, a UVB erythema on the volunteers' lower backs was induced using the double minimal erythema dose (MED). Twenty-four hours after irradiation the test fields were treated with the test substances over a period of 3 days. All reactions were assessed visually and by non-invasive bioengineering methods (evaporimetry and chromametry). Treatment with extracts during the ICD eliciting phase led to a significantly smaller increase of visual scores and transepidermal water loss compared to the untreated test field. For tryptanthrin this benefit was also observed, but the improvement was not statistically significant. When treatment was performed after completing the eliciting phase, accelerated resolution of the irritant reaction could not be observed. In the UVB erythema model anti-inflammatory effects of the test substances were not observed.

Occupational contact urticaria: lessons from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P).

PubMed

Bensefa-Colas, L; Telle-Lamberton, M; Faye, S; Bourrain, J-L; Crépy, M-N; Lasfargues, G; Choudat, D; Momas, I

2015-12-01

Occupational contact urticaria (OCU) is an occupational contact dermatitis that can cause serious health consequences and disability at work. To describe OCU and its temporal trends by the main causal agents and activity sectors in a nationwide scheme in France. Using data from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P), we described OCU reported during the period 2001-10 and analysed the temporal trends of OCU and OCU attributed to the most frequent agents over the study period. Trends analyses were supported by reporting odds ratios using a logistic regression model with reference to 2001, or with time as a continuous variable. During the study period, 251 cases of OCU were reported in RNV3P, half of which were due to natural rubber latex, in particular in the health and social work activity sector (HSW). The number of these cases declined significantly over the study period (19% per year), and particularly after 2006. Conversely, the other causes of OCU did not decrease. Using surveillance data from a French national network, this study has found that there was a significant decline in OCU due to natural rubber latex, particularly in the HSW, when powdered latex gloves were banned from French hospitals. Our results show the effectiveness of this preventive measure, and suggest that this practice should be extended to other sectors. © 2015 British Association of Dermatologists.

Cement-Induced Chromate Occupational Allergic Contact Dermatitis.

PubMed

Kridin, Khalaf; Bergman, Reuven; Khamaisi, Mogher; Zelber-Sagi, Shira; Weltfriend, Sara

2016-01-01

Hexavalent chromium in cement is a common cause of occupational allergic contact dermatitis (OACD). Analysis of patch test data during 1999 to 2013 was done. Patients with cement-induced chromate OACD filled the Dermatology Life Quality Index, graded 1 to 5. Of 4846 consecutive patients who were patch tested, 146 (3%) were chromate-sensitive. Of 46 (31.5%) who presented with chromate OACD, 27 (59%) had cement-induced chromate OACD. The proportion of chromate-sensitive patients with clinically relevant cement exposure increased from 7.7% in 2002 to 2004 to 28.7% in 2011 to 2013 (P = 0.04). The median age of presentation was younger than for other chromate-sensitive patients (32 vs 42 years). Hand eczema (88.9%) was the most frequent clinical presentation. Of the 27 with cement-induced chromate OACD, 21 (77.8%) had ongoing dermatitis at the time of the review. Although 14/27 (51.9%) changed their occupation to avoid exposure to cement, symptoms persisted in 9/14 (64.3%). Prolonged exposure to cement before development of symptoms was associated with chronicity. All the symptomatic patients experienced at least a moderate effect on their quality of life (grade 3 or higher on the Dermatology Life Quality Index). We recommend the adoption of the European legislation in Israel, to reduce the prevalence of chromate OACD from cement.

Higher parental occupational social contact is associated with a reduced risk of incident pediatric type 1 diabetes: Mediation through molecular enteroviral indices

PubMed Central

Pezic, Angela; Cameron, Fergus J.; Rodda, Christine; Kemp, Andrew S.; Carlin, John B.; Hyoty, Heikki; Sioofy-Khojine, Amirbabak; Dwyer, Terence; Ellis, Justine A.; Craig, Maria E.

2018-01-01

We aimed to examine the association between parental occupational social contact and hygiene factors on type 1 diabetes (T1D) risk and possible mediation of these effects through child enteroviral infection. We interviewed 333 incident T1D cases and 660 controls from 2008–2011 in Melbourne, Australia. Enteroviral indices (ribonucleic acid by reverse transcription polymerase chain reaction and Coxsackie B virus antibody levels) in peripheral blood were measured in nested case control samples. Parent occupational social contact was assessed by the number of well or sick children, adults or animals contacted daily through work. Higher parental occupational social contact was strongly associated with reduced T1D risk with evidence of dose response (contact with the well or sick score, Adjusted odds ratio (AOR) per category: 0.73 (95% Confidence Interval (CI): 0.66, 0.81); P<0.001 or AOR 0.63 (95% CI: 0.53, 0.75); P<0.001) respectively). Nine of the ten parental social contact indices, were significant mediated through one or more enteroviral indices. The strength of association between enterovirus presence and T1D onset increased with child age (1.2 fold increase per year; P = 0.05). Lower child hand hygiene enhanced the adverse effect of low parental occupational contact with the sick; Synergy Index 5.16 (95% CI: 3.61, 7.36). The interaction between hand washing and parental occupational contact is more consistent with protection against parental enteroviral shedding than the sharing of a protective infectious agent or microbiome. PMID:29664909

Higher parental occupational social contact is associated with a reduced risk of incident pediatric type 1 diabetes: Mediation through molecular enteroviral indices.

PubMed

Ponsonby, Anne-Louise; Pezic, Angela; Cameron, Fergus J; Rodda, Christine; Kemp, Andrew S; Carlin, John B; Hyoty, Heikki; Sioofy-Khojine, Amirbabak; Dwyer, Terence; Ellis, Justine A; Craig, Maria E

2018-01-01

We aimed to examine the association between parental occupational social contact and hygiene factors on type 1 diabetes (T1D) risk and possible mediation of these effects through child enteroviral infection. We interviewed 333 incident T1D cases and 660 controls from 2008-2011 in Melbourne, Australia. Enteroviral indices (ribonucleic acid by reverse transcription polymerase chain reaction and Coxsackie B virus antibody levels) in peripheral blood were measured in nested case control samples. Parent occupational social contact was assessed by the number of well or sick children, adults or animals contacted daily through work. Higher parental occupational social contact was strongly associated with reduced T1D risk with evidence of dose response (contact with the well or sick score, Adjusted odds ratio (AOR) per category: 0.73 (95% Confidence Interval (CI): 0.66, 0.81); P<0.001 or AOR 0.63 (95% CI: 0.53, 0.75); P<0.001) respectively). Nine of the ten parental social contact indices, were significant mediated through one or more enteroviral indices. The strength of association between enterovirus presence and T1D onset increased with child age (1.2 fold increase per year; P = 0.05). Lower child hand hygiene enhanced the adverse effect of low parental occupational contact with the sick; Synergy Index 5.16 (95% CI: 3.61, 7.36). The interaction between hand washing and parental occupational contact is more consistent with protection against parental enteroviral shedding than the sharing of a protective infectious agent or microbiome.

The upper respiratory tract: mucous membrane irritation.

PubMed Central

Bascom, R

1991-01-01

Despite the widespread recognition that mucosal irritation is a cardinal feature of "sick-building syndrome," few data exist on the cause, natural history, or pathophysiology of upper respiratory mucous membrane irritation. The baseline prevalence of nasal symptoms among building occupants is often 20%, but in some studies it is as high as 50 to 60%. New techniques of nasal challenge and analysis of cells and mediators in nasal lavage fluid have proved useful in the assessment of rhinitis caused by antigens, cold air, and viruses, and these techniques are now being applied to the study the response to irritants. Human inhalation challenge studies have recently demonstrated a spectrum of sensitivity to environmental tobacco smoke, but the basis for this difference requires additional investigation. Animal and in vitro studies indicate that the chemosensitive neurons and airway epithelium may be critical targets for irritants that participate in the induction of inflammation. New research methods are needed, particularly to evaluate complaints of nasal congestion, drying, and irritation. Techniques should be developed that may be useful for field studies, where the health effects of a complex mixture are being assessed in a specific indoor environment. There exists a group of individuals who report a variety of symptoms on exposure to low levels of common volatile organic mixtures such as perfume, cigarette smoke, and cleaning agents. Some of these individuals report having occupied "sick buildings" during the time their symptoms began. Research is needed to understand the basis of their complaints, their etiology, and treatment. PMID:1821376

Occupational skin diseases in automotive industry workers.

PubMed

Yakut, Yunus; Uçmak, Derya; Akkurt, Zeynep Meltem; Akdeniz, Sedat; Palanci, Yilmaz; Sula, Bilal

2014-03-01

Studies on occupational skin diseases in workers of the automotive industry are few. To investigate the prevalence of occupational skin diseases in workers of the automotive industry. Between September and December 2011, a total of 405 workers from the automotive repair industry in Diyarbakır were interviewed. They were active workers in the repair industry who had been employed for at least six months. Business owners, sellers of spare parts and accounting officers were not included. The employees were examined at their workplaces and the working conditions were observed. Detailed dermatological examination was performed. The mean age of the 405 workers who participated in the study was 27.7 ± 10.3. The mean working time of employees was 13.3 ± 10.4 years. All of the employees were male. Dermatological diseases were not detected in 144 out of 405 workers (35.6%) and at least one condition was diagnosed in 261 (64.4%). The most frequent diagnosis was callus, hyperkeratosis, clavus (27.7%), followed by nail changes (16.8%) and superficial mycoses (12.1%). Contact dermatitis was seen at a rate of 5.9%. Traumatic lesions such as hyperkeratotic lesions and nail changes were found most frequently. Traumatic lesions were common among individuals who did not use gloves. Most nail changes were localized leuconychia, a finding not reported in the studies on automotive industry workers. In accordance with the literature, irritant contact dermatitis was observed in patients with a history of atopy and who had been working for a long time. Occupational skin diseases comprise an important field in dermatology, deserving much attention. Further studies on occupational dermatology are necessary.

Two decades of occupational (meth)acrylate patch test results and focus on isobornyl acrylate.

PubMed

Christoffers, Wietske A; Coenraads, Pieter-Jan; Schuttelaar, Marie-Louise A

2013-08-01

Acrylates constitute an important cause of occupational contact dermatitis. Isobornyl acrylate sensitization has been reported in only 2 cases. We encountered an industrial process operator with occupational contact dermatitis caused by isobornyl acrylate. (i) To investigate whether it is relevant to add isobornyl acrylate to the (meth)acrylate test series. (ii) To report patients with (meth)acrylate contact allergy at an occupational dermatology clinic. Our patch test database was screened for positive reactions to (meth)acrylates between 1993 and 2012. A selected group of 14 patients was tested with an isobornyl acrylate dilution series: 0.3%, 0.1%, 0.033%, and 0.01%. Readings were performed on D2, D3, and D7. One hundred and fifty-one patients were tested with our (meth)acrylate series; 24 had positive reactions. Most positive reactions were to 2-hydroxypropyl acrylate, 2-hydroxyethyl acrylate, 2-hydroxypropyl methacrylate, and diethyleneglycol diacrylate. Hypothetical screening with 2-hydroxypropyl acrylate, ethyleneglycol dimethacrylate, ethoxylated bisphenol A glycol dimethacrylate and trimethylolpropane triacrylate identified 91.7% of the 24 patients. No positive reactions were observed in 14 acrylate-positive patients tested with the isobornyl acrylate dilution series. The 0.3% isobornyl acrylate concentration induced irritant reactions in 3 patients. We report a rare case of allergic contact dermatitis caused by isobornyl acrylate. However, this study provides insufficient support for isobornyl acrylate to be added to a (meth)acrylate series. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Short contact therapy of acne with tretinoin.

PubMed

Veraldi, Stefano; Barbareschi, Mauro; Benardon, Susanna; Schianchi, Rossana

2013-10-01

The most frequent side effect of topical retinoids is irritant contact dermatitis. It occurs in approximately 85% of patients; the percentage can reach up to 95% in patients treated with tretinoin. Severity of this dermatitis is moderate to severe in approximately 20% of patients. However, 15% of patients stop the treatment with tretinoin because of skin irritation. The authors used tretinoin as short contact therapy (SCT) in mild to moderate acne, in order to try to reduce the incidence and severity of irritant contact dermatitis. They present the final results of a sponsor-free, pilot, open, multicenter study. Seventy-four patients were treated with 0.05% tretinoin cream. It was applied once daily for 30 min. Treatment duration ranged from 8 to 32 weeks (mean duration: 12 weeks). Acne severity and treatment efficacy were evaluated by means of the Global Acne Grading System. A significant clinical improvement (≥50% from baseline) was observed in 41 patients (55.4%). Thirteen patients (17.6%) developed a mild skin irritation. Four patients (5.4%) stopped the treatment because of severe skin irritation. Efficacy of tretinoin used as SCT seems to be superimposable to that of tretinoin used according to standard modality. Tolerability of SCT with tretinoin is very good. This tolerability allows a high adherence of patients to the treatment and it markedly improves compliance.

Irritable Bowel Syndrome

MedlinePlus

... Staying Safe Videos for Educators Search English Español Irritable Bowel Syndrome KidsHealth / For Teens / Irritable Bowel Syndrome What's in ... intestinal disorder called irritable bowel syndrome. What Is Irritable Bowel Syndrome? Irritable bowel syndrome (IBS) is a common intestinal ...

Significance of hair-dye base-induced sensory irritation.

PubMed

Fujita, F; Azuma, T; Tajiri, M; Okamoto, H; Sano, M; Tominaga, M

2010-06-01

Oxidation hair-dyes, which are the principal hair-dyes, sometimes induce painful sensory irritation of the scalp caused by the combination of highly reactive substances, such as hydrogen peroxide and alkali agents. Although many cases of severe facial and scalp dermatitis have been reported following the use of hair-dyes, sensory irritation caused by contact of the hair-dye with the skin has not been reported clearly. In this study, we used a self-assessment questionnaire to measure the sensory irritation in various regions of the body caused by two model hair-dye bases that contained different amounts of alkali agents without dyes. Moreover, the occipital region was found as an alternative region of the scalp to test for sensory irritation of the hair-dye bases. We used this region to evaluate the relationship of sensitivity with skin properties, such as trans-epidermal water loss (TEWL), stratum corneum water content, sebum amount, surface temperature, current perception threshold (CPT), catalase activities in tape-stripped skin and sensory irritation score with the model hair-dye bases. The hair-dye sensitive group showed higher TEWL, a lower sebum amount, a lower surface temperature and higher catalase activity than the insensitive group, and was similar to that of damaged skin. These results suggest that sensory irritation caused by hair-dye could occur easily on the damaged dry scalp, as that caused by skin cosmetics reported previously.

Oral administration of glucosylceramide ameliorates inflammatory dry-skin condition in chronic oxazolone-induced irritant contact dermatitis in the mouse ear.

PubMed

Yeom, Mijung; Kim, Sung-Hun; Lee, Bombi; Han, Jeong-Jun; Chung, Guk Hoon; Choi, Hee-Don; Lee, Hyejung; Hahm, Dae-Hyun

2012-08-01

Irritant contact dermatitis (ICD) is an inflammatory skin disease triggered by exposure to a chemical that is toxic or irritating to the skin. A major characteristic of chronic ICD is an inflammatory dry-skin condition with associated itching. Although glucosylceramide (GlcCer) is known to improve the skin barrier function, its mechanism of action is unknown. Using a mouse model of oxazolone-induced chronic ICD, this study investigated the effects of oral administration of GlcCer on inflammatory dry skin. Chronic ICD was induced by repeated application of oxazolone in mice. GlcCer was orally administered once daily throughout the elicitation phase. The beneficial efficacy of GlcCer on cutaneous inflammation was evaluated by assessing ear thickness, lymph node weight, histological findings, and mRNA expression of pro-inflammatory cytokines such as IL-1β and IL-6. Additionally, parameters of the itch-associated response, including scratching behavior, water content of the skin, and aquaporin-3 levels in the lesional ear, were measured. Oral GlcCer administration significantly suppressed mRNA expression of the pro-inflammatory cytokines IL-1β and IL-6. GlcCer also suppressed ear swelling, lymph node weight gains, and infiltration of leukocytes and mast cells in ICD mice. In oxazolone-induced ICD mice, GlcCer significantly inhibited irritant-related scratching behavior and dehydration of the stratum corneum, and decreased aquaporin-3 expression. Our results indicate that GlcCer suppressed inflammation not only by inhibiting cytokine production but also by repairing the skin barrier function, suggesting a potential beneficial role for GlcCer in the improvement of chronic ICD. Copyright © 2012 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

[Epidemiology of contact dermatitis: prevalence of sensitization to different allergens and associated factors].

PubMed

Bordel-Gómez, Ma T; Miranda-Romero, A; Castrodeza-Sanz, J

2010-01-01

In clinical practice, contact dermatitis is a relatively common skin complaint, whose prevalence has increased in recent years. Study by patch testing is essential for diagnosis of contact sensitization. To study the prevalence of sensitization to different allergens in a standard battery and observe the influence of different epidemiological and clinical variables on contact sensitization. A large number of allergens were included in our battery in order to detect new sensitizations whose prevalence might justify further study. This was a retrospective, observational, epidemiological study of 1092 patients, conducted in our skin allergy unit between January 1, 2000, and December 31, 2005. All patients were studied with a battery of 51 allergens. We assessed the following variables: sex, age, type of referral, occupation, site and course of skin lesions, personal and family history of atopy, positive patch tests, clinical significance, diagnosis, source of sensitization, and occupational relationship. At least 1 positive result was found in 55% of the patients, and 55.7% presented atopic dermatitis in one of its clinical variants: allergic contact dermatitis (28.2%), irritant contact dermatitis (20.1%), photoallergic contact dermatitis (2.2%), and phototoxic contact dermatitis (1.2%). The most prevalent allergens were nickel sulfate (29.3%), palladium chloride (11.7%), cobalt chloride (10.8%), potassium dichromate (7.5%), fragrance blends (6.3%), and p-phenylenediamine (6.1%). A positive occupational relationship was found in 41.1%, and 21.3% of the patients studied were diagnosed with occupational contact dermatitis. Metal workers, construction workers, and professional hairdressers were the most strongly represented groups. The most common source of sensitization was contact with metallic objects, followed by drugs, cosmetics, and rubber items. Female sex was the only independent variable that had a significant influence on the risk of contact sensitization in

Occupational contact allergy to omeprazole and ranitidine.

PubMed

Herrera-Mozo, Inmaculada; Sanz-Gallen, Pere; Martí-Amengual, Gabriel

2017-05-16

Omeprazole is a proton pump inhibition and ranitidine is an H2 histamine receptor antagonist widely used in the treatment of gastroesophageal reflex disease, peptic ulcer disease, Zollinger-Ellison syndrome and as a protector of the gastric mucosae. We report a case of occupational contact allergy to omeprazole and ranitidine. A 48-year-old man, with no pre-existing history of atopy or lifestyle factors. He neither had any medical history of consumption of drugs such as ranitidine and omeprazole. He worked for 19 months in the pharmaceutical company that manufactured ranitidine base. He presented rash in the face and eczema on the dorsum of the hands with itching. The study by prick tests with ranitidine gave negative response. Patch testing with ranitidine base and ranitidine hydrochloride gave positive response. A month later, when the patient was asymptomatic he returned to the pharmaceutical company, being switched from this previous job to the reactor manufacturing omeprazole. A few days after that, he presented erythematous eruptions involving face and neck with itching. Prick tests, path tests and in vitro laboratories studies with omeprazole gave positives. In this case the patient presented hypersensitivity type I at omeprazole and hypersensitivity type IV at omeprazole and ranitidine. Our aportation indicates the importance of careful analysis of the occupational exposure histories of patients with the suspected type I or type IV hypersensitivity to allergens, to determine whether work exposure is the cause. Med Pr 2017;68(3):433-435. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Incidence of chronic bronchitis in a cohort of pulp mill workers with repeated gassings to sulphur dioxide and other irritant gases

PubMed Central

2013-01-01

Background Occupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis. Methods The study population comprised 3,060 Swedish pulp mill workers (84% males) from a cohort study, who completed a comprehensive questionnaire with items on chronic bronchitis symptoms, smoking habit, occupational history, and specific exposures, including gassings. 2,037 have worked in sulphite mills. Incidence rates and hazard ratios (HRs) for the observation period, 1970–2000, in relation to exposure and the frequency of repeated gassings to SO2 and other irritant gases were calculated. Results The incidence rate for chronic bronchitis among workers with repeated gassings was 3.5/1,000 person-years compared with 1.5/1,000 person-years among unexposed workers (HR 2.1, 95% confidence interval (CI) 1.4-3.1). The risk was even higher in the subgroup with frequent gassings (HR 3.2, 95% CI 2.0-5.2), particularly among never-smokers (HR 8.7, 95% CI 3.5-22). Conclusions Repeated gassings to irritant gases increased the incidence of chronic bronchitis in our study population during and after work in pulp mills, supporting the hypothesis that occupational exposures to irritants negatively affect the airways. These results underscore the importance of preventive actions in this work environment. PMID:24354705

Occupational skin diseases in dental laboratory technicians. (I). Clinical picture and causative factors.

PubMed

Rustemeyer, T; Frosch, P J

1996-02-01

In Germany, occupational skin disease (OSD) in dental technicians (DT) has been steadily rising in recent years and causing considerable costs for medical care and rehabilitation. Our objective in this study was to: (i) examine affected workers; (ii) perform patch tests to identify causative agents; (iii) develop strategies of prevention. 7 dental laboratories were inspected as to materials used, working habits, safety regulations, etc. A computer data base was developed for products (trade name, active ingredient, additives, etc.). A questionnaire regarding development of OSD was sent out to 1132 dental technicians (45 questions). 55 DT with suspected OSD were examined and patch tested with the standard series, an extensive series of methacrylates, and own materials. Working conditions, and knowledge of potential hazards, varied greatly in the laboratories visited. The safety data sheets of working materials were of little use and required supplementation by the computer data base, which provided rapid access to allergological information (e.g., type of acrylate, concentration). In the questionnaire (173 answers), 36% reported skin lesions attributed to work and 1/3 suspected plastic materials as their primary cause. Among the 55 DT examined, allergic contact dermatitis was diagnosed in 63.6% and irritant contact dermatitis in 23.6%. Most of the allergens identified (74%) were found in plastic materials (methyl methacrylate (MMA), 9 patients (16%); 2-hydroxyethyl methacrylate (2-HEMA), 18 patients (33%); ethyleneglycol dimethacrylate (EGDMA), 15 patients (27%)). In 16 patients, multiple sensitizations to various methacrylates were found. The fingertips were primarily involved in allergic contact dermatitis (93%), whereas in irritant contact dermatitis, the dorsa of the fingers (especially of the dominant hand) were affected (80%). 9 patients also showed lesions on the face, neck and forearms. The main irritant factors included wet work, contact with plaster

Severity and functional disability of patients with occupational contact dermatitis: validation of the German version of the Occupational Contact Dermatitis Disease Severity Index.

PubMed

Ofenloch, Robert F; Diepgen, Thomas L; Popielnicki, Ana; Weisshaar, Elke; Molin, Sonja; Bauer, Andrea; Mahler, Vera; Elsner, Peter; Schmitt, Jochen; Apfelbacher, Christian

2015-02-01

The Occupational Contact Dermatitis Disease Severity Index (ODDI) was designed in Australia to measure severity and functional disability in patients with occupational contact dermatitis (OCD) of the hands. The ODDI was translated into the German language with a linguistic validation process. The psychometric properties of the German version of the ODDI are still unclear. To report the linguistic validation procedure and to perform a psychometric validation by investigating the validity and reliability of the German ODDI version in a sample of patients with OCD. Data were drawn from the baseline assessment (T0) and first follow-up (T1) of the German chronic hand eczema (CHE) registry (CARPE). Spearman correlations of the ODDI with reference measures were computed to assess validity. Cronbach's alpha was calculated as a measure of internal consistency, and the intraclass correlation coefficient (ICC) was calculated to assess retest reliability. The smallest real difference (SRD) and minimal clinically important difference (MCID) were calculated to assess sensitivity to change. Physician Global Assessment (PGA) was used as an anchor for the MCID. Four hundred and twenty-two patients (54.5% female, mean age 45.1 years) were included for analysis. Cronbach's alpha was found to be 0.73. The ICC was 0.79. Correlations between the ODDI total and the Dermatology Life Quality Index (rho = 0.36), and between PGA (rho = 0.48) and patient-assessed disease severity (rho = 0.40), were of moderate strength. The MCID (1.29) was found to be smaller than the SRD (1.87). The German ODDI version is reliable and valid for the measurement of functional impairment and disease severity in patients suffering from OCD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational IgE-mediated asthma, rhinoconjunctivitis, and contact urticaria caused by Easter lily (Lilium longiflorum) and tulip.

PubMed

Piirilä, P; Kanerva, L; Alanko, K; Estlander, T; Keskinen, H; Pajari-Backas, M; Tuppurainen, M

1999-03-01

We report on IgE-mediated asthma, rhinoconjunctivitis, and contact urticaria to two Liliaceae plants, tulip and Easter lily (Lilium longiflorum), diagnosed in a floral shop worker. Occupational asthma was diagnosed according to patient history, PEF monitoring, and a work-simulating provocation test. Flower-specific IgE was studied, and RAST inhibition tests were performed. Skin prick testing showed positive reactions to tulip, Easter lily, and chrysanthemum. Total IgE was 180 kU/I, and specific IgE to tulip was 2.6 and to Easter lily 6.5 kU/I. In the RAST-inhibition test, no cross-reactivity was found. Occupational asthma was diagnosed by peak flow monitoring at work and at home, as well as specific inhalation challenge with Easter lily, with an immediate 18% reduction in PEF. In addition, contact urticaria and conjunctivitis were diagnosed. After a 9-year follow-up without exposure to lilies, the skin prick tests to L. longiflorum and tulip were still positive, but the specific IgE had disappeared. A case of IgE-mediated occupational asthma, rhinoconjunctivitis, and contact urticaria caused by L. longiflorum and tulip is presented. RAST inhibition tests indicated concomitant sensitization to the two Liliaceae plants.

Contact Dermatitis in Pediatrics.

PubMed

Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E

2016-08-01

Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. Copyright 2016, SLACK Incorporated.

Additive impairment of the barrier function and irritation by biogenic amines and sodium lauryl sulphate: a controlled in vivo tandem irritation study.

PubMed

Fluhr, J W; Kelterer, D; Fuchs, S; Kaatz, M; Grieshaber, R; Kleesz, P; Elsner, P

2005-01-01

Biogenic amines are potential irritants e.g. in fish-, meat-, milk- and egg-processing professions like cooks, butchers and bakers. The aim of this study was to test the irritative and barrier-disrupting properties of the biogenic amines ammonium hydroxide (AM), dimethylamine (DMA) and trimethylamine (TMA). A repeated sequential irritation of 30 min twice per day was performed over a total of 4 days (tandem repeated irritation test) on the back of 20 healthy volunteers of both sexes with AM, DMA, TMA and sodium lauryl sulphate (SLS). The epidermal barrier function was assessed with a Tewameter TM 210, stratum corneum surface pH was measured with a Skin-pH-Meter 900, inflammation was assessed with a Chromameter CR-300 on the a* axis for redness and a visual score was recorded. All tested biogenic amines (AM, DMA and TMA) induced a barrier disruption and a pH increase paralleled with a 1-day-delayed onset of inflammatory signs. These effects were further enhanced and accelerated by a sequential application of SLS together with the biogenic amines, and inflammation occurred earlier than with the single compounds. Acetic acid (AA) in contrast did only show mild barrier disruption and no significant inflammatory signs. Our system allowed a ranking of the different compounds in their irritative potential in the tandem irritation with SLS: SLS > NaOH > TMA > AA > AM > DMA. The results are suggestive that in the food-processing industry the simultaneous contact with biogenic amines and harmful detergents like SLS should be minimized. Copyright 2005 S. Karger AG, Basel.

Identification of contact and respiratory sensitizers according to IL-4 receptor α expression and IL-2 production

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goutet, Michèle, E-mail: michele.goutet@inrs.fr; Pépin, Elsa; Langonné, Isabelle

2012-04-15

Identification of allergenic chemicals is an important occupational safety issue. While several methods exist to identify contact sensitizers, there is currently no validated model to predict the potential of chemicals to act as respiratory sensitizers. Previously, we reported that cytometry analysis of the local immune responses induced in mice dermally exposed to the respiratory sensitizer trimellitic anhydride (TMA 10%) and contact sensitizer dinitrochlorobenzene (DNCB 1%) could identify divergent expression of several immune parameters. The present study confirms, first, that IgE-positive B cells, MHC class II molecules, interleukin (IL)-2, IL-4 and IL-4Rα can differentiate the allergic reactions caused by high dosesmore » of strong respiratory (TMA, phthalic anhydride and toluene diisocyanate) and contact sensitizers (DNCB, dinitrofluorobenzene and oxazolone). The second part of the study was designed to test the robustness of these markers when classing the weakly immunogenic chemicals most often encountered. Six respiratory allergens, including TMA (2.5%), five contact allergens, including DNCB (0.25%), and two irritants were compared at doses of equivalent immunogenicity. The results indicated that IL-4Rα and IL-2 can be reliably used to discriminate sensitizers. Respiratory sensitizers induced markedly higher IL-4Rα levels than contact allergens, while irritants had no effect on this parameter. Inversely, contact allergens tended to induce higher percentages of IL-2{sup +}CD8{sup +} cells than respiratory allergens. In contrast, the markers MHC-II, IgE and IL-4 were not able to classify chemicals with low immunogenic potential. In conclusion, IL-4Rα and IL-2 have the potential to be used in classifying a variety of chemical allergens. -- Highlights: ► Identification of chemical allergens is an important occupational safety issue. ► There is currently no model to predict the potential of chemicals to induce asthma. ► We analyze immune responses

Shigellosis due to occupational contact with non-human primates.

PubMed Central

Kennedy, F. M.; Astbury, J.; Needham, J. R.; Cheasty, T.

1993-01-01

A small cluster of dysenteric illness, due to Shigella flexneri, was identified among technical assistants of a primate research unit. All of the affected individuals had been in regular contact with a colony of cynomolgus macaque monkeys, one of which was known to have suffered from acute haemorrhagic colitis in the preceding few weeks. Four monkeys were found to be excreting S. flexneri bacilli of identical antigen type (1b) to that isolated from the human cases. Investigation of working practices revealed the potential for inadvertent faeco-oral spread and the need to improve existing control methods. We conclude that this small outbreak of shigellosis represents a primate-associated occupational zoonosis. The risk may not be fully appreciated by handlers or their doctors. PMID:8472767

Scapular instability associated with brachial plexus irritation: a proposed causative relationship with treatment implications.

PubMed

Langley, P

1997-01-01

Brachial plexus irritation and other compression neuropathies can be diverse in their presentations and can cause a myriad of signs and symptoms. The purpose of this paper is to review the pertinent anatomy, kinesiology, and neurophysiology and to outline one possible cascade of events that may contribute to more diffuse upper extremity symptoms. Scapular instability and local myofascial trigger points resulting in possible secondary muscle imbalances are described. Their possible relationship to brachial plexus irritation in addition to the implications of the irritation are also discussed. The author postulates that proximal nerve irritation in the region of the thoracic outlet and shoulder may help to account for diffuse or unrelieved symptoms following conventional treatment of distal extremity problems in patients with occupational or cumulative trauma disorders. This paper outlines specific examination procedures for the therapist, which include upper limb tension testing, extensibility testing of the pectoralis minor, and gross manual muscle testing of the lower trapezius.

Follicular contact dermatitis revisited: A review emphasizing neomycin-associated follicular contact dermatitis

PubMed Central

Cohen, Philip R

2014-01-01

Follicular contact dermatitis clinically presents as individual papules that include a central hair follicle. Pathologic features involve the follicle and the surrounding dermis: spongiosis and vesicle formation of the follicular epithelium associated with perifollicular and perivascular lymphocytic inflammation. Using the PubMed database, an extensive literature search was performed on follicular contact dermatitis and neomycin. Relevant papers were reviewed and the clinical and pathologic features, the associated chemicals (including a more detailed description of neomycin), the hypothesized pathogenesis, and the management of follicular contact dermatitis were described. Several agents-either as allergens or irritants-have been reported to elicit follicular contact dermatitis. Several hypotheses have been suggested for the selective involvement of the follicles in follicular contact dermatitis: patient allergenicity, characteristics of the agent, vehicle containing the agent, application of the agent, and external factors. The differential diagnosis of follicular contact dermatitis includes not only recurrent infundibulofolliculitis, but also drug eruption, mite infestation, viral infection, and dermatoses that affect hair follicles. The primary therapeutic intervention for follicular contact dermatitis is withdrawal of the causative agent; treatment with a topical corticosteroid preparation may also promote resolution of the dermatitis. In conclusion, follicular contact dermatitis may be secondary to allergens or irritants; topical antibiotics, including neomycin, may cause this condition. Several factors may account for the selective involvement of the hair follicle in this condition. Treatment of the dermatitis requires withdrawal of the associated topical agent; in addition, topical corticosteroids may be helpful to promote resolution of lesions. PMID:25516854

Contact dermatitis and patch testing for the allergist.

PubMed

Fonacier, Luz; Noor, Irum

2018-06-01

To review of contact dermatitis (CD) and its key allergens and provide updates and recommendations for the practicing allergist. Through the use of various scientific search engines (eg, PubMed and MEDLINE), we reviewed literature on CD, patch tests (PTs), key allergens, occupational dermatitis, and treatment. Studies on CD, important allergens, and PTs were considered. Contact-induced dermatitis may be due to allergic CD, irritant CD, systemic CD, contact urticaria, and protein CD. Key allergens include metals (nickel, gold), topical medicaments (topical corticosteroids), and cosmetics and personal care products (fragrances and preservatives such as methyl- and methylchloro-isothiazolinone). Present relevance of a positive PT result is the combination of definite, probable, and possible relevance and should be correlated with the patient's history and physical examination. Treatment of allergic CD includes identification of relevant allergens, patient education, avoidance, and provision of alternative products the patient can use. CD is a common inflammatory skin disease and should be suspected in patients presenting with acute, subacute, or chronic dermatitis. The gold standard for diagnosing allergic CD is a PT. This article provides practical recommendations for the diagnosis and management of CD commonly seen by the allergist in their practice. Copyright © 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

CON4EI: Slug Mucosal Irritation (SMI) test method for hazard identification and labelling of serious eye damaging and eye irritating chemicals.

PubMed

Adriaens, E; Guest, R; Willoughby, J A; Fochtman, P; Kandarova, H; Verstraelen, S; Van Rompay, A R

2018-06-01

Assessment of ocular irritancy is an international regulatory requirement in the safety evaluation of industrial and consumer products. Although many in vitro ocular irritation assays exist, alone they are incapable of fully categorizing chemicals. The objective of CEFIC-LRI-AIMT6-VITO CON4EI (CONsortium for in vitro Eye Irritation testing strategy) project was to develop tiered testing strategies for eye irritation assessment that can lead to complete replacement of the in vivo Draize rabbit eye test (OECD TG 405). A set of 80 reference chemicals was tested with seven test methods, one method was the Slug Mucosal Irritation (SMI) test method. The method measures the amount of mucus produced (MP) during a single 1-hour contact with a 1% and 10% dilution of the chemical. Based on the total MP, a classification (Cat 1, Cat 2, or No Cat) is predicted. The SMI test method correctly identified 65.8% of the Cat 1 chemicals with a specificity of 90.5% (low over-prediction rate for in vivo Cat 2 and No Cat chemicals). Mispredictions were predominantly unidirectional towards lower classifications with 26.7% of the liquids and 40% of the solids being underpredicted. In general, the performance was better for liquids than for solids with respectively 76.5% vs 57.1% (Cat 1), 61.5% vs 50% (Cat 2), and 87.5% vs 85.7% (No Cat) being identified correctly. Copyright © 2017 Elsevier Ltd. All rights reserved.

Menthol attenuates respiratory irritation responses to multiple cigarette smoke irritants

PubMed Central

Willis, Daniel N.; Liu, Boyi; Ha, Michael A.; Jordt, Sven-Eric; Morris, John B.

2011-01-01

Menthol, the cooling agent in peppermint, is added to almost all commercially available cigarettes. Menthol stimulates olfactory sensations, and interacts with transient receptor potential melastatin 8 (TRPM8) ion channels in cold-sensitive sensory neurons, and transient receptor potential ankyrin 1 (TRPA1), an irritant-sensing channel. It is highly controversial whether menthol in cigarette smoke exerts pharmacological actions affecting smoking behavior. Using plethysmography, we investigated the effects of menthol on the respiratory sensory irritation response in mice elicited by smoke irritants (acrolein, acetic acid, and cyclohexanone). Menthol, at a concentration (16 ppm) lower than in smoke of mentholated cigarettes, immediately abolished the irritation response to acrolein, an agonist of TRPA1, as did eucalyptol (460 ppm), another TRPM8 agonist. Menthol's effects were reversed by a TRPM8 antagonist, AMTB. Menthol's effects were not specific to acrolein, as menthol also attenuated irritation responses to acetic acid, and cyclohexanone, an agonist of the capsaicin receptor, TRPV1. Menthol was efficiently absorbed in the respiratory tract, reaching local concentrations sufficient for activation of sensory TRP channels. These experiments demonstrate that menthol and eucalyptol, through activation of TRPM8, act as potent counterirritants against a broad spectrum of smoke constituents. Through suppression of respiratory irritation, menthol may facilitate smoke inhalation and promote nicotine addiction and smoking-related morbidities.— Willis, D. N., Liu, B., Ha, M. A., Jordt, S.-E., Morris, J. B. Menthol attenuates respiratory irritation responses to multiple cigarette smoke irritants. PMID:21903934

Risk factors for respiratory work disability in a cohort of pulp mill workers exposed to irritant gases

PubMed Central

2011-01-01

Background The association between chronic respiratory diseases and work disability has been demonstrated a number of times over the past 20 years, but still little is known about work disability in occupational cohorts of workers exposed to respiratory irritants. This study investigated job or task changes due to respiratory problems as an indicator of work disability in pulp mill workers occupationally exposed to irritants. Methods Data about respiratory symptoms and disease diagnoses, socio-demographic variables, occupational exposures, gassing episodes, and reported work changes due to respiratory problems were collected using a questionnaire answered by 3226 pulp mill workers. Information about work history and departments was obtained from personnel files. Incidence and hazard ratios for respiratory work disability were calculated with 95% confidence intervals (CI). Results The incidence of respiratory work disability among these pulp mill workers was 1.6/1000 person-years. The hazard ratios for respiratory work disability were increased for workers reporting gassings (HR 5.3, 95% CI 2.7-10.5) and for those reporting physician-diagnosed asthma, chronic bronchitis, and chronic rhinitis, when analyzed in the same model. Conclusions This cohort study of pulp mill workers found that irritant peak exposure during gassing episodes was a strong predictor of changing work due to respiratory problems, even after adjustment for asthma, chronic bronchitis, and chronic rhinitis. PMID:21896193

Stratum corneum cytokines and skin irritation response to sodium lauryl sulfate.

PubMed

De Jongh, Cindy M; Verberk, Maarten M; Withagen, Carien E T; Jacobs, John J L; Rustemeyer, Thomas; Kezic, Sanja

2006-06-01

Little is known about cytokines involved in chronic irritant contact dermatitis. Individual cytokine profiles might explain at least part of the differences in the individual response to irritation. Our objective was to investigate the relation between baseline stratum corneum (SC) cytokine levels and the skin response to a single and a repeated irritation test. This study also aimed to determine changes in SC cytokine levels after repeated irritation. Transepidermal water loss (TEWL) and erythema were measured in 20 volunteers after single 24-hr exposure to 1% sodium lauryl sulfate (SLS), and during and after repeated exposure to 0.1% SLS over a 3-week period. SC cytokine levels were measured from an unexposed skin site and from the repeatedly exposed site. Interleukin (IL)-1alpha decreased by 30% after repeated exposure, while IL-1RA increased 10-fold and IL-8 increased fourfold. Baseline IL-1RA and IL-8 values were predictors of TEWL and erythema after single exposure (r = 0.55-0.61). 6 subjects showed barrier recovery during repeated exposure. Baseline IL-1RA and IL-8 levels are likely to be indicators of higher skin irritability after single exposure to SLS. Barrier repair in some of the subjects might explain the lack of agreement between the TEWL response after single and repeated irritation.

Multicenter study of preservative sensitivity in patients with suspected cosmetic contact dermatitis in Korea.

PubMed

Lee, Sang S; Hong, Dong K; Jeong, Nam J; Lee, Jeung H; Choi, Yun-Seok; Lee, Ai-Young; Lee, Cheol-Heon; Kim, Kea J; Park, Hae Y; Yang, Jun-Mo; Lee, Ga-Young; Lee, Joon; Eun, Hee C; Moon, Kee-Chan; Seo, Seong J; Hong, Chang K; Lee, Sang W; Choi, Hae Y; Lee, Jun Y

2012-08-01

As many new cosmetic products are introduced into the market, attention must be given to contact dermatitis, which is commonly caused by cosmetics. We investigate the prevalence of preservative allergy in 584 patients with suspected cosmetic contact dermatitis at 11 different hospitals. From January 2010 to March 2011, 584 patients at 11 hospital dermatology departments presented with cosmetic contact dermatitis symptoms. These patients were patch-tested for preservative allergens. An irritancy patch test performed on 30 control subjects using allergens of various concentrations showed high irritancy rates. Preservative hypersensitivity was detected in 41.1% of patients. Allergens with the highest positive test rates were benzalkonium chloride (12.1%), thimerosal (9.9%) and methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) (5.5%). Benzalkonium chloride and chlorphenesin had the highest irritancy rate based on an irritancy patch test performed using various concentrations. Seven of 30 normal subjects had a positive irritant patch reading with 0.1% benzalkonium chloride and eight of 30 normal subjects had a positive irritant patch reading at 4 days with 0.5% chlorphenesin in petrolatum. Although benzalkonium chloride was highly positive for skin reactions in our study, most reactions were probably irritation. MCI/MI and thimerosal showed highly positive allergy reactions in our study. The optimum concentration of chlorphenesin to avoid skin reactions is less than 0.5%. © 2012 Japanese Dermatological Association.

Noneczematous Contact Dermatitis

PubMed Central

Foti, Caterina; Vestita, Michelangelo; Angelini, Gianni

2013-01-01

Irritant or allergic contact dermatitis usually presents as an eczematous process, clinically characterized by erythematoedematovesicous lesions with intense itching in the acute phase. Such manifestations become erythematous-scaly as the condition progresses to the subacute phase and papular-hyperkeratotic in the chronic phase. Not infrequently, however, contact dermatitis presents with noneczematous features. The reasons underlying this clinical polymorphism lie in the different noxae and contact modalities, as well as in the individual susceptibility and the various targeted cutaneous structures. The most represented forms of non-eczematous contact dermatitis include the erythema multiforme-like, the purpuric, the lichenoid, and the pigmented kinds. These clinical entities must obviously be discerned from the corresponding “pure” dermatitis, which are not associated with contact with exogenous agents. PMID:24109520

Occupational asthma: a review.

