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Occupational Contact Dermatitis

  • Anja Thielitz
  • Swen Malte JohnEmail author
Chapter

Abstract

Occupational contact dermatitis affects primarily the hands (90–95 %) and results from a complex interaction of exogenous factors (irritant or allergic) and predisposing endogenous factors like atopy or “sensitive skin.” Irritant factors play a causative role in up to 80 % of occupational skin diseases, primarily determined by “wet work” but also by contact to organic solvents, irritant foods, dust, or mechanical pressure. The diagnosis of chronic irritant dermatitis represents an “exclusion diagnosis” after allergic etiology has meticulously been ruled out by systematic diagnostic procedures including assessment of clinical relevance. The most important preventive measure is to identify and avoid irritant or allergic trigger factors by implementation of both workplace-related and worker-related risk reduction strategies.

Keywords

Occupational Skin Disease Irritant dermatitis Wet work Prevention 

References

  1. 1.
    Allmers H, Schmengler J, John SM. Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German health care workers. J Allergy Clin Immunol. 2004;114(2):347–51.CrossRefPubMedGoogle Scholar
  2. 2.
    Amaro C, Goossens A. Immunological occupational contact urticaria and contact dermatitis from proteins: a review. Contact Dermatitis. 2008;58(2):67–75. doi: 10.1111/j.1600-0536.2007.01267.x.CrossRefPubMedGoogle Scholar
  3. 3.
    Apfelbacher CJ, Funke U, Radulescu M, Diepgen TL. Determinants of current hand eczema: results from case-control studies nested in the PACO follow-up study (PACO II). Contact Dermatitis. 2010;62(6):363–70. doi: 10.1111/j.1600-0536.2010.01729.x.CrossRefPubMedGoogle Scholar
  4. 4.
    Diepgen TL. Occupational skin-disease data in Europe. Int Arch Occup Environ Health. 2003;76(5):331–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Diepgen TL, Coenraads PJ. Occupational contact dermatitis. In: Rustemeyer T, Elsner P, John SM, Maibach HI, editors. Kanerva’s occupational dermatology. 2nd ed. Heidelberg: Springer; 2012. p. 51–8.CrossRefGoogle Scholar
  6. 6.
    Diepgen TL, Elsner P, Schliemann S, Fartasch M, Köllner A, Skudlik C, John SM, Worm M, Deutsche Dermatologische Gesellschaft. Guideline on the management of hand eczema ICD-10 Code: L20. L23. L24. L25. L30. J Dtsch Dermatol Ges. 2009;7 Suppl 3:S1–16. doi: 10.1111/j.1610-0387.2009.07061.x. English, German.PubMedGoogle Scholar
  7. 7.
    Frosch PJ, John SM. Clinical aspects of irritant contact dermatitis. In: Duus Johansen J, Frosch PJ, Lepoittevin JP, editors. Contact dermatitis. 5th ed. Berlin: Springer; 2011. p. 305–45.CrossRefGoogle Scholar
  8. 8.
    Frosch PJ, Geier J, Uter W, Goossens A. Patch testing with the patients’ own products. In: Duus Johansen J, Frosch PJ, Lepoittevin JP, editors. Contact dermatitis. 5th ed. Berlin: Springer; 2011. p. 1108–19.Google Scholar
  9. 9.
    Frosch PJ, Aberer W, Agner T, August PJ, Conde-Salazar L, Constandt L, et al. Legal aspects of workers’ compensation for occupational contact dermatitis. In: Duus Johansen J, Frosch PJ, Lepoittevin JP, editors. Contact dermatitis. 5th ed. Heidelberg: Springer Berlin; 2011. p. 1029–51.CrossRefGoogle Scholar
  10. 10.
    Geier J, Krautheim A, Lessmann H. Allergological diagnostics and current allergens in occupational dermatology. Hautarzt. 2009;60(9):708–17. doi: 10.1007/s00105-008-1705-x. Review. German.CrossRefPubMedGoogle Scholar
  11. 11.
    Geier J, Krautheim A, Uter W, Lessmann H, Schnuch A. Occupational contact allergy in the building trade in Germany: influence of preventive measures and changing exposure. Int Arch Occup Environ Health. 2011;84(4):403–11. doi: 10.1007/s00420-010-0581-8.CrossRefPubMedGoogle Scholar
  12. 12.
    Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol (Stock). 1980;(Suppl 92):44–47.Google Scholar
  13. 13.
    Johansen JD, Hald M, Andersen BL, Laurberg G, Danielsen A, Avnstorp C, Kristensen B, Kristensen O, Kaaber K, Thormann J, Menné T, Veien N, Danish Contact Dermatitis Group. Classification of hand eczema: clinical and aetiological types. Based on the guideline of the Danish Contact Dermatitis Group. Contact Dermatitis. 2011;65(1):13–21. doi: 10.1111/j.1600-0536.2011.01911.x.CrossRefPubMedGoogle Scholar
