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Occupational skin diseases (OSDs) are common in healthcare workers (HCWs).To investigate and compare the incidence and clinical features of OSDs among HCWs before and during the COVID-19 pandemic.Incident cases of OSDs were investigated in the cohort of HCWs at Trieste Hospitals from 1 July 2018 (3340 workers) to 31 October 2021 (137 532 person-months).The monthly incidence was ranging from 0 to 11.90 cases per 10 000 person-months in pre-COVID-19 period (cumulative incidence 4.22; 95% confidence interval [CI]: 2.9-6.0) and from 0 to 13.61 cases per 10 000 person-months in COVID-19 period (cumulative incidence 5.06; 95% CI: 3.6-6.9). The incidence rate ratio (IRR) between COVID-19 and pre-COVID-19 period was 1.22 (95% CI: 0.73-1.98). The incidence of OSDs in the COVID-19 period was 6.1 (4.2-8.6) and 2.7 (95% CI: 1.1-5.6) cases × 10 000 person-months for women and men, respectively, with an IRR of 2.25 (95% CI: 0.98-5.9). Incidence in nurses in the COVID-19 period was 6.7 (95% CI: 4.2-10.2) cases × 10 000 person-months.Incidence of OSDs was a little bit higher during the COVID-19 pandemic compared to the previous period but fluctuation of numbers were mainly related to calendar period, with higher incidence in winter and spring. Incidence data were higher than that observed in 2004-2013 in the same cohort. Face dermatitis cases doubled after the start of COVID-19 pandemic. Overall data demonstrated a non-significant increase of OSDs in HCWs during the pandemic, probably due to the preventive strategies set up in our cohort over the years.

Background: Occupational contact dermatitis (OCD) is frequent in the workplace. Objectives: To provide recent data on the epidemiology of OCD in Italy. Methods: This multicenter retrospective study, conducted from 1996 to 2016, included patients with suspected allergic contact dermatitis (ACD) patch tested in the departments comprising the North-East Italy Contact Dermatitis Group. Results: We studied 18 859 workers with a diagnosis of contact dermatitis (CD), of which 10.4% were recognized as being of professional origin. OCD declined from 1996 to 2011–2013 and increased in 2014–2016. The overall prevalence of both CD and OCD was higher in women compared to men, but the share of OCD of the total CD was greater for men compared to women. A history of atopic dermatitis was less frequent in workers with OCD than in non-OCD patients (5.8% vs 8.6%). Hairdressers were the youngest profession (27.1 ± 11.7 years). Hands were the primary site of involvement in patients with OCD (76.6%). The five highest risk occupations for OCD were hairdressers, cooks, metalworkers, chemical industry workers, and construction workers. Conclusions: OCDs have a relevant impact in our region, mainly for five job categories, and the increase in the last 3 years suggests the need to improve preventive measures.

Background: The use of palladium (Pd) is increasing in metal objects after the banning of nickel in items in prolonged contact with the skin. The properties of Pd make this metal useful in various industrial fields. Objective: The aim of the study was to evaluate the prevalence of Pd sensitization in patients who underwent patch tests for suspected allergic contact dermatitis in the Triveneto region from 2013 to 2018. Methods: A total of 4816 patients with symptoms and/or signs of suspected contact allergic dermatitis were patch tested. Individual characteristics were assessed using a standardized questionnaire. Results: The overall prevalence of Pd sensitization was 7.6% and 10.8% using PdCl2 1% or 2% petrolatum, respectively, with a higher prevalence in women (odds ratio, 2.6; 95% confidence interval, 1.9-3.7) and in 26- to 55-year-old patients. Monosensitization occurred in 1%-1.5% of the patients tested. Health care workers and technicians were more sensitized to Pd than clerks, but the data did not reach statistical significance. Conclusions: Palladium sensitization was high, but it was mainly associated with nickel sensitization. A possible occupational role was found for workers with potential contact with Pd-containing objects, but more data are needed to reach statistical significance.

Objective To evaluate the incidence of COVID-19 infection in health care workers from the start of COVID-19 pandemic in NE of Italy, to the vaccination with BNT162b2. Materials and methods This was a retrospective cohort study. Health care workers were routinely tested for SARS-CoV-2 infections using real-time polymerase chain reaction tests in nasopharyngeal swabs. Logistic regression was used to calculate incident rate ratios (IRRs) of factors associated to COVID-19. Results A total of 4251 workers were followed-up and an annual incidence of COVID-19 of 13.6% was found. In March 2021 the incidence of infection was 4.88 and 103.55 cases for 100.000 person-days in vaccinated and non-vaccinated workers, respectively, with an adjusted IRRs of 0.05 (95% CI 0.02–0.08). Conclusions Our study evaluated the monthly incidence in health care workers in Trieste hospitals before and after the vaccination finding the protective effect of BNT162B2 vaccine in 95% of health care workers routinely tested.