PubMed Central

Lombardo, L J; Balmes, J R

2000-01-01

Occupational asthma is the most common form of occupational lung disease in the developed world at the present time. In this review, the epidemiology, pathogenesis/mechanisms, clinical presentations, management, and prevention of occupational asthma are discussed. The population attributable risk of asthma due to occupational exposures is considerable. Current understanding of the mechanisms by which many agents cause occupational asthma is limited, especially for low-molecular-weight sensitizers and irritants. The diagnosis of occupational asthma is generally established on the basis of a suggestive history of a temporal association between exposure and the onset of symptoms and objective evidence that these symptoms are related to airflow limitation. Early diagnosis, elimination of exposure to the responsible agent, and early use of inhaled steroids may play important roles in the prevention of long-term persistence of asthma. Persistent occupational asthma is often associated with substantial disability and consequent impacts on income and quality of life. Prevention of new cases is the best approach to reducing the burden of asthma attributable to occupational exposures. Future research needs are identified. PMID:10931788

Occupational safety considerations with hydrazine

NASA Technical Reports Server (NTRS)

Clewell, Harvey J., III; Mcdougal, James N.; George, Marilyn E.; Andersen, Melvin E.

1992-01-01

Hydrazine is a reducing agent that is most commonly used as a propellant and as an oxygen scavenger in boilers. Hydrazine is extremely irritating and has been demonstrated to produce both acute and chronic toxicity. As a result, the established permissible inhalation exposure limits are very low, and respiration protection is required whenever vapors are present. Liquid hydrazine penetrates the skin and produces a chemical burn; therefore, some protective measures must also be taken to protect the skin from liquid contact. Often, however, a cumbersome, whole-body protective suit is worn to protect against skin contact with vapor as well. To what extent it is actually necessary to protect skin from vapor penetration had not previously been demonstrated. In an attempt to answer this question, we conducted a study with rats to compare the dermal penetration of hydrazine vapor with inhalation. Pharmacokinetic modeling was used to compare body burdens resulting from these different routes of exposure. The analysis concluded that the vapor concentration during a skin-only exposure would have to be at least 200 times higher than that during inhalation to achieve the same body burden. This type of estimation illustrates the use of predictive toxicology in occupational exposures.

Occupational dermal exposure to nanoparticles and nano-enabled products: Part I-Factors affecting skin absorption.

PubMed

Larese Filon, Francesca; Bello, Dhimiter; Cherrie, John W; Sleeuwenhoek, Anne; Spaan, Suzanne; Brouwer, Derk H

2016-08-01

The paper reviews and critically assesses the evidence on the relevance of various skin uptake pathways for engineered nanoparticles, nano-objects, their agglomerates and aggregates (NOAA). It focuses especially in occupational settings, in the context of nanotoxicology, risk assessment, occupational medicine, medical/epidemiological surveillance efforts, and the development of relevant exposure assessment strategies. Skin uptake of nanoparticles is presented in the context of local and systemic health effects, especially contact dermatitis, skin barrier integrity, physico-chemical properties of NOAA, and predisposing risk factors, such as stratum corneum disruption due to occupational co-exposure to chemicals, and the presence of occupational skin diseases. Attention should be given to: (1) Metal NOAA, since the potential release of ions may induce local skin effects (e.g. irritation and contact dermatitis) and absorption of toxic or sensitizing metals; (2) NOAA with metal catalytic residue, since potential release of ions may also induce local skin effects and absorption of toxic metals; (3) rigid NOAA smaller than 45nm that can penetrate and permeate the skin; (4) non rigid or flexible NOAA, where due to their flexibility liposomes and micelles can penetrate and permeate the intact skin; (5) impaired skin condition of exposed workers. Furthermore, we outline possible situations where health surveillance could be appropriate where there is NOAA occupational skin exposures, e.g. when working with nanoparticles made of sensitizer metals, NOAA containing sensitizer impurities, and/or in occupations with a high prevalence of disrupted skin barrier integrity. The paper furthermore recommends a stepwise approach to evaluate risk related to NOAA to be applied in occupational exposure and risk assessment, and discusses implications related to health surveillance, labelling, and risk communication. Copyright © 2016 Elsevier GmbH. All rights reserved.

Impact of cultural contact on intercultural competency of occupational therapy students and international graduate students.

PubMed

Matsuda, Sandra J; Miller, Marilyn

2007-01-01

This study examined changes in cultural perceptions and communication of 47 occupational therapy students and 39 international graduate students following 5 peer teaching activities. The peer-teaching activities were designed on the premise that positive contact between people of equal status improves intercultural competency, and included social exchanges, interviews, feedback on practice teaching, and role-playing. Changes in intercultural competency were measured with pre- and post administration of the Cross Cultural Adaptability Inventory (CCAI), as well as questionnaires and journals. Significant positive change between pre- and post-test scores on the CCAI (p<.0002) was found for the 86 participants. When stratified into 3 subgroups (international students and occupational therapy students with and without international travel experience), changes were more pronounced. Occupational therapy students with international travel experience benefited the most from the peer-teaching activities (p<.002) and international graduate students benefited as well (p<.009). Occupational therapy students without international travel experienced no significant change. The findings indicate that peer teaching activities significantly impacted cross-cultural communication for students with prior international travel experience and confirm the importance of contextual learning.

Long-term repetitive sodium lauryl sulfate-induced irritation of the skin: an in vivo study.

PubMed

Branco, Nara; Lee, Ivy; Zhai, Hongbo; Maibach, Howard I

2005-11-01

Skin may adapt to topical irritants through accommodation. This study focuses on long-term exposure to irritants and attempts to demonstrate accommodation. Sodium lauryl sulfate (SLS) induced irritant contact dermatitis at 3 concentrations (0.025% to 0.075%). Distilled water, acetone and an empty chamber served as controls. Experimental compounds were applied to forearms of 7 healthy volunteers for 24 hr before replacing by a fresh chamber for 6 non-consecutive weeks over 103 days. Possible accommodation was quantified by visual scoring (erythema and dryness) and by bioengineering parameters: transepidermal water loss (TEWL), capacitance, chromametry and laser Doppler flowmetry (LDF). Significant erythema, dryness, elevated TEWL, skin colour reflectance and LDF values occurred during the exposure periods. Upon repeat exposure, an immediate and augmented response in erythema, TEWL, skin colour reflectance and LDF developed. However, irritant skin changes were not sustained. Irritation parameters return to baseline after cessation of exposure. There was no evidence of sustained irritation or accommodation after the last exposure. Study findings do not document sustained accommodation or adaptive hyposensitivity after long-term repetitive irritant exposure under these test conditions. Alternative models should be developed to prove or disprove the accommodation hypothesis.

Chapter 17: Occupational immunologic lung disease.

PubMed

Sabin, Bradley R; Grammer, Leslie C

2012-01-01

Occupational immunologic lung disease is characterized by an immunologic response in the lung to an airborne agent inhaled in the work environment and can be subdivided into immunologically mediated occupational asthma (OA) and hypersensitivity pneumonitis (HP). Irritant-induced OA, a separate nonimmunologic entity, can be caused by chronic exposure to inhaled irritants or reactive airways dysfunction syndrome, defined as an asthma-like syndrome that persists for >3 months and occurs abruptly after a single exposure to a high concentration of an irritating industrial agent. High-risk fields for OA include farmers, printers, woodworkers, painters, plastic workers, cleaners, spray painters, electrical workers, and health care workers. OA can be triggered by high molecular weight (HMW) proteins that act as complete allergens or low molecular weight (LMW) sensitizers that act as haptens. HMW proteins (>10 kDa) are generally derived from microorganisms (such as molds and bacteria, including thermophilic actinomycetes), plants (such as latex antigens and flour proteins), or animals (such as animal dander, avian proteins, and insect scales) and are not specifically regulated by the Occupational Safety and Health Administration (OSHA). LMW haptens that bind to proteins in the respiratory mucosa include some OSHA-regulated substances such as isocyanates, anhydrides, and platinum. HP can present in an acute, a chronic, or a subacute form. The acute, subacute, and early chronic form is characterized by a CD4(+) T(H)1 and CD8(+) lymphocyte alveolitis. Classically, the bronchoalveolar lavage will show a CD4/CD8 ratio of <1.

Exposure-response relationships of occupational inhalative allergens.

PubMed

Baur, X; Chen, Z; Liebers, V

1998-05-01

comprising 2646 Spanish subjects showed an asthma risk to be attributed to occupational exposures between 5 and 6.7%. Main asthma-inducing agents in the workplace are flour, grain and feed dust, animal dander/urinary proteins and isocyanates. Further, several inhalative irritants such as chlorine, acid or alkaline aerosols play a pivotal role. Many low molecular weight chemicals have irritative as well as allergenic effects on the airways, e. g. isocyanates and acid anhydrides. In addition to chronic or repetitive exposures, also singular accidental exposure to high concentrations of irritative or toxic airborne substances can cause occupational asthma. This condition is frequently called reactive airways dysfunction.

Lettuce contact allergy.

PubMed

Paulsen, Evy; Andersen, Klaus E

2016-02-01

Lettuce (Lactuca sativa L.) and its varieties are important vegetable crops worldwide. They are also well-known, rarely reported, causes of contact allergy. As lettuce allergens and extracts are not commercially available, the allergy may be underdiagnosed. The aims of this article are to present new data on lettuce contact allergy and review the literature. Lettuce is weakly allergenic, and occupational cases are mainly reported. Using aimed patch testing in Compositae-allergic patients, two recent Danish studies showed prevalence rates of positive lettuce reactions of 11% and 22%. The majority of cases are non-occupational, and may partly be caused by cross-reactivity. The sesquiterpene lactone mix seems to be a poor screening agent for lettuce contact allergy, as the prevalence of positive reactions is significantly higher in non-occupationally sensitized patients. Because of the easy degradability of lettuce allergens, it is recommended to patch test with freshly cut lettuce stem and supplement this with Compositae mix. As contact urticaria and protein contact dermatitis may present as dermatitis, it is important to perform prick-to-prick tests, and possibly scratch patch tests as well. Any person who is occupationally exposed to lettuce for longer periods, especially atopics, amateur gardeners, and persons keeping lettuce-eating pets, is potentially at risk of developing lettuce contact allergy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational contact dermatitis caused by 1,3-benzenedimethanamine, N-(2-phenylethyl) derivatives in hardeners for epoxy paints and coatings.

PubMed

Pesonen, Maria; Kuuliala, Outi; Suomela, Sari; Aalto-Korte, Kristiina

2016-12-01

Amines in epoxy hardeners are significant causes of occupational allergic contact dermatitis among workers who use epoxy resin systems. To describe a novel group of contact allergens: N-(2-phenylethyl) derivatives of the reactive amine 1,3-benzenedimethanamine (1,3-BDMA). We describe the clinical examinations and exposure of 6 patients with occupational contact allergy to derivatives of 1,3-BDMA. Of the 6 patients, 4 were spray painters who used epoxy paints, 1 was a floor layer who handled a variety of epoxy coatings, and 1 was a worker in epoxy hardener manufacture. We were able to confirm exposure to epoxy hardeners that contained derivatives of 1,3-BDMA in 5 of the 6 sensitized patients. Despite the close structural resemblance between derivatives of 1,3-BDMA and m-xylylenediamine (MXDA), only 3 patients reacted positively to MXDA. Concomitant contact allergy to diglycidyl ether of bisphenol A resin was seen in 2 of the 6 patients. Because of the lack of a commercially available patch test substance, the diagnosis of contact allergy to derivatives of 1,3-BDMA requires patch testing with either the epoxy hardener product or a hardener ingredient that contains the derivatives of 1,3-BDMA. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Current knowledge on biomarkers for contact sensitization and allergic contact dermatitis.

PubMed

Koppes, Sjors A; Engebretsen, Kristiane A; Agner, Tove; Angelova-Fischer, Irena; Berents, Teresa; Brandner, Johanna; Brans, Richard; Clausen, Maja-Lisa; Hummler, Edith; Jakasa, Ivone; Jurakić-Tončic, Ružica; John, Swen M; Khnykin, Denis; Molin, Sonja; Holm, Jan O; Suomela, Sari; Thierse, Hermann-Josef; Kezic, Sanja; Martin, Stefan F; Thyssen, Jacob P

2017-07-01

Contact sensitization is common and affects up to 20% of the general population. The clinical manifestation of contact sensitization is allergic contact dermatitis. This is a clinical expression that is sometimes difficult to distinguish from other types of dermatitis, for example irritant and atopic dermatitis. Several studies have examined the pathogenesis and severity of allergic contact dermatitis by measuring the absence or presence of various biomarkers. In this review, we provide a non-systematic overview of biomarkers that have been studied in allergic contact dermatitis. These include genetic variations and mutations, inflammatory mediators, alarmins, proteases, immunoproteomics, lipids, natural moisturizing factors, tight junctions, and antimicrobial peptides. We conclude that, despite the enormous amount of data, convincing specific biomarkers for allergic contact dermatitis are yet to be described. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Wild bearded capuchins process cashew nuts without contacting caustic compounds.

PubMed

Sirianni, Giulia; Visalberghi, Elisabetta

2013-04-01

Complex and flexible food processing was a key element for the evolutionary success of hominins, enlarging the range of exploitable foods while enabling occupation of new habitats. Only a few primate species crack open encased food by using percussive tools and/or avoid physical contact with irritant compounds by removing the structures containing them. We describe, for the first time, how a population of bearded capuchin monkeys (Sapajus libidinosus) accesses the nutritious kernel of cashew nuts avoiding the caustic chemicals protecting it. Two processing strategies, namely rubbing/piercing and stone tool use, are used according to maturity of the nuts. The frequency of cashew nuts processing increases with capuchin age, and the same set of processing strategies appears to be absent in other capuchin populations, making cashew nuts processing an excellent candidate for social transmission. © 2013 Wiley Periodicals, Inc.

Contact dermatitis and other skin conditions in instrumental musicians.

PubMed

Gambichler, Thilo; Boms, Stefanie; Freitag, Marcus

2004-04-16

The skin is important in the positioning and playing of a musical instrument. During practicing and performing there is a permanent more or less intense contact between the instrument and the musician's skin. Apart from aggravation of predisposed skin diseases (e.g., atopic eczema or psoriasis) due to music-making, specific dermatologic conditions may develop that are directly caused by playing a musical instrument. To perform a systematic review on instrument-related skin diseases in musicians we searched the PubMed database without time limits. Furthermore we studied the online bibliography "Occupational diseases of performing artist. A performing arts medicine bibliography. October, 2003" and checked references of all selected articles for relevant papers. The most prevalent skin disorders of instrumental musicians, in particular string instrumentalists (e.g., violinists, cellists, guitarists), woodwind players (e.g., flautists, clarinetists), and brass instrumentalists (e.g., trumpeters), include a variety of allergic contact sensitizations (e.g., colophony, nickel, and exotic woods) and irritant (physical-chemical noxae) skin conditions whose clinical presentation and localization are usually specific for the instrument used (e.g., "fiddler's neck", "cellist's chest", "guitar nipple", "flautist's chin"). Apart from common callosities and "occupational marks" (e.g., "Garrod's pads") more or less severe skin injuries may occur in musical instrumentalists, in particular acute and chronic wounds including their complications. Skin infections such as herpes labialis seem to be a more common skin problem in woodwind and brass instrumentalists. Skin conditions may be a significant problem not only in professional instrumentalists, but also in musicians of all ages and ability. Although not life threatening they may lead to impaired performance and occupational hazard. Unfortunately, epidemiological investigations have exclusively been performed on orchestra musicians

The developmental psychopathology of irritability

PubMed Central

LEIBENLUFT, ELLEN; STODDARD, JOEL

2015-01-01

Chronic, severe irritability is common in childhood and is very impairing. Furthermore, childhood irritability predicts suicidality, social impairment, and depressive and anxiety disorders in adulthood. Focusing on both normative and pathologic development, we review the construct of irritability from its origins in aggression and disruptive behavior research to its contemporary relevance for affective psychopathology. We then describe two broad neurocognitive systems that show promise in differentiating irritable from nonirritable youths: aberrant processing of emotional stimuli and impaired context-sensitive regulation. We suggest behavioral, neurocognitive, and physiologic measures that may aid in studying severe irritability and assessing its therapeutics. Finally, we argue for therapeutic trials targeting severe irritability that address emotional aspects of irritability in addition to the associated disruptive behavior. PMID:24342851

Work-related asthma: diagnosis and prognosis of immunological occupational asthma and work-exacerbated asthma.

PubMed

Muñoz, X; Cruz, M J; Bustamante, V; Lopez-Campos, J L; Barreiro, E

2014-01-01

The incidence and prevalence of asthma are increasing. One reason for this trend is the rise in adult-onset asthma, especially occupational asthma, which is 1 of the 2 forms of work-related asthma. Occupational asthma is defined as asthma caused by agents that are present exclusively in the workplace. The presence of pre-existing asthma does not rule out the possibility of developing occupational asthma. A distinction has traditionally been made between immunological occupational asthma (whether IgE-mediated or not) and nonimmunological occupational asthma caused by irritants, the most characteristic example of which is reactive airway dysfunction syndrome. The other form of work-related asthma is known as work-exacerbated asthma, which affects persons with pre-existing or concurrent asthma that is worsened by work-related factors. It is important to differentiate between the 2 entities because their treatment, prognosis, and medical and social repercussions can differ widely. In this review, we discuss diagnostic methods, treatment, and avoidance/nonavoidance of the antigen in immunological occupational asthma and work-exacerbated asthma. Key words: Specific inhalation challenge. Peak expiratory flow. Workplace. Irritants.

Paternal occupational contact level and childhood leukaemia in rural Scotland: a case-control study.

PubMed

Kinlen, L J; Bramald, S

2001-04-06

In a national Scottish study of 809 cases of leukaemia and non-Hodgkins lymphoma diagnosed in 1950-89 among children aged 0-4 years who were born in Scotland, together with 2363 matched population controls, we investigated one aspect of the infective hypothesis. This concerns whether in rural areas (where the prevalence of susceptible individuals is likely to be higher) the risk is greater among the young children of men whose work involves contacts with many different people, particularly children, as noted in certain childhood infections. A positive trend was found in rural areas across 3 levels of increasing paternal occupational contact (as recorded at birth) by each of 2 previously defined classifications; no such effect was found in urban areas. The rural trend was more marked in that part of the study period with greater population mixing, but the difference from the period with less mixing was not itself significant, leaving open whether these rural findings reflect the extreme isolation of much of rural Scotland, or the effects in such areas of a degree of population mixing. In marked contrast, among the 850 cases and 2492 controls aged 5-14, those in rural areas in the higher population mixing period showed a significantly decreasing trend with increasing paternal occupational contact level. This would be consistent with immunity produced either by earlier infection at ages 0-4 years, or directly by low doses of the infective agent that were largely immunizing at these older ages. The findings overall provide further support for infection underlying childhood leukaemia and for the role of adults. Copyright 2001 Cancer Research Campaign http://www.bjcancer.com.

Two cases of occupational allergic contact dermatitis from a cycloaliphatic epoxy resin in a neat oil: Case Report

PubMed Central

Jensen, Charlotte D; Andersen, Klaus E

2003-01-01

Background Metal-working fluids contain complex mixtures of chemicals and metal workers constitute a potential risk group for the development of allergic contact dermatitis. Case presentation Two metal workers developed allergic contact dermatitis on the hands and lower arms from exposure to a neat oil used in metal processing. Patch testing revealed that the relevant contact allergen was a cycloaliphatic epoxy resin, 1,2-cyclohexanedicarboxylic acid, bis(oxiranylmethyl) ester, added to the oil as a stabilizer. None of the patients had positive reactions to the bisphenol A-based epoxy resin in the standard series. Conclusions These cases emphasize that well-known contact allergens may show up from unexpected sources of exposure. Further, it can be a long-lasting, laborious process to detect an occupational contact allergen and cooperation from the patient and the manufacturer of the sensitizing product is essential. PMID:12685935

The effects of two different types of bandage contact lenses on the healthy canine eye.

PubMed

Braus, Barbara Katharina; Riedler, Daniela; Tichy, Alexander; Spergser, Joachim; Schwendenwein, Ilse

2018-02-06

To compare two types of bandage contact lenses on the healthy canine eye. Six healthy Beagles. Two different types of bandage contact lenses (single sized human silicone contact lens 'PureVision 2' (Bausch & Lomb Incorporated, Rochester, NY, USA) and specially designed veterinary hydrogel contact lens 'AcriVet Pat D' (Bausch & Lomb Incorporated) were placed in 12 eyes of healthy Beagle dogs. Retention times and the effects of the lenses regarding irritation of the eye, changes in tear production, impact of contact lenses on tonometric readings, and cytologic and microbiological alterations of the canine eye were investigated. Mean retention times for veterinary hydrogel lenses with special dimensions were significantly shorter (2 days) than for one size human silicon lenses (8.8 days). Irritation scores were overall low for both types of lenses apart from one human lens causing severe irritation and keratoconjunctivitis as a sequel to folding and displacement. Tear production remained stable in human contact lenses. Intraocular pressure readings with a contact lens in place were only slightly altered; the most accurate readings were obtained through a human lens with an applanation tonometer. Cytology revealed a slight, nonsignificant increase in neutrophilic granulocytes with both types of lenses; the microflora did not change significantly. Human silicone lenses have significantly longer retention times and are less expensive than veterinary hydrogel lenses. In regard to irritation, bacterial growth and inflammation, both types of lenses can be recommended for use in canine eyes. © 2018 American College of Veterinary Ophthalmologists.

Burnout Among Chinese Adult Reconstructive Surgeons: Incidence, Risk Factors, and Relationship With Intraoperative Irritability.

PubMed

Zheng, Hanlong; Shao, Hongyi; Zhou, Yixin

2018-04-01

Burnout is a major concern in human service occupations, mainly characterizing in emotional exhaustion and depersonalization. There is very limited research dealing with burnout in orthopedic surgeons. Exploring burnout prevalence, risk factors, and intraoperative irritability-related incidences is necessary to improve the quality of life for surgeons. The study population consisted of 202 registered adult reconstructive doctors in China. Burnout was measured using a normalized translated version of the Maslach Burnout Inventory-Human Service Survey. Demographics, professional characteristics, and intraoperative irritability-related questions were also collected by electronic questionnaires. Statistical analysis was performed using SPSS 22.0. The overall rate of burnout was 85.1%. Variables significantly associated with high emotional exhaustion scores included poor sleeping time per day (P = .008), more nights on call per week (P = .048), and absence of research (P = .014). For depersonalization, absence of marriage (P < .001) and more nights on call per week (P < .001) were selected as risk factors. The incidence of losing temper in operation is 58.9%, significantly higher in senior surgeons (P = .001). Three major reasons for irritation during operations included delays by companies providing operative devices, poor coordination of assistants, and slow movements of instrument nurses. Intraoperative irritability was found to be significantly correlated with burnout, especially in emotional exhaustion. Residents were the population having the least opportunities to lose temper in operation. Burnout is highly prevalent in Chinese adult reconstructive surgeons, and it had some correlations with irritability. Further research is needed to determine more risk factors and reduce intraoperative irritability-related incidences. Copyright © 2017 Elsevier Inc. All rights reserved.

Are You at Risk for Contact Dermatitis? | Poster

Cancer.gov

You probably don’t give much thought to hand health. Until something goes wrong, almost everyone takes for granted that these crucial appendages will continue working as they always have. But hand health is an important consideration, especially at work. According to the Centers for Disease Control and Prevention (CDC), allergic contact dermatitis and irritant contact

The MOAHLFA index of irritant sodium lauryl sulfate reactions: first results of a multicentre study on routine sodium lauryl sulfate patch testing.

PubMed

Uter, Wolfgang; Geier, Johannes; Becker, Detlef; Brasch, Jochen; Löffler, Harald

2004-01-01

In a multicentre study of the German Contact Dermatitis Research Group, sodium lauryl sulfate (SLS) 0.25% and 0.5% aq. has been added to routine allergen patch tests to assess its properties as a convenient diagnostic indicator of individual susceptibility to irritation at the time of patch testing. Previous studies indicated that irritant SLS reactivity may be related to individual factors such as age and sex. As these factors are, in turn, among the important predictors of contact allergy to many allergens, e.g. summarized in the 'MOAHLFA index', the impact of the MOAHLFA factors on irritant SLS patch test reactivity, and thus a potential for confounding, was assessed in the 5971 participating patients. As a result of 2 logistic regression analyses with an irritant reaction to 0.25% and 0.5% SLS, respectively, as outcome, male sex was identified as a relatively weak but significant risk factor (OR 1.38), while age 40 years or older was an even weaker risk factor (OR 1.22 and 1.15, respectively). Upon detailed analysis, no clear age gradient could, however, be identified. 1-day exposure time almost halved the odds of an irritant SLS reaction. In conclusion, this type of SLS patch test can be regarded as robust, indicating individual irritability relatively independent from the individual factors analysed here.

Contact lens complications.

PubMed

Suchecki, Jeanine K; Donshik, Peter; Ehlers, William H

2003-09-01

Complications associated with contact lenses range from mild to severe and occur with all lens modalities. Contact lens wear can cause a change in corneal physiology, which can lead to epithelial, stromal, and endothelial compromise. Other complications include lens deposition, allergic conjunctivitis, giant papillary conjunctivitis, peripheral infiltrates, microbial keratitis, and neovascularization. Pre-existing conditions can contribute to these complications, or they can occur in association with contact lens wear and care regimens. Patient-related factors, such as alteration of the recommended wearing or replacement schedules and noncompliance with recommended contact lens care regimens for economic reasons, convenience, or in error, contribute to contact lens-related complications and have led to difficulty in accurate determination of complication rates among the various lens wear modalities. Complications may require discontinuation of contact lenses, topical therapy, and changes in contact lens wearing schedules, materials, and care solutions. On initial lens fitting and follow-up evaluations, practitioners should review contact lens replacement and cleaning regimens with patients and discuss complications. To avoid serious complications, patients should be reminded to remove their contact lenses as soon as ocular irritation occurs, and to call their eye care practitioner immediately if symptoms persist.

Contact sensitizing potential of pyrogallol and 5-amino-o-cresol in female BALB/c Mice

PubMed Central

Guo, T.L.; Germolec, D.R.; Zhang, Ling X.; Auttachoat, W.; Smith, M.J.; White, K.L.

2013-01-01

Hair dye components such as pyrogallol and cresol have been shown previously to promote allergic reactions such as rashes, dermal inflammation, irritation and dermatitis. The objective of this study was to determine the contact sensitization potential of pyrogallol (PYR) and 5-amino-o-cresol (AOC) when applied dermally to female BALB/c mice. Measurement of the contact hypersensitivity response was initially accomplished using the local lymph node assay. For PYR, significant increases in the proliferation of lymph node cells were observed at concentrations of 0.5% (w/v) and higher. For AOC, borderline increases, albeit significant, in auricular lymph node cell proliferation were observed at 5% and 10%. Results from the irritancy assay suggested that PYR, but not AOC, was an irritant. To further delineate whether PYR was primarily an irritant or a contact sensitizer, the mouse ear swelling test (MEST) was conducted. A significant increase in mouse ear thickness was observed at 72 hr following challenge with 0.5% PYR in mice that had been sensitized with 5% PYR. In contrast, no effects were observed in the MEST in mice sensitized and challenged with the highest achievable concentration of AOC (10%). Additional studies examining lymph node subpopulations and CD86 (B7.2) expression by B cells further support the indication that PYR was a sensitizer in BALB/c mice. The results demonstrate that PYR is both a sensitizer and an irritant in female BALB/c mice. However, the contact sensitization potential of AOC is minimal in this strain of mouse. PMID:24172597

Allergic contact dermatitis due to urethane acrylate in ultraviolet cured inks.

PubMed Central

Nethercott, J R; Jakubovic, H R; Pilger, C; Smith, J W

1983-01-01

Seven workers exposed to ultraviolet printing inks developed contact dermatitis. Six cases were allergic and one irritant. A urethane acrylate resin accounted for five cases of sensitisation, one of which was also sensitive to pentaerythritol triacrylate and another also to an epoxy acrylate resin. One instance of allergy to trimethylpropane triacrylate accounted for the sixth case of contact dermatitis in this group of workers. An irritant reaction is presumed to account for the dermatitis in the individual not proved to have cutaneous allergy by patch tests. In this instance trimethylpropane triacrylate was thought to be the most likely irritating agent. Laboratory investigation proved urethane acrylate to be an allergen. The results of investigations of the sensitisation potentials of urethane acrylate, methylmethacrylate, epoxy acrylate resins, toluene-2,4-diisocyanate, and other multifunctional acrylic monomers in the albino guinea pig are presented. The interpretation of such predictive tests is discussed. Images PMID:6223656

[Contact allergy to dexpanthenol (author's transl)].

PubMed

Ippen, H

1981-01-01

During the testing for skin irritation of a sun protective and baby care lotion in epicutaneous tests over 24 hours, an eczematous test reaction appeared on a 30 year old physiotherapist. Testing of the single ingredients of both lotions showed the presence of contact allergy to Dexpanthenol.

Contact dermatitis and other skin conditions in instrumental musicians

PubMed Central

Gambichler, Thilo; Boms, Stefanie; Freitag, Marcus

2004-01-01

Background The skin is important in the positioning and playing of a musical instrument. During practicing and performing there is a permanent more or less intense contact between the instrument and the musician's skin. Apart from aggravation of predisposed skin diseases (e.g., atopic eczema or psoriasis) due to music-making, specific dermatologic conditions may develop that are directly caused by playing a musical instrument. Methods To perform a systematic review on instrument-related skin diseases in musicians we searched the PubMed database without time limits. Furthermore we studied the online bibliography "Occupational diseases of performing artist. A performing arts medicine bibliography. October, 2003" and checked references of all selected articles for relevant papers. Results The most prevalent skin disorders of instrumental musicians, in particular string instrumentalists (e.g., violinists, cellists, guitarists), woodwind players (e.g., flautists, clarinetists), and brass instrumentalists (e.g., trumpeters), include a variety of allergic contact sensitizations (e.g., colophony, nickel, and exotic woods) and irritant (physical-chemical noxae) skin conditions whose clinical presentation and localization are usually specific for the instrument used (e.g., "fiddler's neck", "cellist's chest", "guitar nipple", "flautist's chin"). Apart from common callosities and "occupational marks" (e.g., "Garrod's pads") more or less severe skin injuries may occur in musical instrumentalists, in particular acute and chronic wounds including their complications. Skin infections such as herpes labialis seem to be a more common skin problem in woodwind and brass instrumentalists. Conclusions Skin conditions may be a significant problem not only in professional instrumentalists, but also in musicians of all ages and ability. Although not life threatening they may lead to impaired performance and occupational hazard. Unfortunately, epidemiological investigations have

Repellent, irritant and toxic effects of 20 plant extracts on adults of the malaria vector Anopheles gambiae mosquito.

PubMed

Deletre, Emilie; Martin, Thibaud; Campagne, Pascal; Bourguet, Denis; Cadin, Andy; Menut, Chantal; Bonafos, Romain; Chandre, Fabrice

2013-01-01

Pyrethroid insecticides induce an excito-repellent effect that reduces contact between humans and mosquitoes. Insecticide use is expected to lower the risk of pathogen transmission, particularly when impregnated on long-lasting treated bednets. When applied at low doses, pyrethroids have a toxic effect, however the development of pyrethroid resistance in several mosquito species may jeopardize these beneficial effects. The need to find additional compounds, either to kill disease-carrying mosquitoes or to prevent mosquito contact with humans, therefore arises. In laboratory conditions, the effects (i.e., repellent, irritant and toxic) of 20 plant extracts, mainly essential oils, were assessed on adults of Anopheles gambiae, a primary vector of malaria. Their effects were compared to those of DEET and permethrin, used as positive controls. Most plant extracts had irritant, repellent and/or toxic effects on An. gambiae adults. The most promising extracts, i.e. those combining the three types of effects, were from Cymbopogon winterianus, Cinnamomum zeylanicum and Thymus vulgaris. The irritant, repellent and toxic effects occurred apparently independently of each other, and the behavioural response of adult An. gambiae was significantly influenced by the concentration of the plant extracts. Mechanisms underlying repellency might, therefore, differ from those underlying irritancy and toxicity. The utility of the efficient plant extracts for vector control as an alternative to pyrethroids may thus be envisaged.

Repellent, Irritant and Toxic Effects of 20 Plant Extracts on Adults of the Malaria Vector Anopheles gambiae Mosquito

PubMed Central

Deletre, Emilie; Martin, Thibaud; Campagne, Pascal; Bourguet, Denis; Cadin, Andy; Menut, Chantal; Bonafos, Romain; Chandre, Fabrice

2013-01-01

Pyrethroid insecticides induce an excito-repellent effect that reduces contact between humans and mosquitoes. Insecticide use is expected to lower the risk of pathogen transmission, particularly when impregnated on long-lasting treated bednets. When applied at low doses, pyrethroids have a toxic effect, however the development of pyrethroid resistance in several mosquito species may jeopardize these beneficial effects. The need to find additional compounds, either to kill disease-carrying mosquitoes or to prevent mosquito contact with humans, therefore arises. In laboratory conditions, the effects (i.e., repellent, irritant and toxic) of 20 plant extracts, mainly essential oils, were assessed on adults of Anopheles gambiae, a primary vector of malaria. Their effects were compared to those of DEET and permethrin, used as positive controls. Most plant extracts had irritant, repellent and/or toxic effects on An. gambiae adults. The most promising extracts, i.e. those combining the three types of effects, were from Cymbopogon winterianus, Cinnamomum zeylanicum and Thymus vulgaris. The irritant, repellent and toxic effects occurred apparently independently of each other, and the behavioural response of adult An. gambiae was significantly influenced by the concentration of the plant extracts. Mechanisms underlying repellency might, therefore, differ from those underlying irritancy and toxicity. The utility of the efficient plant extracts for vector control as an alternative to pyrethroids may thus be envisaged. PMID:24376515

Occupational injury among cooks and food service workers in the healthcare sector.

PubMed

Alamgir, Hasanat; Swinkels, Helena; Yu, Shicheng; Yassi, Annalee

2007-07-01

Incidence of occupational injury is anticipated to be high among cooks and food service workers (CFSWs) because of the nature of their work and the types of raw and finished materials that they handle. Incidents of occupational injury, resulting in lost time or medical care over a period of 1 year in two health regions were extracted from a standardized operational database and with person years obtained from payroll data, detailed analysis was conducted using Poisson regression modeling. Among the CFSWs the annual injury rate was 38.1 per 100 person years. The risk of contusions [RR, 95% CI 9.66 (1.04, 89.72)], burns [1.79 (1.39, 2.31)], and irritations or allergies [3.84 (2.05, 7.18)] was found to be significantly higher in acute care facilities compared to long-term care facilities. Lower risk was found among older workers for irritations or allergies. Female CFSWs, compared to their male counterparts, were respectively 8 and 20 times more likely to report irritations or allergies and contusions. In respect to outcome, almost all irritations or allergies required medical visits. For MSI incidents, about 67.4% resulted in time-loss from work. Prevention policies should be developed to reduce the hazards present in the workplace to promote safer work practices for cooks and food service workers.

Cost-of-illness of patients with contact dermatitis in Denmark.

PubMed

Saetterstrøm, Bjørn; Olsen, Jens; Johansen, Jeanne Duus

2014-09-01

Contact dermatitis is a frequent occupational and non-occupational skin disease. To investigate the effects of contact dermatitis on labour market affiliation and societal costs in terms of healthcare costs and production loss. A total of 21 441 patients patch tested either in hospital departments or at dermatological clinics in the period 2004-2009 were included in the study. The analyses were stratified by children (age 0-15 years), occupational contact dermatitis (age 16-65 years), and non-occupational dermatitis (age ≥ 16 years). Controls were selected from a 30% random sample of the population. Individual encrypted data were retrieved on healthcare utilization, socio-demographics, education, labour market affiliation and transfer payments from public registers in Denmark for cases and controls. Attributable healthcare costs for 4 years prior to patch testing (1 year for children) and the year after patch testing were €959 for children, €724 for occupational contact dermatitis, and €1794 for non-occupational dermatitis. Productivity costs for the same period were €10 722 for occupational contact dermatitis and €3074 for non-occupational contact dermatitis. The main findings of this study were that there were statistically significant attributable healthcare costs for both children and adults, and statistically significant productivity loss for adults. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Reactive airway dysfunction syndrome: more flexible application of diagnostic criteria are important for occupational accident victims].

PubMed

Testud, F; Lambert-Chhum, R

2004-06-01

Reactive airway dysfunction syndrome (RADS), or Brooks syndrome, is a complication observed after inhalation of caustic or highly irritating substances. The diagnosis is based on a group of criteria which include the absence of prior respiratory disease. Strict application of these criteria could have a prejudicial effect for certain victims. Three serious cases of RADS were observed in workers who were exposed to massive inhalation of caustic substances. The products implicated (phosphoric oxychloride, titanium tetrachloride, and trichloroacetyl chloride) hydrolyze to hydrochloric acid when they come in contact with the airway mucosa. After an initial period of acute respiratory distress, the patients encountered serious difficulties in achieving an appropriate diagnosis, and in having their sequellae recognized as resulting from an occupational accident. The problem was that these patients had a history of cured allergic asthma or smoking-related COPD. The presence of prior respiratory disorders must not exclude the diagnosis of RADS. A prior respiratory disorder cannot be used as an argument to exclude such victims from indemnities for occupational accident sequelae.

Occupational seafood allergy: a review

PubMed Central

Jeebhay, M; Robins, T; Lehrer, S; Lopata, A

2001-01-01

BACKGROUND—Recent years have seen increased levels of production and consumption of seafood, leading to more frequent reporting of allergic reactions in occupational and domestic settings. This review focuses on occupational allergy in the fishing and seafood processing industry.
REVIEW—Workers involved in either manual or automated processing of crabs, prawns, mussels, fish, and fishmeal production are commonly exposed to various constituents of seafood. Aerosolisation of seafood and cooking fluid during processing are potential occupational situations that could result in sensitisation through inhalation. There is great variability of aerosol exposure within and among various jobs with reported allergen concentrations ranging from 0.001 to 5.061(µg/m3). Occupational dermal exposure occurs as a result of unprotected handling of seafood and its byproducts. Occupational allergies have been reported in workers exposed to arthropods (crustaceans), molluscs, pisces (bony fish) and other agents derived from seafood. The prevalence of occupational asthma ranges from 7% to 36%, and for occupational protein contact dermatitis, from 3% to 11%. These health outcomes are mainly due to high molecular weight proteins in seafood causing an IgE mediated response. Cross reactivity between various species within a major seafood grouping also occurs. Limited evidence from dose-response relations indicate that development of symptoms is related to duration or intensity of exposure. The evidence for atopy as a risk factor for occupational sensitisation and asthma is supportive, whereas evidence for cigarette smoking is limited. Disruption of the intact skin barrier seems to be an important added risk factor for occupational protein contact dermatitis.
CONCLUSION—The range of allergic disease associated with occupational exposure to crab is well characterised, whereas for other seafood agents the evidence is somewhat limited. There is a need for further epidemiological

A decade of occupational accidents due to direct or indirect electrical contact in the primary, secondary and tertiary sectors in Spain (2003-2012).

PubMed

Castillo-Rosa, Juan; Suárez-Cebador, Manuel; Rubio-Romero, Juan Carlos; Aguado, Jose Antonio

2017-03-01

Occupational accidents caused by electrical contact are a major concern worldwide due to their severe consequences. The study conducted is based on an analysis of the evolution of incidence rates and dependence between variables for 14,022 electrical accidents occurring in Spain between 2003 and 2012. The results show that electrical accidents as a whole are 3.6 times more likely to have severe consequences than the rest of the accidents in the country. This proportion is even nine times greater in the case of fatal accidents. They also confirm a significant relationship between the severity of this type of accidents and the economic sector in which they occur. On the other hand, there is a positive trend in the reduction of the incidence rate, especially in relation to direct contact, although unexpectedly the rate of accidents due to indirect contact is on the rise. Thus, preventing electrical occupational accidents requires efforts to guarantee adequate training adapted to the needs of workers in the various economic sectors. Furthermore, those responsible for safety should work to implement mechanisms to monitor and control compliance with efficient protective measures against electrical contact.

Two Cases of Occupational Contact Urticaria Caused by Percutaneous Sensitization to Parvalbumin

PubMed Central

Sano, Akiyo; Yagami, Akiko; Suzuki, Kayoko; Iwata, Yohei; Kobayashi, Tsukane; Arima, Masaru; Kondo, Yasuto; Yoshikawa, Tetsushi; Matsunaga, Kayoko

2015-01-01

Background In recent years, it has been proposed that the primary mechanism for the development of food allergies is percutaneous sensitization. Since 2010, in Japan, the number of immediate-type wheat allergy due to hydrolyzed wheat protein has dramatically increased among those who have been using soap containing hydrolyzed wheat. This incidence supports the hypothesis that food allergens arise through percutaneous sensitization. Clinical Summary A 25-year-old man (case 1) and an 18-year-old girl (case 2) with atopic dermatitis visited our Department because of food allergy and hand eczema. After starting their work with fish, severe itchy eczema appeared on their hands. They subsequently started to experience oral allergic symptoms, intraoral itchiness and dyspnea after eating fish. Specific IgE antibodies were detected for many fishes, and skin prick tests showed positive reactions for a variety of fishes in both cases. Furthermore, the fluorescence intensities of specific IgE antibodies against parvalbumin from various types of fish in microarray immunoassay analysis showed positive reactions. We diagnosed them as contact urticaria caused by percutaneous sensitization to parvalbumin through job-related physical contact with fish. Conclusion The patients' histories and findings indicate the possibility of percutaneous sensitization through occupational exposure to parvalbumin, leading to food allergy. PMID:26464568

COPD and occupational exposures: a case-control study.

PubMed

Weinmann, Sheila; Vollmer, William M; Breen, Victor; Heumann, Michael; Hnizdo, Eva; Villnave, Jacqueline; Doney, Brent; Graziani, Monica; McBurnie, Mary Ann; Buist, A Sonia

2008-05-01

Evidence demonstrates that occupational exposures are causally linked with chronic obstructive pulmonary disease (COPD). This case-control study evaluated the association between occupational exposures and prevalent COPD based on lifetime occupational history. Cases (n = 388) aged 45 years and older with COPD were compared with controls (n = 356), frequency matched on age, sex, and cigarette smoking history. Odds ratios for exposure to each of eight occupational hazard categories and three composite measures of exposure were computed using logistic regression. RESULTSOccupational exposures most strongly associated with COPD were diesel exhaust, irritant gases and vapors, mineral dust, and metal dust. The composite measures describing aggregate exposure to gases, vapors, solvents, or sensitizers (GVSS) and aggregate exposure to dust, GVSS, or diesel exhaust were also associated with COPD. In the small group of never-smokers, a similar pattern was evident. These population-based findings add to the literature linking occupational exposures to COPD.

Discrimination against contact lens wearers.

PubMed

Blais, B R

1998-10-01

Employers' attitudes toward the use of contact lenses at work have become less discriminatory as lenses have improved and numerous studies have demonstrated their safety, provided that additional personal protective equipment is used when necessary. In 1994, the Occupational Safety and Health Administration published its relevant Standard (29 CFR 1910), stating that "contact lenses do not pose additional hazards to the wearer...". Accommodations required by wearers of contact lenses must comply with Title I of the Americans with Disabilities Act. However, many companies still oppose their use. The recently published policy of the American College of Occupational and Environmental Medicine and the American Academy of Ophthalmology on the use of contact lenses should lead to their wider acceptance. Elements of a corporate contact lens policy are outlined. International aspects are summarized as well.

Occupational allergic contact dermatitis to nitromethane.

PubMed

Webb, Kelli G; Fowler, Joseph F

2002-12-01

Nitromethane has wide industrial and commercial application as a polar solvent for adhesives and acrylics as well as explosive fuel. Allergic contact dermatitis to this chemical has not been described previously. The authors documented allergic contact hand dermatitis in 4 coworkers who similarly handled an adhesive solvent containing nitromethane. All 4 cases were confirmed by patch testing and resolved after allergen avoidance. Copyright 2002, Elsevier Science (USA)

Taxanes: vesicants, irritants, or just irritating?

