北美接触性皮炎小组1998年至2014年转诊进行斑贴试验的北美生产工人职业性接触性皮炎：横断面数据的回顾性分析

Occupational Contact Dermatitis in North American Production Workers Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014.

作者信息

Warshaw Erin M, Hagen Solveig L, DeKoven Joel G, Zug Kathryn A, Sasseville Denis, Belsito Donald V, Zirwas Matthew J, Fowler Joseph F, Taylor James S, Fransway Anthony F, DeLeo Vincent A, Marks James G, Pratt Melanie D, Maibach Howard I, Mathias C G Toby

机构信息

From the *HCMC Parkside Occupational and Contact Dermatitis Clinic; †Department of Dermatology, Minneapolis Veterans Affairs Medical Center; and ‡Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN; §Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; ∥Dartmouth-Hitchcock Medical Center, Lebanon, NH; ¶Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada; #Department of Dermatology, Columbia University, New York, NY; **Ohio State University, Columbus; ††University of Louisville, KY; ‡‡Department of Dermatology, Cleveland Clinic, OH; §§Associates in Dermatology, Fort Myers, FL; ∥∥Department of Dermatology, Keck School of Medicine at University of Southern California, Los Angeles; ¶¶Department of Dermatology, Pennsylvania State University, State College; ##Division of Dermatology, University of Ottawa, Ontario, Canada; ***Department of Dermatology, University of California, San Francisco; and †††Department of Dermatology, University of Cincinnati, OH.

出版信息

Dermatitis. 2017 May/Jun;28(3):183-194. doi: 10.1097/DER.0000000000000277.

DOI:10.1097/DER.0000000000000277

PMID:28394773

Abstract

BACKGROUND

Little is known about the epidemiology of contact dermatitis in production workers (PWs).

OBJECTIVE

The aims of this study were to estimate the prevalence of contact dermatitis and characterize clinically relevant and occupationally related allergens among North American PWs undergoing patch testing.

METHODS

This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1998 to 2014.

RESULTS

Of 39,332 patch-tested patients, 2732 (7.0%) were PWs. Among PWs, most were men (62.4%) and white (83.9%). A history of childhood eczema was uncommon (11.3%). Prevalent occupations included machine operators (27.3%); fabricators, assemblers, and hand-working occupations (16.8%); and precision metalworking occupations (16.1%). The most frequent sites of dermatitis were the hands (53.8%) and arms (29.4%), which were significantly more commonly affected compared with non-PWs (P < 0.0001). Occupationally related skin disease, allergic contact dermatitis, and irritant contact dermatitis were also significantly more common in PWs (49.9% vs 10.6%, 58.9% vs 53.7%, and 32.7% vs 25.7%, respectively; all Ps < 0.0001). Epoxy (15.3%), thiuram mix (8.3%), carba mix (8.1%), formaldehyde (6.3%), and cobalt (5.9%) were the most frequent occupationally related allergens. The top allergen sources included adhesives/glues (16.0%), metalworking fluids/cutting oils (6.8%), and coatings (6.3%).

CONCLUSIONS

Production workers had a high rate of occupationally related skin disease, as well as irritant and allergic contact dermatitis. Involvement of exposed body areas was common. Frequently identified allergens included adhesives/glues, rubber accelerators, metals, and preservatives.

摘要

背景

关于生产工人接触性皮炎的流行病学情况，人们了解甚少。

目的

本研究旨在评估北美接受斑贴试验的生产工人中接触性皮炎的患病率，并确定具有临床相关性和职业相关性的过敏原。

方法

这是一项对1998年至2014年北美接触性皮炎小组数据进行的回顾性横断面分析。

结果

在39332名接受斑贴试验的患者中，有2732名（7.0%）是生产工人。在生产工人中，大多数是男性（62.4%）且为白人（83.9%）。儿童期湿疹病史并不常见（11.3%）。常见职业包括机器操作员（27.3%）；制造者、装配工和手工工作职业者（16.8%）；以及精密金属加工职业者（16.1%）。皮炎最常见的部位是手部（53.8%）和手臂（29.4%），与非生产工人相比，这些部位受影响的情况明显更常见（P < 0.0001）。职业相关性皮肤病、过敏性接触性皮炎和刺激性接触性皮炎在生产工人中也明显更常见（分别为49.9%对10.6%、58.9%对53.7%以及32.7%对25.7%；所有P值均< 0.0001）。环氧树脂（15.3%）、秋兰姆混合物（8.3%）、卡巴混合物（8.1%）、甲醛（6.3%）和钴（5.9%）是最常见的职业相关性过敏原。主要的过敏原来源包括粘合剂/胶水（16.0%）、金属加工液/切削油（6.8%）和涂料（6.3%）。