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COVID-19 became a pandemic in a few months, leading to adverse health outcomes, reducing the quality of life, affecting the sleep/wake cycle, and altering coping strategies, especially among hospital personnel. Life quality, insomnia, and coping strategies were thus assessed among hospital personnel during the first wave of the COVID-19 pandemic in Italy. This cross-sectional study was conducted from May to November 2020 through an online survey. There were 558 participants (28.5% males and 71.5% females) enrolled in two different metropolitan areas (in North and South of Italy, respectively). Three standardized questionnaires were administered: European Quality of life–5 Dimensions (EQ-5D), Athens Insomnia Scale (AIS), and Brief COPE. Differences in sociodemographic characteristics and work-related factors were also investigated in order to identify possible predictors through a generalized linear model and logistic regression analysis. Results showed good perceived life quality and high insomnia prevalence. After sample stratification, the statistical analysis highlighted that personal (gender, age, educational level) and work-related factors (employment in COVID wards, remote working) played different roles in predicting quality of life, insomnia, and coping attitude. Active, Planning, and Acceptance were the most frequently adopted coping strategies. Despite women confirming their attitude in reacting to the difficulties, adopting emotion-focused coping strategies, they showed a higher probability to develop insomnia, so a gender perspective should be considered in the health protection of this working category. An integrated approach should be implemented at individual, interpersonal and organizational levels aiming to monitor psychological distress, favor regular sharing and communication between peers, and also allow conciliation of work with family life. At the organizational level, preventive and protective measures adequate to work-related risk to COVID-19 should be adopted.

Background: Hairdressers are at high risk of contact dermatitis (CD) due to skin exposure to numerous irritants and haptens in hair products in combination with frequent wet work. Objectives: To investigate the characteristics and incidence of CD among hairdressers in north-eastern Italy. Methods: A total of 324 hairdressers who had been examined and patch tested in north-eastern Italy from 1996 to 2016 were retrospectively identified, and compared with 9669 matched controls. Sensitization to allergens of the hairdressing series was analysed among hairdressers attending an occupational medicine clinic in Trieste, Italy. Incidence data were calculated from 1999 to 2016. Results: Sensitization to p-phenylenediamine, thiuram mix, and N-isopropyl-N'-phenyl-p-phenylenediamine was significantly associated with hairdressing and with hand/forearms dermatitis. Frequent sensitizers from hairdressing series were ammonium persulfate, toluene-2,5-diamine, and p-aminobenzene. The overall incidence of CD declined from 2003 (31.7 cases/10 000 workers) to 2016 (20.8 cases/10 000 workers). Conclusions: Sensitization to several haptens was significantly associated with hairdressing. The incidence of CD among hairdressers in north-eastern Italy has declined in recent years, but is still high. Preventive efforts are needed to reduce the burden of CD in this professional group.

Background Assessment of the clinical relevance of patch test reactions is an essential part of the diagnostic work-up of patients with (occupational) contact dermatitis. However, final diagnostic information, particularly the clinical relevance of allergic patch test reactions, has hitherto been ill-represented in clinical documentation systems (patch test software) and surveillance registries based on these. Objectives To develop, implement as a pilot study, and analyse concerning feasibility and contents a new concept of representing the full scope of diagnostic information utilized in the diagnosis of patients with (occupational) contact dermatitis. Methods On the basis of a European working group discussion on items to document and catalogue lists to use for this purpose, an online documentation system to collect data was set up, followed by pilot use involving 9 dermatology departments across Europe. Results Data on 176 patients with suspected occupational hand dermatitis were included; among these, work-relatedness was confirmed in 150, and in 53 non-occupational aetiology was the sole or a contributory cause. Data were further analysed with regard to occupations, product categories, substances (haptens), source of information on which the evaluation was based, and various combinations of these factors, to illustrate the usefulness of the proposed data representation. Conclusions An improved method of data collection is presented that more accurately links allergen to exposure and to clinical disease and patient history, and thus better represents clinical relevance. This enables more precise analysis of the causation of contact dermatitis, occupational or non-occupational, and thereby better targeting of prevention. The development of future databases should incorporate the above considerations to record the results of investigation.

Exposure to laboratory animals (LA) can cause allergic sensitization and symptoms as rhinitis, conjunctivitis, asthma, anaphylaxis and dermatitis. In 2000, a program was instituted at Trieste Universities to decrease LA allergy among scientists and technicians working with animals. The aim of our study was to investigate LA allergy in workers exposed to LA from 2001 to 2016, and to verify the effects of a preventive program. Four hundred sixty seven people underwent pre-employment screening for a job with laboratory animals at Universities of Trieste consisting in a medical examination, a full respiratory and allergy anamnesis, using a standardized questionnaire, skin prick test with common and occupational allergens, and spirometry. Every year, each worker repeated the medical examination and underwent again tests and questionnaire. Each worker can ask for a medical examination and skin prick test, in case of unset of symptoms. Logistic multivariate analysis and generalized equation estimation were use, to verify factors associated to LA allergy. Sensitization to LA decreased in years, going from 25.6% in 2001-2004 to 8.2% in 2013-2016 (p 0.001). Multivariate logistic regression analysis confirmed the role of atopy by prick test (OR = 6; IC95% 2.2-16.6), of common allergic symptoms (OR = 2.9; IC95% 1.4-6.39) and of calendar periods. No association was found between LA allergy, years, and hours of exposure. Our study demonstrated a significant reduction of LA allergy after the application of a preventive program.