PubMed

Barbee, Meagan S; Owonikoko, Taofeek K; Harvey, R Donald

2014-01-01

Several classes of antineoplastic agents are universally referred to as vesicants with ample supporting literature. However, the literature surrounding the taxanes is controversial. While the American Society of Clinical Oncology and Oncology Nursing Society Chemotherapy Administration Safety Standards and the Chemotherapy and Biotherapy Guidelines and Recommendations for Practice identify the risks of extravasation and the parameters surrounding the infusion of known vesicants, recommend administration sites for known agents, and recommend antidotes for particular extravasation cases, they fail to provide specific recommendations for the administration of individual taxanes, or a classification system for antineoplastic agents as vesicants, irritants, or inert compounds. There is also a lack of prescribing information regarding such recommendations. The lack of a formal classification system further complicates the accurate delineation of vesicant antineoplastic agents and subsequent appropriate intravenous administration and extravasation management. There are several factors that make the classification of taxanes as vesicants or irritants challenging. Comprehensive preclinical data describing potential mechanisms of tissue damage or vesicant-like properties are lacking. Furthermore, most case reports of taxane extravasation fail to include the parameters surrounding administration, such as the concentration of medication and duration of infusion, making it difficult to set parameters for vesicant potential. Subsequently, many practitioners default to central venous administration of taxanes without evidence that such administration minimizes the risk of extravasation or improves outcomes thereof. Here, we review briefly the data surrounding taxane extravasation and potential vesicant or irritant properties, classify the taxanes, and propose a spectrum for antineoplastic agent potential to cause tissue injury that warrants clinical intervention if extravasation

'Eczema school' to improve compliance in an occupational dermatology clinic.

PubMed

Kalimo, K; Kautiainen, H; Niskanen, T; Niemi, L

1999-12-01

From the beginning of 1990 a trained nurse has been employed at our Department of Dermatology to give information about skin care, allergen avoidance and skin protection to the patients. To find out the possible benefit obtained by this patient education, a questionnaire was sent out to 540 patients who had been diagnosed with an occupational skin disease established at the Department of Dermatology between 1985 and 1992. It is evident that direct comparison in this kind of longitudinal follow-up must be carried out with great criticism, since changes in patients' work exposure and socioeconomical situation during the follow-up time will also affect the prognosis. In this study, 424 patients returned the questionnaire, 252 who had been examined before 1990 and 172 later. According to the answers, it appeared that during the last 12 months, the majority (65%) had suffered from dermatitis, 13% from constant and 52% from periodic symptoms. However, when the diagnosis had been irritant contact dermatitis without allergens found, the prognosis was significantly better (p<0.008) among those who had received "extra education" and none had persistent dermatitis. Patients with contact allergy to metals or synthetic resins had also managed better, as compared to those who had received traditional treatment (p<0.002, p<0.003). Other factors such as personal motivation and possibilities for work reorganization were also important for the prognosis. 60% of patients were not initially aware of the decision given by the insurance companies, although 94% of their skin diseases had been accepted as occupational dermatoses. Generally, the patients were satisfied with the extra information given by the nurse.

Evaluation of the Occupational Risks from Jet Fuel (Toxicity Screening Battery)

DTIC Science & Technology

2012-09-01

1α may serve as a marker of epidermal damage or stress due to irritation in this in vitro model. As an alternative to the 3-dimensional human skin...AFRL-RH-FS-SR-2013-0003 Final Report: Evaluation of the Occupational Risks from Jet Fuel (Toxicity Screening Battery) David R. Mattie...2. REPORT TYPE Special Report 3. DATES COVERED (From - To) Oct 2010 – Dec 2011 4. TITLE AND SUBTITLE Evaluation of the Occupational Risks from

Occupation and chronic obstructive pulmonary disease (COPD).

PubMed

Cullinan, Paul

2012-01-01

There is growing interest in preventable, non-smoking causes of chronic obstructive pulmonary disease (COPD), among which are chronic exposures to respiratory irritants in the workplace. Reviews of occupational COPD in specific occupations and industries and in general populations; supplemented with other or more recently published material. There is good evidence for an increased risk of COPD from certain specific exposures (coal mine dust, silica, welding fume, textile dust, agricultural dust, cadmium fume). Less clear is the causal role of non-specific dusts or fumes/gases in general populations where the available literature is notably uncritical. Other specific exposures, such as diesel fume; interactions between specific exposures and cigarette smoking; the development of safe working limits. Occupations with large numbers of exposed employees, particularly in low-income countries.

30 CFR 50.20-6 - Criteria-MSHA Form 7000-1, Section C.

Code of Federal Regulations, 2010 CFR

2010-07-01

... as the first day of illness. (i) Code 21—Occupational Skin Diseases or Disorders. Examples: Contact dermatitis, eczema, or rash caused by primary irritants and sensitizers or poisonous plants; oil acne; chrome...

Solvent Orange 60 is a potent contact sensitizer in occupational and everyday life.

PubMed

Linauskienė, Kotryna; Zimerson, Erik; Antelmi, Annarita; Bruze, Magnus; Hagvall, Lina; Hamnerius, Nils; Hauksson, Inese; Ryberg, Kristina; Isaksson, Marléne

2018-05-30

Solvent Orange (SO) 60 is a perinone-type dye that is often used in plastic materials such as spectacle frames and has been shown to cause contact allergy. The first case of SO 60 allergic contact dermatitis caused by spectacle frames was reported in 1999, and the second in 2011. We have recently seen 10 patients, of whom 6 developed dermatitis in the retroauricular/temporal area after wearing plastic spectacles. To report the cause of the dermatitis in the 10 patients and to describe our first case with occupational SO 60 contact allergy. In this retrospective study, patch test results of 10 patients, tested with the Swedish baseline series and our specific spectacle and/or plastic series, including SO 60 1.0% pet., in 2011-2017, were analysed and compared with data published earlier. Ten patients, 2 males and 8 females, aged 43 to 71 years, reacted positively to SO 60 1.0% pet., namely, 4 pensioners, 2 nurses, 1 office worker, 1 teacher, 1 shop assistant, and 1 unemployed person. Four of the patients had an atopic history. Patch test reactions varied from + to +++; some had spread >20 cm outside the test area, and consisted of erythematous, infiltrated skin with papules. Retesting of patient no. 1 with serial dilutions of SO 60 in acetone to pinpoint his level of reactivity showed positive reactions down to 1 ppm. Three patients reacted to the extracts of their earpieces. Gas chromatography-mass spectrometry was used to confirm the presence of SO 60 in 2 earpieces. SO 60 should be included in any spectacle patch test series that may be used. If there is a strong suspicion of contact allergy to SO 60 before patch testing, lowering the test concentration from 1.0% to 0.01% should be considered. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Irritant and sensitizing potential of eight surfactants commonly used in skin cleansers: an evaluation of 105 patients.

PubMed

Corazza, Monica; Lauriola, Maria Michela; Bianchi, Anna; Zappaterra, Mario; Virgili, Annarosa

2010-01-01

Irritation from surfactants contained in detergents is a frequent adverse reaction to cosmetics. Sensitization to surfactants is also possible. In the literature, comparative studies about irritant and sensitizing potential of different surfactants are heterogeneous and inconclusive about the best molecules to use. We compared the irritant and sensitizing potential of some surfactants that are usual components in marketed synthetic detergents (syndets) to obtain practical information regarding commonly used detergents. We patch-tested eight surfactants of the different types (anionic, cationic, amphoteric, and non-ionic) in 105 patients. Assessment of allergic reactions of tested surfactants was carried out in accordance with the recommendations of the International Contact Dermatitis Research Group; assessment of irritant power followed the amended Draize classification. None of the eight surfactants in our series gave positive allergic reactions. Only cocamidopropyl betaine from the Italian standard (Società Italiana di Dermatologia Allergologica, Professionale e Ambientale [SIDAPA]) series gave five positive reactions among 105 patients. None of the eight studied surfactants induced skin irritation. The most tolerated are two new mild anionics (sodium cocoyl glutamate and sodium lauroyl oat amino acids) and an amphoteric agent (disodium cocoamphodiacetate). From this study, we deduce that cosmetic companies' efforts to search for and market new products with very mild surfactants have been generally successful.

Occupational asthma and contact dermatitis in a spray painter after introduction of an aziridine cross-linker.

PubMed Central

Leffler, C T; Milton, D K

1999-01-01

A 23-year-old spray painter developed contact dermatitis and respiratory difficulty characterized by small airways obstruction shortly after the polyfunctional aziridine cross-linker CX-100 began to be used in his workplace as a paint activator. The symptoms resolved after he was removed from the workplace and was treated with inhaled and topical steroids. Painters may have an increased risk of asthma due to exposure to a variety of agents, such as isocyanates, alkyd resins, and chromates. This case illustrates the importance of using appropriate work practices and personal protective equipment to minimize exposure. Occupational asthma is diagnosed by a history of work-related symptoms and exposure to known causative agents. The diagnosis is confirmed by serial pulmonary function testing or inhalational challenge testing. The risk of asthma attributable to occupational exposures is probably underappreciated due to underreporting and to inappropriate use of narrow definitions of exposure in epidemiologic studies of attributable risk. Images Figure 1 PMID:10379008

Neutral endopeptidase terminates substance P-induced inflammation in allergic contact dermatitis.

PubMed

Scholzen, T E; Steinhoff, M; Bonaccorsi, P; Klein, R; Amadesi, S; Geppetti, P; Lu, B; Gerard, N P; Olerud, J E; Luger, T A; Bunnett, N W; Grady, E F; Armstrong, C A; Ansel, J C

2001-01-15

Sensory nerve-derived neuropeptides such as substance P demonstrate a number of proinflammatory bioactivities, but less is known about their role in inflammatory skin disease. The cell surface metalloprotease neutral endopeptidase (NEP) is the principal proteolytic substance P-degrading enzyme. This study tests the hypothesis that the absence of NEP results in dysregulated inflammatory skin responses. The effector phase of allergic contact dermatitis (ACD) responses was examined in NEP(-/-) knockout and NEP(+/+) wild-type mice and compared with the irritant contact dermatitis response in these animals. NEP was found to be normally immunolocalized in epidermal keratinocytes and dermal blood vessels. The ACD ear swelling response was 2.5-fold higher in animals lacking NEP and was accompanied by a significant increase in plasma extravasation and infiltration of inflammatory leukocytes. The augmented ACD response in NEP(-/-) animals was abrogated by either administration of a neurokinin receptor 1 antagonist or by repeated pretreatment with topical capsaicin. Similar to NEP(-/-) mice, the acute inhibition of NEP in NEP(+/+) animals resulted in an augmented ACD response. In contrast to the ACD responses, little differences were observed in the irritant contact dermatitis response of NEP(-/-) compared with NEP(+/+) animals after epicutaneous application of the skin irritants croton oil or SDS. Thus, these results indicate that NEP and cutaneous neuropeptides have a significant role in the pathogenesis of ACD.

Contact allergy in the cleaning industry: analysis of contact allergy surveillance data of the Information Network of Departments of Dermatology.

PubMed

Liskowsky, Joanna; Geier, Johannes; Bauer, Andrea

2011-09-01

Occupational contact allergy is a common problem in the cleaning industry. To identify the most frequent occupation-associated allergens and time trends in contact allergy in female cleaners. We analysed the patch test data concerning 803 female cleaners, who were evaluated for occupational contact dermatitis in 45 dermatological departments contributing to the Information Network of Departments of Dermatology (IVDK) from 1996 to 2009. Female patients, except cleaners, with occupational dermatitis (n = 14494) and female controls without occupational dermatitis (n = 64736) patch tested during this time period formed the control groups. One hundred and fifty-six (19.4%) cleaners had past or present atopic dermatitis. Six hundred and fifty-five (81.6%) cleaners suffered from occupational hand dermatitis. Allergic contact dermatitis was diagnosed in 249 (31%) of the cleaners. As compared with the control group without occupational dermatitis, female cleaners were significantly more often sensitized to occupationally relevant allergens such as rubber additives, especially thiurams [11.6%, 95% confidence interval (CI) 9.1-14.1 vs. 1.5%, 95% CI 1.4-1.6], zinc diethyldithiocarbamate (3.4%, 95% CI 2.1-4.7 vs. 0.4, 95% CI 0.3-0.4), and mercaptobenzothiazole (1.8, 95% CI 0.7-2.9 vs. 0.5, 95% CI 0.4-0.6), as well as formaldehyde (3.4, 95% CI 2.0-4.7 vs. 1.4%, 95% CI 1.3-1.5). No differences were seen in patterns of sensitization to occupational allergens in younger (≤40 years of age) and older (>40 years of age) female cleaners. Formaldehyde and rubber additives such as thiurams, zinc diethyldithiocarbamate and mercaptobenzothiazole are occupationally relevant allergens in female cleaners. Prevention strategies are needed to address the problem. © 2011 John Wiley & Sons A/S.

Professors' Irritating Behavior Study

ERIC Educational Resources Information Center

Malikow, Max

2007-01-01

The purpose of this study was to quantify the irritating behaviors of professors as experienced and reported by 232 Le Moyne College students. In this study, "irritating behavior" was understood as "actions that vex, annoy, bother, pester, frustrate, or provoke anger." The survey used in this study was developed by Larry M. Ludewig, Ph.D.,…

Irritability and Anxiety Severity Among Youth With Anxiety

PubMed Central

Cornacchio, Danielle; Crum, Kathleen I.; Coxe, Stefany; Pincus, Donna B.; Comer, Jonathan S.

2015-01-01

Objective Most research on irritability and child psychopathology has focused on depressive disorders, bipolar disorder, and/or oppositional defiant disorder (ODD). Less is known about relationships between child anxiety and irritability and moderators of such associations. Method Structural equation modeling (SEM) examined associations between anxiety severity and irritability in a large sample of treatment-seeking youth with anxiety disorders (N=663, ages 7–19 years, M=12.25), after accounting for comorbid depressive disorders and ODD. Additional analyses examined whether associations were moderated by child gender, age, and generalized anxiety disorder (GAD) status. Results There was a direct link between child anxiety and irritability even after accounting for comorbid depressive disorders and ODD. Links between child anxiety and irritability were robust across child gender and age. Further, relationships between child anxiety and irritability were comparable across youth with and without GAD, suggesting that the anxiety–irritability link is relevant across child anxiety disorders and not circumscribed to youth with GAD. Conclusion Findings add to an increasing body of evidence linking child irritability to a range of internalizing and externalizing psychopathologies, and suggest that child anxiety assessment should systematically incorporate irritability evaluations. Further, youth in clinical settings displaying irritability should be assessed for the presence of anxiety. Moreover, treatments for childhood anxiety may do well to incorporate new treatment modules as needed that specifically target problems of irritability. PMID:26703910

Effects of irritant chemicals on Aedes aegypti resting behavior: is there a simple shift to untreated "safe sites"?

PubMed

Manda, Hortance; Arce, Luana M; Foggie, Tarra; Shah, Pankhil; Grieco, John P; Achee, Nicole L

2011-07-01

Previous studies have identified the behavioral responses of Aedes aegypti to irritant and repellent chemicals that can be exploited to reduce man-vector contact. Maximum efficacy of interventions based on irritant chemical actions will, however, require full knowledge of variables that influence vector resting behavior and how untreated "safe sites" contribute to overall impact. Using a laboratory box assay, resting patterns of two population strains of female Ae. aegypti (THAI and PERU) were evaluated against two material types (cotton and polyester) at various dark:light surface area coverage (SAC) ratio and contrast configuration (horizontal and vertical) under chemical-free and treated conditions. Chemicals evaluated were alphacypermethrin and DDT at varying concentrations. Under chemical-free conditions, dark material had significantly higher resting counts compared to light material at all SAC, and significantly increased when material was in horizontal configuration. Cotton elicited stronger response than polyester. Within the treatment assays, significantly higher resting counts were observed on chemical-treated dark material compared to untreated light fabric. However, compared to matched controls, significantly less resting observations were made on chemical-treated dark material overall. Most importantly, resting observations on untreated light material (or "safe sites") in the treatment assay did not significantly increase for many of the tests, even at 25% SAC. Knockdown rates were ≤5% for all assays. Significantly more observations of flying mosquitoes were made in test assays under chemical-treatment conditions as compared to controls. When preferred Ae. aegypti resting sites are treated with chemicals, even at reduced treatment coverage area, mosquitoes do not simply move to safe sites (untreated areas) following contact with the treated material. Instead, they become agitated, using increased flight as a proxy indicator. It is this contact

Making contact for contact dermatitis: a survey of the membership of the American Contact Dermatitis Society.

PubMed

Nezafati, Kaveh A; Carroll, Bryan; Storrs, Frances J; Cruz, Ponciano D

2013-01-01

The American Contact Dermatitis Society (ACDS) is the principal organization representing the subspecialty of contact dermatitis in the United States. The aim of this study was to characterize ACDS members with respect to demographic characteristics, patch-test practices, and sentiments regarding the Society and its journal Dermatitis. We conducted cross-sectional postal and online surveys of ACDS members. More than a third of ACDS members responded to the survey, 92% of whom practice dermatology, and most of whom are community practitioners. Responders manage patients with allergic and irritant dermatitis at a similar frequency. On average, they patch test 4 patients per week using 66 allergens per patient, which often include customized trays. Almost half of these practitioners learned patch testing from their residency programs. Most of the responders read and value the Society journal, value the Contact Allergen Management Program database, and attend society meetings. The ACDS is comprised overwhelmingly of dermatologists who are primarily community-based, young relative to the start of their practices, and use the Society's resources for continuing education.

Occupational asthma due to turpentine in art painter--case report.

PubMed

Dudek, Wojciech; Wittczak, Tomasz; Swierczyńska-Machura, Dominika; Walusiak-Skorupa, Jolanta; Pałczyński, Cezary

2009-01-01

Turpentine is a fluid obtained by distillation of wood resins containing mixture of terpens. It can act as an irritant and sensitiser. Most common health problem among workers exposed to turpentine is contact dermatitis. Little is know about turpentine to cause type I hypersensitivity reaction. We present a case of a 27-year old art painter using turpentine as a thinner for oil-based paints. She developed asthmatic reactions after 5 years of working with turpentine. A number of clinical procedures were performed, including clinical examination, routine laboratory tests, total serum IgE, skin prick tests to common aeroallergens, metal salts, oil-based paints and balsamic turpentine, resting spirometry test, histamine challenge, and a single-blind, placebo-controlled specific inhalation challenge with balsamic turpentine. Clinical findings and laboratory test results were normal but a significant bronchial hyperreactivity was found. During the specific challenge, dyspnoea and decreased forced expiratory volume (FEV1) were observed in late phase of asthmatic reaction. An increased proportion of eosinophils in induced sputum could also be noted 24 h after the challenge. Positive clinical response to the specific challenge as well as the morphological changes found in induced sputum served as the basis for diagnosing occupational asthma. To our knowledge, this is the first well-documented case of turpentine-induced occupational asthma.

Identifying an indoor air exposure limit for formaldehyde considering both irritation and cancer hazards

PubMed Central

Golden, Robert

2011-01-01

Formaldehyde is a well-studied chemical and effects from inhalation exposures have been extensively characterized in numerous controlled studies with human volunteers, including asthmatics and other sensitive individuals, which provide a rich database on exposure concentrations that can reliably produce the symptoms of sensory irritation. Although individuals can differ in their sensitivity to odor and eye irritation, the majority of authoritative reviews of the formaldehyde literature have concluded that an air concentration of 0.3 ppm will provide protection from eye irritation for virtually everyone. A weight of evidence-based formaldehyde exposure limit of 0.1 ppm (100 ppb) is recommended as an indoor air level for all individuals for odor detection and sensory irritation. It has recently been suggested by the International Agency for Research on Cancer (IARC), the National Toxicology Program (NTP), and the US Environmental Protection Agency (US EPA) that formaldehyde is causally associated with nasopharyngeal cancer (NPC) and leukemia. This has led US EPA to conclude that irritation is not the most sensitive toxic endpoint and that carcinogenicity should dictate how to establish exposure limits for formaldehyde. In this review, a number of lines of reasoning and substantial scientific evidence are described and discussed, which leads to a conclusion that neither point of contact nor systemic effects of any type, including NPC or leukemia, are causally associated with exposure to formaldehyde. This conclusion supports the view that the equivocal epidemiology studies that suggest otherwise are almost certainly flawed by identified or yet to be unidentified confounding variables. Thus, this assessment concludes that a formaldehyde indoor air limit of 0.1 ppm should protect even particularly susceptible individuals from both irritation effects and any potential cancer hazard. PMID:21635194

Occupational skin diseases in cleaning and kitchen employees: course and quality of life after measures of secondary individual prevention.

PubMed

Soder, Stefanie; Diepgen, Thomas L; Radulescu, Magdalena; Apfelbacher, Christian J; Bruckner, Thomas; Weisshaar, Elke

2007-08-01

Cleaning and kitchen employees have an increased risk of suffering from occupational dermatoses. Prevention including improving individual skin care and skin protection behavior, health education, optimizing diagnostics and therapy as well as avoidance of occupational skin disease (BK 5101) is important. Participants in the courses were patients suspected of having an occupational skin disease. Besides socio-demographic and disease-related data, health-related quality of life (QL) was measured using the SF-36 and Skindex-29. One year later all participants were interviewed by telephone about the course of their skin disease. Out of 212 participants, 84.0 % were female. The mean age was 41.6 (SD = 10.8) years.168 patients (79.2 %) suffered from hand dermatitis,with irritant contact dermatitis being the predominant diagnosis (46.2 %,n = 98). One year later 65.4 % (n = 85) of the patients interviewed still suffered from hand dermatitis.9.2 % (n = 12) had meanwhile quit their job due to the skin disease. QL was impaired in all age groups being lower with increasing age of the patients. The follow-up confirmed the positive impact of the skin protection courses on patients' skin disease and well-being. Occupational skin diseases impair health-related quality of life in these professions but disease severity does not seem to play a key role.

A study of the relationship between susceptibility to skin stinging and skin irritation.

PubMed

Basketter, D A; Griffiths, H A

1993-10-01

In an evaluation of the safety of new chemicals, of products containing them, or of novel formulations of existing chemicals which may come into contact with the skin, it is important to incorporate an assessment of specially susceptible sub-populations. Such a group is represented by those who are more likely to experience sensory effects such as stinging. Since these individuals are easily and rapidly identifiable, we investigated whether they represented a group who were also more susceptible to the effects of an irritant. The primary purpose was to discover whether 'stingers' might represent an easily and rapidly identifiable sub-population with a more generally increased tendency to give skin responses. The response to a 0.3% sodium dodecyl sulphate patch test was assessed in a group of 25 'stingers' and compared to the response in 25 'non-stingers'. There was no difference in either the pattern or strength of the irritant response assessed by subjective erythema and dryness scores. Thus the data suggest that there is no correlation between the susceptibility of an individual to a skin stinging response and an irritation reaction.

Minimum standards on prevention, diagnosis and treatment of occupational and work-related skin diseases in Europe - position paper of the COST Action StanDerm (TD 1206).

PubMed

Alfonso, J H; Bauer, A; Bensefa-Colas, L; Boman, A; Bubas, M; Constandt, L; Crepy, M N; Goncalo, M; Macan, J; Mahler, V; Mijakoski, D; Ramada Rodilla, J M; Rustemeyer, T; Spring, P; John, S M; Uter, W; Wilkinson, M; Giménez-Arnau, A M

2017-06-01

Skin diseases constitute up to 40% of all notified occupational diseases in most European countries, predominantly comprising contact dermatitis, contact urticaria, and skin cancer. While insufficient prevention of work-related skin diseases (WRSD) is a top-priority problem in Europe, common standards for prevention of these conditions are lacking. To develop common European standards on prevention and management of WRSD and occupational skin diseases (OSD). Consensus amongst experts within occupational dermatology was achieved with regard to the definition of minimum evidence-based standards on prevention and management of WRSD/OSD. By definition, WRSDs/OSDs are (partially or fully) caused by occupational exposure. The definition of OSD sensu stricto additionally includes diverging national legal requirements, with an impact on registration, prevention, management, and compensation. With the implementation of the classification of WRSD/OSD in the International Classification of Diseases (ICD) 11th Revision in future, a valid surveillance and comparability across countries will be possible. Currently, WRDS and OSD are still under-reported. Depending on legislation and regulations, huge differences exist in notification procedures in Europe, although notification is crucial to prevent chronic and relapsing disease. Facilities for early diagnosis, essential for individual patient management, should be based on existing guidelines and include a multidisciplinary approach. Patch testing is essential if contact dermatitis persists or relapses. Workplace exposure assessment of WRSD/OSD requires full labelling of product ingredients on material safety data sheets helping to identify allergens, irritants and skin carcinogens. Comparable standards in primary, secondary and tertiary prevention must be established in Europe to reduce the burden of WRSD/OSD in Europe. The adoption of common European standards on prevention of WRSD/OSD will contribute to reduce the incidence of

An approach for development of alternative test methods based on mechanisms of skin irritation.

PubMed

Osborne, R; Perkins, M A

1994-02-01

Recent advances in techniques for culture of human skin cells have led to their potential for use as in vitro models for skin irritation testing to augment or replace existing rabbit skin patch tests. Our work is directed towards the development of cultured human skin cells, together with endpoints that can be linked to in vivo mechanisms of skin irritation, as in vitro models for prediction of human skin irritation, and for study of mechanisms of contact irritant dermatitis. Three types of commercial human skin cell cultures have been evaluated, epidermal keratinocytes and partially or fully cornified keratinocyte-dermal fibroblast co-cultures. Human epidermal keratinocyte cultures (Clonetics) were treated with product ingredients and formulations, and the extent of cell damage was assessed by incorporation of the vital dye neutral red. Cell damage correlated with human skin patch data for ingredient chemicals with the exception of acids and alkalis, but did not correlate with skin irritation to surfactant-containing product formulations. Cultures of human skin equivalents were evaluated as potential models for measurement of responses to test materials that could not be measured in the keratinocyte/neutral red assay. We developed a battery of in vitro endpoints to measure responses to prototype ingredients and formulations in human epidermal keratinocyte-dermal fibroblast co-cultures grown on a nylon mesh ('Skin2' from Advanced Tissue Sciences) or on a collagen gel ('Testskin' from Organogenesis). The endpoints measure cytotoxicity (neutral red and MTT vital dye staining, lactate dehydrogenase and N-acetyl glucosaminidase release, glucose utilization) and inflammatory mediator (prostaglandin E2) release. Initial experiments indicate a promising correlation between responses of the Skin2 model to prototype surfactants and in vivo human skin irritation. The responses of Testskin cultures to acids and alkalis help to prove the concept that a topical application

Occupational exposure of aldehydes resulting from the storage of wood pellets.

PubMed

Rahman, Mohammad Arifur; Rossner, Alan; Hopke, Philip K

2017-06-01

An exposure assessment was conducted to investigate the potential for harmful concentrations of airborne short chain aldehydes emitted from recently stored wood pellets. Wood pellets can emit a number of airborne aldehydes include acetaldehyde, formaldehyde, propionaldehyde, butyraldehyde, valeraldehyde, and hexanal. Exposure limits have been set for these compounds since they can result in significant irritation of the upper respiratory system at elevated concentrations. Formaldehyde is a recognized human carcinogen and acetaldehyde is an animal carcinogen. Thus, air sampling was performed in a wood pellet warehouse at a pellet mill, two residential homes with bulk wood pellet storage bins, and in controlled laboratory experiments to evaluate the risk to occupants. Using NIOSH method 2539, sampling was conducted in five locations in the warehouse from April-June 2016 when it contained varying quantities of bagged pellets as well as two homes with ten ton bulk storage bins. The aldehyde concentrations were found to increase with the amount of stored pellets. Airborne concentrations of formaldehyde were as high as 0.45 ppm in the warehouse exceeding the NIOSH REL-C, and ACGIH TLV-C occupational exposure limits (OELs). The concentrations of aldehydes measured in the residential bins were also elevated indicating emissions may raise indoor air quality concerns for occupants. While individual exposures are of concern the combined irritant effect of all the aldehydes is a further raise the concerns for building occupants. To minimize exposure and the risk of adverse health effects to a building's occupants in storage areas with large quantities of pellets, adequate ventilation must be designed into storage areas.

Sensory irritation and incapacitation evoked by thermal decomposition products of polymers and comparisons with known sensory irritants.

PubMed

Barrow, C S; Alarie, Y; Stock, M F

1978-01-01

A decrease in respiratory rate in mice during exposure to irritating airborne chemicals has been utilized as a response parameter to characterize the degree of upper respiratory tract irritation (sensory irritation) to the thermal decomposition products of various polymers. These included polystyrene, polyvinyl chloride, flexible polyurethane foam, polytetrafluorethylene, a fiber glass reinforced polyester resin, and Douglas Fir. Each of the materials was thermally decomposed in a low-mass vertical furnace in an air atmosphere at a programmed heating rate of 20 degrees C/min. Mice, in groups of four, were exposed to graded concentrations of the thermal decomposition products of each of the above materials. Dose-response curves were obtained by utilizing the maximum percent decrease in respiratory rate as the response parameter during each exposure. Comparison of these dose-response curves with other sensory irritants such as chlorine, ammonia, hydrogen chloride, sulfur dioxide, and toluene diisocyanate gave an indication of the sensory irrtation potential of the thermal decomposition products of these various polymers versus that of well-known single airborne chemical irritants. Total stress and incapacitation of the organism during exposure to sensory irritants such as from the thermal decomposition products of synthetic polymers is discussed.

Irritability in ADHD: Associations with depression liability.

PubMed

Eyre, Olga; Langley, Kate; Stringaris, Argyris; Leibenluft, Ellen; Collishaw, Stephan; Thapar, Anita

2017-06-01

Irritability and the new DSM-5 diagnostic category of Disruptive Mood Dysregulation Disorder (DMDD) have been conceptualised as related to mood disorder. Irritability is common in Attention Deficit Hyperactivity Disorder (ADHD) but little is known about its association with depression risk in this group. This study aims to establish levels of irritability and prevalence of DMDD in a clinical sample of children with ADHD, and examine their association with anxiety, depression and family history of depression. The sample consisted of 696 children (mean age 10.9 years) with a diagnosis of ADHD, recruited from UK child psychiatry and paediatric clinics. Parents completed the Child and Adolescent Psychiatric Assessment, a semi-structured diagnostic interview, about their child. This was used to establish prevalence of DMDD, anxiety disorder and depressive disorder, as well as obtain symptom scores for irritability, anxiety and depression. Questionnaires assessed current parental depression, and family history of depression. Irritability was common, with 91% endorsing at least one irritable symptom. 3-month DMDD prevalence was 31%. Children with higher levels of irritability or DMDD were more likely to have comorbid symptoms of anxiety, depression and a family history of depression. Results are based on a clinical sample, so may not be generalizable to children with ADHD in the general population. Irritability and DMDD were common, and were associated with markers of depression liability. Longitudinal studies are needed to examine the association between irritability and depression in youth with ADHD as they get older. Copyright © 2017. Published by Elsevier B.V.

Healthcare Industry Injuries by Patient Contact Status in Kentucky, 2012-2014.

PubMed

Ranzenberger, Kristen; Bunn, Terry L; Slavova, Svetla

2016-10-01

The healthcare industry continues to have a high number of reported injuries. The purpose of this study was to characterize healthcare industry injuries by patient contact status, identify the occupations associated with healthcare injuries by patient contact status, and determine healthcare injury rates by occupation to gain a better understanding of healthcare industry-compensated injuries and better target safety practices and programs in the healthcare industry. Kentucky healthcare industry workers' compensation first reports of injuries from calendar years 2012-2014 were categorized into injuries involved in direct patient contact versus injuries without direct patient contact using narrative text analysis. Injury numbers and rates were calculated for a number of data variables. Healthcare injuries without direct patient contact (55% of all first reports of injuries) occurred more frequently among older workers (45 years old and older [51%]), in "other" occupations such as housekeeping and maintenance (28%), and as a result of falls/slips/trips (39%) and sprains/tears (38%). In contrast, a higher percentage of healthcare injuries involving direct patient contact occurred among workers younger than 35 years (48%), in healthcare support occupations (50%), and resulting from sprains/tears (66%) and lifting/handling (52%), compared with those without direct patient contact. Findings from this study can better target the need for new and/or additional specific workplace safety training, especially in the healthcare support and nursing occupations with and without patient contact.

Contact allergy in patients with rosacea: a clinic-based, prospective epidemiological study.

PubMed

Jappe, U; Schäfer, T; Schnuch, A; Uter, W

2008-11-01

Rosacea is a relatively common inflammatory skin disease of unknown prevalence. The proportion of contact allergy complicating rosacea and its therapy, respectively, is largely unknown. To estimate the prevalence of specific contact allergy in rosacea patients and to compare this with the prevalence observed in the general population and in general patch test patients. In this prospective monocentre study, 78 patients with rosacea were investigated for contact sensitizations via patch testing the standard series, constituents of topical formulations, preservatives, fragrances, topically applied drugs and, if available, patient's own products. Positive reactions occurred to nickel (II) sulphate (12 of 78, 15.4%), fragrance mix I (4 of 77, 5.2%), balsam of Peru (8 of 77, 10.4%; significantly elevated prevalence compared to that observed in the population-based KORA study), potassium dichromate (4 of 78, 5.1%) and Lyral (3 of 78, 3.8%). Regarding topical antibiotics, only 1 of 78 (1.3%) patients was positive to neomycin sulphate, and none to metronidazole; however, 6 of 75 (8%) patients were positive to gentamicin sulphate, and 4 of 76 (5.3%) patients were positive to framycetin sulphate. No allergic but irritant patch test reactions, instead, were provoked by various patients' own products as well as by the irritant sodium lauryl sulphate (SLS) even in low concentrations. Despite the limited power of the study, a strikingly high prevalence of contact allergy to gentamicin sulphate was observed, which is probably due to antibiotic treatment of rosacea-associated eye symptoms. The reactions to the irritant SLS probably mirror the extreme skin sensitivity in rosacea.

Irritable bowel syndrome: contemporary nutrition management strategies.

PubMed

Mullin, Gerard E; Shepherd, Sue J; Chander Roland, Bani; Ireton-Jones, Carol; Matarese, Laura E

2014-09-01

Irritable bowel syndrome is a complex disorder whose pathophysiology involves alterations in the enteric microbiota, visceral hypersensitivity, gut immune/barrier function, hypothalamic-pituitary-adrenal axis regulation, neurotransmitters, stress response, psychological factors, and more. The importance of diet in the management of irritable bowel syndrome has taken center stage in recent times as the literature validates the relationship of certain foods with the provocation of symptoms. Likewise, a number of elimination dietary programs have been successful in alleviating irritable bowel syndrome symptoms. Knowledge of the dietary management strategies for irritable bowel syndrome will help guide nutritionists and healthcare practitioners to deliver optimal outcomes. This tutorial reviews the nutrition management strategies for irritable bowel syndrome. © 2014 American Society for Parenteral and Enteral Nutrition.

Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome.

PubMed

Anliker, Mark David; Borelli, Siegfried; Wüthrich, Brunello

2002-02-01

Protein contact dermatitis to meat is well known in butchers; spices are another source of potential contact allergy and usually are not recognized. We present a first case of contact-dermatitis to spice mix in a 39-year-old-butcher. The patient underwent skin prick testing (SPT) with standard allergens (ALK) and different meat and spice extracts (Stallergènes), scratch-patch testing with spice mix containing glutamate, paprika and other spices. Specific serum-IgE was measured with CAP-FEIA. SPT only showed an immediate-type sensitization to mugwort (+ +), as well as different spices (paprika +, curry +, cumin +) and camomile (+ + +). Scratch-patch tests were negative for different meat, but strongly positive for spice mix (+ + +) after 30 min (wheal and flare) and (+ +) after 48 h (infiltration and vesiculation). Two healthy controls were tested negative for spice mix used from that patient (scratch-patch). Specific IgE was slightly elevated for paprika 0.47 kU/L (CAP class 1), anise 0.43 kU/L, curry 0.36 kU/L and mugwort 3.83 kU/L. Sx1 atopy-multiscreen was 3.8 kU/L due to a sensitization to mugwort alone. The tests performed demonstrate an IgE-mediated contact allergy to spices but also a delayed type allergy to spice mix as a manifestation of the mugwort-spice syndrome in this individual. When testing for occupational dermatitis in butchers, protein contact allergy to spices must also be taken into consideration.

A method for measuring mouse respiratory allergic reaction to low-dose chemical exposure to allergens: an environmental chemical of uncertain allergenicity, a typical contact allergen and a non-sensitizing irritant.

PubMed

Fukuyama, Tomoki; Tajima, Yukari; Ueda, Hideo; Hayashi, Koichi; Shutoh, Yasufumi; Harada, Takanori; Kosaka, Tadashi

2010-05-19

Our aim was to improve a method for detecting respiratory hypersensitivity by testing three confirmed respiratory allergens (trimellitic anhydride [TMA], phthalic anhydride [PA] and toluene diisocyanate [TDI]), an environmental chemical of uncertain allergenicity (2,4-d-butyl [DB]), a confirmed contact allergen (2,4-dinitrochlorobenzene [DNCB]) and a standard irritant (sodium dodecyl sulfate [SDS]). BALB/c mice were topically sensitized (nine times in 3 weeks) with these chemicals, then challenged via the trachea. One day post-challenge, samples were taken from the mice to assay for total immunoglobulin (IgE and IgG(1)) levels in serum and bronchoalveolar lavage fluid (BALF); differential cell counts and cytokine/chemokine levels in BALF; lymphocyte counts and surface antigen expression on B-cells within lung-associated lymph nodes (LNs); ex situ cytokine production by cells from these LNs; and gene expression in BALF (CCR3) and LNs (CCR4, STAT6 and GATA-3). The three confirmed respiratory allergens and DB induced immune response characteristic of immediate-type respiratory reactions, as evidenced by increased total IgE and IgG(1) levels; influx of eosinophils, neutrophils, chemokines and cytokines in BALF; increased surface antigen expression on B-cells in LNs; increased Th2 cytokine production in LNs; and increased respiratory allergy-related gene expression in both BALF and LNs. In contrast, DNCB and SDS treatments yielded, at most, insignificant increases in all respiratory allergic parameters. Thus, the protocol was equally suitable for use with an environmental chemical of unknown allergenicity and for typical respiratory allergens. Since the protocol differentiated respiratory allergens from contact allergens and irritants, it may be useful for detecting respiratory allergy related to environmental chemicals. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome.

PubMed

Ritchie, J

1973-02-01

The effects of inflating a balloon introduced through a sigmoidoscope to 35 cm in the pelvic colon have been observed and compared in 67 patients with the irritable colon syndrome and in 16 normal and constipated subjects acting as controls. Inflation to 60 ml caused pain in 6% of the controls at a mean diameter of 3.8 cm and in 55% of patients with the irritable colon syndrome (diameter 3.4 cm). An estimate of gut wall tension at this volume of inflation showed it to be normal in patients with the irritable colon syndrome; the incidence of pain in relation to wall tension was increased nearly tenfold in the irritable colon group. Inflation of the balloon to different volumes was normally painless to a maximum acceptable diameter which remained constant for each study under constant conditions; continued inflation eventually gave rise to pain without increasing the diameter. The pain was felt in the hypogastrium in 40%, in one or both iliac fossae in 31%, and in the rectum in 21%; the other 8% felt pain in the back or elsewhere and there were no significant differences between clinical groups. Exceptionally, in 6% of the controls, and in 52% of patients with the irritable colon syndrome, pain occurred at balloon diameters that could still be increased by 10% or more with further inflation. This was probably the outcome of a low threshold for visceral pain in the section of bowel in contact with the balloon. Colonic hyperalgesia of this kind, possibly a random occurrence, may be an important contributory factor in the aetiology of the irritable colon syndrome.

Relational dimension of irritability following traumatic brain injury: a qualitative analysis.

PubMed

Hammond, Flora M; Davis, Christine S; Cook, James R; Philbrick, Peggy; Hirsch, Mark A

2012-01-01

Irritability is a common long-term sequelae of traumatic brain injury (TBI). In a prior study on TBI irritability, relational interactions were one of four dimensions of irritability occurrence and precipitation. This present analysis examines these same data in greater detail. Fifty focus group transcripts from a study on irritability were re-analysed to examine: (1) irritability in spousal relationships following TBI, (2) retrospective accounts of spousal interactions contributing to irritability and (3) impact of irritability on marital relationships. Grounded Theory was used to develop themes, metacodes and theories. Several theories emerged regarding irritability with respect to spousal relations, all based on the overarching theory that irritability in people with TBI has a strong relational component involved in triggering, experiencing and preventing irritability. Sub-theories supporting this include: (1) irritability breeds further irritability, (2) spousal responses can trigger irritability among persons with TBI and vice versa, (3) difficulties making emotional connections may incite negative interactions, (4) expectations of others may contribute to irritable behaviour, and (5) communication breakdowns may provoke irritability. Irritability associated with TBI resides in the family system as well as the individual. In treating irritability one should include comprehensive assessment and assistance to improve interpersonal interactions.

Work-related injury among direct care occupations in British Columbia, Canada.

PubMed

Alamgir, Hasanat; Cvitkovich, Yuri; Yu, Shicheng; Yassi, Annalee

2007-11-01

To examine how injury rates and injury types differ across direct care occupations in relation to the healthcare settings in British Columbia, Canada. Data were derived from a standardised operational database in three BC health regions. Injury rates were defined as the number of injuries per 100 full-time equivalent (FTE) positions. Poisson regression, with Generalised Estimating Equations, was used to determine injury risks associated with direct care occupations (registered nurses [RNs], licensed practical nurses [LPNs) and care aides [CAs]) by healthcare setting (acute care, nursing homes and community care). CAs had higher injury rates in every setting, with the highest rate in nursing homes (37.0 injuries per 100 FTE). LPNs had higher injury rates (30.0) within acute care than within nursing homes. Few LPNs worked in community care. For RNs, the highest injury rates (21.9) occurred in acute care, but their highest (13.0) musculoskeletal injury (MSI) rate occurred in nursing homes. MSIs comprised the largest proportion of total injuries in all occupations. In both acute care and nursing homes, CAs had twice the MSI risk of RNs. Across all settings, puncture injuries were more predominant for RNs (21.3% of their total injuries) compared with LPNs (14.4%) and CAs (3.7%). Skin, eye and respiratory irritation injuries comprised a larger proportion of total injuries for RNs (11.1%) than for LPNs (7.2%) and CAs (5.1%). Direct care occupations have different risks of occupational injuries based on the particular tasks and roles they fulfil within each healthcare setting. CAs are the most vulnerable for sustaining MSIs since their job mostly entails transferring and repositioning tasks during patient/resident/client care. Strategies should focus on prevention of MSIs for all occupations as well as target puncture and irritation injuries for RNs and LPNs.

Construction fatality due to electrical contact in Ontario, Canada, 1997-2007.

PubMed

Kim, Hwan; Lewko, John; Garritano, Enzo; Sharma, Bhanu; Moody, Joel; Colantonio, Angela

2016-06-27

Electrical contact is a leading cause of occupational fatality in the construction industry. However, research on the factors that contribute to electricity-related fatality in construction is limited. To characterize, using an adapted Haddon's Matrix, the factors that contribute to electricity-related occupational fatalities in the construction industry in Ontario, Canada. Coroner's data on occupational electricity-related fatalities between 1997-2007 in the construction industry were acquired from the Ontario Ministry of Labour. Using an adapted Haddon's Matrix, we characterized worker, agent, and environmental characteristics of electricity-related occupational fatalities in the province through a narrative text analysis. Electrical contact was responsible for 15% of all occupational fatalities among construction workers in Ontario. Factors associated with said occupational fatalities included direct contact with electrical sources, lower voltage sources, and working outdoors. This study provides a profile of electricity-related occupational fatalities among construction workers in Ontario, and can be used to inform safety regulations.

