Hand eczema in metalworker trainees--an analysis of risk factors.

The present study, as part of PROMETES (Swiss Prospective Metal Worker Eczema Study), was performed to examine risk factors for the development of occupational hand dermatitis in metal-worker trainees. Since this disease is very common, a high standard of preventive measures is necessary, especially for persons with an endogenous disposition for the development of eczema, e.g.

Is occupational irritant contact dermatitis predictable by cutaneous bioengineering methods? Results of the Swiss Metalworkers' Eczema Study (PROMETES).

Background: Since identification of subjects with high eczema risk by screening tests is desirable, different skin bioengineering methods were studied for their validity as predictive measures for the development of hand eczema.

Methods: 205 metalworker trainees were followed up over 2.5 years from the beginning of their apprenticeship to observe the occurrence of hand eczema.

Role of the atopy score and of single atopic features as risk factors for the development of hand eczema in trainee metal workers.

This study was performed as part of PROMETES (Swiss Prospective Metal Worker Eczema Study) to examine the role of atopy as a possible risk factor for the development of hand eczema in trainee metal workers. In a cohort of 201 young men without any skin problems at the start of their apprenticeship, 9.5% developed signs of dermatitis on their hands within a period of 6 months.

Foreign body granuloma of the penis caused by occupational glass fibre exposure.

We report a patient who presented with the suspected diagnosis of syphilis. Clinical findings included a penile ulcer, positive history of syphilis more than 20 years ago, and positive syphilis serology (TPHA, FTA-Abs). A biopsy showed a plasma-cell rich inflammation with granuloma formation.

Skin roughness is negatively correlated to irritation with DMSO, but not with NaOH and SLS.

While many endogenous and exogenous factors have been found to influence skin irritant reactivity, the role of skin roughness in irritation has not yet been studied. In this study we measured skin roughness by visiometry and performed irritation tests on the flexural side of the forearm with sodium hydroxide (NaOH), sodium lauryl sulphate (SLS) and dimethyl sulfoxide (DMSO) in two different concentrations in a population of 151 volunteers between 15 and 25 years of age. The results showed a significant negative correlation between most roughness parameters and DMSO irritation.

An evaluation of the relationship between 'atopic skin' and skin irritability in metalworker trainees.

Skin hyperirritability to irritants as well as atopy are considered to be predisposing factors for contact dermatitis. The aim of the study was to evaluate whether these predictive factors are independent or whether they are so closely related that one could possibly replace the other 205 metalworker trainees underwent skin examination for skin atopy, including standardized questionnaire, clinical examination of the skin and a series of skin irritability tests. These tests included measurements of transepidermal water loss (TEWL) before and after irritation with 3 different irritants: sodium lauryl sulfate (SLS), dimethylsulfoxide (DMSO) and sodium hydroxide (NaOH).

Reproducibility of a non-invasive skin irritancy test in a cohort of metalworker trainees.

The identification of subjects with increased susceptibility to irritants may play an important rôle in the prevention of irritant contact dermatitis. A short and quick method of non-invasive testing for assessing irritant sensitivity was developed by Wilhelm and coworkers in 1990, based on the alkali resistance test of Burckhardt. In order to determine the reproducibility of this screening method, 204 healthy metalworker trainees were tested 2 x according to Wilhelm within an interval of 6 months.

Predictive testing of metalworking fluids: a comparison of 2 cumulative human irritation models and correlation with epidemiological data.

Metalworking fluids (MWF) have been reported as being an important cause of irritant contact dermatitis in metal workers. Our purpose was to determine whether the irritancy of different MWF assessed by 2 different types of predictive human in vivo tests could be compared with epidemiological data. 3 water-based MWF were tested in the same panel of subjects.

'Patient's delay'--analysis of the preclinical phase of occupational dermatoses.

Background: In order to cure diseases effectively it is important that they are detected in their early stages so that medical precautions can be taken. With job-related disorders it is conceivable that anxiety concerning the workplace, as well as other factors of a demanding nature, may lead to a further delay of diagnosis and treatment.

Objective: The study was carried out for the purpose of gathering information about the patients' reactions in the preclinical phase of job-related eczema.

Irritancy testing in occupational dermatology: comparison between two quick tests and the acute irritation induced by sodium lauryl sulphate.

