Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland.
Contact Dermatitis. 2023 Jan;88(1):27-34. doi: 10.1111/cod.14191. Epub 2022 Aug 3.
Commercial patch test substances do not cover all occupational contact allergens. Workplace materials and in-house test substances are tested to complement the investigation of occupational skin disease (OSD).
To quantify the additional value of testing workplace materials and non-commercial in-house test substances in the diagnosis of OSD.
Patients files of 544 patients patch tested at the Finnish Institute of Occupational Health in 2015-2019 were reviewed for occupation, diagnoses and patch test results.
OSD was diagnosed in 353 (64.9%) of the patients. A total of 206 (37.9%) patients had occupational allergic contact dermatitis (OACD). In 19 (3.5%) patients, the only clues to the diagnoses of OACD were positive reactions to workplace materials, and in 20 (3.7%) patients, the diagnosis of OACD was based on commercially unavailable test substances. In 167 OACD cases diagnosed by commercial test substances, additional causes were found in 17 by testing patients' own and non-commercial test substances. In 43 (7.9%) cases, positive reactions to workplace materials reinforced diagnoses based on commercial test substances. The overall additive value of testing own products was 16.7% (91 cases).
We would have missed 39 (18.9%) of our 206 OACD cases if we had solely used commercial test substances.
商业斑贴测试物质无法涵盖所有职业性接触过敏原。工作场所材料和内部测试物质用于检测以补充职业性皮肤病（OSD）的调查。
量化检测工作场所材料和非商业内部测试物质在 OSD 诊断中的附加价值。
对 2015 年至 2019 年在芬兰职业健康研究所接受斑贴试验的 544 名患者的病历进行了回顾，以了解职业、诊断和斑贴试验结果。
353 名（64.9%）患者被诊断为 OSD。共有 206 名（37.9%）患者患有职业性过敏性接触性皮炎（OACD）。19 名（3.5%）患者的 OACD 诊断仅基于对工作场所材料的阳性反应，20 名（3.7%）患者的 OACD 诊断基于无法获得商业测试物质。在通过商业测试物质诊断的 167 例 OACD 病例中，通过测试患者自身和非商业测试物质，发现了 17 例额外原因。在 43 例（7.9%）阳性反应工作场所材料的病例中，阳性反应增强了基于商业测试物质的诊断。测试自有产品的总体附加价值为 16.7%（91 例）。
如果我们仅使用商业测试物质，我们将错过 39 例（18.9%）OACD 病例。
