Houseworkers

Abstract

Houseworkers are exposed to irritants and allergens in their work and are at significant risk for developing contact dermatitis. Housework can be seen as the work involved in housekeeping, such as cleaning, cooking, and laundering. It is the systematic process of making a home neat and clean. Outdoor housecleaning includes removing leaves from rain gutters, washing windows, sweeping doormats, cleaning the pool, putting away lawn furniture, and taking out the trash. However housework is also seen as the activity of caring for family members and for transactional matters. Moreover, housework can be applied more broadly than just in an individual home. Many different tools and substances are used in housework. Housework and home-help services represent 3–10% of paid work and a large proportion of the unpaid activities of human society. Professional houseworkers are exposed to basically the same tools and products as others who perform unpaid housework. The amount of exposure though is larger and the risks for occupational dermatitis mainly enlarged because of the larger amount of exposure.

Appendix

1.1 Dermatopathies in the Domestic Worker: The Lombard Experience

[Article in Italian]

Nava C, Beretta E, Brambilla G, Campiglio R, Moroni P, Veneroni C, Zerboni R, Grieco A.

Istituto di Medicina del Lavoro dell’Università degli Studi di Milano Clinica del Lavoro L. Devoto.

In order to identify the etiopathogenesis of cutaneous diseases in housewives, a questionnaire was made, and the gathered data are here described. One thousand eight hundred and twenty-four people have answered this questionnaire: 1,007 have reported lesions with a suspicious immunological pathogenesis. The commercial products which were reported as a cause of the dermatitis have been 834. In a group of 142 housewives (86 with allergic contact dermatitis and 56 with irritative contact dermatitis), the allergic sensitizations to the chemicals in the detergents were tested. Twenty-one percent of the cases had positive cutaneous reactions for nickel salts and 8.4% for chromium salts. The analysis in atomic absorption method of these metals in 34 commercial products has shown their presence in almost all the samples. A hypothesis is formulated to find the source of these polluting substances. The aims and the methods of the investigation carried out on 1800 housewives, who are going to be controlled in order to estimate the prevalence, the clinical kinds, and the etiopathogenesis of dermatitis related to housework, are described. The study will be carried out at the Occupational Health Institute “Clinica del Lavoro L. Devoto” of Milan and at the Dermatological Departments of the Universities of Bari and Florence.

1.2 Contact Dermatitis of the Hands in Housewives: Preliminary Data of a Multicenter Study

[Article in Italian]

Nava C, Meneghini CL, Sertoli A, Angelini G, Moroni P, Pierini F, Veneroni C, Farli M, Francalanci S, Gola M.

Istituto di Medicina del Lavoro-Università di Milano.

The preliminary results of a survey carried out by the Institutes of Dermatology of Bari and Florence Universities and by the Clinica del Lavoro of Milan University are analyzed. The survey, whose aim is to identify the causes of contact dermatitis on housewives’ hands and whose conclusions are forecasted for June 1990, will examine 1,650 female people, 1,050 of which are ill and 600 are case controls. The results of the first 617 cases (514 ill and 103 case controls) are reported. The anamnesis has shown that the hands (in 488 cases) are the most affected part of the body, that the most frequent symptoms are itch and burning sensation (in 410 cases), and that cosmetics, followed by detergents and softeners, are considered by the patients among the products more responsible for these symptoms. The allergic tests, even if with a different percentage of incidence, have shown metals (above all nickel), rubber additives, and resins as the main haptens. Another survey, also in progress, concerning the search of metals in detergents and in washing waters for pollution caused by abrasives, pots, Inox sinks, pipes, and tabs of the water system, is reported.

1.3 Contact Dermatitis of the Hands in Housewives: The Results of a Multicenter Study

[Article in Italian]

Nava C, Angelini G, Meneghini CL, Sertoli A, Beretta E, Brambilla G, Farli M, Filotico R, Foti C, Francalanci S, et al.

Istituto di Medicina del Lavoro, Università di Milano.

The survey was carried out between January 1988 and June 1990. It consisted of a clinical and allergological study of 1489 housewives, 880 of which had contact dermatitis at their hands (group of “cases”). The other 609 represented the control group. The anamnesis was gathered with a guided questionnaire: the questions concerned familiar and personnel pathology, the use of detergents and cosmetics, and the use of means of prevention and therapies. Patch tests with haptens of GIRDCA series and with the most common detergent components were performed. In 98% of cases, hands were the lace of the beginning of symptoms; in the group of “cases,” 46% were positive to at least one patch test. Nickel sulfate gave positivities in the 28% of cases. Results of the search of this metal (and of chrome and cobalt) in detergents are described. Other possible occasions of contact are described. Other causes of sensitization are represented by rubber additives, by perfumes, and by preservatives. Cutipositivities for detergents are very really limited. The means of protection, in particular barrier creams, are described as scarcely used.