Epidemiology of occupational injury among cleaners in the healthcare sector.

PubMed

Alamgir, Hasanat; Yu, Shicheng

2008-09-01

The cleaning profession has been associated with multiple ergonomic and chemical hazards which elevate the risk for occupational injury. This study investigated the epidemiology of occupational injury among cleaners in healthcare work settings in the Canadian province of British Columbia. Incidents of occupational injury among cleaners, resulting in lost time from work or medical care, over a period of 1 year in two healthcare regions were extracted from a standardized operational database and with person-years obtained from payroll data. Detailed analysis was conducted using Poisson regression modeling. A total of 145 injuries were identified among cleaners, with an annual incidence rate of 32.1 per 100 person-years. After adjustment for age, gender, subsector, facility, experience and employment status, Poisson regression models demonstrated that a significantly higher relative risk (RR) of all injury, musculoskeletal injury and cuts was associated with cleaning work in acute care facilities, compared with long-term care facilities. Female cleaners were at a higher RR of all injuries and contusions than male cleaners. A lower risk of all injury and allergy and irritation incidents among part-time or casual workers was found. Cleaners with >10 years of experience were at significantly lower risk for all injury, contusion and allergy and irritation incidents. Cleaners were found to be at an elevated risk of all injury categories compared with healthcare workers in general.

The evaluation of the local tolerance of vaginal formulations containing dapivirine using the Slug Mucosal Irritation test and the rabbit vaginal irritation test.

PubMed

Dhondt, Marijke M M; Adriaens, Els; Roey, Jens Van; Remon, Jean Paul

2005-08-01

The purpose of this study was to evaluate the local tolerance of vaginal gels (three gels containing dapivirine, the placebo gel, and Conceptrol) with the Slug Mucosal Irritation test and to compare the results with those of the rabbit vaginal irritation test. The irritation potential on the slug mucosa was assessed by the mucus production caused by a repeated treatment for 5 successive days. Additionally, membrane damage was estimated by the protein and enzyme release. By means of a classification prediction model the formulations were classified into four irritation classes. The effect of a 10-day intravaginal application of the gels on the rabbit vaginal and cervical mucosa was evaluated by means of macroscopic and microscopic examination. The placebo and dapivirine gels induced no irritation of the slug mucosa (low mucus production and protein release, no enzyme release) and no vaginal or cervical irritation in rabbits. Conceptrol caused severe irritation of the slug mucosa (increased mucus production, protein release, and enzyme release) and irritation of the rabbit vagina and cervix. The results obtained with the Slug Mucosal Irritation test were comparable to those of the rabbit vaginal irritation test.

Prospective multicenter survey on the clinical management of pediatric contact dermatitis.

PubMed

Ruggiero, Giuseppe; Carnevale, Claudia; Diociaiuti, Andrea; Arcangeli, Fabio; El Hachem, May

2016-12-01

Contact dermatitis can be defined as an inflammatory process affecting the skin surface and induced by contact with chemical, physical and/or biotic agents in the environment. It causes lesions to skin, mucosae and semi-mucosae by means of allergic and irritant pathogenic mechanisms. Among the main triggers of contact dermatitis in the pediatric age are chemical or physical agents, which cause irritant contact dermatitis (ICD), and sensitizers, which cause a tissue damage through an allergic mechanism (allergic contact dermatitis [ACD]). A prospective, multicenter, observational study was carried out in 204 children affected by contact dermatitis, aged up to 14 years, and enrolled by pediatricians from 7 different Italian provinces. The diagnosis of contact dermatitis was based on the pediatrician's clinical evaluation. The data were collected through a series of simple and multiple choice questions, anonymously filled out by pediatricians. In 90% of cases (184 of 204 patients), there was complete remission of contact dermatitis, with no cases of worsening. No adverse events were observed, either. The effectiveness of the therapy was rated as "very effective" by 84.4% of the parents and 86.8% of the pediatricians. In only 10 patients a new therapy had to be prescribed. Contact dermatitis is a heterogeneous inflammatory skin disease induced by contact with different kinds of environmental agents. Cutaneous manifestations are highly variable and depend on the modality of contact, on the causative agent and on the pathogenesis. This Italian experience of a clinical approach to contact dermatitis stresses the need of daily skin care through different therapeutic strategies, based on the diagnosis, the clinical severity and the parents and children compliance. The first therapeutic measure to be implemented is prevention, through the removal of the causative agent and the use of protective devices. Indeed, preserving the skin's barrier function is an important goal and

Effects of JP-8 on Molecular and Histological Parameters Related to Acute Skin Irritation

DTIC Science & Technology

2000-06-01

in irritant dermatitis are understood. Cytokines are cell signaling molecules that are involved in the inflammatory response. These include the...are involved in inflammatory responses in contact dermatitis (Figure 2, Ormerod et al., 1997). The analysis of iNOS mRNA or protein, as well as the...placed into a Bessman steel tissue pulverizer (Fisher Scientific, Cat # 08-418-2) that was pre-chilled in liquid nitrogen. Using a lead hammer

Occupational contact dermatitis I: incidence and return to work pressures.

PubMed

Emmett, Edward A

2002-03-01

Since the passage of the United States Occupational Safety and Health Act (OSHA) in 1970, there have been extensive changes in United States workplaces that should have served to enhance the prevention of occupational skin disease (OSD). Analysis of skin diseases reported to OSHA (OSHA recordables) shows that the number of OSDs declined steadily from 1974 to 1983 to about half the previous annual incidence. After 1984, there was a modest resurgence peaking in 1994, with a subsequent decline. A similar but somewhat greater decline in the late 1990s has been observed for occupational respiratory diseases, diseases caused by toxic agents and for poisonings. Likely explanations for the trends in OSD are discussed; the initial decline probably reflected an improvement in workplace conditions, the later resurgence and decline may have been attributable to changes in recording behaviors and in worker's compensation. The decline in recorded OSD since 1996 has been fairly uniform in most major industrial sectors but has been less marked in agriculture, forestry, and fishing so that this sector has replaced manufacturing in recording the highest incidence rate. In 1999, the incidence rate of recorded OSD was 0.49 per 1,000 workers, which appears to grossly under report the true incidence. OSD now constitutes about 10% of all occupational disease cases. Currently, there is increasing emphasis in corporate and occupational medicine on reducing costs and maintaining productivity as well as in preventing occupational injuries and diseases. This is shown by the trend for a greater proportion of workers with occupational conditions to return to modified duty positions rather than to be completely off work. Implications of this phenomena for management of OSD are discussed. Copyright 2002, Elsevier Science (USA). All rights reserved.

[Contact dermatitis: an approach used by a medical officer].

PubMed

Vologzhanin, D A; Bozhchenko, A A; Bala, A M

2012-01-01

The article deals with contact dermatitis issues, that are of interest not only for dermatologists and specialists in professional pathology, but as well as for general practitioners. Issues of contact dermatitis classification, pathogenic peculiarities of the disease main forms and their basic causes are discussed. Clinical manifestations of irritative and allergic contact dermatitis are described in detail, aspects of differential diagnostics analysed. A detailed consideration is given to allergic diagnostics of contact dermatitis using application test-systems with the most common contact allergens. Main principles of contact dermatitis treatment are outlined in the article. The necessity of a complex approach to this disease therapy that requires not only external therapy, but the compliance with an appropriate treatment regimen, diet as well as application of a particular system therapy is shown. Recommendations for contact dermatitis prophylaxis are given.

Effect of very brief psychotherapy on the irritable bowel syndrome.

PubMed

Hislop, I G

1980-11-29

The relationship between emotional factors and abdominal dysfunction in the irritable bowel syndrome (IBS) has been the focus of uncertainty. In support of an integrated psychophysiological basis for the disorder, 60 consecutive IBS patients were treated by psychotherapy. Of the 52 subjects who responded to a self-assessment questionnaire, 46% indicated that they were asymptomatic or had only mild persistence of their symptoms. Only 11 patients (22%) indicated little or no improvement. These results support the efficacy of a very brief, but active, interview designed to contact and release subconscious feelings of distress in patients with IBS.

Genome-wide expression analysis of human in vivo irritated epidermis: differential profiles induced by sodium lauryl sulfate and nonanoic acid.

PubMed

Clemmensen, Anders; Andersen, Klaus E; Clemmensen, Ole; Tan, Qihua; Petersen, Thomas K; Kruse, Torben A; Thomassen, Mads

2010-09-01

The pathogenesis of irritant contact dermatitis (ICD) is poorly understood, and genes participating in the epidermal response to chemical irritants are only partly known. It is commonly accepted that different irritants have different mechanisms of action in the development of ICD. To define the differential molecular events induced in the epidermis by different irritants, we collected sequential biopsies ((1/2), 4, and 24 hours after a single exposure and at day 11 after repeated exposure) from human volunteers exposed to either sodium lauryl sulfate (SLS) or nonanoic acid (NON). Gene expression analysis using high-density oligonucleotide microarrays (representing 47,000 transcripts) revealed essentially different pathway responses (1/2)hours after exposure: NON transiently induced the IL-6 pathway as well as a number of mitogen-activated signaling cascades including extracellular signal-regulated kinase and growth factor receptor signaling, whereas SLS transiently downregulated cellular energy metabolism pathways. Differential expression of the cyclooxygenase-2 and matrix metalloproteinase 3 transcripts was confirmed immunohistochemically. After cumulative exposure, 883 genes were differentially expressed, whereas we identified 23 suggested common biomarkers for ICD. In conclusion, we bring new insights into two hitherto less well-elucidated phases of skin irritancy: the very initial as well as the late phase after single and cumulative mild exposures, respectively.

Home gardening may be a risk factor for contact dermatitis to Alstroemeria.

PubMed

Tavares, Beatriz; Loureiro, Graça; Pereira, Celso; Chieira, Celso

2006-01-01

Occupational allergy among florists and people who work in cut flower production of Alstroemeria cultivars (Peruvian lily or Inca lily) has been previously reported. The allergen involved in sensitization is tulipalin A (alpha-methylene-gamma-butyrolactone). We describe the case of a 65-year-old woman who developed severe dermatitis on her right thumb, index and middle fingers and less severe dermatitis on her left palm and front of forearm with occasional itching of the neck and face after taking up home gardening activities, including cutting flowers such as Alstroemeria. The patient and three healthy individuals were submitted to epicutaneous tests with the European standard series, the plant series, and stem portions of three suspected ornamental plants (Alstroemeria, Lilium and Zantedeschia), garlic, and onion. Patch tests performed in our patient, revealed an extreme reaction (+ + +) to Alstroemeria and alpha-methylene-gamma-butyrolactone, a strong reaction (+ +) to propolis and wood tar mix, a weak reaction (+) to balsam of Peru, an irritant reaction to garlic and negative results to diallyl disulfide and the other components investigated. Patch tests performed in the healthy individuals revealed negative. We stress the importance of Alstroemeria as a cause of allergic contact dermatitis not only in workers involved in the flower trade, but also in other people that come into contact with this plant in their leisure activities.

78 FR 64504 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH or..., Number 177, Pages 56235-56236. Contact Person for More Information: Price Connor, Ph.D., NIOSH Health...

Assessing occupational exposure to sea lamprey pesticides.

PubMed

Ceballos, Diana M; Beaucham, Catherine C; Kurtz, Kristine; Musolin, Kristin

2015-01-01

Sea lampreys are parasitic fish found in lakes of the United States and Canada. Sea lamprey is controlled through manual application of the pesticides 3-trifluoromethyl-4-nitrophenol (TFM) and Bayluscide(TM) into streams and tributaries. 3-Trifluoromethyl-4-nitrophenol may cause irritation and central nervous system depression and Bayluscide may cause irritation, dermatitis, blisters, cracking, edema, and allergic skin reactions. To assess occupational exposures to sea lamprey pesticides. We developed a wipe method for evaluating surface and skin contamination with these pesticides. This method was field tested at a biological field station and at a pesticide river application. We also evaluated exposures using control banding tools. We verified TFM surface contamination at the biological station. At the river application, we found surfaces and worker's skin contaminated with pesticides. We recommended minimizing exposures by implementing engineering controls and improved use of personal protective equipment.

Developmental Trajectories of Irritability and Bidirectional Associations With Maternal Depression

PubMed Central

Wiggins, Jillian Lee; Mitchell, Colter; Stringaris, Argyris; Leibenluft, Ellen

2014-01-01

Objective Irritability is a dimensional trait in typical development and a common presenting symptom in many psychiatric disorders, including depression. However, little is known about the developmental trajectory of irritability or how child irritability interacts with maternal depression. The present study (1) identifies classes of irritability trajectories from toddlerhood to middle childhood; (2) characterizes maternal depression and other family, social environment, and child variables within each irritability trajectory class; and (3) as a more exploratory analysis, examines bidirectional associations between maternal depression and child irritability. Method 4,898 families from the Fragile Families and Child Wellbeing Study reported on irritability symptoms at ages 3, 5, and 9, assessed with items from the Child Behavior Checklist. Parental major depressive episode was assessed using the Composite International Diagnostic Interview – Short Form at child ages 1, 3, 5, 9. Results A latent class growth analysis identified five irritability classes: low decreasing; moderate decreasing; high steady; initially very high, then decreasing; and high increasing. Children with more severe irritability trajectories are more likely to have mothers with recurrent depression, and, with the exception of the most severe (high increasing irritability) class, were more likely to have mothers who were exposed to violence. Moreover, paternal depression and alcohol use, as well as maternal drug and alcohol use, were also risk factors for membership in the more severe irritability classes. A latent auto-regressive cross-lag model showed that child irritability at ages 3 and 5 is associated with increased mother depression at 5 and 9, respectively. Conversely, mother depression at child ages 1 and 3 is associated with increased child irritability at 3 and 5. Conclusion Irritability development across toddlerhood and middle childhood has five main trajectory types, which differ on

Developmental trajectories of irritability and bidirectional associations with maternal depression.

PubMed

Wiggins, Jillian Lee; Mitchell, Colter; Stringaris, Argyris; Leibenluft, Ellen

2014-11-01

Irritability is a dimensional trait in typical development and a common presenting symptom in many psychiatric disorders, including depression. However, little is known about the developmental trajectory of irritability or how child irritability interacts with maternal depression. The present study identifies classes of irritability trajectories from toddlerhood to middle childhood; characterizes maternal depression and other family, social environment, and child variables within each irritability trajectory class; and, as a more exploratory analysis, examines bidirectional associations between maternal depression and child irritability. A total of 4,898 families from the Fragile Families and Child Wellbeing Study reported on irritability symptoms at ages 3, 5, and 9 years, assessed with items from the Child Behavior Checklist. Parental major depressive episode was assessed using the Composite International Diagnostic Interview-Short Form at child ages 1, 3, 5, and 9 years. A latent class growth analysis identified 5 irritability classes: low decreasing; moderate decreasing; high steady; initially very high, then decreasing; and high increasing. Children with more severe irritability trajectories are more likely to have mothers with recurrent depression, and, with the exception of the most severe (high increasing irritability) class, were more likely to have mothers who were exposed to violence. Moreover, paternal depression and alcohol abuse, as well as maternal drug and alcohol abuse, were also risk factors for membership in the more severe irritability classes. A latent auto-regressive cross-lag model showed that child irritability at ages 3 and 5 years is associated with increased mother depression at ages 5 and 9, respectively. Conversely, mother depression at child ages 1 and 3 years is associated with increased child irritability at 3 and 5. Irritability development across toddlerhood and middle childhood has 5 main trajectory types, which differ on maternal

Prevention of occupational dermatitis.

PubMed

Sartorelli, P; Kezic, S; Larese Filon, F; John, S M

2011-01-01

Occupational dermatitis is among the most frequent occupational diseases. Dermal exposure risk affects many professional categories such as healthcare workers, hairdressers, bakers, cleaning and kitchen employees. The economical burden of occupational dermatitis (OD) is huge (greater than 5 billion Euro per year in Europe), comprising direct costs (treatment, compensation), as well as indirect costs due to sick leave and lack of productivity. A scientifically based preventive program consisting of skin protection during work, cleaning and skin care after work has generally been recommended to prevent occupational contact dermatitis. However the rate of reported occupational skin diseases seems unchanged in the recent years. In cases of impaired skin condition the secondary prevention (i.e. therapeutic treatment by dermatologists and health-educational intervention seminars) is fundamental. For cases of occupational dermatoses in which these outpatient prevention measures are not successful, interdisciplinary inpatient rehabilitation measures have been developed (tertiary individual prevention). In the past years, various pilot-concepts to improve occupational dermatitis prevention have been successfully put into practice focussing on interdisciplinary (dermatological and educational) skin protection training programmes for high-risk professions. Currently a multi-step intervention approach is implemented which is aiming at offering quick preventive help at all levels of severity of occupational contact dermatitis. Recent data reveals that there are reliable evidence-based options for multidisciplinary prevention and patient management of occupational dermatitis using a combined approach by a network of clinics, practices and statutory social insurance bodies. At this stage, it seemed reasonable to form a European joint initiative for skin prevention. Recently a European network of preventive dermatology (European Initiative for the Prevention of Occupational Skin

Occupational obstructive airway diseases in Germany: Frequency and causes in an international comparison

DOE Office of Scientific and Technical Information (OSTI.GOV)

Latza, U.; Baur, X.

2005-08-01

Occupational inhalative exposures contribute to a significant proportion of obstructive airway diseases (OAD), namely chronic obstructive pulmonary disease (COPD) and asthma. The number of occupational OAD in the German industrial sector for the year 2003 are presented. Other analyses of surveillance data were retrieved from Medline. Most confirmed reports of OAD are cases of sensitizer induced occupational asthma (625 confirmed cases) followed by COPD in coal miners (414 cases), irritant induced occupational asthma (156 cases), and isocyanate asthma (54 cases). Main causes of occupational asthma in Germany comprise flour/flour constituents (35.9%), food/feed dust (9.0%), and isocyanates (6.5%). Flour and grainmore » dust is a frequent cause of occupational asthma in most European countries and South Africa. Isocyanates are still a problem worldwide. Although wide differences in the estimated incidences between countries exist due to deficits in the coverage of occupational OAD, the high numbers necessitate improvement of preventive measures.« less

Contact allergy to finished woods in furniture and furnishings: a small allergic contact dermatitis epidemic to western red cedar in sauna interior decoration.

PubMed

Huilaja, L; Kubin, M E; Riekki, R

2016-01-01

Allergic contact dermatitis caused by wood dust remains uncommon and most cases are occupational. Contact allergy to finished wooden products is even more rare and only few cases of contact dermatitis to wooden furnishings and furniture are described. During 2012-2014 surprisingly many patients with dermatitis associated to sauna baths were referred to our clinic. We report three novel cases with allergic contact dermatitis to western red cedar due to exposure during sauna baths. Three cases of non-occupational contact dermatitis to western red cedar were confirmed by patch testing. Allergic contact dermatitis to interior decoration or furniture is a rarity, but can be induced by novel exposures, like western red cedar in sauna interior decoration. © 2015 European Academy of Dermatology and Venereology.

Occupational health in Saudi Arabia.

PubMed

Ballal, Seifeddin G; Ahmed, Hafiz O; Sebiany, Abdulaziz M

2002-01-01

The Kingdom of Saudi Arabia is rapidly industrializing, and the economy is now less dependent on oil. The future of industrial growth is very bright. Two industrial complexes (at the Arabian Gulf and the Red Sea coasts) of eight provide the basis for the Kingdom s programs to develop hydrocarbon-based and energy-intensive industries. Expatriates form the driving workforce in industry. Today, more Saudis are being recruited and trained to man the factories. Occupation-related disorders in industry vary from minor irritations to injuries and cancers. However, the risk of massive releases of toxic chemicals is not great. The national Occupational Health Service directorate is based at the Ministry of Health. Together with the Ministry of Labor, it assumes the overall supervision of industrial health and safety. However, there are constraints the most important of which is the lack of enough qualified Saudis in this field.

A new, female-specific irritability rating scale

PubMed Central

Born, Leslie; Koren, Gideon; Lin, Elizabeth; Steiner, Meir

2008-01-01

Objective Irritability is a prominent symptom in the spectrum of female-specific mood disorders, and in some women, irritability is serious enough to disrupt their lives and warrant treatment. The objective of this research was to develop a new, female-specific state measure of irritability. Methods We constructed self-rating and observer rating scales using items derived from spontaneous descriptions of irritability by women with mood disturbances related to the menstrual cycle, childbearing or menopause. Following a pretest, the scales were shortened to the core items of irritability (annoyance, anger, tension, hostility, sensitivity to noise and touch) and tested on a new cohort of patients. Results The 14-item Self-Rating Scale and the 5-item Observer Rating Scale showed evidence for internal consistency (Self-Rating: n = 36 patients, Cronbach's α = 0.9257, mean interitem correlation = 0.4690; Observer Rating: Cronbach's α = 0.7418, mean interitem correlation = 0.3616), Self-Rating test–retest reliability (n = 29 patients, rs = 0.704, p = 0.01) and interrater reliability (n = 20 patients; τb = 1.000, p = 0.001). Conclusion This new, female-specific scale for rating irritability has the potential to further the evaluation of this prominent symptom cluster and increase specificity in clinical assessments of emotional disturbances related to reproductive cyclicity in women. PMID:18592028

The use of different concentrations of betaine as a reducing irritation agent in soaps monitored visually and non-invasively.

PubMed

Nicander, Ingrid; Aberg, Peter; Ollmar, Stig

2003-02-01

Products containing detergents can damage the skin and give rise to irritant contact dermatitis. Therefore, attempts have been made to find less irritating detergents as well as substances decreasing undesired side-effects of detergents, and a novel approach is offered by betaine. The aim of the study has been to determine the irritating properties of some liquid soaps for personal hygiene and to map the effect of different concentrations of betaine using electrical impedance, trans-epidermal water loss and visual inspection. Twenty-eight healthy subjects were patch tested with different commercial soaps with and without betaine and sodium lauryl sulphate on both volar forearms for 24 h. A site with distilled water and an unoccluded area were used as references. Responses of the skin reactions were evaluated by visual inspection and by measuring trans-epidermal water loss and electrical impedance before application and 24 h after removal of the chambers. Significant skin reactions were found for all soaps tested but the soaps containing betaine were the least irritating. However, the skin irritation did not decrease with increasing concentrations of betaine in the tested range. On the whole the differences between the products were not large. The non-invasive methods used were more sensitive than visual assessment for evaluation of invisible or barely visible skin responses. Copyright Blackwell Munksgaard 2003

Pizza makers' contact dermatitis.

PubMed

Lembo, Serena; Lembo, Claudio; Patruno, Cataldo; Balato, Anna; Balato, Nicola; Ayala, Fabio

2014-01-01

Contact eczema to foods, spices, and food additives can occur in occupational and nonoccupational settings in those who grow, handle, prepare, or cook food. Pizza is one of the most eaten foods in every continent, and pizza making is a common work in many countries. We aimed to evaluate the occurrence and the causes of contact dermatitis in pizza makers in Naples. We performed an observational study in 45 pizza makers: all the enrolled subjects had to answer a questionnaire designed to detect personal history of respiratory or cutaneous allergy, atopy; work characteristics and timing were also investigated. Every subject attended the dermatology clinic for a complete skin examination, and when needed, patients were patch tested using the Italian baseline series of haptens integrated with an arbitrary pizza makers series. Our results reported that 13.3% of the enrolled pizza makers (6/45) presented hand eczema, and that 8.9% (4/45) were affected by occupational allergic contact dermatitis. Diallyl disulfide and ammonium persulfate were the responsible substances. Performing patch tests in pizza makers and food handlers affected by hand contact dermatitis is useful. We propose a specific series of haptens for this wide working category.

16 CFR 1500.42 - Test for eye irritants.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Test for eye irritants. 1500.42 Section 1500... eye irritants. (a)(1) Six albino rabbits are used for each test substance. Animal facilities for such... materials that might produce eye irritation. Both eyes of each animal in the test group shall be examined...

Atopic and Contact Dermatitis of the Vulva.

PubMed

Pichardo-Geisinger, Rita

2017-09-01

Pruritus, or itch, is a common vulvar complaint that is often treated empirically as a yeast infection; however, yeast infections are just one of the many conditions that can cause vulvar itch. Ignoring other conditions can prolong pruritus unnecessarily. Atopic dermatitis, irritant contact dermatitis, and allergic contact dermatitis are extremely common noninfectious causes of vulvar itch that are often underdiagnosed by nondermatologists. Identifying these conditions and treating them appropriately can significantly improve a patient's quality of life and appropriately decrease health care expenditures by preventing unnecessary additional referrals or follow-up visits and decreasing pharmaceutical costs. Copyright © 2017 Elsevier Inc. All rights reserved.

Toxicity evaluation of the photoprotective compound LQFM048: Eye irritation, skin toxicity and genotoxic endpoints.

PubMed

de Ávila, Renato Ivan; de Sousa Vieira, Marcelo; Gaeti, Marilisa Pedroso Nogueira; Moreira, Larissa Cleres; de Brito Rodrigues, Laís; de Oliveira, Gisele Augusto Rodrigues; Batista, Aline Carvalho; Vinhal, Daniela Cristina; Menegatti, Ricardo; Valadares, Marize Campos

2017-02-01

A new molecule, LQFM048, originally designed through molecular hybridization using green chemistry approach, is in development as a photoprotective agent. Eye irritation, skin toxicity and genotoxicity evaluations are mandatory for predicting health risks. In this context, the purpose of this study was to investigate the eye irritation potential of LQFM048 by combining Short Time Exposure (STE), Bovine Corneal Opacity and Permeability (BCOP) associated with corneal histomorphometry and Hen's Egg Test-Chorioallantoic Membrane (HET-CAM). Additionally, skin toxicity was evaluated by interleukin-18 production in the HaCaT keratinocyte, Local Lymph Node Assay (LLNA:BrdU-ELISA) method, 3T3 Neutral red uptake (NRU) assay and in vivo phototoxicity test. Genotoxic potential of LQFM048 was also analyzed by cytokinesis-block micronucleus assay (MNvit test-cytoB) in HepG2 cells. Our results showed that LQFM048 did not induce eye irritation and it was classified as UN GHS No Category for both STE and BCOP assays and non-irritating for HET-CAM test. LQFM048 showed non-potential skin sensitization with stimulation index (SI=0.7) in the LLNA:BrdU-ELISA method. Corroborating in vivo tests, it did not promote significant cytotoxicity in HaCaT cells and it showed similar levels of IL-18 when compared to control. Furthermore, LQFM048 induced non-phototoxic potential with photo-irritation factor (PIF) and mean photo effect (MPE) of 1 and -0.138, respectively, for 3T3 cells. Similarly, it was not phototoxic for in vivo testing with or without exposure to UVA, showing SI values of 1 and 1.2, respectively. The micronucleus test showed that LQFM048 was not genotoxic, under the conditions tested.In conclusion, LQFM048, a heterocyclic compound obtained through an environmentally acceptable simple synthetic route, seems to be safe for human use, especially for the development of a new sunscreen product, since it is neither an eye irritant, nor a contact allergen, nor mutagenic and nor

Rates of allergic sensitization and irritation to oxybenzone-containing sunscreen products: a quantitative meta-analysis of 64 exaggerated use studies.

PubMed

Agin, Patricia P; Ruble, Karen; Hermansky, Steven J; McCarthy, Timothy J

2008-08-01

Oxybenzone is an active ingredient found in sunscreen products that absorbs a broad spectrum of ultraviolet (UV) light, with absorbance peaking in the UVB region and extending into the UVA region. Although the overall incidence of sensitization and irritation associated with oxybenzone in the general population remains unclear, a few studies have reported on the incidence in specific circumstances. However, the relevance of these studies to the general population is limited, because the sample populations reported in these papers generally have consisted of individuals who sought medical attention for pre-existing skin conditions. Therefore, the reported incidence of allergic reactions to oxybenzone in these studies may be overestimated as related to the general population. The objective of this meta-analysis was to determine the safety of oxybenzone in participants recruited from the general population. The data from 64 unpublished exaggerated use human repeat insult patch tests (HRIPT) and photoallergy (PA) studies sponsored by Schering-Plough HealthCare Products Inc. between 1992 and 2006 were aggregated and analyzed to evaluate the irritancy and sensitization potential of sunscreen products containing oxybenzone at concentrations between 1% and 6%. Forty-eight of 19 570 possible dermal responses were considered to be suggestive of irritation or sensitization; the mean rate of responses across all formulations was 0.26%. Sensitization rates did not correlate significantly with oxybenzone concentration. The available re-challenge data indicated that only eight of these responses were contact allergies from oxybenzone, and the mean rate of contact allergy to oxybenzone was 0.07%. The source of the skin responses was not confirmed for 15 subjects who were lost to follow-up. However, all subjects were given the opportunity to participate in follow-up testing. Our data indicate that sunscreen products formulated with 1-6% oxybenzone do not possess a significant

Larvicidal and irritant activities of hexane leaf extracts of Citrus sinensis against dengue vector Aedes aegypti L.

PubMed

Warikoo, Radhika; Ray, Ankita; Sandhu, Jasdeep Kaur; Samal, Roopa; Wahab, Naim; Kumar, Sarita

2012-02-01

To assess the larvicidal and irritant activities of the hexane extracts of leaves of Citrus sinensis (C. sinensis) against the early fourth instars and female adults of Aedes aegypti (Ae. aegypti). The larvicidal potential of the prepared leaf extract was evaluated against early fourth instar larvae of Ae. aegypti using WHO protocol. The mortality counts were made after 24 h and LC50 and LC90 values were calculated. The efficacy of extract as mosquito irritant was assessed by contact irritancy assays. Extract-impregnated paper was placed on a glass plate over which a perspex funnel with a hole on the top was kept inverted. Single female adult, 3-day old unfed/blood-fed, was released inside the funnel. After 3 min of acclimatization time, the time taken for the first take-off and total number of flights undertaken during 15 min were scored. The citrus leaf extracts from hexane possessed moderate larvicidal efficiency against dengue vector. The bioassays resulted in an LC50 and LC90 value of 446.84 and 1 370.96 ppm, respectively after 24 h of exposure. However, the extracts were proved to be remarkable irritant against adults Ae. aegypti, more pronounced effects being observed on blood-fed females than unfed females. The extract-impregnated paper was thus proved to be 7-11 times more irritable as compared with the control paper. The hexane extracts from C. sinensis leaves are proved to be reasonably larvicidal but remarkably irritant against dengue vector. Further studies are needed to identify the possible role of extract as adulticide, oviposition deterrent and ovicidal agent. The isolation of active ingredient from the extract could help in formulating strategies for mosquito control.

Larvicidal and irritant activities of hexane leaf extracts of Citrus sinensis against dengue vector Aedes aegypti L.

PubMed Central

Warikoo, Radhika; Ray, Ankita; Sandhu, Jasdeep Kaur; Samal, Roopa; Wahab, Naim; Kumar, Sarita

2012-01-01

Objective To assess the larvicidal and irritant activities of the hexane extracts of leaves of Citrus sinensis (C. sinensis) against the early fourth instars and female adults of Aedes aegypti (Ae. aegypti). Methods The larvicidal potential of the prepared leaf extract was evaluated against early fourth instar larvae of Ae. aegypti using WHO protocol. The mortality counts were made after 24 h and LC50 and LC90 values were calculated. The efficacy of extract as mosquito irritant was assessed by contact irritancy assays. Extract-impregnated paper was placed on a glass plate over which a perspex funnel with a hole on the top was kept inverted. Single female adult, 3-day old unfed/blood-fed, was released inside the funnel. After 3 min of acclimatization time, the time taken for the first take-off and total number of flights undertaken during 15 min were scored. Results The citrus leaf extracts from hexane possessed moderate larvicidal efficiency against dengue vector. The bioassays resulted in an LC50 and LC90 value of 446.84 and 1 370.96 ppm, respectively after 24 h of exposure. However, the extracts were proved to be remarkable irritant against adults Ae. aegypti, more pronounced effects being observed on blood-fed females than unfed females. The extract-impregnated paper was thus proved to be 7–11 times more irritable as compared with the control paper. Conclusions The hexane extracts from C. sinensis leaves are proved to be reasonably larvicidal but remarkably irritant against dengue vector. Further studies are needed to identify the possible role of extract as adulticide, oviposition deterrent and ovicidal agent. The isolation of active ingredient from the extract could help in formulating strategies for mosquito control. PMID:23569887

PSYCHOLOGICAL ASPECTS OF IRRITABLE BOWEL SYNDROME

PubMed Central

Rajagopalan, Mani; Kurian, George; John, Jacob K.

1996-01-01

Psychological aspects of Irritable Bowel Syndrome have been well investigated in Western countries, but there is a paucity of Indian studies focusing on this area. A series of fifty patients with the Irritable Bowel Syndrome were studied with respect to their depressive symptoms, anxiety symptoms and their personality traits. Patients had a mean score of 14.68 on Hamilton's depression rating scale and 11.22 on Hamilton's anxiety rating scale, and were more introverted and more neurotic than the general population. No association was found between psychological symptoms and severity of gastrointestinal symptoms. These findings suggest that psychological symptoms are a concomitant part of the Irritable Bowel Syndrome. PMID:21584134

Correlates of Irritability in College Students With Depressive Symptoms

PubMed Central

Pedrelli, Paola; Nyer, Maren; Holt, Daphne; Bakow, Brianna R.; Fava, Maurizio; Baer, Lee; Cassiello, Clair; Mulligan, Maura; Cusin, Cristina; Farabaugh, Amy

2015-01-01

Depression is a prevalent psychiatric disorder associated with significant personal and societal burden. There is accumulating evidence for the presence of a subtype of depression characterized by the presence of irritability that is associated with increased morbidity, risk for suicidal ideation, and functional impairments in adults. Little is known about the features of depressive symptoms with and without irritability among young adults in college. The primary aim of this study was to characterize the presentation of college students with depressive symptoms and irritability. Two-hundred eighty-seven undergraduate college students with depressive symptoms with and without irritability were compared across several psychiatric and functional outcome variables. Independent samples t-tests or logistic regressions were conducted for each outcome variable using the irritability item of the Beck Depression Inventory as a dichotomous grouping variable. Analyses were conducted separately for the men and the women. Both male and female students with depressive symptoms and severe irritability reported a greater severity of depressive symptoms compared with their peers with no or mild irritability. In the women, the presence of irritability was associated with greater symptoms of anxiety, whereas in the men, it was associated with increased likelihood of engaging in risky behaviors, including compulsive use of alcohol, illicit drugs, and prescription drugs. The male and female college students with depressive symptoms with and without irritability did not differ on severity of suicidal ideation, hopelessness, or cognitive functioning. The findings from this study suggest that depressive symptoms and irritability may characterize a subtype of college students who have a greater symptom burden and with the potential need for more aggressive and prompt treatment. PMID:24177482

Assessing occupational exposure to sea lamprey pesticides

PubMed Central

Ceballos, Diana M; Beaucham, Catherine C; Kurtz, Kristine; Musolin, Kristin

2015-01-01

Background: Sea lampreys are parasitic fish found in lakes of the United States and Canada. Sea lamprey is controlled through manual application of the pesticides 3-trifluoromethyl-4-nitrophenol (TFM) and BayluscideTM into streams and tributaries. 3-Trifluoromethyl-4-nitrophenol may cause irritation and central nervous system depression and Bayluscide may cause irritation, dermatitis, blisters, cracking, edema, and allergic skin reactions. Objectives: To assess occupational exposures to sea lamprey pesticides. Methods: We developed a wipe method for evaluating surface and skin contamination with these pesticides. This method was field tested at a biological field station and at a pesticide river application. We also evaluated exposures using control banding tools. Results: We verified TFM surface contamination at the biological station. At the river application, we found surfaces and worker’s skin contaminated with pesticides. Conclusion: We recommended minimizing exposures by implementing engineering controls and improved use of personal protective equipment. PMID:25730600

Contact dermatitis.

PubMed

Gurwood, A S; Altenderfer, D S

2001-01-01

Anatomically, the eyelid can be divided microscopically into (1) skin, which is made up of epidermis and dermis; (2) submucosa (3) muscular layer; (4) submuscular layer (dense connective tissue); (5) fibrous layer; and (6) palpebral conjunctiva. The thin nature of the eyelid makes it susceptible to inflammation resulting from allergy. Minimum levels of irritants contacting the adnexal area can penetrate the skin to initiate the allergic cascade. Allergic reactions that involve the eye may begin via contact to the skin, but often involve the conjunctiva. Eczema is the general term that describes the superficial inflammatory process involving the epidermis. Contact eczema is characterized by varying elements of epidermal erythema, papules, and vesicles. Allergic dermatoconjunctivitis connotes involvement of both the skin and conjunctiva. A 24-year-old man came to the clinic with a red, swollen left eye. Based on the history, the constellation of signs and symptoms (lack of diffuse or focal pain, presence of periorbital and conjunctival edema, absence of fever), and failed resolution after treatment with injectable antibiotics, the diagnosis of type IV delayed hypersensitivity reaction secondary to toxic/chemical exposure was made. Speedy resolution was accomplished using a sequenced therapy, which included oral antihistamines, topical cycloplegics, topical antibiotics, topical steroids, and palliative therapies. Optometrists should be familiar with the signs and symptoms of contact eczema and allergic dermatoconjunctivitis. Treatment includes management of the skin and adnexae, as well as the ocular manifestations.

Wet Work and Barrier Function.

PubMed

Fartasch, Manigé

2016-01-01

Wet work defined as unprotected exposure to humid environments/water; high frequencies of hand washing procedures or prolonged glove occlusion is believed to cause irritant contact dermatitis in a variety of occupations. This review considers the recent studies on wet-work exposure and focuses on its influence on barrier function. There are different methods to study the effect of wet work on barrier function. On the one hand, occupational cohorts at risk can be monitored prospectively by skin bioengineering technology and clinical visual scoring systems; on the other hand, experimental test procedures with defined application of water, occlusion and detergents are performed in healthy volunteers. Both epidemiological studies and the results of experimental procedures are compared and discussed. A variety of epidemiological studies analyze occupational cohorts at risk. The measurement of transepidermal water loss, an indicator of the integrity of the epidermal barrier, and clinical inspection of the skin have shown that especially the frequencies of hand washing and water contact/contact to aqueous mixtures seem to be the main factors for the occurrence of barrier alterations. On the other hand, in a single cross-sectional study, prolonged glove wearing (e.g. occlusion for 6 h per shift in clean-room workers) without exposure to additional hazardous substances seemed not to affect the skin negatively. But regarding the effect of occlusion, there is experimental evidence that previously occluded skin challenged with sodium lauryl sulfate leads to an increased susceptibility to the irritant with an aggravation of the irritant reaction. These findings might have relevance for the real-life situation in so far as after occupational glove wearing, the skin is more susceptible to potential hazards to the skin even during leisure hours. © 2016 S. Karger AG, Basel.

[Current contact allergens].

PubMed

Geier, J; Uter, W; Lessmann, H; Schnuch, A

2011-10-01

Ever-changing exposure to contact allergens, partly due to statutory directives (e.g. nickel, chromate, methyldibromo glutaronitrile) or recommendations from industrial associations (e.g. hydroxyisohexyl 3-cyclohexene carboxaldehyde), requires on-going epidemiologic surveillance of contact allergy. In this paper, the current state with special focus in fragrances and preservatives is described on the basis of data of the Information Network of Departments of Dermatology (IVDK) of the year 2010. In 2010, 12,574 patients were patch tested in the dermatology departments belonging to the IVDK. Nickel is still the most frequent contact allergen. However the continuously improved EU nickel directive already has some beneficial effect; sensitization frequency in young women is dropping. In Germany, chromate-reduced cement has been in use now for several years, leading to a decline in chromate sensitization in brick-layers. Two fragrance mixes are part of the German baseline series; they are still relevant. The most important fragrances in these mixes still are oak moss absolute and hydroxyisohexyl 3-cyclohexene carboxaldehyde. However, in relation to these leading allergens, sensitization frequency to other fragrances contained in the mixes seems to be increasing. Among the preservatives, MCI/MI has not lost its importance as contact allergen, in contrast to MDBGN. Sources of MCI/MI sensitization obviously are increasingly found in occupational context. Methylisothiazolinone is a significant allergen in occupational settings, and less frequently in body care products.

Shoe contact dermatitis from dimethyl fumarate: clinical manifestations, patch test results, chemical analysis, and source of exposure.

PubMed

Giménez-Arnau, Ana; Silvestre, Juan Francisco; Mercader, Pedro; De la Cuadra, Jesus; Ballester, Isabel; Gallardo, Fernando; Pujol, Ramón M; Zimerson, Erik; Bruze, Magnus

2009-11-01

The methyl ester form of fumaric acid named dimethyl fumarate (DMF) is an effective mould-growth inhibitor. Its irritating and sensitizing properties were demonstrated in animal models. Recently, DMF has been identified as responsible for furniture contact dermatitis in Europe. To describe the clinical manifestations, patch test results, shoe chemical analysis, and source of exposure to DMF-induced shoe contact dermatitis. Patients with suspected shoe contact dermatitis were studied in compliance with the Declaration of Helsinki. Patch test results obtained with their own shoe and the European baseline series, acrylates and fumaric acid esters (FAE), were recorded according to international guidelines. The content of DMF in shoes was analysed with gas chromatography and mass spectrometry. Acute, immediate irritant contact dermatitis and non-immunological contact urticaria were observed in eight adults and two children, respectively. All the adult patients studied developed a delayed sensitization demonstrated by a positive patch testing to DMF < or = 0.1% in pet. Cross-reactivity with other FAEs and acrylates was observed. At least 12 different shoe brands were investigated. The chemical analysis from the available shoes showed the presence of DMF. DMF in shoes was responsible for severe contact dermatitis. Global preventive measures for avoiding contact with DMF are necessary.

Screening for eye irritancy using cultured HeLa cells.

PubMed

Selling, J; Ekwall, B

1985-01-01

To investigate whether toxicity tests on HeLa cells were predictive of eye irritancy, 18 compounds of known eye irritancy and in vitro cytotoxicity were tested on HeLa cells in the MIT-24 system. The results correlated well with eye irritancy as determined by the Draize test in rabbits for 16 of the test substances, but failed to detect the high eye irritancy of 1-heptanol and allyl alcohol, both of which were cytotoxic in other cellular systems.

Work-related stress management between workplace and occupational health care.

PubMed

Kinnunen-Amoroso, Maritta; Liira, Juha

2016-06-13

Work-related stress has been evaluated as one of the most important health risks in Europe. Prevention of work related stress and interventions to reduce risk factors for stress in the workplace are conducted together by the enterprise and occupational health services. The aim of the study was to examine the experiences of Finnish occupational physicians on the stress management with enterprises. From the Finnish Association of Occupational Health Physicians membership list 207 physicians responded to self-administered anonymous questionnaire. The data were analysed using SPSS 17.0. The client enterprises contacted occupational health services frequently about work-related stress. Collaboration between occupational health and enterprises was strongest in companies' own occupational health services and generally with most experienced physicians. Occupational health services and enterprises shared responsibility for managing work-related stress. Professional experience and close contact with organisation management favours successful stress management between occupational health and enterprises.

Paederus dermatitis featuring chronic contact dermatitis.

