Dickel Heinrich, Kuss Oliver, Schmidt Anne, Kretz Judith, Diepgen Thomas L
Department of Clinical Social Medicine, Center of Occupational and Environmental Dermatology, University Hospital of Heidelberg, Heidelberg, Germany.
Am J Clin Dermatol. 2002;3(4):283-9. doi: 10.2165/00128071-200203040-00006.
Irritant contact dermatitis (ICD), provoked by work materials or workflows, is believed to be a frequent cause of occupational skin disease (OSD). Data of incidence rates of ICD within different occupations are inadequate.
We conducted a population-based study to identify occupational groups at risk for irritant and allergic contact dermatitis (ACD).
The data are based on all workers' compensation claims reported to our register of OSDs in Northern Bavaria [Berufskrankheitenregister Haut-Nordbayern (BKH-N)], Germany.
From 1990 to 1999, 5285 patients had their cases completely assessed and recorded by government-employed physicians. We calculated the incidence rates of ICD and ACD in various occupations, divided into 24 occupational groups, in co-operation with the German State Institute of Labor and Occupation; there were a known total number of employees in each of the occupations. In these groups 3097 (59%) patients with OSD were observed, with an overall annual incidence rate of 4.5 patients per 10,000 workers for ICD, compared with 4.1 patients per 10,000 workers for ACD. The highest ICD annual incidence rates were found in hairdressers (46.9 per 10,000 workers per year), bakers (23.5 per 10,000 workers per year), and pastry cooks (16.9 per 10,000 workers per year); at the same time ICD was the main diagnosis of OSD in pastry cooks (76%), cooks (69%), food processing industry workers and butchers (63%), mechanics (60%), and locksmiths and automobile mechanics (59%). The results of a questionnaire showed frequent skin contact with detergents (52%), disinfectants (24%), and acidic and alkaline chemicals (24%) in the workplace.
Based on the incidence data of the BKH-N, this study identified occupational groups with a high risk of ICD. Different frequencies of ICD and ACD within a single group are demonstrated. The frequent usage of detergents is being addressed because of the introduction of German legislation of recent date (the Approved Code of Practice 531 on 'wet work').
由工作材料或工作流程引发的刺激性接触性皮炎（ICD）被认为是职业性皮肤病（OSD）的常见病因。不同职业中ICD发病率的数据并不充分。
我们开展了一项基于人群的研究，以确定有刺激性和过敏性接触性皮炎（ACD）风险的职业群体。
数据基于向德国巴伐利亚北部职业性皮肤病登记处[北巴伐利亚职业性皮肤病登记处（BKH-N）]报告的所有工伤赔偿申请。
1990年至1999年期间，5285例病例由政府雇佣的医生进行了全面评估和记录。我们与德国国家劳动与职业研究所合作，计算了分为24个职业组的各职业中ICD和ACD的发病率；每个职业的员工总数是已知的。在这些组中，观察到3097例（59%）职业性皮肤病患者，ICD的总体年发病率为每10000名工人中有4.5例患者，而ACD为每10000名工人中有4.1例患者。ICD年发病率最高的是美发师（每年每10000名工人中有46.9例）、面包师（每年每10000名工人中有23.5例）和糕点厨师（每年每10000名工人中有16.9例）；同时，ICD是糕点厨师（76%）、厨师（69%）、食品加工业工人和屠夫（63%）、机械师（60%）以及锁匠和汽车机械师（59%）职业性皮肤病的主要诊断。一份调查问卷的结果显示，工作场所中经常皮肤接触洗涤剂（52%）、消毒剂（24%）以及酸性和碱性化学品（24%）。
基于BKH-N的发病率数据，本研究确定了ICD高风险的职业群体。展示了单一职业组内ICD和ACD的不同发病频率。由于德国近期立法（关于“湿作业”的《认可操作规范531》）的出台，洗涤剂的频繁使用问题正在得到解决。
