1/13. Irritant contact dermatitis due to 1-bromo-3-chloro-5,5-dimethylhydantoin in a hydrotherapy pool. Risk assessments: the need for continuous evidence-based assessments.A physiotherapist working in hydrotherapy presented to occupational health with irritant contact dermatitis. Subsequent investigation revealed that the likely causative agent was 1-bromo 3-chloro 5,5 dimethylhydantoin which was used to disinfect the hydrotherapy pool. A COSHH risk assessment had been performed which failed to take full account of current knowledge and this agent had been introduced into the workplace. The development of adverse health effects among staff and other pool users lead to a review of this risk assessment and eventually a return to less hazardous chlorine-based disinfection. Had an evidence-based approach been combined with an appropriate COSHH assessment prior to and following changes in the workplace then unnecessary risk to employees would not have occurred.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
2/13. Repeated hand urticaria due to contact with fishfood.BACKGROUND: The etiology of urticaria is often difficult to determine. However, in case of repeated circumstance-connected urticaria, the reason may be easily clarifyable. CASE: A 51-year-old healthy woman repeatedly experienced occupational hand urticaria when handling fish food. An unexpected reason for the urticaria was found in that the fishfood contained histamine as a "contaminant". CONCLUSIONS: In fishfood batches, biological degradation can produce histamine and possibly other toxic substances that can lead to occupational health problems.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
3/13. Occupational dermatitis from a one-component naphthalene type epoxy adhesive.In an electronics plant, a new one-component naphthalene type epoxy resin was used as an adhesive for reinforcing a circuit board. The resinous part of the adhesive consisted of diglycidyl ether of bisphenol A (DGEBA) and 1,6-bis(2,3-epoxypropoxy)naphthalene type epoxy resins. The hardener was methylhexahydrophthalic anhydride (MHHPA). Of 54 workers, 15 (27.8%) were diagnosed to have work-related dermatitis but were not patch tested. Therefore, it was impossible to determine the specific agent responsible for the worker's symptoms or to distinguish between allergic and irritant contact dermatitis. They worked without protective gloves until they started to develop skin symptoms. The hands were the commonly affected region (13 out of 15 cases). The latent period of dermatitis was very short (mean 2.2 weeks). Of these, 10 cases (66.7%) received medication for dermatitis, and 9 cases (60%) were transferred to other work. The work-related skin symptoms were closely related to the specific tasks, i.e., filling dispensers with the adhesive and manual application of the adhesive to a portion of a circuit board using a dispenser. For occupational hygiene reasons, contact with epoxy resins should be minimized by taking all possible measures into use, including protective gloves. Further studies are required to clarify the allergenicity of 1,6-bis(2,3-epoxypropoxy)naphthalene, since very little is known about the mechanism through which it leads to the symptoms of dermatitis.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
4/13. Airborne allergic contact dermatitis from 3-iodo-2-propynyl-butylcarbamate at a paint factory.3-Iodo-2-propynyl-butylcarbamate (IPBC) is a fungicide used in both industrial products and cosmetics. We report the first case of allergic contact dermatitis from airborne exposure to this preservative. A 34-year-old female production worker at a paint factory developed dermatitis on air-exposed skin areas. Patch testing showed a reaction to the preservative IPBC 0.01% in petrolatum. The compound was used as a preservative in wood treatment products manufactured at her work place. Based on animal studies, IPBC is considered safe as a cosmetic preservative. However, widespread use of the chemical might lead to increasing levels of contact allergy, and therefore, close monitoring of IPBC is recommended.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
5/13. Cutaneous larva migrans, an occupational disease.Creeping skin eruption is known to follow exposure to canine and feline hookworm larvae found in contaminated soil encountered in humid, tropical and subtropical regions. A little known hazard of similar infections exists among veterinarians and laboratory workers exposed to strongyloides larvae from horses located in temperate climates. The evolving clinical picture is described in detail. Continued exposure may lead to a state of hypersensitivity to the parasitic protein resulting in severe hyperimmune reactions. The invasiveness of strongyloides larvae through intact skin and the pathologic changes associated with infection were demonstrated in a rabbit.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
