Uter Wolfgang, Rühl Reinhold, Pfahlberg Ammette, Geier Johannes, Schnuch Axel, Gefeller Olaf
Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 6, 91054 Erlangen, Germany.
Ann Occup Hyg. 2004 Jan;48(1):21-7. doi: 10.1093/annhyg/meg080.
To quantify the risk of contact allergy (CA) to important ubiquitous allergens associated with certain occupations, in particular the construction industry, and to identify possible time trends, controlling for potential confounding variables.
Bivariate as well as Poisson regression analysis of standardized anamnestic and patch test data comprising 82,561 patients assessed in the 33 German and Austrian contact dermatitis units of the Information Network of Departments of Dermatology (IVDK) between 1992 and 2000.
CA to five of the 18 (groups of) allergens considered here were observed significantly more often in construction workers: dichromate, epoxy resin (BADGE), cobalt, thiurams and N-isopropyl-p-phenylenediamine (IPPD). Multifactorial analysis confirmed an increased risk of CA to these allergens in construction workers, compared with other occupations. A very strong association between cobalt and chromate allergy was found in construction workers (OR 39.1, 95% CI 21.1-79.6).
Dichromate is still an prominent allergen in construction workers; as yet, there is only weak evidence of a decrease in Germany. Therefore, the addition of ferrous sulphate to cement, which has been a successful intervention in other countries, should be promoted further. Although CA to other important occupational allergens like thiurams, IPPD and epoxy resin or cobalt (very often associated with dichromate CA) is less frequent, prevention should address these allergens, too. The use of protective gloves with minimal intrinsic CA risk, e.g. due to thiurams in (synthetic) rubber or chromate in leather gloves, should be promoted.
量化与某些职业（特别是建筑业）相关的重要常见过敏原引起接触性过敏（CA）的风险，并确定可能的时间趋势，同时控制潜在的混杂变量。
对1992年至2000年间在德国和奥地利33个皮肤科接触性皮炎科室（皮肤科信息网络，IVDK）评估的82561例患者的标准化问诊和斑贴试验数据进行双变量及泊松回归分析。
在建筑工人中，观察到对这里所考虑的18种（组）过敏原中的5种发生CA的频率明显更高：重铬酸盐、环氧树脂（BADGE）、钴、秋兰姆和N-异丙基对苯二胺（IPPD）。多因素分析证实，与其他职业相比，建筑工人对这些过敏原发生CA的风险增加。在建筑工人中发现钴过敏与铬酸盐过敏之间存在非常强的关联（比值比39.1，95%可信区间21.1 - 79.6）。
重铬酸盐在建筑工人中仍然是一种突出的过敏原；在德国，目前仅有微弱证据表明其有所减少。因此，应进一步推广在水泥中添加硫酸亚铁的做法，这在其他国家已取得成功。尽管对秋兰姆、IPPD和环氧树脂或钴（常与重铬酸盐CA相关）等其他重要职业过敏原的CA较少见，但预防措施也应针对这些过敏原。应推广使用内在CA风险最小的防护手套，例如因（合成）橡胶中的秋兰姆或皮手套中的铬酸盐而导致风险增加的情况。
