Development of allergic and non-allergic dermatoses in entry-level hairdressers, nurses and metal workers on account of endogenous risk factors

Status:

completed 03/1996

Aims:

In the project FF0054 an atopy-score was derived for standardised, reproducible atopy diagnosis from anamnestic, clinical and laboratory chemical criteria. Goal: Validation of the atopy-score by means of a field study; determining the importance of endogenous and exogenous risk factors in the development of work related exema.

Activities/Methods:

Prospective cohort-study; standardised dermatological examination of approximately 1,400 entry-level employees (690 hairdressers, 426 nurses, 327 metal workers), at the beginning of the training, in the first year, at the beginning of the second year, at the end of the third year; determination and analysis of skin diseases, occupational risk factors, constitutional factors, tolerance to costume jewellery, skin protection measures; case control study with 103 hairdressers with known occupational illness no. 5101 and control group (156 hairdressers).

Results:

In the first year of training 60 % of hairdressers / 25 % of nurses / 15 % of metal workers developed exema of the hands. The most important (degree of severity associated) risk factors are atopic skin diathesis (in particular dyshidrosis and early exema of the hands), working in damp conditions (unprotected), acid perms, hand cleaning and disinfection, wearing gloves, contact with cooling lubricants, existing sensitisation (type IV) nickel allergy or intolerance to costume jewellery do not constitute particular risk factors without atopy. Appropriate skin protection measures are usually only taken once a condition arises. Gloves are often problematic as they lead to irritation of the skin and sweating. Gloves are penetrated by damp and non-reusable gloves are worn several times. A classification according to risk of skin disease is suggested for professions where "particularly high levels of skin damage" (15) and "skin damage" (7) occur.

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