PubMed

Stanimirović, Andrija; Skerlev, Mihael; Culav-Košćak, Ivana; Kovačević, Maja

2013-01-01

Paederus dermatitis is a distinct variant of acute irritant contact dermatitis caused by mucocutaneous contact with the specific toxin of an insect belonging to the genus Paederus. It is characterized by the sudden onset of erythema and vesiculobullous lesions on exposed skin, with special predilection for the periorbital region. Paederus species have been mostly identified in Africa, Asia, Australia, and Central/South America. We report a 51-year-old woman who experienced 4 recurrences of periorbital erythema and edema in the previous year. No consistent etiology could be established at the beginning. Only after taking a detailed medical history was it discovered that 1 year before our examination, the patient had traveled to Kenya, where she had experienced contact with the insect. This fact led us to the diagnosis of Paederus dermatitis. After appropriate treatment, a complete regression was observed over a 3-week period.

Acrylate and methacrylate contact allergy and allergic contact disease: a 13-year review.

PubMed

Spencer, Ashley; Gazzani, Paul; Thompson, Donna A

2016-09-01

(Meth)acrylates are important causes of contact allergy and allergic contact disease, such as dermatitis and stomatitis, with new and emerging sources resulting in changing clinical presentations. To identify the (meth)acrylates that most commonly cause allergic contact disease, highlight their usefulness for screening, and examine their relationship with occupational and clinical data. A retrospective review of results from patch tests performed between July 2002 and September 2015, in one tertiary Cutaneous Allergy Unit, was performed A series of 28 (meth)acrylates was applied to 475 patients. Results were positive in 52 cases, with occupational sources being identified in 24. Industrial exposures and acrylic nails were responsible for 13 and 10 cases, respectively, with wound dressings being implicated in 7. We found that four individual (meth)acrylates (2-hydroxyethyl acrylate, 2-hydroxypropyl methacrylate, bisphenol A glycerolate dimethacrylate, and ethyl acrylate), if used as a screening tool, could have identified 47 (90.4%) of our positive cases. Our 13-year experience indicates a changing landscape of (meth)acrylate contact allergy and allergic contact disease, with an observed shift in exposures away from manufacturing and towards acrylic nail sources. Wound dressings are highlighted as emerging sources of sensitization. Larger studies are required to establish the sensitivity and specificity of the four (meth)acrylates proposed for potential screening. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Irritability in Pediatric Patients: Normal or Not?

PubMed Central

Hameed, Usman; Dellasega, Cheryl A.

2016-01-01

The goal of this article is to describe the concept of irritability in children and youth, which has been revisited in the DSM-5. Traditionally, this behavior has been more commonly associated with mood disorders, which may account for the rising incidence of bipolar disorder diagnosis and overuse of mood-stabilizing medications in pediatric patients. While not predictive of mania, persistent nonepisodic irritability, if undetected, may escalate to violent behavior with potentially serious outcomes. It is therefore important to educate clinicians about how to accurately assess irritability in pediatric patients. PMID:27486529

Irritable bowel syndrome

MedlinePlus

... Side Effects of Drugs . 16th ed. Philadelphia, PA: Elsevier; 2016:488-494. Canavan C, West J, Card ... FF, ed. Ferri's Clinical Advisor 2018 . Philadelphia, PA: Elsevier; 2018:722-725. Ford AC, Talley NJ. Irritable ...

Occupational poison ivy and oak dermatitis.

PubMed

Epstein, W L

1994-07-01

Among the growing and diverse groups of outdoor and environmental workers, poison ivy and poison oak continue to be the major cause of occupational contact dermatitis. This article reviews the practical and theoretic means to prevent poison ivy and poison oak dermatitis in workers occupationally exposed to these weeds.

Severe allergic contact dermatitis resulting from occupational exposure to tincture of benzoin aerosol spray in an anesthesiologist.

PubMed

Klein, Thomas G; Woehlck, Harvey J; Pagel, Paul S

2009-01-01

We describe the clinical presentation and management of an anesthesiologist who developed a severe allergic contact dermatitis resulting from occupational exposure to tincture of benzoin aerosol spray. A previously healthy male anesthesiologist with a small laceration between his right thumb and forefinger used a tincture of benzoin aerosol spray to improve adhesion of a small bandage immediately before performing a spinal anesthetic. He had previously used benzoin for skin reinforcement on several occasions during weight-lifting. The anesthesiologist experienced severe pruritus in the affected hand 48 h after benzoin exposure. A well-demarcated, bright red erythematous confluent vesicular dermatitis with and without painful hemorrhagic bullae erupted on the palmar and dorsal surfaces, respectively, of his hand, accompanied by pronounced edema. The palmar bullae were drained with several small incisions and the anesthesiologist was treated with intravenous methylprednisolone. He was unable to work for 10 days while the dermatitis gradually resolved. The case emphasizes that occupational exposure to benzoin represents a potential risk for operating room personnel who may be susceptible to cutaneous delayed hypersensitivity-mediated allergic reactions as a result of previous exposure to benzoin or chemically related cross-reacting substances.

Recent advances in occupational dermatitis.

PubMed

Holness, Dorothy Linn

2013-04-01

This review examined recent advances in occupational contact dermatitis (OCD). Both genetic and environmental factors contribute to OCD. There is continuing growth in our understanding of the genetic factors, particularly related to filaggrin mutations. In spite of increased understanding of irritant exposures, the prevalence of hand eczema in workers with wet work exposures remains high at approximately 20%. Patch test database surveillance systems have documented reductions in the occurrence of sensitivity to some allergens such as chromium wherein regulatory efforts have reduced workplace exposures. These surveillance data have also documented increases in sensitivity to several allergens in particular trades, serving as an effective system to identify new exposure situations or new allergens. The impact of OCD on quality of life and mental health conditions, employment and financial aspects is increasingly documented. Progress in understanding the underreporting of OCD and the underlying reasons continues. Several groups have developed robust multidisciplinary secondary and tertiary prevention programmes and the evaluations demonstrate promise. Although several recent systematic reviews have documented the evidence for various prevention strategies, there is increasing understanding of the gaps in prevention practices in actual workplaces. Understanding of the underlying genetic and environmental agents contributing to OCD is increasing. In spite of progress with reducing exposure to some allergens, the prevalence of OCD continues to be high, particularly related to wet work. New prevention programmes are being developed and evaluated and hold promise for improved outcomes.

A cross-cultural perspective on irritable bowel syndrome.

PubMed

Gerson, Charles D; Gerson, Mary-Joan

2010-01-01

Irritable bowel syndrome is a functional gastrointestinal illness, defined by symptoms. Irritable bowel syndrome has been described as a biopsychosocial condition, in which colonic dysfunction is affected by psychological and social factors. As a result of this unusual constellation, irritable bowel syndrome may be subject to cultural variables that differ in different parts of the globe. In this article, we describe some of the ways in which irritable bowel syndrome may be experienced differently, depending on local belief systems, psychological pressures, acceptance or resistance to a mind-body paradigm, and breakdown in support or relationship structure. Examples are given in which irritable bowel syndrome investigators from countries around the world describe various aspects of the syndrome that may affect the illness experience of their patients. We describe our own research studies that have demonstrated possible adverse effects on disease severity from relationship conflict, attribution of symptoms to physical rather than emotional cause, and the belief that irritable bowel syndrome is enduring and mysterious. Also described is our finding that symptom patterns may differ significantly between different geographic locations. Finally, we discuss the importance of "cultural competence" on the part of healthcare professionals in regard to caring for patients of diverse cultural backgrounds. © 2010 Mount Sinai School of Medicine.

Lack of Evidence for Contact Sensitization by Pfiesteria Extract

PubMed Central

Patterson, Rachel M.; Noga, Edward; Germolec, Dori

2007-01-01

Background Members of the estuarine dinoflagellate genus Pfiesteria are reported to have been responsible for massive fish kills in the southeastern United States. Some reports suggest that exposure to waters having Pfiesteria blooms or occupation-related exposure might result in Pfiesteria-induced dermal irritation and inflammation. Although the toxin has not been isolated and purified, the original data suggested both hydrophilic and hydrophobic toxic components. Some investigators propose that dermonecrotic properties are associated with a hydrophobic fraction. Objectives A bioactive C18-bound putative toxin (CPE) extracted from Pfiesteria-laden aquarium water during active fish-killing conditions was examined in the present study to evaluate its potential to produce inflammation and dermal sensitization and to determine whether the inflammation and dermatitis reported in early human exposure studies were allergic or irritant in nature. Results This fraction was cytotoxic to mouse Neuro-2A cells and primary human epidermal keratinocytes (NHEK) at a concentration of 1 mg/mL. Balb/C mice exposed to 50–200% CPE by skin painting exhibited a 6–10% increase in ear swelling relative to vehicle-treated mice in a primary irritancy assay. There was no increase in lymph node cell proliferation as measured using the local lymph node assay. Exposure to CPE in culture up-regulated interleukin-8 in NHEK, whereas granulocyte macrophage–colony-stimulating factor and tumor necrosis factor α were only minimally altered. Conclusions This study suggests that CPE is cytotoxic to keratinocytes in culture at high concentrations and that it induces mild, localized irritation but not dermal sensitization. PMID:17637917

Lack of evidence for contact sensitization by Pfiesteria extract.

PubMed

Patterson, Rachel M; Noga, Edward; Germolec, Dori

2007-07-01

Members of the estuarine dinoflagellate genus Pfiesteria are reported to have been responsible for massive fish kills in the southeastern United States. Some reports suggest that exposure to waters having Pfiesteria blooms or occupation-related exposure might result in Pfiesteria-induced dermal irritation and inflammation. Although the toxin has not been isolated and purified, the original data suggested both hydrophilic and hydrophobic toxic components. Some investigators propose that dermonecrotic properties are associated with a hydrophobic fraction. A bioactive C18-bound putative toxin (CPE) extracted from Pfiesteria-laden aquarium water during active fish-killing conditions was examined in the present study to evaluate its potential to produce inflammation and dermal sensitization and to determine whether the inflammation and dermatitis reported in early human exposure studies were allergic or irritant in nature. This fraction was cytotoxic to mouse Neuro-2A cells and primary human epidermal keratinocytes (NHEK) at a concentration of 1 mg/mL. Balb/C mice exposed to 50-200% CPE by skin painting exhibited a 6-10% increase in ear swelling relative to vehicle-treated mice in a primary irritancy assay. There was no increase in lymph node cell proliferation as measured using the local lymph node assay. Exposure to CPE in culture up-regulated interleukin-8 in NHEK, whereas granulocyte macrophage-colony-stimulating factor and tumor necrosis factor alpha were only minimally altered. This study suggests that CPE is cytotoxic to keratinocytes in culture at high concentrations and that it induces mild, localized irritation but not dermal sensitization.

Irritant and cytotoxic coumarins from Angelica glauca Edgew roots.

PubMed

Saeed, M Asif; Sabir, A W

2008-01-01

Irritant and cytotoxic potentiality of six coumarins, isolated for the first time from the roots of Angelica glauca identified as 5,6,7-trimethoxycoumarin, 6-methoxy-7,8-methylenedioxycoumarin, bergapten, decursinol angelate, decursin, and nodakenetin, were investigated. The irritant potential was explored by open mouse ear assay, evaluating their ID(50) after acute and by IU (Irritant units) after chronic effects, while the cytotoxic capability was explored by their LC(50), using brine shrimp (Artemia salina) larvae (nauplii). All the coumarins exhibited well-defined irritancy on mouse's ears, compared with the positive controlled euphorbium reaction and cytotoxic response against brine shrimp larvae, compared with the positive control colchicine. Decursinol angelate and decursin were the most potent and persistent irritant compounds with least ID(50), whose reactions lasted for 48 h. 6-Methoxy-7,8-methylenedioxycoumarin and bergaten revealed an intermediate irritant reactions, while 5,6,7-trimethoxycoumarin and nodakenetin displayed the least irritant and least persistent reactions on mouse ears. Both decursin and decursinol angelate also appeared to be the stronger cytotoxic agents than other coumarins. 5,6,7-trimethoxycoumarin displayed an intermediate cytotoxic behaviour, while other three coumarins, i.e., 6-methoxy-7,8-methylenedioxycoumarin, bergapten, and nodakenetin, exhibited the least cytotoxic capacity against brine shrimp larvae.

The Usefulness of Assessing and Identifying Workers' Temperaments and Their Effects on Occupational Stress in the Workplace.

PubMed

Deguchi, Yasuhiko; Iwasaki, Shinichi; Konishi, Akihito; Ishimoto, Hideyuki; Ogawa, Koichiro; Fukuda, Yuichi; Nitta, Tomoko; Inoue, Koki

2016-01-01

The relationship between temperaments and mental disorders has been reported in previous studies, but there has been little attention to temperaments in the occupational safety and health research. The aim of this study was to clarify the effects of temperaments on occupational stress among local government employees. The subjects were 145 Japanese daytime workers in local government. Temperaments were assessed by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A). Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ). Hierarchical multiple linear regression analysis was used. Hyperthymic temperament predicted a higher level of job control, and a lower level of role ambiguity and job future ambiguity. Irritable temperament predicted a lower level of social support from supervisors and a higher level of role conflict, variance in workload and intragroup conflict. Anxious temperament predicted a lower level of social support from coworkers and a higher level of job future ambiguity. The sample size was small. Only Japanese local government employees were surveyed. Hyperthymic temperament played a protective role, and irritable, anxious temperament played a vulnerable role against one's own occupational stress and recognizing the roles they play in work life would lead to self-insight. Additionally, recognition of the temperaments and temperament-related stressors by one's supervisors or coworkers would facilitate provision of social support.

The Usefulness of Assessing and Identifying Workers’ Temperaments and Their Effects on Occupational Stress in the Workplace

PubMed Central

Konishi, Akihito; Ishimoto, Hideyuki; Ogawa, Koichiro; Fukuda, Yuichi; Nitta, Tomoko; Inoue, Koki

2016-01-01

The relationship between temperaments and mental disorders has been reported in previous studies, but there has been little attention to temperaments in the occupational safety and health research. The aim of this study was to clarify the effects of temperaments on occupational stress among local government employees. The subjects were 145 Japanese daytime workers in local government. Temperaments were assessed by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A). Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ). Hierarchical multiple linear regression analysis was used. Hyperthymic temperament predicted a higher level of job control, and a lower level of role ambiguity and job future ambiguity. Irritable temperament predicted a lower level of social support from supervisors and a higher level of role conflict, variance in workload and intragroup conflict. Anxious temperament predicted a lower level of social support from coworkers and a higher level of job future ambiguity. The sample size was small. Only Japanese local government employees were surveyed. Hyperthymic temperament played a protective role, and irritable, anxious temperament played a vulnerable role against one’s own occupational stress and recognizing the roles they play in work life would lead to self-insight. Additionally, recognition of the temperaments and temperament-related stressors by one’s supervisors or coworkers would facilitate provision of social support. PMID:27227771

Irritable Bowel Syndrome

MedlinePlus

Irritable bowel syndrome (IBS) is a problem that affects the large intestine. It can cause abdominal cramping, bloating, and a change in bowel ... go back and forth between the two. Although IBS can cause a great deal of discomfort, it ...

Comparison of human skin irritation patch test data with in vitro skin irritation assays and animal data.

PubMed

Jírová, Dagmar; Basketter, David; Liebsch, Manfred; Bendová, Hana; Kejlová, Kristina; Marriott, Marie; Kandárová, Helena

2010-02-01

Efforts to replace the rabbit skin irritation test have been underway for many years, encouraged by the EU Cosmetics Directive and REACH. Recently various in vitro tests have been developed, evaluated and validated. A key difficulty in confirming the validity of in vitro methods is that animal data are scarce and of limited utility for prediction of human effects, which adversely impacts their acceptance. This study examines whether in vivo or in vitro data most accurately predicted human effects. Using the 4-hr human patch test (HPT) we examined a number of chemicals whose EU classification of skin irritancy is known to be borderline, or where in vitro methods provided conflicting results. Of the 16 chemicals classified as irritants in the rabbit, only five substances were found to be significantly irritating to human skin. Concordance of the rabbit test with the 4-hr HPT was only 56%, whereas concordance of human epidermis models with human data was 76% (EpiDerm) and 70% (EPISKIN). The results confirm observations that rabbits overpredict skin effects in humans. Therefore, when validating in vitro methods, all available information, including human data, should be taken into account before making conclusions about their predictive capacity.

The impact of intolerance of uncertainty, worry and irritability on quality of life in persons with epilepsy: irritability as mediator.

PubMed

Barahmand, Usha; Haji, Afsar

2014-10-01

Epilepsy is a neurological disorder afflicting many people in the world. The impact of epilepsy on the quality of life of those afflicted with epilepsy is greater than the limitations imposed by the seizures alone. Among the several psychological disorders found to be comorbid with epilepsy are anxiety and depression, both of which impair quality of life in epilepsy. Some studies have reported that the anxiety seen in epilepsy is characterized by worry while the depression seen is characterized by irritability. A concept common to both anxiety and depression is intolerance of uncertainty. Therefore, the study explores the relationship between intolerance of uncertainty, worry and irritability and their association to quality of life in epilepsy. A descriptive-correlational research method was used and the research sample comprised 60 consecutive referrals seeking outpatient neurological services for epilepsy at Alavi Hospital in Ardebil. Data were collected by administering the Penn State Worry Questionnaire, Intolerance of Uncertainty Scale, Irritability Questionnaire and Quality of Life in Epilepsy Inventory. Data were analyzed using Pearson's correlation coefficients and multivariate regression analysis. Mediation and moderation analyses were conducted. Findings indicated that intolerance of uncertainty, worry and irritability have unique significant effects on quality of life. The implications are that interventions aimed at improving the quality of life of patients with epilepsy should address their feelings of uncertainty, worry and irritability. Furthermore, irritability seems to mediate the impact of both intolerance of uncertainty and worry on quality of life of individuals with epilepsy. No significant moderation effects were noted. Results underscore the important role of irritability in the quality of life of persons with epilepsy. The findings are discussed with reference to the possibility of particular predisposing temperaments and add credence to

Can the epoxides of cinnamyl alcohol and cinnamal show new cases of contact allergy?

PubMed

Hagvall, Lina; Niklasson, Ida B; Luthman, Kristina; Karlberg, Ann-Therese

2018-06-01

Cinnamyl alcohol is considered to be a prohapten and prehapten with cinnamal as the main metabolite. However, many individuals who are allergic to cinnamyl alcohol do not react to cinnamal. Sensitizing epoxides of cinnamyl alcohol and cinnamal have been identified as metabolites and autoxidation products of cinnamyl alcohol. To investigate the clinical relevance of contact allergy to epoxycinnamyl alcohol and epoxycinnamal. Irritative effects of the epoxides were investigated in 12 dermatitis patients. Epoxycinnamyl alcohol and epoxycinnamal were patch tested in 393 and 390 consecutive patients, respectively. In parallel, cinnamyl alcohol and cinnamal were patch tested in 607 and 616 patients, respectively. Both epoxides were irritants, but no more positive reactions were detected than when testing was performed with cinnamyl alcohol and cinnamal. Late allergic reactions to epoxycinnamyl alcohol were observed. In general, patients with late reactions showed doubtful or positive reactions to cinnamal and fragrance mix I at regular patch testing. The investigated epoxides are not important haptens in contact allergy to cinnamon fragrance. The high frequency of fragrance allergy among patients included in the irritancy study showed the difficulty of suspecting fragrance allergy on the basis of history; patch testing broadly with fragrance compounds is therefore important. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

In vivo assessment of cytological changes by means of reflectance confocal microscopy - demonstration of the effect of topical vitamin E on skin irritation caused by sodium lauryl sulfate.

PubMed

Casari, Alice; Farnetani, Francesca; De Pace, Barbara; Losi, Amanda; Pittet, Jean-Christophe; Pellacani, Giovanni; Longo, Caterina

2017-03-01

Irritant contact dermatitis is caused by skin barrier damage. Vitamin E is an antioxidant that is commonly used in cosmetics to prevent photo-damage. To show the usefulness of reflectance confocal microscopy in the assessment of irritant skin damage caused by sodium lauryl sulfate (SLS) and of the protective action of vitamin E applied prior to skin irritation. Ten healthy volunteers were enrolled. Irritation was induced by the application of a patch test containing SLS 5% aq. for 24 h. Three sites were compared: one site on which a product with vitamin E was applied before SLS treatment, one site on which the same product was applied after SLS treatment, and one control site (SLS only). Each site was evaluated with reflectance confocal microscopy, providing in vivo tissue images at nearly histological resolution. We also performed a computerized analysis of the VivaStack® images. Reflectance confocal microscopy is able to identify signs of skin irritation and the preventive effect of vitamin E application. Reflectance confocal microscopy is useful in the objective assessment of irritative skin damage. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

From topical antidote against skin irritants to a novel counter-irritating and anti-inflammatory peptide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brodsky, Berta; Erlanger-Rosengarten, Avigail; Proscura, Elena

2008-06-15

The primary purpose of the present study was to investigate the mechanism of the counter-irritating activity of topical iodine against skin lesions induced by chemical and thermal stimuli. The hypothesis that iodine exerts its activity by inducing an endogenous anti-inflammatory factor was confirmed by exposing guinea pig skin to heat stimulus followed by topical iodine treatment and skin extraction. Injection of the extract into naive guinea pigs reduced heat-induced irritation by 69%. The protective factor, identified as a new nonapeptide (histone H2A 36-44, H-Lys-Gly-Asn-Tyr-Ala-Glu-Arg-Ileu-Ala-OH), caused reduction of 40% in irritation score in heat-exposed guinea pigs. The murine analog (H-Lys-Gly-His-Tyr-Ala-Glu-Arg-Val-Gly-OH, termedmore » IIIM1) reduced sulfur mustard (SM)-induced ear swelling at a dose-dependent bell-shape manner reaching peak activity of 1 mg/kg. Cultured keratinocytes transfected with the peptide were more resistant towards SM than the control cells. The peptide suppressed oxidative burst in activated neutrophils in a concentration-dependent manner. In addition, the peptide reduced glucose oxidase-induced skin edema in mice at a dose-dependent bell-shape manner. Apart from thermal and chemical-induced skin irritation this novel peptide might be of potential use in chronic dermal disorders such as psoriasis and pemphigus as well as non-dermal inflammatory diseases like multiple sclerosis, arthritis and colitis.« less

Skin-specific training experience of workers assessed for contact dermatitis.

PubMed

Zack, B; Arrandale, V; Holness, D L

2018-05-17

Contact dermatitis is a common and preventable work-related disease. Skin-specific training may be effective for preventing occupational contact dermatitis, but little information is available regarding actual workplace training and its effectiveness. To describe workplace skin-specific training among workers with suspected contact dermatitis. Patch test patients being assessed for suspected contact dermatitis at an occupational health clinic in Toronto, Canada, completed a questionnaire on training experiences, workplace characteristics, exposures and skin protection practices. Of 175 patients approached, 122 (71%) workers completed questionnaires. Many (80%) had received general occupational health and safety and hazardous materials training (76%). Fewer (39%) received skin-specific training. Of those with work-related contact dermatitis, 52% did not receive skin-specific training. Skin-specific training was commonly provided by health and safety professionals or supervisors using video, classroom and online techniques. Content included glove use, exposure avoidance and hand washing information. Workers that received skin-specific training found it memorable (87%), useful (85%) and common sense in nature (100%). This study indicates gaps in workplace training on skin disease prevention for workers with contact dermatitis. Workers perceived skin-specific training to be useful. Understanding worker training experiences is important to prevention programme development and reducing work-related skin disease.

Contact dermatitis to Vicks VapoRub.

PubMed

Noiles, Kristin; Pratt, Melanie

2010-01-01

Vicks VapoRub (VVR) is a commonly used inhalant ointment that helps relieve symptoms of upper respiratory tract infections. It contains several plant substances, including turpentine oil, eucalyptus oil, and cedar leaf oil, which can potentially irritate or sensitize the skin, as well as camphor, menthol, nutmeg oil, and thymol. Although many reports describe allergic contact dermatitis (ACD) to the various constituents in VVR ointment, there are no cases of VVR directly causing ACD. We present a case of a patient who developed an ACD secondary to application of her VVR.

Performance of a commercially available plant allergen series in the assessment of suspected occupational contact dermatitis to plants in north Indian patients.

PubMed

De, Dipankar; Khullar, Geeti; Handa, Sanjeev

2015-01-01

Parthenium hysterophorus is the leading cause of phytogenic allergic contact dermatitis in India. The Indian Standard Series currently supplied by Systopic Laboratories Ltd and manufactured by Chemotechnique Diagnostics ® contains parthenolide as the only allergen representing plant allergens. The study was conducted to assess the performance of the Chemotechnique plant series (PL-1000), consisting of 14 allergens, in patients with clinically suspected occupational contact dermatitis to plant allergens. Ninety patients were patch tested with the Chemotechnique plant series from 2011 to 2013. Demographic details, clinical diagnosis and patch test results were recorded in the contact dermatitis clinic proforma. Of 90 patients, 24 (26.7%) showed positive reactions to one or more allergens in the plant series. Positive patch tests were elicited most commonly by sesquiterpene lactone mix in 19 (78.6%) patients, followed by parthenolide in 14 (57.1%), Achillea millefolium in 10 (42.9%) and others in decreasing order. The plant allergen series prepared by Chemotechnique Diagnostics is possibly not optimal for diagnosing suspected allergic contact dermatitis to plants in north Indians. Sesquiterpene lactone mix should replace parthenolide as the plant allergen in the Indian Standard Series until relevant native plant extracts are commercially available for patch testing.

Normative Irritability in Youth: Developmental Findings From the Great Smoky Mountains Study.

PubMed

Copeland, William E; Brotman, Melissa A; Costello, E Jane

2015-08-01

The goal of this study is to examine the developmental epidemiology of normative irritability and its tonic and phasic components in a longitudinal community sample of youth. Eight waves of data from the prospective, community Great Smoky Mountains Study (6,674 assessments of 1,420 participants) were used, covering children in the community 9 to 16 years of age. Youth and 1 parent were interviewed using the Child and Adolescent Psychiatric Assessment to assess tonic (touchy/easily annoyed, irritable mood, angry or resentful) and phasic (temper tantrums or anger outbursts) components of irritability, including frequency, duration, onset, and cross-context variability. At any given point in childhood/adolescence, 51.4% (standard error [SE] = 1.4) of participants reported phasic irritability, 28.3% (SE = 1.2) reported tonic irritability, and 22.8% (SE = 1.1) reported both. These prevalence levels decreased with age but did not vary by sex. The overlap between tonic and phasic irritability was high (odds ratio = 5.8, 95% CI = 3.3-10.5, p < .0001), with little evidence of tonic occurring without phasic irritability. Both tonic and phasic irritability predicted one another over time, supporting both heterotypic and homotypic continuity. Low levels of either tonic or phasic irritability increased risk for disrupted functioning including service use, school suspensions, parental burden, and emotional symptoms both concurrently and at 1-year follow-up. Irritability is relatively common, decreases with age but does not vary by sex, and at almost any level is associated with increased risk of disrupted functioning. Its relative components frequently overlap, although irritable outbursts are more common than irritable mood. Irritability appears to be a high-priority transdiagnostic marker for screening children in need of clinical attention. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. All rights reserved.

Occupational therapy during the first 10 years of rheumatoid arthritis.

PubMed

Malcus-Johnson, Pia; Carlqvist, Carin; Sturesson, Anna-Lena; Eberhardt, Kerstin

2005-01-01

To describe disease development and occupational therapy during the first 10 years of rheumatoid arthritis (RA), and to assess patients' experiences of occupational therapy and comprehensive care. A total of 168 early RA patients with variable disease severity were followed up with regular team visits. The occupational therapist evaluated hand function and activity and performed the necessary interventions. These were recorded and the number of visits generating interventions was calculated. Semi-structured interview of 11 patients regarding their views of occupational therapy and team contact was performed. Impairments of hand function were in general mild to moderate and remained fairly unchanged over time. Activity limitations increased slowly. Half of the follow-up visits generated interventions. Most common were prescriptions of assistive devices and orthoses, hand-training instructions and patient education. The patients interviewed were positive regarding occupational therapy and felt safe with comprehensive care. RA patients in all stages of the disease benefit from regular contact with an occupational therapist and team care.

The EpiOcular Eye Irritation Test (EIT) for hazard identification and labelling of eye irritating chemicals: protocol optimisation for solid materials and the results after extended shipment.

PubMed

Kaluzhny, Yulia; Kandárová, Helena; Handa, Yuki; DeLuca, Jane; Truong, Thoa; Hunter, Amy; Kearney, Paul; d'Argembeau-Thornton, Laurence; Klausner, Mitchell

2015-05-01

The 7th Amendment to the EU Cosmetics Directive and the EU REACH Regulation have reinforced the need for in vitro ocular test methods. Validated in vitro ocular toxicity tests that can predict the human response to chemicals, cosmetics and other consumer products are required for the safety assessment of materials that intentionally, or inadvertently, come into contact with the eye. The EpiOcular Eye Irritation Test (EIT), which uses the normal human cell-based EpiOcular™ tissue model, was developed to address this need. The EpiOcular-EIT is able to discriminate, with high sensitivity and accuracy, between ocular irritant/corrosive materials and those that require no labelling. Although the original EpiOcular-EIT protocol was successfully pre-validated in an international, multicentre study sponsored by COLIPA (the predecessor to Cosmetics Europe), data from two larger studies (the EURL ECVAM-COLIPA validation study and an independent in-house validation at BASF SE) resulted in a sensitivity for the protocol for solids that was below the acceptance criteria set by the Validation Management Group (VMG) for eye irritation, and indicated the need for improvement of the assay's sensitivity for solids. By increasing the exposure time for solid materials from 90 minutes to 6 hours, the optimised EpiOcular-EIT protocol achieved 100% sensitivity, 68.4% specificity and 84.6% accuracy, thereby meeting all the acceptance criteria set by the VMG. In addition, to satisfy the needs of Japan and the Pacific region, the EpiOcular-EIT method was evaluated for its performance after extended shipment and storage of the tissues (4-5 days), and it was confirmed that the assay performs with similar levels of sensitivity, specificity and reproducibility in these circumstances. 2015 FRAME.

The Ex Vivo Eye Irritation Test as an alternative test method for serious eye damage/eye irritation.

PubMed

Spöler, Felix; Kray, Oya; Kray, Stefan; Panfil, Claudia; Schrage, Norbert F

2015-07-01

Ocular irritation testing is a common requirement for the classification, labelling and packaging of chemicals (substances and mixtures). The in vivo Draize rabbit eye test (OECD Test Guideline 405) is considered to be the regulatory reference method for the classification of chemicals according to their potential to induce eye injury. In the Draize test, chemicals are applied to rabbit eyes in vivo, and changes are monitored over time. If no damage is observed, the chemical is not categorised. Otherwise, the classification depends on the severity and reversibility of the damage. Alternative test methods have to be designed to match the classifications from the in vivo reference method. However, observation of damage reversibility is usually not possible in vitro. Within the present study, a new organotypic method based on rabbit corneas obtained from food production is demonstrated to close this gap. The Ex Vivo Eye Irritation Test (EVEIT) retains the full biochemical activity of the corneal epithelium, epithelial stem cells and endothelium. This permits the in-depth analysis of ocular chemical trauma beyond that achievable by using established in vitro methods. In particular, the EVEIT is the first test to permit the direct monitoring of recovery of all corneal layers after damage. To develop a prediction model for the EVEIT that is comparable to the GHS system, 37 reference chemicals were analysed. The experimental data were used to derive a three-level potency ranking of eye irritation and corrosion that best fits the GHS categorisation. In vivo data available in the literature were used for comparison. When compared with GHS classification predictions, the overall accuracy of the three-level potency ranking was 78%. The classification of chemicals as irritating versus non-irritating resulted in 96% sensitivity, 91% specificity and 95% accuracy. 2015 FRAME.

Influence of dynamic contact of hard contact lens materials on corneal epithelial cells examined by rose bengal staining.

PubMed

Iguchi, I; Kamiyama, K; Imamichi, M; Ohashi, T; He, J; Wang, X; Imanishi, J

1996-06-01

To establish a method for evaluation of less irritating contact lens materials by dynamic contact with cornea, we examined epithelial and endothelial cell injury to the porcine cornea caused by rotatory rubbing with four kinds of hard contact lenses (HCL). The HCLs used were (1) polymethylmethacrylate (PMMA) HCL, (2) gas-permeable HCL composed of a graft co-polymer of dextran derivative and methylmethacrylate (MMA) (Suncon Mild II(TM), 12 Dk), (3) gas-permeable HCL composed of a graft co-polymer of dextran derivative, a monomer containing silicone, a monomer containing fluorine and MMA (New Dx HCL-136, 32 Dk), and (4) gas-permeable HCL composed of a monomer containing silicone, a monomer containing fluorine and MMA(RGPL-A, 216 Dk). Using a specially designed apparatus, we produced a standardized injury to the epithelium or endothelium of porcine corneas by holding the HCL against the corneal surface while rotating the lens rapidly. After rotatory rubbing of the HCL on the epithelium, the degree of rose bengal staining of the epithelial cells, indicating degeneration of the cells and mucin detachment, were significantly different among these HCLs (New Dx HCL-136 < Suncon Mild II(TM), PPMA < RGPL-A), and the cell injury rates of the endothelium were also significantly different among them (Suncon Mild II(TM) < New Dx HCL-136, PMMA < RGPL-A). The water-wettability of HCLs was not directly correlated with cell injury rates on epithelial and endothelial cells. Both the New Dx HCL-136 and Suncon Mild II(TM), which have a common composition of graft co-polymer of dextran derivative, are less irritating to the epithelium and to the endothelium. Also a very few patients complaints regarding Suncon Mild II(TM) wearing in individuals with dry eyes have been reported. Therefore, we would expect that the New Dx HCL-136 should be satisfactory for wear by individuals with dry eyes.

Irritability in children and adolescents: past concepts, current debates, and future opportunities

PubMed Central

Krieger, Fernanda Valle; Leibenluft, Ellen; Stringaris, Argyris; Polanczyk, Guilherme V.

2015-01-01

Irritability is defined as a low threshold to experience anger in response to frustration. It is one of the most common symptoms in youth and is part of the clinical presentation of several disorders. Irritability can present early in life and is a predictor of long-term psychopathology; yet, the diagnostic status of irritability is a matter of intense debate. In the present article, we address two main components of the debate regarding irritability in youth: the misdiagnosis of chronic irritability as pediatric bipolar disorder, and the proposal of a new diagnosis in the DSM-5, disruptive mood dysregulation disorder, whose defining symptoms are chronic irritability and temper outbursts. PMID:24142126

Are Histrionic Personality Traits Associated with Irritability during Conscious Sedation Endoscopy?

PubMed Central

Lee, Sang Shin; Park, Hyo Jung

2015-01-01

Aim. We aimed to evaluate whether histrionic personality traits are associated with irritability during conscious sedation endoscopy (CSE). Materials and Methods. A prospective cross-sectional study was planned. Irritability during CSE was classified into five grades: 0, no response; I, minimal movement; II, moderate movement; III, severe movement; IV, fighting against procedure. Patients in grades III and IV were defined as the irritable group. Participants were required to complete questionnaire sheet assessing the extent of histrionic personality traits, extraversion-introversion, and current psychological status. The present authors also collected basic sociodemographic data including alcohol use history. Results. A total of 32 irritable patients and 32 stable patients were analyzed. The histrionic personality trait score of the irritable group was higher than that of the stable group (9.5 ± 3.1 versus 6.9 ± 2.9; P = 0.001), as was the anxiety score (52.8 ± 8.6 versus 46.1 ± 9.6; P = 0.004). Heavy alcohol use was more frequently observed in the irritable group (65.6% versus 28.1%; P = 0.003). In multivariate analysis, all these three factors were independently correlated with irritability during CSE. Conclusion. This study revealed that histrionic personality traits, anxiety, and heavy alcohol use can affect irritability during CSE. PMID:25954307

Studies on the cellular and subcellular reactions in epidermis at irritant and allergic dermatitis.

PubMed

Lindberg, M

1982-01-01

To determine the cellular and subcellular reactions of keratinocytes at contact dermatitis, transmission electron microscopy was used in combination with energy dispersive X-ray microanalysis. Stereology and optical diffraction were used as complements to electron microscopy for studies of the effects of variations in the preparation technique on the ultrastructure of epidermis. The morphological effects of an increased hydration of epidermis were assessed by the use of occlusive patch tests. It was found that the relative volume of the epidermal intercellular space and the ultrastructure of the epidermal cells (keratinocytes and Langerhans' cells) were directly dependent on the osmolality of the fixative vehicle if glutaraldehyde was used as fixative. Cellular volume and morphology did also depend on the fixative used. Variations in the volume of the intercellular space were also detected when the water transport through epidermis was impaired by occlusive treatment. In normal epidermis prolonged fixation times (4 weeks) did not affect the morphology of the keratinocytes. However, if the structure and function of the keratinocytes were affected by the application of a irritant substance (DNCB), a loss of electron dense material from the cells was detected within 3 weeks. The ultrastructural changes in the keratinocytes at the irritant chromate and DNCB reactions were of a non-specific nature and are in accordance with the changes described for other irritant agents in the literature. A few cells with the features of apoptosis were recorded. The allergic chromate reaction was found to be a combination of the irritant reaction and a marked inflammatory response. To correlate the ultrastructural alterations in the keratinocytes with the functional state of the cells, X-ray microanalysis was used to determine the elemental redistribution occurring at the irritant DNCB reaction. The results of the X-ray microanalysis showed a good correlation between dose and time

An update on airborne contact dermatitis.

PubMed

Huygens, S; Goossens, A

2001-01-01

This review is an update of 2 previously published articles on airborne contact dermatoses. Because reports in the literature often omit the term 'airborne', 18 volumes of Contact Dermatitis (April 1991-June 2000), 8 volumes of the American Journal of Contact Dermatitis (1992 1999) and 4 volumes of La Lettre du Gerda (1996-1999) were screened, and the cases cited were classified as to history, lesion locations, sensitization sources, and other factors. Reports on airborne dermatitis are increasingly being published, sometimes in relation to specific occupational areas.

Association of contact loading in diffuse axonal injuries from motor vehicle crashes.

PubMed

Yoganandan, Narayan; Gennarelli, Thomas A; Zhang, Jiangyue; Pintar, Frank A; Takhounts, Erik; Ridella, Stephen A

2009-02-01

Although studies have been conducted to analyze brain injuries from motor vehicle crashes, the association of head contact has not been fully established. This study examined the association in occupants sustaining diffuse axonal injuries (DAIs). The 1997 to 2006 motor vehicle Crash Injury Research Engineering Network database was used. All crash modes and all changes in velocity were included; ejections and rollovers were excluded; injuries to front and rear seat occupants with and without restraint use were considered. DAI were coded in the database using Abbreviated Injury Scale 1990. Loss of consciousness was included and head contact was based on medical- and crash-related data. Sixty-seven occupants with varying ages were coded with DAI. Forty-one adult occupants (mean, 33 years of age, 171-cm tall, 71-kg weight; 30 drivers, 11 passengers) were analyzed. Mean change in velocity was 41.2 km/h and Glasgow Coma Scale score was 4. There were 33 lateral, 6 frontal, and 2 rear crashes with 32 survivors and 9 were fatalities. Two occupants in the same crash did not sustain DAI. Although skull fractures and scalp injuries occurred in some impacts, head contact was identified in all frontal, rear, and far side, and all but one nearside crashes. Using a large sample size of occupants sustaining DAI in 1991 to 2006 model year vehicles, DAI occurred more frequently in side than frontal crashes, is most commonly associated with impact load transfer, and is not always accompanied by skull fractures. The association of head contact in >95% of cases underscores the importance of evaluating crash-related variables and medical information for trauma analysis. It would be prudent to include contact loading in addition to angular kinematics in the analysis and characterization of DAI.

Effect of topically applied lipids on surfactant-irritated skin.

PubMed

Lodén, M; Andersson, A C

1996-02-01

Moisturizers are used daily by many people to alleviate symptoms of dry skin. All of them contain lipids. It has been suggested that topically applied lipids may interfere with the structure and function of the permeability barrier. The influence of a single application of nine different lipids on normal skin and skin irritated by sodium lauryl sulphate (SLS) was studied in 21 healthy subjects. Parameters assessed were visible signs of irritation, and objectively measured cutaneous blood flow and transepidermal water loss (TEWL). The substances tested were hydrocortisone, petrolatum, fish oil, borage oil, sunflower seed oil, canola oil, shea butter, and fractions of unsaponifiable lipids from canola oil and shea butter. Water was included as a control. On normal skin, no significant differences in the effects of the test substances were found, whereas significant differences were observed when they were applied to SLS-irritated skin. The visible signs of SLS-induced irritation were significantly less pronounced after treatment with the sterol-enriched fraction from canola oil than after treatment with water. This fraction, and hydrocortisone, reduced cutaneous blood flow. Furthermore, application of hydrocortisone, canola oil, and its sterol-enriched fraction, resulted in significantly lower TEWL than with water. The other lipids had no effect on the degree of irritation. In conclusion, lipids commonly used in moisturizers may reduce skin reactions to irritants. Previous studies have shown that, in barrier perturbed skin, the synthesis of sterols is increased. The observed effects of canola oil and its fraction of unsaponifiable lipids on SLS-induced irritation suggest the possibility that they assisted the skin in supplying the damaged barrier with adequate lipids.

Quality of life in patients with allergic contact dermatitis.

PubMed

Kadyk, Deana L; McCarter, Kevin; Achen, Fritz; Belsito, Donald V

2003-12-01

Allergic contact dermatitis (ACD), a common dermatological disorder, often results in ongoing disease and disability. However, relatively little has been published quantifying the quality of life (QoL) of patients with ACD. This study was conducted to investigate the impact of ACD on QoL and explore prognostic factors that influence outcomes. A total of 428 subjects with ACD were, at varying times after diagnosis, mailed a QoL questionnaire modified from Skindex-16 to include an additional 5 items pertaining to occupational impact. The QoL scores were correlated with subject demographics, disease characteristics, and management techniques to ascertain factors that impact QoL in subjects with ACD. The response rate was 35%, with 149 subjects returning the postal survey. Responders reported being bothered most by itching, skin irritation, and persistence of the condition. Of the four scales included in the QoL questionnaire, the emotions scale had the worst composite QoL score, followed by symptoms, functioning, and occupational impact. Patients with ACD of the face were significantly more bothered by the appearance of their skin. Hand involvement and occupationally related ACD were associated with worse QoL scores within the occupational impact and functioning scales. Subjects that had changed jobs because of ACD had more severe QoL impairment than any other group analyzed, with significantly worse scores on 17 of the 21 QoL items. A history of atopic eczema seemed to impart improved outcomes on patients with ACD, and these subjects were less worried about being fired from their jobs. Subjects diagnosed by patch testing more than 36 months after disease onset seemed to have worse QoL scores than those diagnosed earlier in the natural history of the disease. Patients diagnosed by patch testing within the last 6 months had the worst QoL scores, while the best outcomes were reported in subjects patch tested 6 to 12 months ago. A slight decline in QoL was observed 12

Contact dermatitis is an unrecognized problem in the construction industry: Comparison of four different assessment methods.

