Schnuch A, Uter W, Geier J, Frosch P J, Rustemeyer T
IVDK-Zentrale/Department of Dermatology, University of Göttingen, Germany.
Acta Derm Venereol. 1998 Sep;78(5):358-63. doi: 10.1080/000155598443060.
Healthcare workers often suffer from occupational skin disease frequently caused by allergic sensitization. Therefore the patch-test results and important patient history items of 31,849 patients recorded between 1992 and 1995 in the 24 allergy departments participating in the Information Network of Departments of Dermatology (IVDK) were evaluated. Significantly increased sensitization rates common to the healthcare sector as a whole were found for the vaccine preservative thiomersal (12.6% vs. 4.9%), the surface and instrument disinfectants glutardialdehyde (9.9% vs. 2.6%), formaldehyde (3.6% vs. 2.1%) and glyoxal (4.2% vs. 1.4%), and for the compounds of the thiuram mix (6.7% vs. 2.6%) present in protective gloves. Formaldehyde seems to lose its importance, but glyoxal must be added to the list of occupational allergens in the healthcare sector. In addition, occupation-specific sensitization was observed, with fragrances in massage therapists (16.1% vs. 10.6%) and nurses (13.8% vs. 11.4%), as well as with methacrylates in dental technicians. The often assumed importance of drugs as type-IV allergens was not confirmed, at least in terms of quantity. The identification of subgroups of increased risk and of occupation-specific allergens could be the basis of targeted preventive action in the healthcare sector.
医护人员经常患有由过敏性致敏引起的职业性皮肤病。因此，对1992年至1995年间参与皮肤科信息网络（IVDK）的24个过敏科室记录的31849名患者的斑贴试验结果和重要的患者病史项目进行了评估。发现整个医疗行业普遍存在的致敏率显著增加的情况，涉及疫苗防腐剂硫柳汞（12.6%对4.9%）、表面和器械消毒剂戊二醛（9.9%对2.6%）、甲醛（3.6%对2.1%）和乙二醛（4.2%对1.4%），以及防护手套中存在的秋兰姆混合物的化合物（6.7%对2.6%）。甲醛似乎不再重要，但乙二醛必须添加到医疗行业职业过敏原清单中。此外，还观察到特定职业的致敏情况，按摩治疗师（16.1%对10.6%）和护士（13.8%对11.4%）对香料过敏，牙科技术人员对甲基丙烯酸酯过敏。至少在数量方面，通常认为药物作为IV型过敏原的重要性并未得到证实。识别风险增加的亚组和特定职业的过敏原可能是医疗行业有针对性预防行动的基础。