  14. 14.
    John SM. Primary and acquired sensitive skin. In: Berardesca E, Fluhr J, Maibach HI, editors. The sensitive skin syndrome. New York: Taylor & Francis; 2006. p. 129–47.Google Scholar
  15. 15.
    Landeck L, Visser M, Skudlik C, Brans R, Kezic S, John SM. Clinical course of occupational irritant contact dermatitis of the hands in relation to filaggrin genotype status and atopy. Br J Dermatol. 2012;167(6):1302–9. doi: 10.1111/bjd.12035.CrossRefPubMedGoogle Scholar
  16. 16.
    Mahler V, Diepgen T, Skudlik C, Becker D, Dickel H, Fartasch M, Geier J, Häberle M, Hillen U, Krohn S, John SM, Weisshaar E, Werfel T, Zagrodnik F, Work Group “Assessment of allergens in occupational disease (BK) 5101” of the Study Group Occupational and Environmental Dermatology (ABD), German Contact Dermatitis Group (DKG) of the German Dermatological Society. Psoriasis predisposition and occupational triggering factors in the appraisal of occupational medical expertises. J Dtsch Dermatol Ges. 2014;12(6):519–29. doi: 10.1111/ddg.12262.CrossRefPubMedGoogle Scholar
  17. 17.
    Menné T, Johansen JD, Sommerlund M, Veien NK, Danish Contact Dermatitis Group. Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema. Contact Dermatitis. 2011;65(1):3–12. doi: 10.1111/j.1600-0536.2011.01915.x.CrossRefPubMedGoogle Scholar
  18. 18.
    Schmidt M, Raghavan B, Müller V, Vogl T, Fejer G, Tchaptchet S, et al. Crucial role for human Toll-like receptor 4 in the development of contact allergy to nickel. Nat Immunol. 2010;11(9):814–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Skudlik C, Weisshaar E, Scheidt R, Elsner P, Wulfhorst B, Schönfeld M, ROQ Study Group, et al. First results from the multicentre study rehabilitation of occupational skin diseases–optimization and quality assurance of inpatient management (ROQ). Contact Dermatitis. 2012;66(3):140–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Schnuch A, Aberer W, Agathos M, Becker D, Brasch J, Elsner P, German Contact Dermatitis Group (DKG) of the German Dermatological Society – Guidelines of the German Dermatologic Society and German Society of Allergy and Clinical Immunology, et al. Performing patch testing with contact allergens. J Dtsch Dermatol Ges. 2008;6(9):770–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Uter W, Schwanitz HJ, Pfahlberg A, Gefeller O. Atopic signs and symptoms: assessing the ‘atopy score’ concept. Dermatology. 2001;202(1):4–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Uter W, Geier J, Lessmann H, Schnuch A. Is contact allergy to glyceryl monothioglycolate still a problem in Germany? Contact Dermatitis. 2006;55(1):54–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Weisshaar E, Skudlik C, Scheidt R, Matterne U, Wulfhorst B, Schönfeld M, Elsner P, Diepgen TL, John SM, ROQ Study Group. Multicentre study ‘rehabilitation of occupational skin diseases -optimization and quality assurance of inpatient management (ROQ)’-results from 12-month follow-up. Contact Dermatitis. 2013;68(3):169–74.CrossRefPubMedGoogle Scholar
  24. 24.
    European Agency for Safety and Health at Work. European Risk Observatory Report. Occupational skin diseases and dermal exposure in the European Union (EU-25): policy and practice overview. Available from: http://osha.europa.eu/en/publications/reports/TE7007049ENC_skin_diseases. Last Accessed 5 Jan 2015.
  25. 25.
    Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, Cannavó A, Giménez-Arnau A, Gonçalo M, Goossens A, John SM, Lidén C, Lindberg M, Mahler V, Matura M, Rustemeyer T, Serup J, Spiewak R, Thyssen JP, Vigan M, White IR, Wilkinson M, Uter W. European Society of Contact Dermatitis guideline for diagnostic patch testing – recommendations on best practice. Contact dermatitis. 2015.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of DermatologyInstitute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) of the University of Osnabrück, and Dermatologic Centre, Trauma HospitalHamburgGermany
  2. 2.Department of Dermatology, Environmental Medicine and Health TheoryLower Saxonian Institute of Occupational Dermatology (NIB), University of OsnabrueckOsnabrückGermany

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