PubMed

Timmerman, Johan G; Heederik, Dick; Spee, Ton; van Rooy, Frits G; Krop, Esmeralda J M; Rustemeyer, Thomas; Smit, Lidwien A M

2017-10-01

A high contact dermatitis symptoms prevalence has been observed in Dutch construction workers. Contact dermatitis was diagnosed by an expert panel using questionnaire data and photographs of 751 subjects' hands. A subset was evaluated by two occupational physicians. Their diagnoses were compared to those of the expert panel. In addition, two self-reported questionnaire-based assessment methods were compared to the expert panel evaluation. Associations between contact dermatitis and determinants were assessed using log-binomial regression analysis. Contact dermatitis prevalence was high: 61.4% (expert panel's diagnosis) and 32.9% (self-reported). Agreement between occupational physicians and the expert panel was low but increased after training. Washing hands with solvents and performing job-related tasks at home were related to contact dermatitis. Contact dermatitis prevalence among construction workers is high. Recognition of contact dermatitis by occupational physicians is poor but can be improved by training. Awareness of skin disorders should be raised. © 2017 Wiley Periodicals, Inc.

Contact dermatitis in students practicing sports: incidence of rubber sensitisation.

PubMed

Ventura, M T; Dagnello, M; Matino, M G; Di Corato, R; Giuliano, G; Tursi, A

2001-04-01

Over the last few years, changes in cutaneous homoeostasis resulting from sports activities have been reported. In particular, alterations in sweating mechanisms, the hydrolipid barrier, and surface bacterial flora, together with exposure to atmospheric conditions and the need to use medicaments, detergents, and other topical substances, predispose subjects to allergic contact dermatitis. To evaluate the incidence of allergic contact dermatitis in a group of young people practising sports activities. Patch tests were performed to confirm the diagnosis of irritant or allergic dermatitis; in addition, the radioallergoabsorbent test (RAST) to latex was evaluated in the group studied. Allergic contact dermatitis caused by thiourams (23.3%) and mercaptobenzothiazole (20.9%) was prevalent. Other haptens, such as benzocaine and nickel, which are contained in clothing, equipment, topical medicaments, and creams used for massage, were also allergenic. In two cases, RAST positivity to latex was registered. -The results suggest that close contact with sports equipment may increase the incidence of allergic contact dermatitis. Students practising certain sports may have "professional" allergic contact dermatitis to additives used in the production of rubber.

Gaps in Workplace Education For Prevention of Occupational Skin Disease.

PubMed

Gupta, Tanya; Arrandale, Victoria H; Kudla, Irena; Holness, D Linn

2018-02-13

Occupational contact dermatitis (OCD) is a common occupational disease. Evidence suggests that education and training are effective prevention strategies. In spite of these known prevention strategies, workers continue to develop OCD. Little is reported regarding the actual training experience of workers. To examine the training experience of workers with contact dermatitis to identify areas for improvement. Participants were workers being assessed for contact dermatitis in an occupational health clinic. The anonymous survey collected demographics, workplace characteristics, and education and prevention practices. Approximately 80% reported general occupational health and safety training; however, only 49% reported skin-specific training (SST). For workers reporting SST, most received information regarding exposure avoidance, hand washing, and glove use. This content was reported as helpful by at least 50%. Workers who did not receive SST indicated the most important content would be warning signs of skin problems, how to avoid exposure and skin care while using gloves. While the study was anonymous and used self-reported of training experience, the study suggests there are gaps in skin protection training. Addressing these gaps may lead to improved prevention and reduction in OCD. © The Author(s) 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Surfactant irritation: in vitro corneosurfametry and in vivo bioengineering.

PubMed

Gabard, B; Chatelain, E; Bieli, E; Haas, S

2001-02-01

Irritant reactions to surfactants, cleansing products, soaps and detergents are common in clinical and occupational dermatology. Mildness has become a major benefit claimed, and testing for mildness now ranks among the first concerns of the manufacturing industry. A wealth of publications deals with this problem, trying to improve the methodology, reduce the costs of testing and facilitate decision-making. Differences in vivo can be measured clinically and/or instrumentally. This is difficult, as commercially available products are generally safe to use and none are harsh in the absolute sense. Nineteen different products (syndets, shampoos, personal cleansers), all claiming to be mild, were tested in vitro by a newly introduced method, corneosurfametry. For evaluating the aggressiveness of the products, the calculation of an index of irritation (IOI) was proposed. A concentration-effect curve of sodium lauryl sulfate (SLS) as standard and model surfactant was obtained. Some of the products were further tested in vivo with a flex wash test and with a soap chamber test and compared to SLS. Bioengineering methods (transepidermal water loss TEWL, skin color) were used to evaluate the results. The results of the corneosurfametry allowed us to classify the products in three categories, with increasing aggressiveness towards the stratum corneum, according to their IOIs. The in vivo tests were not able to discriminate between the products, but ranks from the results of the bioengineering measurements showed a good correlation between TEWL changes, but not between colour changes, and IOIs from corneosurfametry. Corneosurfametry emerged as a simple, low-cost and fast method for ranking commercial products according to their mildness. However, the skin bioengineering techniques showed that some products could lead to skin reactions, such as erythema, that could not be detected by the in vitro technique.

The EpiOcular™ Eye Irritation Test is the Method of Choice for the In Vitro Eye Irritation Testing of Agrochemical Formulations: Correlation Analysis of EpiOcular Eye Irritation Test and BCOP Test Data According to the UN GHS, US EPA and Brazil ANVISA Classification Schemes.

PubMed

Kolle, Susanne N; Rey Moreno, Maria Cecilia; Mayer, Winfried; van Cott, Andrew; van Ravenzwaay, Bennard; Landsiedel, Robert

2015-07-01

The Bovine Corneal Opacity and Permeability (BCOP) test is commonly used for the identification of severe ocular irritants (GHS Category 1), but it is not recommended for the identification of ocular irritants (GHS Category 2). The incorporation of human reconstructed tissue model-based tests into a tiered test strategy to identify ocular non-irritants and replace the Draize rabbit eye irritation test has been suggested (OECD TG 405). The value of the EpiOcular™ Eye Irritation Test (EIT) for the prediction of ocular non-irritants (GHS No Category) has been demonstrated, and an OECD Test Guideline (TG) was drafted in 2014. The purpose of this study was to evaluate whether the BCOP test, in conjunction with corneal histopathology (as suggested for the evaluation of the depth of the injury( and/or the EpiOcular-EIT, could be used to predict the eye irritation potential of agrochemical formulations according to the UN GHS, US EPA and Brazil ANVISA classification schemes. We have assessed opacity, permeability and histopathology in the BCOP assay, and relative tissue viability in the EpiOcular-EIT, for 97 agrochemical formulations with available in vivo eye irritation data. By using the OECD TG 437 protocol for liquids, the BCOP test did not result in sufficient correct predictions of severe ocular irritants for any of the three classification schemes. The lack of sensitivity could be improved somewhat by the inclusion of corneal histopathology, but the relative viability in the EpiOcular-EIT clearly outperformed the BCOP test for all three classification schemes. The predictive capacity of the EpiOcular-EIT for ocular non-irritants (UN GHS No Category) for the 97 agrochemical formulations tested (91% sensitivity, 72% specificity and 82% accuracy for UN GHS classification) was comparable to that obtained in the formal validation exercise underlying the OECD draft TG. We therefore conclude that the EpiOcular-EIT is currently the best in vitro method for the prediction

Illness perception and quality of life in patients with contact dermatitis.

PubMed

Benyamini, Yael; Goner-Shilo, Daphna; Lazarov, Aneta

2012-10-01

People's subjective perceptions of illness are important determinants of their ways of coping with health threats and the ensuing physical and mental outcomes, including quality of life (QoL), which has been consistently reported to be impaired by contact dermatitis. To investigate the relationships of subjective illness perceptions and dermatological QoL in atopic, contact and occupational dermatitis patients and a comparison group of patients with other dermatological diseases. Three hundred and three patients of four diagnostic groups filled in the Brief Illness Perception Questionnaire and the Skindex-16 (+ occupational impact items) Dermatological QoL questionnaire before clinical examination and patch testing. Perceptions of serious consequences, greater symptom burden and more uncertainty and worry were associated with lower QoL (r(s) > 0.50). Overall, patients reported low personal control over their condition and low understanding of the disease (3.5 and 4.8, respectively, on a 0-10 scale). QoL was most impaired among occupational dermatitis patients (mean = 46) and least impaired among patients who were later diagnosed as suffering from conditions other than contact dermatitis (mean = 62). Identifying critical components of illness perceptions in patients with atopic, contact and occupational dermatitis may enable the design of consultations and interventions to fit patients' perceptions, which could affect their QoL. © 2012 John Wiley & Sons A/S.

75 FR 55625 - Occupational Information Development Advisory Panel Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-13

... claims; occupational analysis, including definitions, ratings and capture of physical and mental... should contact the Panel staff by any one of these three methods: Mail: Occupational Information... Federal Officer. [FR Doc. 2010-22711 Filed 9-10-10; 8:45 am] BILLING CODE 4191-02-P ...

Are the children of fathers whose jobs involve contact with many people at an increased risk of leukaemia?

PubMed Central

Fear, N. T.; Roman, E.; Reeves, G.; Pannett, B.

1999-01-01

OBJECTIVES: To investigate the hypothesis that children of men whose jobs involve contact with many people (particularly children) are at an increased risk of leukaemia. METHODS: A population based dataset obtained from routinely collected death certificates involving 14,168 cancer deaths occurring before the age of 15 years registered in England and Wales between 1959-63 and 1970-90. Associations were assessed with the proportional cancer mortality ratio (PCMR), with all childhood cancer deaths forming the standard for comparison. The PCMRs were adjusted, by stratification, for age and year of death (in 1-year bands) and paternal social class (nine categories). Analyses were performed by estimated level of paternal occupational social contact (high, medium, and low) for all leukaemias, leukaemia subtype, age at death, year of death, and individual occupation. RESULTS: Out of 223 occupations, 36 (16%) were identified as having potentially high levels of social contact, and 27 (12%) as having potentially medium levels of social contact. No associations were found between paternal occupational social contact and death during childhood from leukaemia (high social contact: PCMR 94, 95% confidence interval (95% CI) 87 to 102; medium social contact: 101, 95 to 106). No associations were found when the data were analysed by leukaemia subtype, age at death, year of death, or individual occupation. CONCLUSION: The findings presented here do not support the suggestion that childhood leukaemia is related to the amount of social contact that fathers experience at work.   PMID:10472313

[Individual prevention of occupational contact dermatitis: protective gloves and skin protection recommendations as part of the patient management scheme by the public statutory employers' liability insurance].

PubMed

Wilke, A; Skudlik, C; Sonsmann, F K

2018-05-02

The dermatologist's procedure is a pivotal tool for early recognition of occupational contact dermatitis (OCD), for reporting OCD cases to the statutory accident insurance and for treating the diseases. The employer is in charge of implementing skin protection measures at the workplace. However, in terms of an individual prevention approach it may be necessary to propose targeted skin protection recommendations in specific patient cases. The patient's own skin protection behavior significantly contributes to regenerating and maintaining healthy skin. This behavior includes the use of occupational skin products, and in particular the correct use of appropriately selected protective gloves. Protective gloves are the most important personal protective measure in the prevention of OCD. Prevention services, occupational health and safety specialists, occupational physicians and centers specialized in occupational dermatology can support the identification of suitable protective measures. Nowadays, suitable protective gloves exist for (almost) every occupational activity and exposure. However, improper use in practice can become a risk factor by itself for the skin (e. g., incorrectly used gloves). Therefore, it is of utmost importance to identify application errors, to educate patients in terms of skin protection and to motivate them to perform an appropriate skin protection behavior. With particular focus on protective gloves, this article gives an overview of various types, materials and potentially glove-related allergens, presents strategies for reducing occlusion effects and discusses some typical application errors and solutions.

Neural Correlates of Irritability in Disruptive Mood Dysregulation and Bipolar Disorders.

PubMed

Wiggins, Jillian Lee; Brotman, Melissa A; Adleman, Nancy E; Kim, Pilyoung; Oakes, Allison H; Reynolds, Richard C; Chen, Gang; Pine, Daniel S; Leibenluft, Ellen

2016-07-01

Bipolar disorder and disruptive mood dysregulation disorder (DMDD) are clinically and pathophysiologically distinct, yet irritability can be a clinical feature of both illnesses. The authors examine whether the neural mechanisms mediating irritability differ between bipolar disorder and DMDD, using a face emotion labeling paradigm because such labeling is deficient in both patient groups. The authors hypothesized that during face emotion labeling, irritability would be associated with dysfunctional activation in the amygdala and other temporal and prefrontal regions in both disorders, but that the nature of these associations would differ between DMDD and bipolar disorder. During functional MRI acquisition, 71 youths (25 with DMDD, 24 with bipolar disorder, and 22 healthy youths) performed a labeling task with happy, fearful, and angry faces of varying emotional intensity. Participants with DMDD and bipolar disorder showed similar levels of irritability and did not differ from each other or from healthy youths in face emotion labeling accuracy. Irritability correlated with amygdala activity across all intensities for all emotions in the DMDD group; such correlation was present in the bipolar disorder group only for fearful faces. In the ventral visual stream, associations between neural activity and irritability were found more consistently in the DMDD group than in the bipolar disorder group, especially in response to ambiguous angry faces. These results suggest diagnostic specificity in the neural correlates of irritability, a symptom of both DMDD and bipolar disorder. Such evidence of distinct neural correlates suggests the need to evaluate different approaches to treating irritability in the two disorders.

Cumulative irritation potential of topical retinoid formulations.

PubMed

Leyden, James J; Grossman, Rachel; Nighland, Marge

2008-08-01

Localized irritation can limit treatment success with topical retinoids such as tretinoin and adapalene. The factors that influence irritant reactions have been shown to include individual skin sensitivity, the particular retinoid and concentration used, and the vehicle formulation. To compare the cutaneous tolerability of tretinoin 0.04% microsphere gel (TMG) with that of adapalene 0.3% gel and a standard tretinoin 0.025% cream. The results of 2 randomized, investigator-blinded studies of 2 to 3 weeks' duration, which utilized a split-face method to compare cumulative irritation scores induced by topical retinoids in subjects with healthy skin, were combined. Study 1 compared TMG 0.04% with adapalene 0.3% gel over 2 weeks, while study 2 compared TMG 0.04% with tretinoin 0.025% cream over 3 weeks. In study 1, TMG 0.04% was associated with significantly lower cumulative scores for erythema, dryness, and burning/stinging than adapalene 0.3% gel. However, in study 2, there were no significant differences in cumulative irritation scores between TMG 0.04% and tretinoin 0.025% cream. Measurements of erythema by a chromameter showed no significant differences between the test formulations in either study. Cutaneous tolerance of TMG 0.04% on the face was superior to that of adapalene 0.3% gel and similar to that of a standard tretinoin cream containing a lower concentration of the drug (0.025%).

Perspectives on Non-Animal Alternatives for Assessing Sensitization Potential in Allergic Contact Dermatitis

PubMed Central

Sharma, Nripen S.; Jindal, Rohit; Mitra, Bhaskar; Lee, Serom; Li, Lulu; Maguire, Tim J.; Schloss, Rene; Yarmush, Martin L.

2014-01-01

Skin sensitization remains a major environmental and occupational health hazard. Animal models have been used as the gold standard method of choice for estimating chemical sensitization potential. However, a growing international drive and consensus for minimizing animal usage have prompted the development of in vitro methods to assess chemical sensitivity. In this paper, we examine existing approaches including in silico models, cell and tissue based assays for distinguishing between sensitizers and irritants. The in silico approaches that have been discussed include Quantitative Structure Activity Relationships (QSAR) and QSAR based expert models that correlate chemical molecular structure with biological activity and mechanism based read-across models that incorporate compound electrophilicity. The cell and tissue based assays rely on an assortment of mono and co-culture cell systems in conjunction with 3D skin models. Given the complexity of allergen induced immune responses, and the limited ability of existing systems to capture the entire gamut of cellular and molecular events associated with these responses, we also introduce a microfabricated platform that can capture all the key steps involved in allergic contact sensitivity. Finally, we describe the development of an integrated testing strategy comprised of two or three tier systems for evaluating sensitization potential of chemicals. PMID:24741377

Vitrigel-eye irritancy test method using HCE-T cells.

PubMed

Yamaguchi, Hiroyuki; Kojima, Hajime; Takezawa, Toshiaki

2013-10-01

We previously reported that the time-dependent relative changes of transepithelial electrical resistance (TEER) after exposing four different chemicals to a human corneal epithelium (HCE) model were well correlated to the potential of ocular irritancy. Meanwhile, we recently developed a collagen vitrigel membrane (CVM) chamber possessing a scaffold composed of high-density collagen fibrils equivalent to connective tissues in vivo as a three-dimensional culture tool. The CVM chamber is useful for biomedical assays and immunohistology using cryosections that are inappropriate to be performed using the conventional Millicell chamber with a polyethylene terephthalate membrane. In this study, we aimed to develop a new eye irritancy test (EIT) method called "Vitrigel-EIT method" that can facilitate to briefly and accurately estimate the widespread irritancy of test chemicals by applying the TEER assay system to a HCE model fabricated in the CVM chamber. HCE-T cells (a HCE-derived cell strain) were cultured in the CVM chamber for 6 days, and consequently, the Vitrigel-HCE model possessing the following characteristics of HCE in vivo was formed: six cell layers with specific protein expressions and their barrier function. Time-dependent profiles of TEER values after exposing 30 test chemicals to the HCE model were converted into the scores of three indexes (time lag, intensity, and plateau level), and each chemical was successfully classified into irritant or nonirritant category by utilizing the criteria for the indexes, resulting in the excellent correlation with Globally Harmonized System of Classification and Labelling of Chemicals (GHS) classification (sensitivity: 100%, specificity: 75%, accuracy: 90%). These data suggest that the widespread eye irritancy of chemicals can be predicted without false negatives by the Vitrigel-EIT method. Interestingly, the disruption of tight junctions was immunohistologically observed after exposing not only irritants but also three

Epidemiological data on airborne contact dermatitis - results of the IVDK.

PubMed

Breuer, Kristine; Uter, Wolfgang; Geier, Johannes

2015-10-01

Airborne contact dermatitis (AirbCD) is not uncommon, according to a large number of published case reports and review articles. Epidemiological data on AirbCD based on larger clinical samples have not yet been published. To investigate demographic characteristics and patch test reactivity in patients diagnosed with both occupational and non-occupational AirbCD. A retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 1994-2013, including 201 344 consecutively patch tested patients, was performed. One thousand two hundred and three patients (0.6%) were diagnosed with AirbCD, 421 (35.0%) of these with an occupational background. Occupational dermatitis and face involvement were more prevalent than in patients without AirbCD (n = 200 141). Sensitization to epoxy resin and sensitization to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) were significantly associated with AirbCD, and there was a trend for sensitization to Compositae mix and/or sesquiterpene lactone mix to be associated with AirbCD. Adhesives, plastics, construction materials, paints and varnishes in occupational cases, and plants in non-occupational cases, were the most commonly documented culprit product categories. AirbCD is more common in patients with occupational dermatitis than in patients with non-occupational dermatitis. In our clinical sample, components of epoxy resin systems, MCI/MI and Compositae allergens were the most important contact allergens associated with AirbCD. Patch testing with additional allergens is important. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Apoptosis in the areas of squamous differentiation of irritated seborrheic keratosis.

PubMed

Pesce, C; Scalora, S

2000-03-01

Seborrheic keratosis (SK) consists of a localized proliferation of basaloid keratinocytes, often accompanied by hyperkeratosis and hyperpigmentation. In irritated SK, these features are associated with areas of squamous differentiation with larger keratinocytes and squamous cell eddies. This work is concerned with the evaluation of apoptosis, as demonstrated by the TUNEL method, in the different varieties of SK. Apoptosis was highly expressed in the areas of squamous differentiation of irritated SK, but only mildly increased in the other varieties of SK. These data support the hypothesis that apoptosis has a role in the squamous differentiation of irritated SK. In consideration also of previous data showing that irritated SK is associated with downregulation of EGF-R expression and 125I-EGF binding, we postulate that the morphologic features of irritated SK could correspond to an involution phase of the disease, characterized by altered cell balance with inadequate cell renewal and increased cell loss.

CON4EI: EpiOcular™ Eye Irritation Test (EpiOcular™ EIT) for hazard identification and labelling of eye irritating chemicals.

PubMed

Kandarova, H; Letasiova, S; Adriaens, E; Guest, R; Willoughby, J A; Drzewiecka, A; Gruszka, K; Alépée, Nathalie; Verstraelen, Sandra; Van Rompay, An R

2018-06-01

Assessment of the acute eye irritation potential is part of the international regulatory requirements for testing of chemicals. The objective of the CON4EI project was to develop tiered testing strategies for eye irritation assessment. A set of 80 reference chemicals (38 liquids and 42 solids) was tested with eight different methods. Here, the results obtained with the EpiOcular™ Eye Irritation Test (EIT), adopted as OECD TG 492, are shown. The primary aim of this study was to evaluate of the performance of the test method to discriminate between chemicals not requiring classification for serious eye damage/eye irritancy (No Category) and chemicals requiring classification and labelling. In addition, the predictive capacity in terms of in vivo drivers of classification (i.e. corneal opacity, conjunctival redness and persistence at day 21) was investigated. EpiOcular™ EIT achieved a sensitivity of 97%, a specificity of 87% and accuracy of 95% and also confirmed its excellent reproducibility (100%) from the original validation. The assay was applicable to all chemical categories tested in this project and its performance was not limited to the particular driver of the classification. In addition to the existing prediction model for dichotomous categorization, a new prediction model for Cat 1 is suggested. Copyright © 2017. Published by Elsevier Ltd.

Stratum corneum profiles of inflammatory mediators in patch test reactions to common contact allergens and sodium lauryl sulfate.

PubMed

Koppes, S A; Ljubojevic Hadzavdic, S; Jakasa, I; Franceschi, N; Jurakić Tončić, R; Marinović, B; Brans, R; Gibbs, S; Frings-Dresen, M H W; Rustemeyer, T; Kezic, S

2017-06-01

Recent studies have demonstrated allergen-specific differences in the gene expression of inflammatory mediators in patch tested skin. To determine levels of various inflammatory mediators in the stratum corneum (SC) after patch testing with common contact allergens and the skin irritant sodium lauryl sulfate (SLS). In total, 27 individuals who had previously patch tested positive to nickel, chromium, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) or para-phenylenediamine were retested and then patch tested with SLS and petrolatum, with petrolatum serving as the patch test control. At 72 h, the test sites were clinically graded and the SC samples collected on adhesive tape. The levels of 18 of the 32 quantified mediators differed significantly from that of the control patches for at least one of the tested substances. SLS and MCI/MI induced the largest number of immunomediators. Interleukin (IL)-16 levels were significantly higher in patch test reactions in all allergens than they were in the controls, while no significant difference was detected for SLS. Furthermore, a strong negative correlation was found between strength of patch test reaction and IL-1α levels. Cytokine profiles in the SC of patch tested skin did not show a distinct allergen-specific pattern. However, MCI/MI induced a larger and wider immune response than the other allergens, perhaps due to its potency as an irritant. The levels of IL-16 were significantly increased in patch test reactions to allergens but not to SLS; thus, they may help clinicians to differentiate between allergic contact dermatitis and irritant contact dermatitis. © 2016 British Association of Dermatologists.

IRRITABLE MOOD IN ADULT MAJOR DEPRESSIVE DISORDER: RESULTS FROM THE WORLD MENTAL HEALTH SURVEYS

PubMed Central

Kovess-Masfety, Viviane; Alonso, Jordi; Angermeyer, Matthias; Bromet, Evelyn; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia E.; Gruber, Michael J.; Gureje, Oye; Hu, Chiyi; Huang, Yueqin; Karam, Elie G.; Jin, Robert; Lépine, Jean-Pierre; Levinson, Daphna; McLaughlin, Katie A.; Medina-Mora, María E.; O’Neill, Siobhan; Ono, Yutaka; Posada-Villa, José A.; Sampson, Nancy A.; Scott, Kate M.; Shahly, Victoria; Stein, Dan J.; Viana, Maria C.; Zarkov, Zahari; Kessler, Ronald C.

2014-01-01

Background Although irritability is a core symptom of DSM-IV major depressive disorder (MDD) for youth but not adults, clinical studies find comparable rates of irritability between nonbipolar depressed adults and youth. Including irritability as a core symptom of adult MDD would allow detection of depression-equivalent syndromes with primary irritability hypothesized to be more common among males than females. We carried out a preliminary examination of this issue using cross-national community-based survey data from 21 countries in the World Mental Health (WMH) Surveys (n = 110,729). Methods The assessment of MDD in the WHO Composite International Diagnostic Interview includes one question about persistent irritability. We examined two expansions of the definition of MDD involving this question: (1) cases with dysphoria and/or anhedonia and exactly four of nine Criterion A symptoms plus irritability; and (2) cases with two or more weeks of irritability plus four or more other Criterion A MDD symptoms in the absence of dysphoria or anhedonia. Results Adding irritability as a tenth Criterion A symptom increased lifetime prevalence by 0.4% (from 11.2 to 11.6%). Adding episodes of persistent irritability increased prevalence by an additional 0.2%. Proportional prevalence increases were significantly higher, but nonetheless small, among males compared to females. Rates of severe role impairment were significantly lower among respondents with this irritable depression who did not meet conventional DSM-IV criteria than those with DSM-IV MDD. Conclusion Although limited by the superficial assessment in this single question on irritability, results do not support expanding adult MDD criteria to include irritable mood. PMID:23364997

Estimation of the chemical-induced eye injury using a weight-of-evidence (WoE) battery of 21 artificial neural network (ANN) c-QSAR models (QSAR-21): part I: irritation potential.

PubMed

Verma, Rajeshwar P; Matthews, Edwin J

2015-03-01

Evaluation of potential chemical-induced eye injury through irritation and corrosion is required to ensure occupational and consumer safety for industrial, household and cosmetic ingredient chemicals. The historical method for evaluating eye irritant and corrosion potential of chemicals is the rabbit Draize test. However, the Draize test is controversial and its use is diminishing - the EU 7th Amendment to the Cosmetic Directive (76/768/EEC) and recast Regulation now bans marketing of new cosmetics having animal testing of their ingredients and requires non-animal alternative tests for safety assessments. Thus, in silico and/or in vitro tests are advocated. QSAR models for eye irritation have been reported for several small (congeneric) data sets; however, large global models have not been described. This report describes FDA/CFSAN's development of 21 ANN c-QSAR models (QSAR-21) to predict eye irritation using the ADMET Predictor program and a diverse training data set of 2928 chemicals. The 21 models had external (20% test set) and internal validation and average training/verification/test set statistics were: 88/88/85(%) sensitivity and 82/82/82(%) specificity, respectively. The new method utilized multiple artificial neural network (ANN) molecular descriptor selection functionalities to maximize the applicability domain of the battery. The eye irritation models will be used to provide information to fill the critical data gaps for the safety assessment of cosmetic ingredient chemicals. Copyright © 2014 Elsevier Inc. All rights reserved.

Finding the optimal patch test material and test concentration to detect contact allergy to geraniol.

PubMed

Hagvall, Lina; Karlberg, Ann-Therese; Christensson, Johanna B

2013-04-01

Geraniol is a commonly used fragrance terpene, and is tested in the baseline series in fragrance mix I. Geraniol is a pro-hapten and a pre-hapten, and sensitizers are formed in the autoxidation and skin metabolism of geraniol. Previous patch testing with air-exposed (oxidized) geraniol has suggested that oxidized geraniol could be a better marker for contact allergy to geraniol than pure geraniol. To find the optimal patch test substance and concentration for detecting contact allergy to geraniol. Six hundred and fifty-five patients were patch tested with pure and oxidized geraniol at 4.0%, 6.0% and 11.0% in petrolatum. Before patch testing, the irritant properties of pure and oxidized geraniol were studied in 27 patients at 2.5%, 5.0%, 10.0% and 20.0% pet. Pure geraniol detected positive reactions in 0.15-1.1% of the patients, and oxidized geraniol detected positive reactions in 0.92-4.6% of the patients. Reactions to pure geraniol in patients not reacting to oxidized geraniol indicated metabolic activation of geraniol. Neither pure nor oxidized geraniol gave significant irritant reactions. Increasing the test concentrations of pure and oxidized geraniol enables the detection of more cases of contact allergy. Oxidized geraniol detects more patients than pure geraniol, but patch testing with only oxidized geraniol does not detect all cases of contact allergy to geraniol. © 2013 John Wiley & Sons A/S.

From railway spine to whiplash--the recycling of nervous irritation.

PubMed

Ferrari, Robert; Shorter, Edward

2003-11-01

The search for a specific structural basis for chronic whiplash and other chronic pain and fatigue syndromes has been in progress for decades, and yet currently there remains no "structural" solution to these enigmata. In light of the failure of research to identify the chronic "damage" or pathology as lying in a muscular, bony, or "connective tissue" sites for many chronic pain syndromes like whiplash, fibromyalgia, et cetera, more recent attention has been paid to nervous system structures. Nerve irritation has been implicated as the basis for the pain and other symptoms that are common to many chronic disability syndromes. We postulate here, however, that the concept of nervous irritation has been prostituted for centuries whenever more concrete structural explanations for chronic pain and other controversial illness have been untenable. We suggest that, after each cycle of nervous irritation as a disease, and subsequent dismissal of the notion, the doctrine of irritation as a disease was too good to go away. First, with the hypersthenic and asthenic diseases of the nineteenth century, then railway spine, whiplash, thoracic outlet syndrome, and now brachial plexus irritation, we detect the same pattern: patients with symptoms, but no objective evidence of nerve disease. Nervous irritation has repeatedly served this purpose for the last 200 years. It is our intent that bringing an understanding of this trend will encourage current clinicians and researchers to appreciate the need to abandon this form of speculation without historical insight when dealing with today's controversial syndromes.

Evaluation of Ocular Irritation and Bioavailability of Voriconazole Loaded Microemulsion.

PubMed

Kumar, Rakesh; Sinha, Vivek Ranjan

2017-01-01

Voriconazole (VCZ), a second-generation antifungal with excellent attributes like, broad-spectrum activity, targeted delivery, and tolerability. VCZ loaded microemulsion could be an effective strategy for efficient ocular delivery of the drug. To perform corneal irritation studies and in vivo delivery of VCZ microemulsion to establish its potential as an efficient ocular delivery system. Ocular irritancy was performed by HETCAM (Hen's Egg Test Chorio Allantoic Membrane) assay, corneal histopathology and Draize test. Ex vivo and in vivo studies were performed to determine permeation efficiency of VCZ microemulsion. The irritation studies suggested the non-irritant nature of the microemulsion. The ex vivo studies performed on excised cornea displayed significant enhancement in drug permeation/penetration from microemulsion in contrast to the drug suspension. Further, the in vivo study confirmed the higher availability of VCZ (from microemulsion) in aqueous humor with minimal nasolacrimal drainage (lower plasma drug content) when compared with the drug suspension. The non-irritant nature and high corneal permeation of VCZ encourages the role of microemulsion as a potential ocular delivery system. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Medical and psychological aspects of irritable bowel syndrome.

PubMed

Kim, E C; Dundon, M

1998-01-01

Irritable bowel syndrome is a disease process commonly encountered by primary care providers. Although the cause of this illness is unknown, much is known about the pathophysiology and strong psychosocial influences. Medical practitioners often are aware of the medical aspects of managing irritable bowel syndrome but are not familiar with specific psychologic options. Long-term care of these patients may be aided by collaboration with mental health professionals.

The use of nanoencapsulation to decrease human skin irritation caused by capsaicinoids

PubMed Central

Contri, Renata V; Frank, Luiza A; Kaiser, Moacir; Pohlmann, Adriana R; Guterres, Silvia S

2014-01-01

Capsaicin, a topical analgesic used in the treatment of chronic pain, has irritant properties that frequently interrupt its use. In this work, the effect of nanoencapsulation of the main capsaicinoids (capsaicin and dihydrocapsaicin) on skin irritation was tested in humans. Skin tolerance of a novel vehicle composed of chitosan hydrogel containing nonloaded nanocapsules (CH-NC) was also evaluated. The chitosan hydrogel containing nanoencapsulated capsaicinoids (CH-NC-CP) did not cause skin irritation, as measured by an erythema probe and on a visual scale, while a formulation containing free capsaicinoids (chitosan gel with hydroalcoholic solution [CH-ET-CP]) and a commercially available capsaicinoids formulation caused skin irritation. Thirty-one percent of volunteers reported slight irritation one hour after application of CH-NC-CP, while moderate (46% [CH-ET-CP] and 23% [commercial product]) and severe (8% [CH-ET-CP] and 69% [commercial product]) irritation were described for the formulations containing free capsaicinoids. When CH-NC was applied to the skin, erythema was not observed and only 8% of volunteers felt slight irritation, which demonstrates the utility of the novel vehicle. A complementary in vitro skin permeation study showed that permeation of capsaicinoids through an epidermal human membrane was reduced but not prevented by nanoencapsulation. PMID:24611011

Occupational dermatitis in Danish gardeners and greenhouse workers (III). Compositae-related symptoms.

PubMed

Paulsen, E; Søgaard, J; Andersen, K E

1998-03-01

The clinical part of the study aimed at describing epidemiological and diagnostic aspects of occupational Compositae dermatitis. Patch testing with the sesquiterpene lactone (SL) and Compositae mixes, feverfew extract and supplementary allergens in 250 selected gardeners showed Compositae allergy in 25, 17 females and 8 males. 24 were possibly occupationally sensitized. The mean age was lower and the preponderance of women higher compared to classical Compositae dermatitis, and the distribution and course of the dermatitis most often did not differ from other occupational plant dermatoses. The Compositae mix detected 2x as many as the SL mix, and the overall detection rate with both was 76%, making aimed patch testing necessary. Chrysanthemum (Dendranthema), marguerite daisy (Argyranthemum frutescens) and lettuce (Lactuca sativa) were frequent sensitizers. Occupational type I allergy to Compositae comprised sensitization to Gerbera, chrysanthemum, lettuce, Senecio cruentus and Aster. Among 1657 respondents in the questionnaire part of the study, 824 had worked with Compositae, and 160 (19%) reported occupational Compositae-related symptoms of skin and mucous membranes. Possible risk factors for the development of these were assessed in a stepwise logistic regression model and a history of childhood eczema, hay fever and duration of exposure were significantly associated with Compositae-related irritant and allergic symptoms in both sexes.

Contact Dermatitis to Personal Sporting Equipment in Youth.

PubMed

Marzario, Barbara; Burrows, Dianne; Skotnicki, Sandy

2016-07-01

Contact dermatitis to personal sporting equipment in youth is poorly studied. To review the results of patch testing 6 youth to their sporting equipment in a dermatology general private practice from 2006 to 2011. A retrospective analysis of 6 youth aged 11 to 14 who were evaluated for chronic and persistent dermatitis occurring in relation to sports equipment was conducted. All patients were subjected to epicutaneous (patch) testing, which included some or all of the following: North American Contact Dermatitis Group (NACGD) series, textile series, rubber series, corticosteroid series, and raw material from the patients' own personal equipment. All cases had 1 or more positive patch test reactions to an allergen within the aforementioned series, and 3 subjects tested positive to their personal equipment in raw form. Allergic contact dermatitis, not irritant, was deemed the relevant cause of chronic dermatitis in 4 of the 6 patients due to positive reactions to epicutaneous tests and/or personal equipment. The utility of testing to patients' own sporting equipment was shown to be of additional value and should be considered when patch testing for contact allergy to sporting equipment. © The Author(s) 2015.

PLANT DERMATITIS: ASIAN PERSPECTIVE

PubMed Central

Goon, Anthony Teik Jin; Goh, Chee Leok

2011-01-01

Occupational and recreational plant exposure on the skin is fairly common. Plant products and extracts are commonly used and found extensively in the environment. Adverse reactions to plants and their products are also fairly common. However, making the diagnosis of contact dermatitis from plants and plant extracts is not always simple and straightforward. Phytodermatitis refers to inflammation of the skin caused by a plant. The clinical patterns may be allergic phytodermatitis, photophytodermatitis, irritant contact dermatitis, pharmacological injury, and mechanical injury. In this article, we will focus mainly on allergy contact dermatitis from plants or allergic phytodermatitis occurring in Asia. PMID:22345775

IN VIVO EVALUATION OF SKIN IRRITATION POTENTIAL, MELASMA AND SEBUM CONTENT FOLLOWING LONG TERM APPLICATION OF SKIN CARE CREAM IN HEALTHY ADULTS, USING NON-INVASIVE BIOMETROLOGICAL TECHNIQUES.

PubMed

Arshad, Atif I; Khan, Shoaib H M; Akhtar, Naveed; Mahmood, Asif; Sarfraz, Rai Muhammad

2016-01-01

The present investigation was conducted to evaluate non-invasively, various functional skin parameters i.e., irritation potential, melasma and sebum contents following long term application of topical cream (w/o) loaded with 2% methanolic extract of Ananas comosus L. versus placebo control (base) in healthy adults. Healthy human volunteers (n = 11, aged 20-30 years) were recruited for investigation and written informed consent was taken from each volunteer. In this single blinded study every volunteer applied formulation on one side of face and placebo on the other side of face twice daily for a period of 12 weeks (three months). Different skin parameters i.e., skin irritancy, melasma, and sebum contents were measured on both sides of face at baseline and after two weeks interval, using photometric device Mexameter and Sebumeter in a draught free room with modulated conditions of temperature (22-25°C) and humidity (55-60%). It was evident from the results that no primary skin irritancy was observed with patch test. Besides, statistical interpretation indicates that treatment with formulation is superior to placebo because it significantly (p ≤ 0.05) reduced the skin irritancy, melasma and sebum secretions throughout the study and reaching maximum -20.76 ± 0.89, -54.2 ± 0.37 and -40.71 ± 0.75%, respectively, at the end of study period. Antioxidant activity of extract was 92% compared to standard antioxidant. Conclusively, active cream loaded with fruit extract was well tolerated by all the volunteers and suitable to treat contact dermatitis, greasy skin, acne and seborrheic dermatitis and augmenting beauty and attraction by depigmentation of human skin. So, in the future, there is need to clinically evaluate these formulations in patients with compromised skin functions i.e., contact dermatitis, melasma, and acne vulgaris in order to explore the actual potential of this fruit.

[Occupational risks in grocery stores].

PubMed

Graziosi, Francesca; Bonfiglioli, Roberta; Violante, Francesco S

2014-01-01

This work provides an overview of the spectrum of possible occupational risk factors in the retail grocery store/supermarket workplace. Literature on this theme, obtained consulting PubMed database and Google Scholar, was checked. We also exjlore results from the National bInstitute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA). RESULTs: Contacts with objects, use of dangerous equipment (cutter, food slicer) and falls to the same level (slips, trips and falls) are the mainly described workplace hazards. Exposure to chemical (flour dust, components of detergents or disinfectants, volatile organic compounds and contact with nickel) and physical agents (cold exposure, nonionizing radiation and whole bpdy vibration) are reported by many authors. Relations between biomechanical and ergonomic risk factors and musculoskeletal disorders represent the main subjects of study. Few studies are found about biological agents (particularly among butchers). Data regarding psychosocial risks factors in this setting are still limited. Musculoskeletal disorders continue to be the most recurrent health problem between the grocery store workers (particularly low back pain and carpal tunnel syndrome among cashiers). Many technical documents and international Srecommendations are present to prevent these kinds of disorders. Psychosocial risk factors and risk of workplace violence should deserve further investigation.

Occupations and amyotrophic lateral sclerosis: are jobs exposed to the general public at higher risk?

PubMed

D'Ovidio, F; d'Errico, A; Calvo, A; Costa, G; Chiò, A

2017-08-01

Aim of this study was to assess whether previous employment in certain occupations could be a risk factor for Amyotrophic Lateral Sclerosis (ALS) incidence. This topic has been explored by several studies, but no risk factor has been firmly identified. The study population consisted of all subjects over 30 years old resident in Turin in 1996 who worked or were unemployed at 1991 Italian census (n = 284 406), followed up for ALS occurrence from 1996 to 2014. The risk of ALS was estimated in relation to the occupation held in 1991, using the Italian classification of occupations at the greatest detail. The association between occupations and ALS risk was estimated through Huber-White sandwich multivariate Poisson regression models adjusted for age, gender, education and marital status. During the follow-up, 208 subjects developed ALS. ALS risk was significantly associated with previous employment as bank teller (IRR = 7.33), general practitioner (IRR = 4.61) and sales representative (IRR = 3.06). Categorizing all occupations as exposed or unexposed to direct contact with general public, it was found that previous employment in this group of occupations increased significantly ALS risk (IRR = 1.51), mainly driven by occupations in direct contact with customers (IRR = 1.79). The study results indicate that ALS risk may be increased by previous employment in occupations implying direct contact with the general public, in particular customers. A possible explanation of this finding, partly supported by the literature, is that workers in contact with the public could be more exposed to certain infections, which would increase their ALS risk. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Occupational exposures associated with severe exacerbation of asthma.

PubMed

Henneberger, P K; Liang, X; Lillienberg, L; Dahlman-Höglund, A; Torén, K; Andersson, E

2015-02-01

The exacerbation of asthma by workplace conditions is common, but little is known about which agents pose a risk. We used data from an existing survey of adults with asthma to identify occupational exposures associated with severe exacerbation of asthma. Questionnaires were completed by 557 working adults with asthma. Severe exacerbation of asthma in the past 12 months was defined as asthma-related hospitalization, or reports of both unplanned asthma care and treatment with a short course of oral corticosteroids. Occupational exposures for the same time period were assessed using an asthma-specific job exposure matrix. We modeled severe exacerbation to yield prevalence ratios (PRs) for exposures while controlling for potential confounders. A total of 164 participants (29%) were positive for severe exacerbation, and 227 (40.8%) were assessed as being exposed to asthma agents at work. Elevated PRs were observed for several specific agents, notably the irritant subcategories of environmental tobacco smoke (PR 1.84, 95%CI 1.34-2.51) among all participants, inorganic dusts (PR 2.53, 95%CI 1.37-4.67) among men, and the low molecular weight subcategory of other highly reactive agents (PR 1.97, 95%CI 1.08-3.60) among women. Among working adults with asthma, severe exacerbation was associated with several occupational agents.

Occupational rhinitis in the Slovak Republic--a long-term retrospective study.

PubMed

Perečinský, Slavomir; Legáth, L'ubomír; Varga, Marek; Javorský, Martin; Bátora, Igor; Klimentová, Gabriela

2014-12-01

Allergic and non-allergic rhinitis ranks among the common occupational health problems. However, data on the incidence of occupational rhinitis are lacking, since comprehensive studies are rare. The study includes a group of patients in the Slovak Republic who were reported as having occupational rhinitis in the years 1990-2011. The following parameters were tracked in the investigated sample: age, gender, number of cases by individual years, occupations, causative factors and the length of exposure to the given agent. Possible progression of rhinitis to bronchial asthma was evaluated as well. The diagnostic algorithm was also analysed retrospectively, which included skin tests, the examination of specific IgE antibodies and nasal provocation tests. A total of 70 cases of occupational rhinitis were reported. The disease most often occurred in food industry workers (50% of cases). The most common aetiological factor was flour. Among other relatively common allergens were synthetic textile, wool, cotton and different types of moulds. Significant agents were also different chemical factors causing allergic and irritant rhinitis. The average length of exposure was 14.8 years. Exposure was shorter in men than in women (11 years vs. 16 years) (p = 0.04). Bronchial asthma as a comorbidity was diagnosed in 13 patients (19.7%). The critical diagnostic method on the basis of which the causal association between rhinitis and work environments was confirmed in 59% of cases was skin test; confirmation of the occupational cause using nasal provocation test was less frequent (18%). Food industry, textile industry and agriculture were the most risky occupational environments. Workers in these sectors require preventive intervention. In case of showing rhinitis symptoms it is necessary to confirm the occupational aetiology of the disease by the objective diagnostic methods. Since occupational rhinitis mostly precedes the occupational asthma, the elimination from the workplace is

Allergic contact dermatitis from acrylic nails in a flamenco guitarist.