To reduce the incidence of irritant contact dermatitis, the development of screening methods to identify subjects with increased susceptibility to irritants is essential. In a pilot study on the comparison between two quick, non-invasive irritancy tests (dimethyl sulfoxide (DMSO) and sodium hydroxide (NaOH) with the time-consuming patch testing with sodium lauryl sulphate (SLS), no correlation between the "quick tests" and SLS patch testing was observed. In the present paper the results of irritancy testing in 181 metal worker trainees are presented.

Prevention of hand eczema in the metal-working industry: risk awareness and behaviour of metal worker apprentices.

Background: In the metal-working industry, occupational hand eczema is very common and often due to contact with cutting fluids. Since it can be avoided by adequate protective measures, prevention plays an important role. However, the effectiveness of prevention depends heavily on the employees' awareness of this health risk.

Skin risk assessment of metalworking fluids: a survey among Swiss suppliers.

Background: Metalworking fluids (MWF) are the most important cause of hand dermatitis in the metal industry. The substitution of noxious products by less aggressive MWFs is therefore an important measure to reduce the incidence of hand eczema in this type of industry. In order to do so, producers and suppliers have to evaluate the skin risk of such products by predictive allergenicity and irritancy testing.

[Exposure to solvents in scleroderma: disseminated circumscribed scleroderma (morphea) in a painter exposed to perchloroethylene].

We report on a 45-year-old painter who developed morphea-like scleroderma. He had been exposed to perchlorethylene for one year while operating a metal degreaser; the perchlorethylene concentration in the workplace ranged between 10 and 25 ppm. Whereas systemic scleroderma has frequently been attributed to solvent exposure in the past, this is only the third description of a morphea-like scleroderma suspected to be related to occupational contact with organic solvents.

Assessment of skin irritancy by 2 short tests compared to acute irritation induced by sodium lauryl sulfate.

Irritant contact dermatitis is a very common disease that is preventable by protective measures. The development of screening methods to identify subjects with increased susceptibility to irritants is essential to reduce the incidence of this disorder in the workplace. On the outlook for such methods, 2 quick non-invasive tests for irritability of the skin were compared to reliable, but time-consuming, patch testing with sodium lauryl sulfate (SLS).

Surveillance of occupational illness through a national poison control center: an approach to reach small-scale enterprises?

A pilot study was performed in order to evaluate the usefulness of the Swiss Toxicological Information Center (STIC) in detecting cases of occupational illness. One hundred and fifty-two symptomatic occupational exposure cases were collected, comprising 3.2% of 4830 cases reported to the STIC between 1 April 1992 and 15 August 1992.

[Effect of occupation on health behavior and biological cardiovascular risk factors].

Within the framework of the second survey of MONICA-Switzerland (cantons of Vaud and Fribourg; canton of Tessin), the data of 683 working men were analysed to examine the relation between occupation and cardiovascular risk factors. For this purpose, lifestyle factors (smoking, nutritional habits, physical activity, alcohol intake) as well as blood pressure and serum lipoprotein concentrations were compared among 17 different occupational groups. Furthermore, every occupational group was ranked, based on the medians of the mentioned dependent variables.

Design of check-out systems including laser scanners for sitting work posture.

Forty-six laser scanner operators were compared with 106 cashiers operating conventional cash registers. The influence of job rotation on the two groups was evaluated, and several design features were examined. For this purpose the prevalence of musculoskeletal disorders was determined by means of a questionnaire and a physical examination.

[Toxic substances at the work place: do occupational diseases still occur in Switzerland?].

The statistics about work-related diseases influence greatly the setting of prevention priorities. It is consequently of prime importance that these statistics correctly mirror the reality. This paper summarizes the results of studies which show that the real prevalence of work-related diseases is probably two to three times greater than generally admitted; therefore, it seems very important to improve the quality of diagnosis and of data collection.

[Assessment of musculoskeletal disorders using a questionnaire].

The standardized illustrated questionnaire on musculoskeletal disorders of the Japanese Committee on Occupational Cervico-branchial Disorders was translated into German. This questionnaire, composed of 37 items about the occurrence (never/seldom, occasionally, almost daily) of symptoms (pain, stiffness, fatigue) in twelve body regions, was used together with medical examinations (pressure points), and further information was gathered on the consumption of analgetics and medical visits prompted by musculoskeletal symptoms. The questionnaire's reliability and validity were tested in 644 persons from twelve occupational groups within the service sector.