6/13. Persistent post-occupational dermatitis.Wall and Gebauer (Contact dermatitis 1991: 24: 241-243) first described persistent post-occupational dermatitis (PPOD) as ongoing dermatitis for which there is no obvious present cause, precipitated by prior occupational contact dermatitis (OCD). We propose that individuals exhibiting PPOD lose the capacity for resolution of their condition upon removal from exposure to causative agents and subsequently develop persistent dermatitis, which can be continual or intermittent. Accordingly, we suggest modification of criterion 6 of the OCD criteria developed by Mathias (J Am Acad Dermatol 1989: 20: 842-848): 'Removal from exposure initially leads to improvement of dermatitis, however, over time there may be incomplete or no improvement, despite removal from exposures at work'. To satisfy the definition of PPOD, individuals must meet at least 4 of the 7 criteria, including the altered criterion 6. We present 6 cases of PPOD exemplifying these scenarios, which met the altered Mathias criteria. In some cases, subsequent failure to recognize the initial work relatedness of their skin conditions resulted in the termination of workers' compensation benefits. This situation is particularly relevant in the Australian context. The diagnosis of PPOD needs to be considered in all individuals with work-initiated dermatitis who present with ongoing endogenous-like eczema.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
7/13. The edema of fiddler's neck.Fiddler's neck is a dermatosis of violinists and violists. It characteristically presents as focal lichenification and pigmentation on the left side of the neck. edema may also occur in the same area and lead to cosmetic concern or fear of malignancy. The edema apparently results from pressure on the patient's neck by the base of the violin or viola and is worsened by holding the instrument in a drooping position.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
8/13. Occupational protein contact dermatitis from shiitake mushroom and demonstration of shiitake-specific immunoglobulin e.Shiitake are popular edible mushrooms all over the world, and eating raw shiitake may lead to relatively common 'shiitake dermatitis' or toxicodermia. Workers involved in shiitake cultivation and marketing have distinct occupational respiratory and skin diseases unrelated to 'shiitake dermatitis'. There are no previous reports of protein contact dermatitis (PCD) from shiitake, and there is only 1 report of shiitake-specific immunoglobulin (Ig) E. We report 2 shiitake growers who developed work-related eczematous eruption on their hands. Both of the patients had small prick test reactions to fresh shiitake, and specific IgE to shiitake was detected in their sera by immunospot. One of the patients had a large prick test reaction to dry shiitake and also a positive wheal reaction to fresh shiitake in an open application test. Neither of the patients had noticed any symptoms of contact urticaria at work. Both of the patients had immediate IgE-mediated allergy to shiitake, and the diagnosis of occupational PCD was made. There are no commercial in vitro tests for shiitake-specific IgE. Tests for immediate allergy are important when shiitake contact dermatitis is investigated.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
9/13. Contact and systemic contact-type dermatitis to spices.Contact and systemic contact-type dermatitis reactions to spices such as nutmeg, mace, cardamom, curry, cinnamon, and laurel may be rare but may well be overlooked. In our experience, patch testing with these spices "as is" is very useful; if there is a positive reaction, testing with dilutions is helpful. Scratch-chamber testing often leads to false-positive irritant reactions. As Hjorth and Niinimaki have pointed out, a positive test to balsam of peru may indicate a spice allergy, but the absence of such a reaction does not rule it out. In all the cases in our experience, the careful drafting of the anamnesis or case history was critical in the diagnosis.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
10/13. An overexposure in industrial radiography using an 192Ir radionuclide.An industrial radiographer was accidentally exposed to a high dose of ionizing radiation from an 192Ir source during radiography of weldjoints in gas pipelines. Some symptoms of high radiation exposure occurred immediately after the incident. The clinical effect of skin erythema developed within 7 d, leading to progressive tissue deterioration. The dose to the body was estimated to be about 2-3 Gy, and the dose to the fingertips was approximately 24 Gy.- - - - - - - - - - ranking = 1keywords = lead (Clic here for more details about this article) |
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