PubMed

Alcántara-Nicolás, F A; Pastor-Nieto, M A; Sánchez-Herreros, C; Pérez-Mesonero, R; Melgar-Molero, V; Ballano, A; De-Eusebio, E

2016-12-01

Acrylates are molecules that are well known for their strong sensitizing properties. Historically, many beauticians and individuals using store-bought artificial nail products have developed allergic contact dermatitis from acrylates. More recently, the use of acrylic nails among flamenco guitarists to strengthen their nails has become very popular. A 40-year-old non-atopic male patient working as a flamenco guitarist developed dystrophy, onycholysis and paronychia involving the first four nails of his right hand. The lesions were confined to the fingers where acrylic materials were used in order to strengthen his nails to play the guitar. He noticed improvement whenever he stopped using these materials and intense itching and worsening when he began reusing them. Patch tests were performed and positive results obtained with 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxyethyl acrylate (2-HEA), ethyleneglycol-dimethacrylate (EGDMA) and 2-hydroxypropyl methacrylate (2-HPMA). The patient was diagnosed with occupational allergic contact dermatitis likely caused by acrylic nails. Artificial nails can contain many kinds of acrylic monomers but most cases of contact dermatitis are induced by 2-HEMA, 2-HPMA and EGDMA. This is the first reported case of occupational allergic contact dermatitis from acrylates in artificial nails in a professional flamenco guitar player. Since the practice of self-applying acrylic nail products is becoming very popular within flamenco musicians, we believe that dermatology and occupational medicine specialists should be made aware of the potentially increasing risk of sensitization from acrylates in this setting. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Anti-irritant and anti-inflammatory effects of glycerol and xylitol in sodium lauryl sulphate-induced acute irritation.

PubMed

Szél, E; Polyánka, H; Szabó, K; Hartmann, P; Degovics, D; Balázs, B; Németh, I B; Korponyai, C; Csányi, E; Kaszaki, J; Dikstein, S; Nagy, K; Kemény, L; Erős, G

2015-12-01

Glycerol is known to possess anti-irritant and hydrating properties and previous studies suggested that xylitol may also have similar effects. Our aim was to study whether different concentrations of these polyols restore skin barrier function and soothe inflammation in sodium lauryl sulphate (SLS)-induced acute irritation. The experiments were performed on male SKH-1 hairless mice. The skin of the dorsal region was exposed to SLS (5%) for 3 h alone or together with 5% or 10% of glycerol respectively. Further two groups received xylitol solutions (8.26% and 16.52% respectively) using the same osmolarities, which were equivalent to those of the glycerol treatments. The control group was treated with purified water. Transepidermal water loss (TEWL) and skin hydration were determined. Microcirculatory parameters of inflammation were observed by means of intravital videomicroscopy (IVM). Furthermore, accumulation of neutrophil granulocytes and lymphocytes, the expression of inflammatory cytokines and SLS penetration were assessed, as well. Treatment with the 10% of glycerol and both concentrations of xylitol inhibited the SLS-induced elevation of TEWL and moderated the irritant-induced increase in dermal blood flow and in the number of leucocyte-endothelial interactions. All concentrations of the applied polyols improved hydration and prevented the accumulation of lymphocytes near the treatment site. At the mRNA level, neither glycerol nor xylitol influenced the expression of interleukin-1 alpha. However, expression of interleukin-1 beta was significantly decreased by the 10% glycerol treatment, while expression of tumour necrosis factor-alpha decreased upon the same treatment, as well as in response to xylitol. Higher polyol treatments decreased the SLS penetration to the deeper layers of the stratum corneum. Both of the analysed polyols exert considerable anti-irritant and anti-inflammatory properties, but the effective concentration of xylitol is lower than that of

Building a Definition of Irritability From Academic Definitions and Lay Descriptions.

PubMed

Barata, Paula C; Holtzman, Susan; Cunningham, Shannon; O'Connor, Brian P; Stewart, Donna E

2016-04-08

The current work builds a definition of irritability from both academic definitions and lay perspectives. In Study 1, a quantitative content analysis of academic definitions resulted in eight main content categories (i.e., behaviour, emotion or affect, cognition, physiological, qualifiers, irritant, stability or endurance, and other). In Study 2, a community sample of 39 adults participated in qualitative interviews. A deductive thematic analysis resulted in two main themes. The first main theme dealt with how participants positioned irritability in relation to other negative states. The second dealt with how participants constructed irritability as both a loss of control and as an experience that should be controlled. The discussion integrates the findings of both studies and provides a concise, but comprehensive definition.

Cutaneous irritancy of an ibuprofen medicated plaster in healthy volunteers.

PubMed

Maganji, Manisha; Connolly, Mark P; Bhatt, Aomesh

2018-01-01

Ibuprofen is a commonly used non-steroidal anti-inflammatory drug administered to treat injuries, joint pain, and recurrent muscular skeletal pain. The aim of this study was to determine the cutaneous irritancy of a medicated ibuprofen plaster compared with a placebo plaster in healthy volunteers. Healthy volunteers (N = 31) were treated at the same time with one ibuprofen and one placebo plaster. The ibuprofen and placebo plaster were applied in a randomized fashion to sites on the left or right side of subjects' lower backs. At each scheduled visit, the plasters and applications sites were assessed for degree of adhesion and skin irritancy, respectively. The plasters were applied on study Days 1, 2, 3, 5, 8, 10, 12, 15, 17, and 19, with final plaster removal on Day 22. The ibuprofen medicated plaster compared with placebo had a lower percentage of Grade 1 (23.3% vs. 46.7%, respectively), Grade 2 (10% vs. 20%), and ≥Grade 3 (3% vs. 16.1%) irritancy scores after 21 days of application. The mean irritation score across the study was 0.40 for the ibuprofen medicated plaster and 1.18 for the placebo plaster. The irritation score on Day 22 of the study was 0.53 for the ibuprofen medicated plaster and 1.50 for placebo. The placebo plaster was associated with a higher number of stopped applications due to Grade 3 or above skin reactions compared with the ibuprofen medicated plaster (5 vs. 1, respectively). The ibuprofen medicated plaster was well tolerated and was associated with lower irritancy than the placebo plaster.

Occupational contact dermatitis in Australia: diagnostic and management practices, and severity of worker impairment.

PubMed

Keegel, Tessa; Erbas, Bircan; Cahill, Jennifer; Noonan, Amanda; Dharmage, Shyamali; Nixon, Rosemary

2007-06-01

The aims of this study were to compare treatment and referral practices between general practitioners (GPs) and dermatologists and to evaluate predictors for occupational contact dermatitis (OCD) disease severity measured in terms of worker impairment. Data were collected from 181 patients recruited for a larger study of OCD. Information about treatment recommendations and usual referral practices are reported for 123 patients. Data from patients, diagnosed with work-related skin disease, were modelled for severity of worker impairment. GPs were more likely to treat a patient independently, referring if the patient did not improve, whereas dermatologists were more likely to refer for patch testing on initial presentation. Dermatologists were more likely to recommend gloves and GPs were more likely to recommend soap avoidance/substitution. 2 GPs and no dermatologists reported recommending the best practice combination of moisturizers, topical corticosteroids and soap substitutes. When adjusted for all variables including age, sex, duration and diagnostic subgroup, workers with atopy as a cofactor had the most severe impairment. This study suggests that in Australia, patients with suspected OCD are initially managed within general practice, few clinicians recommend best practice treatments for OCD, and that atopy is associated with severity. These findings have implications for health resource allocation, clinician education, and the pre-employment counselling of atopic patients.

Contact Dermatitis for the Practicing Allergist.

PubMed

Bernstein, David I

2015-01-01

This article provides an overview of important practice recommendations from the recently updated Contact Dermatitis Practice Parameter. This updated parameter provides essential recommendations pertaining to clinical history, physical examination, and patch testing evaluation of patients suspected of allergic contact dermatitis. In addition to providing guidance for performing and interpreting closed patch testing, the updated parameter provides concrete recommendations for assessing metal hypersensitivity in patients receiving prosthetic devices, for evaluating workers with occupational contact dermatitis, and also for addressing allergic contact dermatitis in children. Finally, the document provides practical recommendations useful for educating patients regarding avoidance of exposure to known contact sensitizers in the home and at work. The Contact Dermatitis Parameter is designed as a practical, evidence-based clinical tool to be used by allergists and dermatologists who routinely are called upon to evaluate patients with skin disorders. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Utilization of the ex vivo LLNA: BrdU-ELISA to distinguish the sensitizers from irritants in respect of 3 end points-lymphocyte proliferation, ear swelling, and cytokine profiles.

PubMed

Arancioglu, Seren; Ulker, Ozge Cemiloglu; Karakaya, Asuman

2015-01-01

Dermal exposure to chemicals may result in allergic or irritant contact dermatitis. In this study, we performed ex vivo local lymph node assay: bromodeoxyuridine-enzyme-linked immunosorbent assay (LLNA: BrdU-ELISA) to compare the differences between irritation and sensitization potency of some chemicals in terms of the 3 end points: lymphocyte proliferation, cytokine profiles (interleukin 2 [IL-2], interferon-γ (IFN-γ), IL-4, IL-5, IL-1, and tumor necrosis factor α [TNF-α]), and ear swelling. Different concentrations of the following well-known sensitizers and irritant chemicals were applied to mice: dinitrochlorobenzene, eugenol, isoeugenol, sodium lauryl sulfate (SLS), and croton oil. According to the lymph node results; the auricular lymph node weights and lymph node cell counts increased after application of both sensitizers and irritants in high concentrations. On the other hand, according to lymph node cell proliferation results, there was a 3-fold increase in proliferation of lymph node cells (stimulation index) for sensitizer chemicals and SLS in the applied concentrations; however, there was not a 3-fold increase for croton oil and negative control. The SLS gave a false-positive response. Cytokine analysis demonstrated that 4 cytokines including IL-2, IFN-γ, IL-4, and IL-5 were released in lymph node cell cultures, with a clear dose trend for sensitizers whereas only TNF-α was released in response to irritants. Taken together, our results suggest that the ex vivo LLNA: BrdU-ELISA method can be useful for discriminating irritants and allergens. © The Author(s) 2015.

Immunologic contact urticaria--the human touch.

PubMed

Wang, Christina Y; Maibach, Howard I

2013-06-01

To review immunologic contact urticaria (ICU) in the occupational and environmental context, and describe its continued relevance in light of the ever-increasing onslaught of new chemicals and products, as well as new technology placing novel interactions, such as nanoparticles, within reach of the population at home and work. Publications were searched via PubMed, using key words: Occupational, immunologic, contact urticaria, nanoparticle. ICU remains an important diagnosis to make and treat because it has widespread health and social morbidity, including job and income loss, persistent life-long allergies, and progression from self-limiting skin eruptions to multi-systemic, sometimes life-threatening, illnesses. There is no short supply of known ICU causing allergens, but it is equally important to be ever vigilant in recognizing, and even adding to, items in the constantly expanding list of novel allergenic agents provided to us by the advances of modern chemistry and technology, and by the changing social structure and lifestyle dynamics.

Technologies in the evaluation of irritable bowel syndrome.

PubMed

Smout, A J P M; Azpiroz, F; Brummer, R-J; Coremans, G; Dapoigny, M; Müller-Lissner, S A; Pace, F; Stockbrügger, R M; Vatn, M; Whorwell, P J

2004-01-01

During a meeting in The Hague, The Netherlands, the IBiS Club evaluated the most important techniques that can be used in the investigation of irritable bowel syndrome, either in the context of scientific research or as a clinical diagnostic tool. In each of these, the relevance of findings made in irritable bowel syndrome was balanced against the applicability of the technique. The discussion of the group is summarized in this paper. Copyright 2004 S. Karger AG, Basel

Occupational and Environmental Contributions to Chronic Cough in Adults: Chest Expert Panel Report.

PubMed

Tarlo, Susan M; Altman, Kenneth W; Oppenheimer, John; Lim, Kaiser; Vertigan, Anne; Prezant, David; Irwin, Richard S

2016-10-01

In response to occupational and environmental exposures, cough can be an isolated symptom reflecting exposure to an irritant with little physiological consequence, or it can be a manifestation of more significant disease. This document reviews occupational and environmental contributions to chronic cough in adults, focusing on aspects not previously covered in the 2006 ACCP Cough Guideline or our more recent systematic review, and suggests an approach to investigation of these factors when suspected. MEDLINE and TOXLINE literature searches were supplemented by articles identified by the cough panel occupational and environmental subgroup members, to identify occupational and environmental aspects of chronic cough not previously covered in the 2006 ACCP Cough Guideline. Based on the literature reviews and the Delphi methodology, the cough panel occupational and environmental subgroup developed guideline suggestions that were approved after review and voting by the full cough panel. The literature review identified relevant articles regarding: mechanisms; allergic environmental causes; chronic cough and the recreational and involuntary inhalation of tobacco and marijuana smoke; nonallergic environmental triggers; laryngeal syndromes; and occupational diseases and exposures. Consensus-based statements were developed for the approach to diagnosis due to a lack of strong evidence from published literature. Despite increased understanding of cough related to occupational and environmental triggers, there remains a gap between the recommended assessment of occupational and environmental causes of cough and the reported systematic assessment of these factors. There is a need for further documentation of occupational and environmental causes of cough in the future. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Food patch testing for irritable bowel syndrome.

PubMed

Stierstorfer, Michael B; Sha, Christopher T; Sasson, Marvin

2013-03-01

The traditional classification of irritable bowel syndrome (IBS) as a functional disorder has been challenged in recent years by evidence of ongoing low-grade gastrointestinal tract inflammation. Inflammation may alter gastrointestinal motility and thus be central to the pathogenesis of IBS. Many foods and food additives are known to cause allergic contact dermatitis. We hypothesize that allergenic foods and food additives may elicit a similar allergic reaction in the gastrointestinal tract, giving rise to symptoms suggestive of IBS. We sought to determine whether skin patch testing to a panel of foods and food additives may identify food allergens that may be responsible for symptoms of IBS. We performed skin patch testing to common allergenic foods and food additives on individuals with a history of or symptoms suggestive of IBS. We used patch test-guided avoidance diets to determine whether avoidance alleviates IBS symptoms. Thirty of the 51 study participants showed at least 1 doubtful or positive patch test result. Fourteen of the participants reported symptomatic improvement, ranging from slight to great, upon avoidance of the foods/food additives to which they reacted. Double-blind study design, inclusion of only patients with active IBS, larger sample size, more balanced gender distribution, testing of more foods/food additives, and longer duration of and more precise quantification of response to dietary avoidance are suggested for future studies. Allergic contact enteritis to ingested foods, food additives, or both may contribute to IBS symptoms. Patch testing may be useful in identifying the causative foods. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Hypersensitivity to Cold Stimuli in Symptomatic Contact Lens Wearers

PubMed Central

Situ, Ping; Simpson, Trefford; Begley, Carolyn

2016-01-01

Purpose To examine the cooling thresholds and the estimated sensation magnitude at stimulus detection in controls and symptomatic and asymptomatic contact lens (CL) wearers, in order to determine whether detection thresholds depend on the presence of symptoms of dryness and discomfort. Methods 49 adapted CL wearers and 15 non-lens wearing controls had room temperature pneumatic thresholds measured using a custom Belmonte esthesiometer, during Visits 1 and 2 (Baseline CL), Visit 3 (2 weeks no CL wear) and Visit 4 (2 weeks after resuming CL wear). CL wearers were subdivided into symptomatic and asymptomatic groups based on comfortable wearing time (CWT) and CLDEQ-8 score (<8 hours CWT and ≥14 CLDEQ-8 stratified the symptom groups). Detection thresholds were estimated using an ascending method of limits and each threshold was the average of the three first-reported flow rates. The magnitude of intensity, coolness, irritation and pain at detection of the stimulus were estimated using a 1-100 scale (1 very mild, 100 very strong). Results In all measurement conditions, the symptomatic CL wearers were the most sensitive, the asymptomatic CL wearers were the least sensitive and the control group was between the two CL wearing groups (group factor p < 0.001, post hoc asymptomatic vs. symptomatic group, all p’s < 0.015). Similar patterns were found for the estimated magnitude of intensity and irritation (group effect p=0.027 and 0.006 for intensity and irritation, respectively) but not for cooling (p>0.05) at detection threshold. Conclusions Symptomatic CL wearers have higher cold detection sensitivity and report greater intensity and irritation sensation at stimulus detection than the asymptomatic wearers. Room temperature pneumatic esthesiometry may help to better understand the process of sensory adaptation to CL wear. PMID:27046090

Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome

ERIC Educational Resources Information Center

Ross, Colin A.

2005-01-01

Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the…

Somatic symptoms among cosmetologists compared to women in other occupations.

PubMed

Gallicchio, Lisa; Miller, Susan R; Greene, Teresa; Zacur, Howard; Flaws, Jodi A

2011-04-01

Although the literature pertaining to the cosmetology occupation and specific health effects, such as asthma, dermatitis, and reproductive function, has grown substantially, little information is available about whether cosmetologists are at increased risk of other symptoms compared to women working in other occupations. Thus, the purpose of this study was to determine if cosmetologists of reproductive age are at increased risk of self-reported symptoms compared to women of the same age working in other occupations. Data were analyzed from 450 cosmetologists and 511 women in other occupations, aged 21-55 years, in the Baltimore metropolitan region who responded to a mailed survey that ascertained detailed data on symptoms as well as usual work tasks. The data showed that cosmetologists were at increased risk of memory and sleep disturbances, muscle weakness, throat irritation, and hot flashes compared to women of the same age working in other occupations after adjustment for confounders, including cigarette smoking. Among the cosmetologists, handling cleaning supplies; hair bleaching; use of straighteners, texturizers, or permanent chemicals; and several nail care work tasks were associated with one or more of the queried symptoms. Findings from this study suggest that, compared to noncosmetologists, cosmetologists are at increased risk for a number of symptoms reported to be associated with decreased quality of life. These symptoms may also reflect chronic exposure to chemicals that have been shown to be related to more severe long-term health outcomes.

Assessment of Occupational Symptoms and Chemical Exposures for Nail Salon Technicians in Daegu City, Korea

PubMed Central

Park, Sung-Ae; Gwak, Sugyeong

2014-01-01

Objectives This study aimed to evaluate occupational symptoms and chemical exposures of nail salon technicians. Methods Work-related symptoms of nail salon technicians in Daegu City were surveyed using a researcher-administered questionnaire, and responses were compared to those of non-exposed office workers as controls. Personal exposure level of airborne volatile organic compounds was also monitored using passive samplers. Results A total of 159 subjects in 120 salons were interviewed. Average work-shift concentrations of 13 chemicals were measured for 50 workers from 30 salons using personal passive samplers. The most frequently reported respiratory or neurologic symptoms by nail shop technicians compared to controls were nose irritation (odds ratio [OR], 54.0; confidence interval [CI], 21.6 to 134.8), followed by headache (OR, 9.3; CI, 4.7 to 18), and throat irritation (OR, 4.3; CI, 2.2 to 8.5). For eyes and skin, 92% of respondents complained eye irritation (OR, 13.1; CI, 5.7 to 30.1). In musculoskeletal symptoms, workers reported pain or discomfort in shoulders (OR, 20.3; CI, 7.7 to 54) and neck (OR, 19.7; CI, 8.9 to 43.6). From personal measurements, the proportion of exceeding the Korean Occupational Exposure Limit was the highest for acetone with 64%, followed by toluene (50%), butyl acetate (46%), and methyl methacrylate (12%). However, the service was being provided without a proper ventilation system in most surveyed shops. Conclusions Based on these findings, it is warranted to have appropriate local exhaust ventilation place to ensure adequate health protection of nail shop technicians as well as customers. At the same time, greater policy interests are warranted in nail care business to protect health of both workers and customers. PMID:24921020

Antioxidant activity and irritation property of venoms from Apis species.

PubMed

Somwongin, Suvimol; Chantawannakul, Panuwan; Chaiyana, Wantida

2018-04-01

Pharmacological effects of bee venom has been reported, however, it has been restricted to the bee venom collected from European honey bee (Apis mellifera). The aim of the present study was to compare the antioxidant activities and irritation properties of venoms collected from four different Apis species in Thailand, which includes Apis cerena (Asian cavity nesting honeybee), Apis florea (dwarf honeybee), Apis dorsata (giant honeybee), and A. mellifera. Melittin content of each bee venom extracts was investigated by using high-performance liquid chromatography. Ferric reducing antioxidant power, 2, 2'-azinobis (3-ethylbenzothiazoline-6-sulfonic acid), and 1, 1-diphenyl-2-picrylhydrazyl assay were used to determine the antioxidant activity, whereas, hen's egg test chorioallantoic membrane assay was used to determine the irritation property of each bee venom extracts. Melittin was the major constituent in all bee venom extracts. The melittin content in A. dorsata, A. mellifera, A. florea, and A. cerena were 95.8 ± 3.2%, 76.5 ± 1.9%, 66.3 ± 8.6%, and 56.8 ± 1.8%, respectively. Bee venom extract from A. dorsata possessed the highest antioxidant activity with the inhibition of 41.1 ± 2.2% against DPPH, Trolox equivalent antioxidant capacity of 10.21 ± 0.74 mM Trolox/mg and equivalent concentration (EC 1 ) of 0.35 ± 0.02 mM FeSO 4 /mg. Bee venom extract from A. mellifera exhibited the highest irritation, followed by A. cerena, A. dorsata, and A. florea, respectively. Melittin was the compound responsible for the irritation property of bee venom extracts since it could induce severe irritation (irritation score was 13.7 ± 0.5, at the concentration of 2 mg/ml). The extract from A. dorsata which possessed the highest antioxidant activity showed no irritation up to the concentration of 0.1 mg/ml. Therefore, bee venom extract from A. dorsata at the concentration not more than 0.1 mg/ml would be suggested for using

Sources of sensitization, cross-reactions, and occupational sensitization to topical anaesthetics among general dermatology patients.

PubMed

Jussi, Liippo; Lammintausta, Kaija

2009-03-01

Contact sensitization to local anaesthetics is often from topical medicaments. Occupational sensitization to topical anaesthetics may occur in certain occupations. The aim of the study was to analyse the occurrence of contact sensitization to topical anaesthetics in general dermatology patients. Patch testing with topical anaesthetics was carried out in 620 patients. Possible sources of sensitization and the clinical histories of the patients are analysed. Positive patch test reactions to one or more topical anaesthetics were seen in 25/620 patients. Dibucaine reactions were most common (20/25), and lidocaine sensitization was seen in two patients. Six patients had reactions to ester-type and/or amide-type anaesthetics concurrently. Local preparations for perianal conditions were the most common sensitizers. One patient had developed occupational sensitization to procaine with multiple cross-reactions and with concurrent penicillin sensitization from procaine penicillin. Dibucaine-containing perianal medicaments are the major source of contact sensitization to topical anaesthetics. Although sensitization to multiple anaesthetics can be seen, cross-reactions are possible. Contact sensitization to lidocaine is not common, and possible cross-reactions should be determined when reactions to lidocaine are seen. Occupational procaine sensitization from veterinary medicaments is a risk among animal workers.

Case-control study of paternal occupation and childhood leukaemia in Great Britain, 1962-2006.

PubMed

Keegan, T J; Bunch, K J; Vincent, T J; King, J C; O'Neill, K A; Kendall, G M; MacCarthy, A; Fear, N T; Murphy, M F G

2012-10-23

Paternal occupational exposures have been proposed as a risk factor for childhood leukaemia. This study investigates possible associations between paternal occupational exposure and childhood leukaemia in Great Britain. The National Registry of Childhood Tumours provided all cases of childhood leukaemia born and diagnosed in Great Britain between 1962 and 2006. Controls were matched on sex, period of birth and birth registration subdistrict. Fathers' occupations were assigned to 1 or more of 33 exposure groups. Social class was derived from father's occupation at the time of the child's birth. A total of 16 764 cases of childhood leukaemia were ascertained. One exposure group, paternal social contact, was associated with total childhood leukaemia (odds ratio 1.14, 1.05-1.23); this association remained significant when adjusted for social class. The subtypes lymphoid leukaemia (LL) and acute myeloid leukaemia showed increased risk with paternal exposure to social contact before adjustment for social class. Risk of other leukaemias was significantly increased by exposure to electromagnetic fields, persisting after adjustment for social class. For total leukaemia, the risks for exposure to lead and exhaust fumes were significantly <1. Occupationally derived social class was associated with risk of LL, with the risk being increased in the higher social classes. Our results showed some support for a positive association between childhood leukaemia risk and paternal occupation involving social contact. Additionally, LL risk increased with higher paternal occupational social class.

Pigmented and hyperkeratotic napkin dermatitis: a liquid detergent irritant dermatitis.

PubMed

Patrizi, A; Neri, I; Marzaduri, S; Fiorillo, L

1996-01-01

Napkin or diaper dermatitis (DD) is an inflammatory cutaneous eruption limited to the diaper area and common in the first 2 years of life. A number of clinical variants of DD have been identified. We report a new variant of DD characterized by papyraceous skin, brownish discoloration and predilection for the depth of folds. 15 infants and toddlers affected by this peculiar type of DD were evaluated regarding duration, localization, morphology and evolution of their dermatosis. This variant of DD was mainly confined to the depth of inguinal and gluteal folds and invariably associated with severe xerosis with papyraceous and glazed skin. The patients were healthy and asymptomatic and all laboratory investigations performed were normal. All patients were frequently changed and thoroughly washed with synthetic detergents with acid pH. DD improved rapidly with reduced frequency of washing and discontinuation of liquid detergents. We conclude that this condition is a type of irritant contact dermatitis from excessive use of lipid acid detergents.

Menthol attenuates respiratory irritation and elevates blood cotinine in cigarette smoke exposed mice.

PubMed

Ha, Michael A; Smith, Gregory J; Cichocki, Joseph A; Fan, Lu; Liu, Yi-Shiuan; Caceres, Ana I; Jordt, Sven Eric; Morris, John B

2015-01-01

Addition of menthol to cigarettes may be associated with increased initiation of smoking. The potential mechanisms underlying this association are not known. Menthol, likely due to its effects on cold-sensing peripheral sensory neurons, is known to inhibit the sensation of irritation elicited by respiratory irritants. However, it remains unclear whether menthol modulates cigarette smoke irritancy and nicotine absorption during initial exposures to cigarettes, thereby facilitating smoking initiation. Using plethysmography in a C57Bl/6J mouse model, we examined the effects of L-menthol, the menthol isomer added to cigarettes, on the respiratory sensory irritation response to primary smoke irritants (acrolein and cyclohexanone) and smoke of Kentucky reference 2R4 cigarettes. We also studied L-menthol's effect on blood levels of the nicotine metabolite, cotinine, immediately after exposure to cigarette smoke. L-menthol suppressed the irritation response to acrolein with an apparent IC₅₀ of 4 ppm. Suppression was observed even at acrolein levels well above those necessary to produce a maximal response. Cigarette smoke, at exposure levels of 10 mg/m³ or higher, caused an immediate and marked sensory irritation response in mice. This response was significantly suppressed by L-menthol even at smoke concentrations as high as 300 mg/m³. Counterirritation by L-menthol was abolished by treatment with a selective inhibitor of Transient Receptor Potential Melastatin 8 (TRPM8), the neuronal cold/menthol receptor. Inclusion of menthol in the cigarette smoke resulted in roughly a 1.5-fold increase in plasma cotinine levels over those observed in mice exposed to smoke without added menthol. These findings document that, L-menthol, through TRPM8, is a strong suppressor of respiratory irritation responses, even during highly noxious exposures to cigarette smoke or smoke irritants, and increases blood cotinine. Therefore, L-menthol, as a cigarette additive, may promote smoking

Menthol Attenuates Respiratory Irritation and Elevates Blood Cotinine in Cigarette Smoke Exposed Mice

PubMed Central

Ha, Michael A.; Smith, Gregory J.; Cichocki, Joseph A.; Fan, Lu; Liu, Yi-Shiuan; Caceres, Ana I.; Jordt, Sven Eric; Morris, John B.

2015-01-01

Addition of menthol to cigarettes may be associated with increased initiation of smoking. The potential mechanisms underlying this association are not known. Menthol, likely due to its effects on cold-sensing peripheral sensory neurons, is known to inhibit the sensation of irritation elicited by respiratory irritants. However, it remains unclear whether menthol modulates cigarette smoke irritancy and nicotine absorption during initial exposures to cigarettes, thereby facilitating smoking initiation. Using plethysmography in a C57Bl/6J mouse model, we examined the effects of L-menthol, the menthol isomer added to cigarettes, on the respiratory sensory irritation response to primary smoke irritants (acrolein and cyclohexanone) and smoke of Kentucky reference 2R4 cigarettes. We also studied L-menthol’s effect on blood levels of the nicotine metabolite, cotinine, immediately after exposure to cigarette smoke. L-menthol suppressed the irritation response to acrolein with an apparent IC₅₀ of 4 ppm. Suppression was observed even at acrolein levels well above those necessary to produce a maximal response. Cigarette smoke, at exposure levels of 10 mg/m³ or higher, caused an immediate and marked sensory irritation response in mice. This response was significantly suppressed by L-menthol even at smoke concentrations as high as 300 mg/m³. Counterirritation by L-menthol was abolished by treatment with a selective inhibitor of Transient Receptor Potential Melastatin 8 (TRPM8), the neuronal cold/menthol receptor. Inclusion of menthol in the cigarette smoke resulted in roughly a 1.5-fold increase in plasma cotinine levels over those observed in mice exposed to smoke without added menthol. These findings document that, L-menthol, through TRPM8, is a strong suppressor of respiratory irritation responses, even during highly noxious exposures to cigarette smoke or smoke irritants, and increases blood cotinine. Therefore, L-menthol, as a cigarette additive, may promote smoking

A qualitative review of existing national and international occupational safety and health policies relating to occupational sedentary behaviour.

PubMed

Coenen, Pieter; Gilson, Nicholas; Healy, Genevieve N; Dunstan, David W; Straker, Leon M

2017-04-01

Prolonged sedentary time is now recognised as an emergent ergonomics issue. We aimed to review current occupational safety and health policies relevant to occupational sedentary behaviour. An electronic search for documents was conducted on websites of ergonomics and occupational safety and health organisations from 10 countries and six international/pan-European agencies. Additionally, 43 informants (nine countries) were contacted and an international conference workshop held. 119 documents (e.g. legislation, guidelines, codes of practice) were identified. Using a qualitative synthesis, it was observed that many jurisdictions had legal frameworks establishing a duty of care for employers, designers/manufacturers/suppliers and employees. While no occupational authority policies focusing specifically on sedentary behaviour were found, relevant aspects of existing policies were identified. We highlight implications for ergonomics research and practice and recommend the development of policy to specifically address occupational sedentary behaviour and support workplace initiatives to assess and control the risks of this emergent hazard. Copyright © 2016 Elsevier Ltd. All rights reserved.

Skin sensitization quantitative risk assessment for occupational exposure of hairdressers to hair dye ingredients.

PubMed

Goebel, Carsten; Diepgen, Thomas L; Blömeke, Brunhilde; Gaspari, Anthony A; Schnuch, Axel; Fuchs, Anne; Schlotmann, Kordula; Krasteva, Maya; Kimber, Ian

2018-06-01

Occupational exposure of hairdressers to hair dyes has been associated with the development of allergic contact dermatitis (ACD) involving the hands. p-Phenylenediamine (PPD) and toluene-2,5-diamine (PTD) have been implicated as important occupational contact allergens. To conduct a quantitative risk assessment for the induction of contact sensitization to hair dyes in hairdressers, available data from hand rinsing studies following typical occupational exposure conditions to PPD, PTD and resorcinol were assessed. By accounting for wet work, uneven exposure and inter-individual variability for professionals, daily hand exposure concentrations were derived. Secondly, daily hand exposure was compared with the sensitization induction potency of the individual hair dye defined as the No Expected Sensitization Induction Levels (NESIL). For PPD and PTD hairdresser hand exposure levels were 2.7 and 5.9 fold below the individual NESIL. In contrast, hand exposure to resorcinol was 50 fold below the NESIL. Correspondingly, the risk assessment for PPD and PTD indicates that contact sensitization may occur, when skin protection and skin care are not rigorously applied. We conclude that awareness of health risks associated with occupational exposure to hair dyes, and of the importance of adequate protective measures, should be emphasized more fully during hairdresser education and training. Copyright © 2018 Elsevier Inc. All rights reserved.

Winter season, frequent hand washing, and irritant patch test reactions to detergents are associated with hand dermatitis in healthcare workers

PubMed Central

Callahan, Adrienne; Baron, Elma; Fekedulegn, Desta; Kashon, Michael; Yucesoy, Berran; Johnson, Victor J.; Santo Domingo, Diana; Kirkland, Brent; Luster, Michael I.; Nedorost, Susan

2013-01-01

Background Irritant hand dermatitis (IHD) is common in healthcare workers. Objective We studied endogenous irritant contact dermatitis threshold by patch testing, and exogenous factors such as season and hand washing for their association with IHD in healthcare workers. Methods Irritant patch testing with sodium lauryl sulfate (SLS), sodium hydroxide (NaOH) and benzalkonium chloride (BAK) at varying concentrations was measured in 113 healthcare workers. Examination for hand dermatitis occurred at one month intervals for a period of six months in the Midwestern US. Results Positive patch testing to low concentration SLS was associated with IHD (p=0.0310) after adjusting for age, gender, ethnicity, season, history of childhood flexural dermatitis, mean indoor relative humidity, glove and hand sanitizer usage). Subjects with a positive patch test to SLS were 78% more likely to have occurrence of IHD (IRR=1.78, 95% CI: 0.92, 3.45). Hand washing frequency (≥ 10 times a day; IRR=1.55, 95% CI: 1.01, 2.39) and cold season (IRR=2.76, 95% CI: 1.35, 5.65) were associated with IHD. No association was found between history of childhood flexural dermatitis and IHD in this population. Conclusions Both genetic and environmental factors are important in the etiology of IHD and should be considered in designing strategies to protect, educate and treat susceptible individuals. PMID:23857011

Allergic contact dermatitis: Patient management and education.

PubMed

Mowad, Christen M; Anderson, Bryan; Scheinman, Pamela; Pootongkam, Suwimon; Nedorost, Susan; Brod, Bruce

2016-06-01

Allergic contact dermatitis is a common diagnosis resulting from exposure to a chemical or chemicals in a patient's personal care products, home, or work environment. Once patch testing has been performed, the education and management process begins. After the causative allergens have been identified, patient education is critical to the proper treatment and management of the patient. This must occur if the dermatitis is to resolve. Detailed education is imperative, and several resources are highlighted. Photoallergic contact dermatitis and occupational contact dermatitis are other considerations a clinician must keep in mind. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

A retrospective analysis of in vivo eye irritation, skin irritation and skin sensitisation studies with agrochemical formulations: Setting the scene for development of alternative strategies.

PubMed

Corvaro, M; Gehen, S; Andrews, K; Chatfield, R; Macleod, F; Mehta, J

2017-10-01

Analysis of the prevalence of health effects in large scale databases is key in defining testing strategies within the context of Integrated Approaches on Testing and Assessment (IATA), and is relevant to drive policy changes in existing regulatory toxicology frameworks towards non-animal approaches. A retrospective analysis of existing results from in vivo skin irritation, eye irritation, and skin sensitisation studies on a database of 223 agrochemical formulations is herein published. For skin or eye effects, high prevalence of mild to non-irritant formulations (i.e. per GHS, CLP or EPA classification) would generally suggest a bottom-up approach. Severity of erythema or corneal opacity, for skinor eye effects respectively, were the key drivers for classification, consistent with existing literature. The reciprocal predictivity of skin versus eye irritation and the good negative predictivity of the GHS additivity calculation approach (>85%) provided valuable non-testing evidence for irritation endpoints. For dermal sensitisation, concordance on data from three different methods confirmed the high false negative rate for the Buehler method in this product class. These results have been reviewed together with existing literature on the use of in vitro alternatives for agrochemical formulations, to propose improvements to current regulatory strategies and to identify further research needs. Copyright © 2017 Elsevier Inc. All rights reserved.

Impact of regulation on contact dermatitis.

PubMed

Hogan, Daniel; Ledet, Johnathan J

2009-07-01

Contact dermatitis is a serious public health and dermatologic concern. The prevalence of contact dermatitis in the United States was estimated to be 13.6 per 1000 population according to the National Health and Nutritional Examination Survey using physical examinations by dermatologists of a selected sample of Americans. The American Medical Care Survey estimated that for all American physicians dermatitis is the second most common dermatologic diagnosis proffered. It is essential that government, industry, and dermatologists work together to enhance regulatory methods to control and prevent contact allergy epidemics. Increased knowledge and awareness of occupational skin diseases by dermatologists and other health care professionals will assist in achieving national public health goals. This article reviews governmental regulations-some helpful for patients and workers and some not helpful for dermatologists in their quest to assist patients with contact dermatitis.

Lurasidone for major depressive disorder with mixed features and irritability: a post-hoc analysis.

PubMed

Swann, Alan C; Fava, Maurizio; Tsai, Joyce; Mao, Yongcai; Pikalov, Andrei; Loebel, Antony

2017-04-01

The aim of this post-hoc analysis was to evaluate the efficacy of lurasidone in treating major depressive disorder (MDD) with mixed features including irritability. The data in this analysis were derived from a study of patients meeting DSM-IV-TR criteria for unipolar MDD, with a Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≥26, presenting with two or three protocol-defined manic symptoms, and who were randomized to 6 weeks of double-blind treatment with either lurasidone 20-60 mg/d (n=109) or placebo (n=100). We defined "irritability" as a score ≥2 on both the Young Mania Rating Scale (YMRS) irritability item (#5) and the disruptive-aggressive item (#9). Endpoint change in the MADRS and YMRS items 5 and 9 were analyzed using a mixed model for repeated measures for patients with and without irritability. Some 20.7% of patients met the criteria for irritability. Treatment with lurasidone was associated with a significant week 6 change vs. placebo in MADRS score in both patients with (-22.6 vs. -9.5, p<0.0001, effect size [ES]=1.4) and without (-19.9 vs. -13.8, p<0.0001, ES=0.7) irritability. In patients with irritable features, treatment with lurasidone was associated with significant week 6 changes vs. placebo in both the YMRS irritability item (-1.4 vs. -0.3, p=0.0012, ES=1.0) and the YMRS disruptive-aggressive item (-1.0 vs. -0.3, p=0.0002, ES=1.2). In our post-hoc analysis of a randomized, placebo-controlled, 6-week trial, treatment with lurasidone significantly improved depressive symptoms in MDD patients with mixed features including irritability. In addition, irritability symptoms significantly improved in patients treated with lurasidone.

Lurasidone for the Treatment of Irritability Associated with Autistic Disorder

ERIC Educational Resources Information Center

Loebel, Antony; Brams, Matthew; Goldman, Robert S.; Silva, Robert; Hernandez, David; Deng, Ling; Mankoski, Raymond; Findling, Robert L.

2016-01-01

The aim of this study was to evaluate the short-term efficacy and safety of lurasidone in treating irritability associated with autistic disorder. In this multicenter trial, outpatients age 6-17 years who met DSM-IV-TR criteria for autistic disorder, and who demonstrated irritability, agitation, and/or self-injurious behaviors were randomized to…

Postanaesthetic tear production and ocular irritation in cats.

PubMed

Peche, N; Köstlin, R; Reese, S; Pieper, K

2015-01-01

General anaesthesia significantly reduces tear production and normal values are not immediately re-established on ending anaesthesia. Therefore, adequate protection of the cornea has to be assured during the perianaesthetic period. There are various methods available, including taping of the eyelids and the application of eye ointments, gels and drops. In human medicine studies, different formulations were found to induce signs of ocular irritation. The aim of the present study was to determine tear production in cats after general anaesthesia, and to identify possible causes of irritation. Tear production was determined in 41 cats after general anaesthesia and eyes were examined for signs of irritation. Two different anaesthetic protocols were used. To protect the cornea, an ointment and gel were applied to the right and left eyes, respectively. Postoperatively, tear production was significantly reduced for 6 hours and 18 hours in the right and left eyes, respectively. Two hours after anaesthesia, blepharospasm of the right eye was observed in 92.7% (n = 38) of the cats. In contrast, the left eye was always held open. This study demonstrated that tear production in cats is significantly decreased both during and after anaesthesia. The degree of reduction was independent of the anaesthetic protocol. Both the eye ointment and gel proved effective in protecting the corneal surface. However, eye gel use is recommended because the eye ointment consistently caused an irritation comparable to the foreign-body sensation reported in humans.

An approach for evaluating the respiratory irritation of mixtures: application to metalworking fluids.

PubMed

Schaper, M M; Detwiler-Okabayashi, K A

1995-01-01

Recently, the sensory and pulmonary irritating properties of ten metalworking fluids (MWF) were assessed using a mouse bioassay. Relative potency of the MWFs was estimated, but it was not possible to identify the component(s) responsible for the the respiratory irritation induced by each MWF. One of the ten fluids, MWF "ET", produced sensory and pulmonary irritation in mice, and it was of moderate potency in comparison to the other nine MWFs. MWF "E" had three major components: tall oil fatty acids (TOFA), sodium sulfonate (SA), and paraffinic oil (PO). In the present study, the sensory and pulmonary irritating properties of these individual components of MWF "E" were evaluated. Mixtures of the three components were also prepared and similarly evaluated. This analysis revealed that the sensory irritation from MWF "E" was largely due to TOFA, whereas SA produced the pulmonary irritation observed with MWF "E". Both TOFA and SA were more potent irritants than was MWF "E", and the potency of TOFA and/or SA was diminished through combination with PO. There was no evidence of synergism of the components when combined to form MWF "E". This approach for identifying the biologically "active" component(s) in a mixture should be useful for other MWFs. Furthermore, the approach should be easily adapted for other applications involving concerns with mixtures.

[Gallbladder contractility in children with functional abdominal pain or irritable bowel syndrome].

PubMed

Iwańczak, Franciszek; Siedlecka-Dawidko, Jolanta; Iwanczak, Barbara

2013-07-01

III Rome Criteria of functional gastrointestinal disorders in children, distinguished the disturbances with abdominal pain, to which irritable bowel syndrome, functional abdominal pains, functional dyspepsia and abdominal migraine were included. THE AIM OF THE STUDY was sonographic assessment of the gallbladder and its contractility in functional abdominal pain and irritable bowel syndrome in children. The study comprised 96 children aged 6 to 18 years, 59 girls and 37 boys. Depending on diagnosis, the children were divided into three groups. 38 children with functional abdominal pain constituted the first group, 26 children with irritable bowel syndrome were included to the second group, the third group consisted of 32 healthy children (control group). Diagnosis of functional abdominal pain and irritable bowel syndrome was made based on the III Rome Criteria. In irritable bowel syndrome both forms with diarrhea (13) and with constipation (13) were observed. Anatomy and contractility of the gallbladder were assessed by ultrasound examination. The presence of septum, wall thickness, thick bile, vesicle volume in fasting state and 30th and 60th minute after test meal were taken into consideration. Test meal comprised about 15% of caloric requirement of moderate metabolism. Children with bile stones and organic diseases were excluded from the study. Thickened vesicle wall and thick bile were present more frequently in children with irritable bowel syndrome and functional abdominal pain than in control group (p < 0.02). Fasting vesicle volume was significantly greater in children with functional abdominal pain than in irritable bowel syndrome and control group (p = 0.003, p = 0.05). Vesicle contractility after test meal was greatest in children with functional abdominal pain. Evaluation of diminished (smaller than 30%) and enlarged (greater then 80%) gallbladder contractility at 30th and 60th minute after test meal demonstrated disturbances of contractility in children

Positive lymphocyte transformation test in a patient with allergic contact dermatitis of the scalp after short-term use of topical minoxidil solution.

