Barbaud Annick
Service de dermatologie Hôpital Fournier 54035 Nancy.
Rev Prat. 2002 Sep 1;52(13):1425-32.
Occupational dermatosis are frequent among healthcare workers. Irritant hand dermatitis is more common than allergic contact dermatitis. It is enhanced by the exposure to irritants: water, detergents, disinfectants and a history of atopic dermatitis. Natural rubber latex contained in rubber gloves can induce contact urticaria or generalized immediate allergic reactions. Contact eczema can be induced by rubber accelerators such as thiurams, disinfectants (glutaraldehyde, dodecyldimethylammonium). Nurses can become sensitized to handled drugs (antibiotics, propacetamol...). These occupational allergies have to be diagnosed, because sensitized nurses can develop severe generalized cutaneous adverse drug reactions if they are systemically exposed to the same drug than those that has previously induced an occupational contact allergy.
职业性皮肤病在医护人员中很常见。刺激性手部皮炎比过敏性接触性皮炎更常见。接触刺激物(水、洗涤剂、消毒剂)以及有特应性皮炎病史会加重病情。橡胶手套中含有的天然橡胶乳胶可诱发接触性荨麻疹或全身性速发型过敏反应。橡胶促进剂(如秋兰姆)、消毒剂(戊二醛、十二烷基二甲基氯化铵)可诱发接触性湿疹。护士可能会对所处理的药物(抗生素、丙帕他莫等)产生过敏。必须对这些职业性过敏进行诊断,因为致敏护士如果全身接触与之前诱发职业性接触过敏的药物相同的药物,可能会发生严重的全身性皮肤药物不良反应。