From the University of Utah School of Medicine, Salt Lake City, UT.
Dermatitis. 2015 Nov-Dec;26(6):276-83. doi: 10.1097/DER.0000000000000142.
BACKGROUND: Workers are exposed to potential irritants and allergens with constant introduction of new industrial chemicals in the workplace. OBJECTIVE: Characterize the final diagnoses, demographics, occupations, exposures, clinical presentations, patch test results, dermatologic histories, and risk factors of workers evaluated for suspected work-related allergic contact dermatitis (ACD). METHODS: A retrospective chart review of 310 workers' compensation independent medical examinations evaluated for suspected work-related ACD was performed. Workers were seen in a community dermatology clinic in Portland, Oregon, from 2005 to 2014. Evaluation included history, physical examination, patch testing, and further diagnostic workup when indicated. RESULTS: Hand dermatitis was the most common presentation (n = 148, 47.7%). Prevalent occupations included health care workers (n = 51, 16.5%), custodial staff (n = 41, 13.2%), and machinists (n = 36, 11.6%). Allergic contact dermatitis (47.5%) was more common than irritant contact dermatitis (ICD) (38.9%) in those diagnosed as having occupational skin disease (n = 185). The highest-frequency work-related allergens were thiuram mix (21 of 88, 23.9%), carba mix (20 of 88, 22.7%), potassium dichromate (9 of 88, 10.2%), and epoxy resin (9 of 88, 10.2%). CONCLUSIONS: Allergic contact dermatitis and ICD are common occupational skin disorders. In this population of workers' compensation referrals, ACD was more common, with 73.3% of those cases work related, compared with 86.7% of ICD. Blue collar work and wet work were risk factors for the development of ACD and ICD.
背景:随着新的工业化学物质在工作场所的不断引入,工人不断接触到潜在的刺激物和过敏原。
目的:描述疑似与工作相关的过敏性接触性皮炎(ACD)患者的最终诊断、人口统计学、职业、暴露情况、临床表现、斑贴试验结果、皮肤病病史和危险因素。
方法:对俄勒冈州波特兰市社区皮肤科诊所 2005 年至 2014 年间进行的 310 例疑似与工作相关的 ACD 的工人赔偿独立医学检查进行回顾性图表审查。评估包括病史、体格检查、斑贴试验以及在需要时进行进一步的诊断性检查。
结果:手部皮炎是最常见的表现(n = 148,47.7%)。常见的职业包括医护人员(n = 51,16.5%)、保洁人员(n = 41,13.2%)和机械师(n = 36,11.6%)。在被诊断为职业性皮肤病的患者中(n = 185),ACD(47.5%)比 ICD(38.9%)更为常见。在与工作相关的过敏原中,最常见的是噻二唑混合物(n = 88,21/88,23.9%)、卡巴混合物(n = 88,20/88,22.7%)、重铬酸钾(n = 88,9/88,10.2%)和环氧树脂(n = 88,9/88,10.2%)。
结论:ACD 和 ICD 是常见的职业性皮肤病。在这群工人赔偿推荐患者中,ACD 更为常见,其中 73.3%的病例与工作相关,而 ICD 为 86.7%。蓝领工作和湿工作是 ACD 和 ICD 发展的危险因素。
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