PubMed

Hagemann, Tobias; Schlütter-Böhmer, Brigitte; Allam, Jean-Pierre; Bieber, Thomas; Novak, Natalija

2005-07-01

Topical 2,4-diamino-6-piperidinopyrimidine-3-oxide (minoxidil) solution has been widely used for the treatment of androgenetic alopecia for over 15 years now and the substance is currently approved for this indication in 2% and 5% formulation. Typical side effects of this topical treatment include irritative dermatitis going along with pruritus, erythema, scaling and dryness, which occur especially at the onset of the therapy. In some cases, allergic contact dermatitis or exacerbation of seborrheic dermatitis has been reported. While most of the patients with allergic contact dermatitis described in the literature showed a positive sensitization to the vehicle substance propylene glycol evaluated by patch testing, reactions to the active ingredient minoxidil are rare. Here, we report a case of allergic sensitization to minoxidil, which we evaluated and differentiated from an irritative reaction by a combination of patch testing and lymphocyte transformation test. The differentiation of allergic and irritative adverse effects and the identification of the causative allergen are of major relevance for the proceeding and adjustment of the therapy. Patients with sensitizations against propylene glycol are candidates for preparations with alternative solvents but can proceed treatment with minoxidil. In contrast, patients with allergies to the active ingredient itself are no longer candidates for treatment with minoxidil and should undergo alternative therapeutic options.

Analysis of touch used by occupational therapy practitioners in skilled nursing facilities.

PubMed

Morris, Douglas; Henegar, J; Khanin, S; Oberle, G; Thacker, S

2014-09-01

Instrumental touch is identified as having purposeful physical contact in order to complete a task. Expressive touch is identified as warm, friendly physical contact and is not solely for performing a task. Expressive touch has been associated with improved client status, increased rapport and greater gains made during therapy. The purpose of the study was to observe the frequency of expressive and instrumental touch utilized by an occupational therapist during an occupational therapy session. Thirty-three occupational therapy professionals, including occupational therapists and occupational therapy assistants, employed at skilled nursing facilities in southwest Florida were observed. Data were collected on the Occupational Therapy Interaction Assessment. The results of the data analysis showed a positive relationship between the gender of the therapist and the frequency of expressive touch. The data also showed that a large majority of touches were instrumental touch and pertained to functional mobility. The results of the study can contribute to a better understanding of the holistic aspects of occupational therapy. By the use of more expressive touch, occupational therapy practitioners may have a positive, beneficial effect on both the client and the therapy process as a whole. Further research is needed to determine the effect an occupational therapy setting has on the frequency of instrumental and expressive touch. A larger sample size and a distinction between evaluation and treatment sessions would benefit future studies. Copyright © 2014 John Wiley & Sons, Ltd.

Irritability and Parenting Styles in Adolescents With Attention-Deficit/Hyperactivity Disorder: A Controlled Study.

PubMed

Uçar, Halit Necmi; Vural, Ayşe Pınar

2018-04-17

Attention-deficit/hyperactivity disorder (ADHD) affects functioning of the family, decreasing interactions and loyalty and increasing conflict between adolescents with ADHD and their families. Irritable mood and difficulties with emotional dysregulation are common in children with ADHD. The objective of the current study was to assess levels of irritability in adolescents with ADHD using self- and parent-report scales, and investigate the relationship between irritability levels and parental attitudes. A total of 47 adolescents with ADHD and 39 adolescents with typical development participated in the current study. Findings demonstrated that higher levels of parent-reported irritability were associated with decreased egalitarian attitudes in the ADHD group. Although other parental attitudes were not associated with self- and parent-reported irritability, evaluation of the relationship between parental attitudes and irritability in adolescents with ADHD, which can guide diagnosis and treatment of ADHD, is of critical importance. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.]. Copyright 2018, SLACK Incorporated.

Pesticide patch test series for the assessment of allergic contact dermatitis among banana plantation workers in panama.

PubMed

Penagos, Homero; Ruepert, Clemens; Partanen, Timo; Wesseling, Catharina

2004-09-01

Irritant contact dermatitis and allergic contact dermatitis (ACD) are frequent among agricultural workers and require targeted interventions. Patch testing is necessary for differential diagnosis, but patch testing with pesticides is uncommon. This study explores the frequency of ACD and sensitization to pesticides among highly exposed banana plantation workers. Frequently and recently used pesticides on banana plantations in Divala, Panama, were documented. A pesticide patch test tray specific for this population was prepared. A structured interview was administered to 366 participants, followed by a complete skin examination. The pesticide patch test series, as well as a standard patch test series, was applied to 37 workers with dermatoses likely to be pesticide related and to 23 control workers without dermatoses. The pesticide patch tests identified 15 cases (41%) of ACD (20 positive reactions) among the 37 workers diagnosed with pesticide dermatosis. Three controls had allergic reactions to pesticides (4 positive reactions). The pesticides were carbaryl (5 cases), benomyl (4 cases), ethoprophos (3), chlorothalonil (2), imazalil (2), glyphosate (2), thiabendazole (2), chlorpyrifos (1), oxyfluorfen (1), propiconazole (1), and tridemorph (1). Ethoprophos and tridemorph had not been previously identified as sensitizers. Thus, the prevalence of ACD was 0.03 (15 of 366). On the basis of observed prevalences of positive patch-test reactions among the subgroups with and without dermatoses, we estimated that > or = 16% of the entire population may be sensitized to pesticides. Sensitization to pesticides among banana plantation workers is a frequent occupational health problem. Pesticide patch test trays should be used in assessing skin diseases in highly exposed workers.

Irritability, Externalizing, and Internalizing Psychopathology in Adolescence: Cross-Sectional and Longitudinal Associations and Moderation by Sex.

PubMed

Humphreys, Kathryn L; Schouboe, Sophie N F; Kircanski, Katharina; Leibenluft, Ellen; Stringaris, Argyris; Gotlib, Ian H

2018-04-18

Irritability is a common feature of many psychiatric disorders, including both externalizing and internalizing disorders. There is little research, however, examining associations between irritability and these symptom domains, particularly during the important developmental period of adolescence, characterized by sex differences in the prevalence of disorders. We examined the cross-sectional associations between irritability, measured with the Affective Reactivity Index, and symptoms of externalizing and internalizing domains of psychopathology, measured with the Youth Self Report, in a volunteer community sample (N = 183) of 9- to 13-year-old (M = 11.39, SD = 1.07) boys and girls (37% White/Caucasian, 8% Asian, 11% Hispanic, 8% African American, 2% Native American, 2% Pacific Islander, 28% Other, and 3% not reported). A subset of the sample (n = 112) provided data at a 2-year follow-up, used to extend these associations. There were no sex differences in levels of irritability; however, the associations between irritability and symptom domains were moderated by sex. Specifically, in girls, irritability was associated equally with externalizing and internalizing symptoms. In contrast, in boys, irritability was associated more strongly with externalizing symptoms than with internalizing symptoms. Thus, across both sexes, irritability was moderately associated with externalizing symptoms, but the association between irritability and internalizing symptoms was stronger in girls than in boys. At follow-up, sex moderated the association between baseline irritability and later externalizing and internalizing symptoms. These findings indicate that irritability is associated with both externalizing and internalizing symptoms in early adolescence and that irritability is associated with internalizing symptoms more strongly in girls than in boys.

Irritability Trajectories, Cortical Thickness, and Clinical Outcomes in a Sample Enriched for Preschool Depression.

PubMed

Pagliaccio, David; Pine, Daniel S; Barch, Deanna M; Luby, Joan L; Leibenluft, Ellen

2018-05-01

Cross-sectional, longitudinal, and genetic associations exist between irritability and depression. Prior studies have examined developmental trajectories of irritability, clinical outcomes, and associations with child and familial depression. However, studies have not integrated neurobiological measures. The present study examined developmental trajectories of irritability, clinical outcomes, and cortical structure among preschoolers oversampled for depressive symptoms. Beginning at 3 to 5 years old, a sample of 271 children enriched for early depressive symptoms were assessed longitudinally by clinical interview. Latent class mixture models identified trajectories of irritability severity. Risk factors, clinical outcomes, and cortical thickness were compared across trajectory classes. Cortical thickness measures were extracted from 3 waves of magnetic resonance imaging at 7 to 12 years of age. Three trajectory classes were identified among these youth: 53.50% of children exhibited elevated irritability during preschool that decreased longitudinally, 30.26% exhibited consistently low irritability, and 16.24% exhibited consistently elevated irritability. Compared with other classes, the elevated irritability class exhibited higher rates of maternal depression, early life adversity, later psychiatric diagnoses, and functional impairment. Further, elevated baseline irritability predicted later depression beyond adversity and personal and maternal depression history. The elevated irritability class exhibited a thicker cortex in the left superior frontal and temporal gyri and the right inferior parietal lobule. Irritability manifested with specific developmental trajectories in this sample enriched for early depression. Persistently elevated irritability predicted poor psychiatric outcomes, higher risk for later depression, and decreased overall function later in development. Greater frontal, temporal, and parietal cortical thickness also was found, providing neural

[Occupational risks among public safety and security forces].

PubMed

Candura, S M; Verni, P; Minelli, C M; Rosso, G L; Cappelli, M I; Strambi, S; Martellosio, V

2006-01-01

The present paper tries to identify the occupational risk factors (physical, chemical, biological, psychological), variable depending on jobs and tasks, to which the heterogeneous public safety/security workers are exposed. The fight against criminality and public order maintenance imply (sometimes fatal) traumatic risks, and expose to psychophysical and sensorial tiring, unfavourable macro- and microclimatic conditions, the risk of baropathy (air navigation, underwater activities), noise (generated by firearms and several other sources), vibrations and shakings (automatic weapons, transport vehicles), the risk of electric injury, ionizing (X and gamma rays) and non-inonizing (ultraviolet rays, microwaves and radiofrequencies, electromagnetic fields) radiations. Chemical hazards include carbon monoxide and other combustion products (fires, urban traffic), substances released in chemical accidents, tear gases, lead (firing grounds, metal works, environmental pollution), solvents, lubrificants and cutting oils (mechanic repair and maintenance), laboratory materials and reagents, irritant and/or sensitizing agents contained in gloves. The main biological risks are tetanus, blood-borne diseases (viral hepatitis, AIDS), aerogenous diseases (e.g., tuberculosis, Legionnaire's disease, epidemic cerebrospinal meningitis), dog- or horse-transmitted zoonosis. Finally, emotional, psychosomatic and behavioural stress-related disorders (e.g., burn-out syndrome, post-traumatic stress disorder) are typically frequent. The presence of numerous and diversified hazards among public safety/security forces imposes the adoption of occupational medicine measures, including risk assessment, health education, technical and environmental prevention, personal protective devices, sanitary surveillance and biological monitoring, clinical interventions (diagnosis, therapy and rehabilitation of occupational accidents and illnesses), prompt medico-legal evaluation of occupational

Fentanyl reduces desflurane-induced airway irritability following thiopental administration in children.

PubMed

Lee, J; Oh, Y; Kim, C; Kim, S; Park, H; Kim, H

2006-10-01

Airway irritation is a major drawback of desflurane anesthesia. This study was designed to evaluate the effect of intravenous fentanyl given before thiopental induction on airway irritation caused by a stepwise increase in desflurane in children. Eighty children (2-8 years) were enrolled in a randomized, double-blind study. Forty received saline and 40 received 2 microg/kg of fentanyl intravenously; this was followed by thiopental sodium 5 mg/kg in both groups. Patients were assistant-ventilated with desflurane 1%, which was then increased by 1% every six breaths up to 10%. During this period, cough, secretion, excitation and apnea were graded and the desflurane concentration at which airway irritation symptoms first occurred was recorded. The results were analyzed using Pearson's chi-squared test. The incidence of typical airway irritation events was lower with fentanyl than with saline (cough, 2.5% vs. 42.5%; secretion, 27.5% vs. 82.5%; excitation, 10% vs. 82.5%; apnea, 20% vs. 65%; P < 0.05). The mean expired desflurane concentration at which the first airway irritation symptom occurred was greater with fentanyl than with saline (7.3% vs. 5.5%, P < 0.05). Intravenous fentanyl in children reduces airway complications caused by desflurane.

Newborn Irritability Moderates the Association between Infant Attachment Security and Toddler Exploration and Sociability

ERIC Educational Resources Information Center

Stupica, Brandi; Sherman, Laura J.; Cassidy, Jude

2011-01-01

This longitudinal investigation of 84 infants examined whether the effect of 12-month attachment on 18- and 24-month exploration and sociability with unfamiliar adults varied as a function of newborn irritability. As expected, results revealed an interaction between attachment (secure vs. insecure) and irritability (highly irritable vs. moderately…

Case–control study of paternal occupation and childhood leukaemia in Great Britain, 1962–2006

PubMed Central

Keegan, T J; Bunch, K J; Vincent, T J; King, J C; O'Neill, K A; Kendall, G M; MacCarthy, A; Fear, N T; MFG, Murphy

2012-01-01

Background: Paternal occupational exposures have been proposed as a risk factor for childhood leukaemia. This study investigates possible associations between paternal occupational exposure and childhood leukaemia in Great Britain. Methods: The National Registry of Childhood Tumours provided all cases of childhood leukaemia born and diagnosed in Great Britain between 1962 and 2006. Controls were matched on sex, period of birth and birth registration subdistrict. Fathers' occupations were assigned to 1 or more of 33 exposure groups. Social class was derived from father's occupation at the time of the child's birth. Results: A total of 16 764 cases of childhood leukaemia were ascertained. One exposure group, paternal social contact, was associated with total childhood leukaemia (odds ratio 1.14, 1.05–1.23); this association remained significant when adjusted for social class. The subtypes lymphoid leukaemia (LL) and acute myeloid leukaemia showed increased risk with paternal exposure to social contact before adjustment for social class. Risk of other leukaemias was significantly increased by exposure to electromagnetic fields, persisting after adjustment for social class. For total leukaemia, the risks for exposure to lead and exhaust fumes were significantly <1. Occupationally derived social class was associated with risk of LL, with the risk being increased in the higher social classes. Conclusion: Our results showed some support for a positive association between childhood leukaemia risk and paternal occupation involving social contact. Additionally, LL risk increased with higher paternal occupational social class. PMID:22968649

The identification and classification of skin irritation hazard by a human patch test.

PubMed

Basketter, D A; Whittle, E; Griffiths, H A; York, M

1994-08-01

There exist various regulatory instruments the purpose of which is to ensure that the intrinsic toxic hazards associated with substances and preparations are identified. In the context of identification of skin irritation potential, the method is normally the Draize test. Guidance notes provided by the OECD and the EEC expect that corrosive substances will have been screened out by a variety of methods. Substances or preparations which cause a sufficient degree of skin irritation will be classified as skin irritants. The primary motivation behind the present work was to introduce the concept that it is possible to assess the hazard potential of a substance or preparation to produce skin irritation in a human study. In the example presented here, 20% sodium lauryl sulfate (SLS) has been chosen as the positive control. With the protocol currently devised, occluded patch treatment with 20% SLS for up to 4 hr produces an irritant response in just over half of the panel. An irritant response is taken as a clinically evident and significant increase in erythema, oedema or dryness--a minimum of a+ reaction on the ICDRG scale. At such a level of response with the positive control (both in terms of intensity and in proportion of the panel), it is then possible to judge and/or to determine statistically, whether the test material has produced a level of skin irritation which is similar to, greater, or lower than the positive control. In this way a human patch test protocol can form a fundamental component of a strategy for the replacement of animals in determination of skin irritation and corrosion potential. By use of a careful and progressive protocol and by comparison of test data against a positive control it is both possible and practical to classify substances and preparations in terms of their skin irritation potential using that endpoint in the species of concern, man.

Winter season, frequent hand washing, and irritant patch test reactions to detergents are associated with hand dermatitis in health care workers.

PubMed

Callahan, Adrienne; Baron, Elma; Fekedulegn, Desta; Kashon, Michael; Yucesoy, Berran; Johnson, Victor J; Domingo, Diana Santo; Kirkland, Brent; Luster, Michael I; Nedorost, Susan

2013-01-01

Irritant hand dermatitis (IHD) is common in health care workers. We studied endogenous irritant contact dermatitis threshold by patch testing and exogenous factors such as season and hand washing for their association with IHD in health care workers. Irritant patch testing with sodium lauryl sulfate (SLS), sodium hydroxide, and benzalkonium chloride at varying concentrations was measured in 113 health care workers. Examination for hand dermatitis occurred at 1-month intervals for a period of 6 months in the Midwestern United States. Positive patch testing to low-concentration SLS was associated with IHD (P = 0.0310) after adjusting for age, sex, ethnicity, season, history of childhood flexural dermatitis, mean indoor relative humidity, and glove and hand sanitizer usage. Subjects with a positive patch test to SLS were 78% more likely to have occurrence of IHD (incidence rate ratio [IRR] = 1.78; 95% confidence interval [CI], 0.92-3.45). Hand washing frequency (≥10 times a day; IRR = 1.55; 95% CI, 1.01-2.39) and cold season (IRR = 2.76; 95% CI, 1.35-5.65) were associated with IHD. No association was found between history of childhood flexural dermatitis and IHD in this population. Both genetic and environmental factors are important in the etiology of IHD and should be considered in designing strategies to protect, educate, and treat susceptible individuals.

Development of an in vitro alternative assay method for vaginal irritation.

PubMed

Ayehunie, Seyoum; Cannon, Chris; Larosa, Karen; Pudney, Jeffrey; Anderson, Deborah J; Klausner, Mitchell

2011-01-11

The vaginal mucosa is commonly exposed to chemicals and therapeutic agents that may result in irritation and/or inflammation. In addition to acute effects, vaginal irritation and inflammation can make women more susceptible to infections such as HIV-1 and herpes simplex virus 2 (HSV-2). Hence, the vaginal irritation potential of feminine care formulations and vaginally administered therapeutic agents is a significant public health concern. Traditionally, testing of such materials has been performed using the rabbit vaginal irritation (RVI) assay. In the current study, we investigated whether the organotypic, highly differentiated EpiVaginal™ tissue could be used as a non-animal alternative to the RVI test. The EpiVaginal tissue was exposed to a single application of ingredients commonly found in feminine hygiene products and the effects on tissue viability (MTT assay), barrier disruption (measured by transepithelial electrical resistance, TEER and sodium fluorescein (NaFl) leakage), and inflammatory cytokine release (interleukin (IL)-1α, IL-1β, IL-6, and IL-8) patterns were examined. When compared to untreated controls, two irritating ingredients, nonoxynol 9 and benzalkonium chloride, reduced tissue viability to <40% and TEER to <60% while increasing NaFl leakage by 11-24% and IL-1α and IL-1β release by >100%. Four other non-irritating materials had minimal effects on these parameters. Assay reproducibility was confirmed by testing the chemicals using three different tissue production lots and by using tissues reconstructed from cells obtained from three different donors. Coefficients of variation between tissue lots reconstructed with cells obtained from the same donor or lots reconstructed with cells obtained from different donors were less than 10% and 12%, respectively. In conclusion, decreases in tissue viability and barrier function and increases in IL-1α and IL-1β release appear to be useful endpoints for preclinical screening of topically applied

Transcutaneous sacral neurostimulation for irritative voiding dysfunction.

PubMed

Walsh, I K; Johnston, R S; Keane, P F

1999-01-01

Patients with irritative voiding dysfunction are often unresponsive to standard clinical treatment. We evaluated the response of such individuals to transcutaneous electrical stimulation of the third sacral nerve. 32 patients with refractory irritative voiding dysfunction (31 female and 1 male; mean age 47 years) were recruited to the study. Ambulatory transcutaneous electrical neurostimulation was applied bilaterally to the third sacral dermatomes for 1 week. Symptoms of frequency, nocturia, urgency, and bladder pain were scored by each patient throughout and up to 6 months following treatment. The mean daytime frequency was reduced from 11.3 to 7.96 (p = 0.01). Nocturia episodes were reduced from a mean of 2.6 to 1.8 (p = 0.01). Urgency and bladder pain mean symptom scores were reduced from 5.97 to 4.89 and from 1.48 to 0.64, respectively. After stopping therapy, symptoms returned to pretreatment levels within 2 weeks in 40% of the patients and within 6 months in 100%. Three patients who continued with neurostimulation remained satisfied with this treatment modality at 6 months. Transcutaneous third sacral nerve stimulation may be an effective and noninvasive ambulatory technique for the treatment of patients with refractory irritative voiding dysfunction. Following an initial response, patients may successfully apply this treatment themselves to ensure long-term relief.

Clinical Profiles of Premenstrual Experiences Among Women Having Premenstrual Syndrome (PMS): Affective Changes Predominate and Relate to Social and Occupational Functioning.

PubMed

Schmelzer, Katarina; Ditzen, Beate; Weise, Cornelia; Andersson, Gerhard; Hiller, Wolfgang; Kleinstäuber, Maria

2015-01-01

Our objective for this study was to examine symptom severity among women suffering from premenstrual syndrome as well as associations between symptom severity and impairment. In a one-cycle prospective study, various premenstrual symptoms of 91 women were assessed. Tension and irritability were the most severe symptoms. Headache, irritability, self-deprecating thoughts, and depressed mood were the symptoms that were subjectively rated as the most burdensome. Significant correlations were found between the mean premenstrual severity and functional impairment. The severity of premenstrual affective symptoms was related to social impairment. The severity of psychological symptoms was correlated with occupational impairment. These findings confirm the prominent role of premenstrual affective symptoms and support classification guidelines focusing on both affective and physical changes.

Pediatric Mania: The Controversy between Euphoria and Irritability

PubMed Central

Serra, Giulia; Uchida, Mai; Battaglia, Claudia; Casini, Maria Pia; De Chiara, Lavinia; Biederman, Joseph; Vicari, Stefano; Wozniak, Janet

2017-01-01

Abstract: Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95–100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder. PMID:28503110

Pediatric Mania: The Controversy between Euphoria and Irritability.

PubMed

Serra, Giulia; Uchida, Mai; Battaglia, Claudia; Casini, Maria Pia; De Chiara, Lavinia; Biederman, Joseph; Vicari, Stefano; Wozniak, Janet

2017-04-01

Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95-100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder.

Irritancy and Allergic Responses Induced by Topical Application of ortho-Phthalaldehyde

PubMed Central

Anderson, Stacey E.; Umbright, Christina; Sellamuthu, Rajendran; Fluharty, Kara; Kashon, Michael; Franko, Jennifer; Jackson, Laurel G.; Johnson, Victor J.; Joseph, Pius

2010-01-01

Although ortho-phthalaldehyde (OPA) has been suggested as an alternative to glutaraldehyde for the sterilization and disinfection of hospital equipment, the toxicity has not been thoroughly investigated. The purpose of these studies was to evaluate the irritancy and sensitization potential of OPA. The EpiDerm Skin Irritation Test was used to evaluate in vitro irritancy potential of OPA and glutaraldehyde. Treatment with 0.4125 and 0.55% OPA induced irritation, while glutaraldehyde exposure at these concentrations did not. Consistent with the in vitro results, OPA induced irritancy, evaluated by ear swelling, when mice were treated with 0.75%. Initial evaluation of the sensitization potential was conducted using the local lymph node assay at concentrations ranging from 0.005 to 0.75%. A concentration-dependent increase in lymphocyte proliferation was observed with a calculated EC3 value of 0.051% compared to that of 0.089%, previously determined for glutaraldehyde. Immunoglobulin (Ig) E-inducing potential was evaluated by phenotypic analysis of draining lymph node (DLN) cells and measurement of total and specific serum IgE levels. The 0.1 and 0.75% exposed groups yielded significant increases in the IgE+B220+ cell population in the lymph nodes while the 0.75% treated group demonstrated significant increases in total IgE, OPA-specific IgE, and OPA-specific IgG1. In addition, significant increases in interleukin-4 messenger RNA and protein expression in the DLNs were observed in OPA-treated groups. The results demonstrate the dermal irritancy and allergic potential of OPA and raise concern about the proposed/intended use of OPA as a safe alternative to glutaraldehyde. PMID:20176622

Benzalkonium chloride neutralizes the irritant effect of sodium dodecyl sulfate.

PubMed

McFadden, J P; Holloway, D B; Whittle, E G; Basketter, D A

2000-11-01

When benzalkonium chloride (BKC), a cationic surfactant, is added to sodium dodecyl sulfate (SDS), an anionic surfactant, and used in patch testing, on the basis of their known physicochemical interaction, it is possible to predict that there will be a tendency towards a reduction in the expected irritant response when compared to SDS alone. The aim of this study was to investigate whether BKC could reduce the irritant response to SDS when applied after the SDS exposure. 54 non-atopic adult volunteers were recruited for the study. 20% SDS was applied for 2 h under occlusion. 1% BKC was then applied to the same site. Various controls, including SDS application followed by water for 2 h, were included. The irritant reaction was assessed at 24 h and 48 h. 40 of the 54 subjects had some reaction when SDS was applied for 2 h followed by either benzalkonium chloride or water control under occlusion. In comparison to water control, where BKC was applied after SDS, 20 of the 40 responders had a weaker reaction but only 4 had a stronger response. This study shows that BKC applied to skin exposed to SDS attenuates the resulting irritant reaction.

Comparing goblet cell densities in patients wearing disposable hydrogel contact lenses versus silicone hydrogel contact lenses in an extended-wear modality.

PubMed

Lievens, Christopher W; Connor, Charles G; Murphy, Heather

2003-10-01

The current study evaluates the response of the ocular surface to extended contact lens wear by comparing a new silicone hydrogel lens to an ACUVUE 2 lens. Twenty subjects with an average age of 28 years were randomly assigned to a fitting with ACUVUE 2 or PureVision lenses. Ocular surface assessment by impression cytology was performed at baseline and for the 6 months after initiation of lens wear. Although goblet cell density significantly increased with wear time, no statistically significant difference was observed between the contact lens groups. The average baseline goblet cell percentages were as follows: ACUVUE 2 group, 1.44; PureVision group, 1.11. The 6-month averages were as follows: ACUVUE 2 group, 3.16; PureVision group, 2.22. It appears that silicone hydrogel lenses may be slightly less irritating to the ocular surface than lenses not containing silicone. This could be a promising indicator for successful 30-day continuous wear.

[Toxic contact dermatitis from poison ivy in a private garden in Germany].

PubMed

Schauder, S; Callauch, R; Hausen, B M

2006-07-01

A couple suffered for 5 years from recurrent eruptions with vesicles and bullae after contact with an unknown "climbing weed" in their private garden in Germany. After this plant was identified as poison ivy and eradicated, their skin problems were solved. This is the first report of poison ivy in this setting. Urushiols in poison ivy are not only strong allergens but also potent irritants. Negative patch tests in the husband suggest that the bullous dermatitis was a toxic reaction.

Impact of irritability: a 2-year observational study of outpatients with bipolar I or schizoaffective disorder.

PubMed

Berk, Lesley; Hallam, Karen T; Venugopal, Kamalesh; Lewis, Andrew James; Austin, David W; Kulkarni, Jayashri; Dodd, Seetal; de Castella, Anthony; Fitzgerald, Paul B; Berk, Michael

2017-05-01

Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder. We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) - a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables. At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity. Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Predictive performance of the Vitrigel‐eye irritancy test method using 118 chemicals

PubMed Central

Yamaguchi, Hiroyuki; Kojima, Hajime

2015-01-01

Abstract We recently developed a novel Vitrigel‐eye irritancy test (EIT) method. The Vitrigel‐EIT method is composed of two parts, i.e., the construction of a human corneal epithelium (HCE) model in a collagen vitrigel membrane chamber and the prediction of eye irritancy by analyzing the time‐dependent profile of transepithelial electrical resistance values for 3 min after exposing a chemical to the HCE model. In this study, we estimated the predictive performance of Vitrigel‐EIT method by testing a total of 118 chemicals. The category determined by the Vitrigel‐EIT method in comparison to the globally harmonized system classification revealed that the sensitivity, specificity and accuracy were 90.1%, 65.9% and 80.5%, respectively. Here, five of seven false‐negative chemicals were acidic chemicals inducing the irregular rising of transepithelial electrical resistance values. In case of eliminating the test chemical solutions showing pH 5 or lower, the sensitivity, specificity and accuracy were improved to 96.8%, 67.4% and 84.4%, respectively. Meanwhile, nine of 16 false‐positive chemicals were classified irritant by the US Environmental Protection Agency. In addition, the disappearance of ZO‐1, a tight junction‐associated protein and MUC1, a cell membrane‐spanning mucin was immunohistologically confirmed in the HCE models after exposing not only eye irritant chemicals but also false‐positive chemicals, suggesting that such false‐positive chemicals have an eye irritant potential. These data demonstrated that the Vitrigel‐EIT method could provide excellent predictive performance to judge the widespread eye irritancy, including very mild irritant chemicals. We hope that the Vitrigel‐EIT method contributes to the development of safe commodity chemicals. Copyright © 2015 The Authors. Journal of Applied Toxicology published by John Wiley & Sons Ltd. PMID:26472347

Predictive performance of the Vitrigel-eye irritancy test method using 118 chemicals.

PubMed

Yamaguchi, Hiroyuki; Kojima, Hajime; Takezawa, Toshiaki

2016-08-01

We recently developed a novel Vitrigel-eye irritancy test (EIT) method. The Vitrigel-EIT method is composed of two parts, i.e., the construction of a human corneal epithelium (HCE) model in a collagen vitrigel membrane chamber and the prediction of eye irritancy by analyzing the time-dependent profile of transepithelial electrical resistance values for 3 min after exposing a chemical to the HCE model. In this study, we estimated the predictive performance of Vitrigel-EIT method by testing a total of 118 chemicals. The category determined by the Vitrigel-EIT method in comparison to the globally harmonized system classification revealed that the sensitivity, specificity and accuracy were 90.1%, 65.9% and 80.5%, respectively. Here, five of seven false-negative chemicals were acidic chemicals inducing the irregular rising of transepithelial electrical resistance values. In case of eliminating the test chemical solutions showing pH 5 or lower, the sensitivity, specificity and accuracy were improved to 96.8%, 67.4% and 84.4%, respectively. Meanwhile, nine of 16 false-positive chemicals were classified irritant by the US Environmental Protection Agency. In addition, the disappearance of ZO-1, a tight junction-associated protein and MUC1, a cell membrane-spanning mucin was immunohistologically confirmed in the HCE models after exposing not only eye irritant chemicals but also false-positive chemicals, suggesting that such false-positive chemicals have an eye irritant potential. These data demonstrated that the Vitrigel-EIT method could provide excellent predictive performance to judge the widespread eye irritancy, including very mild irritant chemicals. We hope that the Vitrigel-EIT method contributes to the development of safe commodity chemicals. Copyright © 2015 The Authors. Journal of Applied Toxicology published by John Wiley & Sons Ltd. Copyright © 2015 The Authors. Journal of Applied Toxicology published by John Wiley & Sons Ltd.

CON4EI: SkinEthic™ Human Corneal Epithelium Eye Irritation Test (SkinEthic™ HCE EIT) for hazard identification and labelling of eye irritating chemicals.

PubMed

Van Rompay, A R; Alépée, N; Nardelli, L; Hollanders, K; Leblanc, V; Drzewiecka, A; Gruszka, K; Guest, R; Kandarova, H; Willoughby, J A; Verstraelen, S; Adriaens, E

2018-06-01

Assessment of ocular irritancy is an international regulatory requirement and a necessary step in the safety evaluation of industrial and consumer products. Although a number of in vitro ocular irritation assays exist, none are capable of fully categorizing chemicals as a stand-alone assay. Therefore, the CEFIC-LRI-AIMT6-VITO CON4EI (CONsortium for in vitro Eye Irritation testing strategy) project was developed with the goal of assessing the reliability of eight in vitro/alternative test methods as well as establishing an optimal tiered-testing strategy. One of the in vitro assays selected was the validated SkinEthic™ Human Corneal Epithelium Eye Irritation Test method (SkinEthic™ HCE EIT). The SkinEthic™ HCE EIT has already demonstrated its capacity to correctly identify chemicals (both substances and mixtures) not requiring classification and labelling for eye irritation or serious eye damage (No Category). The goal of this study was to evaluate the performance of the SkinEthic™ HCE EIT test method in terms of the important in vivo drivers of classification. For the performance with respect to the drivers all in vivo Cat 1 and No Cat chemicals were 100% correctly identified. For Cat 2 chemicals the liquids and the solids had a sensitivity of 100% and 85.7%, respectively. For the SkinEthic™ HCE EIT test method, 100% concordance in predictions (No Cat versus No prediction can be made) between the two participating laboratories was obtained. The accuracy of the SkinEthic™ HCE EIT was 97.5% with 100% sensitivity and 96.9% specificity. The SkinEthic™ HCE EIT confirms its excellent results of the validation studies. Copyright © 2017. Published by Elsevier Ltd.

Self-perceived sensory responses to soap and synthetic detergent bars correlate with clinical signs of irritation.

PubMed

Simion, F A; Rhein, L D; Morrison, B M; Scala, D D; Salko, D M; Kligman, A M; Grove, G L

1995-02-01

Epidemiologic studies indicate that after using soaps and other personal care products, many consumers experience irritation. In 50% of the cases the feelings of skin dryness, itching, and stinging occur in the absence of visible signs of irritation. We sought to determine the relation between self-perceived sensory responses of panelists to cleansing products and clinical signs of irritation. A combination of exaggerated arm-washing methods was designed to induce clinical signs of irritation with psychometric techniques developed to quantify sensations. Two studies demonstrated that panelists could reproducibly differentiate between products on the basis of the sensations they felt and that there was a significant correlation (frequently r > 0.80) between these and the observable signs. In the case of skin dryness panelists differentiated products several washing cycles before observable differences were detected. Sensory evaluations of irritation yield additional information on soap and detergent irritancy beyond clinical observations and expand understanding of the irritation process.

Airborne occupational allergic contact dermatitis from triglycidyl-p-aminophenol and tetraglycidyl-4,4'-methylene dianiline in preimpregnated epoxy products in the aircraft industry.

PubMed

Kanerva, L; Jolanki, R; Estlander, T; Henriks-Eckerman, M; Tuomi, M; Tarvainen, K

2000-01-01

Very little is known about allergic contact dermatitis (ACD) from preimpregnated epoxy products (prepregs). To describe a patient with occupational ACD from prepregs, and report new quantitative data on the content of prepregs. A laminator developed work-related vesicular hand dermatitis. He worked in an aircraft plant assembling aircraft parts, being exposed to preimpregnated carbon fiber and fiberglass sheets (prepregs), and epoxy adhesive tapes and foams. Triglycidyl-p-aminophenol (TGPAP; 1-0.25%, 2+; 0.05%, 1+) and tetraglycidyl-4,4'-methylene dianiline (TGMDA; 1%, 3+; 0.5-0.05%, 2+) provoked allergic patch test reactions, whereas o-diglycidyl phthalate was negative (1-0.05% pet) and standard epoxy provoked a weak (?+) reaction. Six prepreg products provoking allergic patch test reactions were analyzed for their TGPAP, TGMDA and diglycidyl ether of bisphenol A (DGEBA) content using gas and liquid chromatographic methods, showing up to 10% of TGPAP, 19% of TGMDA and 5% of DGEBA in the prepregs. An epoxy primer contained 61% of TGPAP. TGPAP and TGMDA caused occupational ACD. These chemicals need to be used when patch testing patients are exposed to prepregs, because patch testing with DGEBA may be negative. Copyright 2000 S. Karger AG, Basel.

Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012.

PubMed

Stocks, S Jill; McNamee, Roseanne; van der Molen, Henk F; Paris, Christophe; Urban, Pavel; Campo, Giuseppe; Sauni, Riitta; Martínez Jarreta, Begoña; Valenty, Madeleine; Godderis, Lode; Miedinger, David; Jacquetin, Pascal; Gravseth, Hans M; Bonneterre, Vincent; Telle-Lamberton, Maylis; Bensefa-Colas, Lynda; Faye, Serge; Mylle, Godewina; Wannag, Axel; Samant, Yogindra; Pal, Teake; Scholz-Odermatt, Stefan; Papale, Adriano; Schouteden, Martijn; Colosio, Claudio; Mattioli, Stefano; Agius, Raymond

2015-04-01

The European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal are scarce. We aim to estimate and compare changes in incidence over time for occupational asthma, contact dermatitis, noise-induced hearing loss (NIHL), carpal tunnel syndrome (CTS) and upper limb musculoskeletal disorders across 10 European countries. OD surveillance systems that potentially reflected nationally representative trends in incidence within Belgium, the Czech Republic, Finland, France, Italy, the Netherlands, Norway, Spain, Switzerland and the UK provided data. Case counts were analysed using a negative binomial regression model with year as the main covariate. Many systems collected data from networks of 'centres', requiring the use of a multilevel negative binomial model. Some models made allowance for changes in compensation or reporting rules. Reports of contact dermatitis and asthma, conditions with shorter time between exposure to causal substances and OD, were consistently declining with only a few exceptions. For OD with physical causal exposures there was more variation between countries. Reported NIHL was increasing in Belgium, Spain, Switzerland and the Netherlands and decreasing elsewhere. Trends in CTS and upper limb musculoskeletal disorders varied widely within and between countries. This is the first direct comparison of trends in OD within Europe and is consistent with a positive impact of European initiatives addressing exposures relevant to asthma and contact dermatitis. Taking a more flexible approach allowed comparisons of surveillance data between and within countries without harmonisation of data collection methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A STUDY OF EMPLOYMENT OPPORTUNITIES IN OFF-FARM AGRICULTURAL OCCUPATIONS IN ALABAMA.

ERIC Educational Resources Information Center

BAKER, RICHARD A.

THE PURPOSE OF THE STUDY WAS TO ASCERTAIN THE NATURE AND EXTENT OF OFF-FARM AGRICULTURAL EMPLOYMENT OPPORTUNITIES IN THE STATE. BUSINESS FIRMS, OCCUPATIONS, OCCUPATIONAL CHARACTERISTICS, AND METHODS OF RECRUITMENT WERE IDENTIFIED. THE SAMPLES OF BUSINESS FIRMS WAS SELECTED FROM 20 SAMPLE COUNTIES. INTERVIEWERS CONTACTED 545 OF THE 638 FIRMS IN THE…

30 CFR 57.15006 - Protective equipment and clothing for hazards and irritants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and irritants. 57.15006 Section 57.15006 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL... environment, chemical hazards, radiological hazards, or mechancial irritants are encountered in a manner...

30 CFR 57.15006 - Protective equipment and clothing for hazards and irritants.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and irritants. 57.15006 Section 57.15006 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL... environment, chemical hazards, radiological hazards, or mechancial irritants are encountered in a manner...

30 CFR 57.15006 - Protective equipment and clothing for hazards and irritants.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and irritants. 57.15006 Section 57.15006 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL... environment, chemical hazards, radiological hazards, or mechancial irritants are encountered in a manner...

30 CFR 57.15006 - Protective equipment and clothing for hazards and irritants.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and irritants. 57.15006 Section 57.15006 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL... environment, chemical hazards, radiological hazards, or mechancial irritants are encountered in a manner...

30 CFR 57.15006 - Protective equipment and clothing for hazards and irritants.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and irritants. 57.15006 Section 57.15006 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL... environment, chemical hazards, radiological hazards, or mechancial irritants are encountered in a manner...

Allergic contact dermatitis from medical adhesive bandages in patients who report having a reaction to medical bandages.

PubMed

Widman, Travis J; Oostman, Holly; Storrs, Frances J

2008-01-01

Medical adhesive bandages are extensively used in both inpatient and outpatient medicine. However, few reports describing proven allergic contact dermatitis (ACD) from medical adhesive bandages exist in the literature. These reports do not adequately correspond to the frequency that patients report having an "allergy" to medical adhesive bandages. To determine if there is a chemical present in medical adhesive bandages that causes ACD in people who identify themselves as having an "allergy" to medical adhesive bandages. Twenty-six patients were enrolled and underwent patch testing with our standard trays (104 chemicals) and a customized adhesive tray (54 chemicals and 10 tapes and bandages in their whole form). We were able to identify an allergen in four patients that was related to their presumed adhesive allergy (Mastisol, neomycin/bacitracin [two different patients], and cortisone-10 cream, respectively). However, there were no positive allergic reactions to the tapes or bandages or any relevant allergic reactions to our customized adhesive tray. Eight (73%) of the 11 patients who had the bandage or tape left on for 7 days had an irritant reaction. We feel that the perceived reactions are not secondary to ACD but instead are due to an irritant contact dermatitis.

A Conceptual Model of Irritability Following Traumatic Brain Injury: A Qualitative, Participatory Research Study.

PubMed

Hammond, Flora M; Davis, Christine; Cook, James R; Philbrick, Peggy; Hirsch, Mark A

2016-01-01

Individuals with a history of traumatic brain injury (TBI) may have chronic problems with irritability, which can negatively affect their lives. (1) To describe the experience (thoughts and feelings) of irritability from the perspectives of multiple people living with or affected by the problem, and (2) to develop a conceptual model of irritability. Qualitative, participatory research. Forty-four stakeholders (individuals with a history of TBI, family members, community professionals, healthcare providers, and researchers) divided into 5 focus groups. Each group met 10 times to discuss the experience of irritability following TBI. Data were coded using grounded theory to develop themes, metacodes, and theories. Not applicable. A conceptual model emerged in which irritability has 5 dimensions: affective (related to moods and feelings); behavioral (especially in areas of self-regulation, impulse control, and time management); cognitive-perceptual (self-talk and ways of seeing the world); relational issues (interpersonal and family dynamics); and environmental (including environmental stimuli, change, disruptions in routine, and cultural expectations). This multidimensional model provides a framework for assessment, treatment, and future research aimed at better understanding irritability, as well as the development of assessment tools and treatment interventions.

Review article: the economic impact of the irritable bowel syndrome.

PubMed

Canavan, C; West, J; Card, T

2014-11-01

Irritable bowel syndrome (IBS) is a chronic functional disorder of the gastrointestinal system affecting a large number of people worldwide. Whilst it has no attributable mortality, it has substantial impact on patients' quality of life (QoL) and is associated with considerable healthcare resource use. To review the economic impact of IBS, firstly on the individual, secondly on healthcare systems internationally and thirdly to society. Appropriate databases were searched for relevant papers using the terms: Irritable Bowel Syndrome; IBS; irritable colon; functional bowel/colonic disease; economics; health care/service costs; health expenditure/resources; health care/service utilisation; productivity. Irritable bowel syndrome impacts most substantially on patients' work and social life. Reduction in QoL is such that on average patients would sacrifice between 10 and 15 years of their remaining life expectancy for an immediate cure. Between 15% and 43% of patients pay for remedies. No studies quantify loss of earnings related to IBS. Direct care costs are substantial; 48% of patients incur some costs in any year with annual international estimates per patient of: USA $742-$7547, UK £90-£316, France €567-€862, Canada $259, Germany €791, Norway NOK 2098 (€262) and Iran $92. Minimising extensive diagnostic investigations could generate savings and has been shown as not detrimental to patients. Cost to industry internationally through absenteeism and presenteeism related to IBS is estimated between £400 and £900 per patient annually. Irritable bowel syndrome is associated with substantial costs to patients, healthcare systems and society. Considerable benefit could be obtained from effective interventions. © 2014 John Wiley & Sons Ltd.

The Affective Reactivity Index: a concise irritability scale for clinical and research settings