Dermatoses in metal workers : (I). Irritant contact dermatitis

Of 368 patients with hand eczema examined during the years 1978-79, at a Department of Occupational Dermatology, 39% had a history of atopic disease (dermatitis, asthma, or rhinitis). 28% of the patients had or had had atopic dermatitis. The % of atopics in the patient material was highest in the age range 20-24 years, in which 57% of the patients had a history of atopic dermatitis, compared with only 11% in the age range above 35 years. Of all patients with a history of atopy, 22% had developed allergic contact dermatitis, while the corresponding figure for non-atopics was 45% (p less than = 0.001). Positive patch test reactions occurred in a significantly smaller number of individuals with past or present atopic disease than in non-atopics. Atopics had not changed jobs because of hand eczema to a greater extent, but had healed to a lesser extent after change of occupation than non-atopics (p less than 0.01). Show more

Metalworkers exposed to metalworking fluids often encounter dermatological problems. In an epidemiological study of 286 metalworkers, 14% had dermatitis. Of these, 21 (54%) presented with the clinical appearance of dyshidrotic eczema. 3 out of these 21 operators had positive patch test reactions, 1 to nickel and 2 to formaldehyde and formaldehyde releasers, while 1 other was diagnosed as atopic. According to the literature, dyshidrotic eczema is strongly related to an atopic constitution and to contact sensitization, especially to nickel. However, our findings suggest that dyshidrotic eczema in metalworkers is a predominantly irritant dermatitis, mainly induced by exposure to soluble oils and unrelated to atopy. Show more