Carino Mauro, Romita Paolo, Foti Caterina
Occupational Health Unit, National Health Service, Lungomare Starita 6, 70123 Bari, Italy.
Department of Biomedical Science and Human Oncology, Unit of Dermatology, University of Bari, 70124 Bari, Italy.
ISRN Prev Med. 2013 Dec 5;2013:864679. doi: 10.5402/2013/864679. eCollection 2013.
Working conditions in the construction industry have improved in many industrialized countries, but heavy physical work with recurrent exposure to chemical agents, dust, and climatic influences still represents considerable risk for construction workers and may affect their health. The aim of this review is to analyze available data of the literature on allergy-related respiratory and skin disorders with emphasis on a preventive appraisal in order to produce statements and recommendations based on research evidence. The most common agents involved in the construction industry as a cause of occupational asthma (OA) in industrialized countries are isocyanates, wood dust, resins, glues, cobalt, and chromium. Allergic contact dermatitis (ACD) is an immunologic cell-mediated response to a sensitizing agent and the most common sensitizing agents associated with construction workers are epoxy resins, thiurams and thiazoles, and chromates. Medical surveillance must consider individual risk factors such as differences in individual susceptibility and sensitization to agents at workplace. Once work-related disorder is confirmed, adequate fitness for work should be assessed for the worker impaired by health condition. A reliable diagnosis of an index case is a sentinel event that may reveal risks for workers with similar exposure, leading to a revised risk assessment at the workplace that should reduce the risk and prevent further cases.
在许多工业化国家，建筑业的工作条件已有改善，但繁重的体力劳动、反复接触化学制剂、灰尘和气候影响，对建筑工人来说仍存在相当大的风险，可能影响他们的健康。这篇综述的目的是分析文献中关于过敏相关的呼吸道和皮肤疾病的现有数据，重点是进行预防性评估，以便根据研究证据提出声明和建议。在工业化国家，建筑业中作为职业性哮喘（OA）病因的最常见因素是异氰酸酯、木尘、树脂、胶水、钴和铬。过敏性接触性皮炎（ACD）是一种对致敏剂的免疫细胞介导反应，与建筑工人相关的最常见致敏剂是环氧树脂、秋兰姆和噻唑以及铬酸盐。医学监测必须考虑个体风险因素，如个体易感性差异以及在工作场所对制剂的致敏情况。一旦确诊与工作相关的疾病，应对因健康状况受损的工人进行适当的工作适应性评估。对首例病例的可靠诊断是一个警示事件，可能揭示出接触情况相似的工人面临的风险，从而促使对工作场所的风险评估进行修订，以降低风险并防止更多病例出现。
