Penagos Homero, Ruepert Clemens, Partanen Timo, Wesseling Catharina
Department of Occupational Dermatology, Social Security Bureau of Panama, David, Panama.
Dermatitis. 2004 Sep;15(3):137-45. doi: 10.2310/6620.2004.04014.
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.
刺激性接触性皮炎和过敏性接触性皮炎（ACD）在农业工人中很常见，需要针对性干预。斑贴试验对于鉴别诊断是必要的，但使用农药进行斑贴试验并不常见。
本研究探讨高度暴露的香蕉种植园工人中ACD的发生率以及对农药的致敏情况。
记录了巴拿马迪瓦拉香蕉种植园经常和近期使用的农药。制备了针对该人群的农药斑贴试验盘。对366名参与者进行了结构化访谈，随后进行了全面的皮肤检查。将农药斑贴试验系列以及标准斑贴试验系列应用于37名可能与农药相关的皮肤病工人和23名无皮肤病的对照工人。
在37名被诊断为农药性皮肤病的工人中，农药斑贴试验确定了15例（41%）ACD（20个阳性反应）。3名对照者对农药有过敏反应（4个阳性反应）。这些农药包括西维因（5例）、苯菌灵（4例）、灭线磷（3例）、百菌清（2例）、抑霉唑（2例）、草甘膦（2例）、噻菌灵（2例）、毒死蜱（1例）、乙氧氟草醚（1例）、丙环唑（1例）和十三吗啉（1例）。灭线磷和十三吗啉以前未被确定为致敏原。因此，ACD的患病率为0.03（366人中的15人）。根据在有皮肤病和无皮肤病亚组中观察到的阳性斑贴试验反应患病率，我们估计整个人口中≥16%可能对农药致敏。
香蕉种植园工人对农药的致敏是一个常见的职业健康问题。在评估高度暴露工人的皮肤病时应使用农药斑贴试验盘。