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Cerium oxide (CeO2) nanoparticles (NPs) are used in polishing products and absorbents, as promoters in wound healing, and as organopesticide decontaminants. While systemic bioaccumulation and organ toxicity has been described after inhalation, data on CeO2 NPs&rsquo, transdermal permeation are lacking. Our study was an in vitro investigation of the permeation of 17-nm CeO2 NPs dispersed in synthetic sweat (1 g L&minus, 1) using excised human skin on Franz cells. Experiments were performed using intact and needle-abraded skin, separately. The average amount of Ce into intact and damaged skin samples was 3.64 &plusmn, 0.15 and 7.07 &plusmn, 0.78 &micro, g cm&minus, 2, respectively (mean &plusmn, SD, p = 0.04). Ce concentration in the receiving solution was 2.0 &plusmn, 0.4 and 3.3 &plusmn, 0.7 ng cm&minus, 2 after 24 h (p = 0.008). The Ce content was higher in dermal layers of damaged skin compared to intact skin (2.93 &plusmn, 0.71 &micro, 2 and 0.39 &plusmn, 0.16 &micro, 2, respectively, p = 0.004). Our data showed a very low dermal absorption and transdermal permeation of cerium, providing a first indication of Ce skin uptake due to contact with CeO2.

Highlights After the introduction of the EU regulatory interventions, nickel sensitization decreased significantly in the group of females aged ≤25 years. Women born between 1966 and 1975 presented the higheest prevalence of sensitization to nickel, then prevalence of sensitization gradually decreased with a minimum in more recent years. Nickel sensitization is higher in Italian patients compared to people living in other EU coutries. Additional interventions are needed to address nickel sensitization.

BACKGROUND: During work, hairdressers are exposed to several hazardous agents that can cause skin and respiratory symptoms. Because few data are available for long-term follow-up, and none are from Italy, the aim of our study was to investigate occupational symptoms in hairdressers after a 10-year follow-up. METHODS: Work-related skin and respiratory symptoms were investigated in 2006 and 2016 by means of a standardized questionnaire and medical examination. RESULTS: Eighty-two workers completed the 10-year follow-up with a response rate of 86.3%. At follow-up, skin- and respiratory work-related symptoms had increased significantly, involving 40.7% of workers. Skin symptoms increased to 12.5%, throat irritation to 15.6%, and cough to 12.5%. The occurrence of the symptom of skin irritation was significantly related to dryness of the skin at the baseline. CONCLUSIONS: Our long-term follow-up on hairdressers demonstrated an increase in work-related irritant skin and upper respiratory symptoms that involved more than one-third of the population studied. More efforts are needed in prevention activities to promote better ventilation of workplaces, use of less irritating and less sensitizing hair products, and use of moisturizers to prevent dry skin.

Background UV exposure is strongly associated with the incidence of non melanoma skin cancers (NMSCs), both basal and squamous cell carcinomas. The aim of our study was to analyze risk perception, UV exposure, preventive habits, and occupation in 126 subjects affected by NMSC and 187 controls. Methods Consecutive cases with incident NMSC were recruited in Dermatologic Unit at University of Trieste; controls were recruited in Unit of Occupational Medicine. All had a medical examination to define Fitzpatrick skin type and skin lesions, and filled a standardized questionnaire on sun exposure habits, sun protection, occupational exposures, and sunburns in adulthood and childhood. Results In multivariate regression analysis, NMSC resulted significantly associated with age (OR: 1.03; 95% CI 1.01-1.05), with a positive feeling for tan (OR: 1.10; 95% CI 1.01-1.20), and sunbath numbers per year (OR: 1.02; 95% CI: 1.001-1.03). A protective effect was demonstrated for Fitzpatrick phototypes III-IV compared to I and II (OR: 0.31; 95% CI: 0.18-0.55), sunscreen use (OR: 0.35; 95% CI: 0.22-0.58), and risk perception (OR: 0.98; 95% CI: 0.97-0.99). In univariate analysis, we demonstrated an increased risk for fishermen, sailors, and lifeguards (OR: 4.3; 95% CI: 1.1-16.4); foundry and metallurgy workers (OR: 5.58; 95% CI: 1.14-27.3); and mechanics, fixers, and welders (OR: 8.2; 95% CI: 1.76-37.9). Conclusions Our study demonstrated that protective behavior must be implemented in people living in Trieste. Workers must avoid direct UV exposure and must use protective equipment. More efforts are needed to increase knowledge on this risk and to raise awareness among at-risk people.

Dermal exposure to Aluminium nanoparticles (AlNPs) can occur in occupationally- and non occupationally exposed- population, due to the use of Al salts-based antiperspirants. No AlNPs transdermal permeation data exists. Our study investigated in vitro the permeation of 30-60 nm Al

Background: Work-related musculoskeletal (MS) disorders are very common among dentists due to abnormal positions maintained during their work. There is the need to teach undergraduate students ergonomic procedures to prevent MS pain and disorders. Methods: All the students of the School of Dentistry at the University of Trieste were enrolled for the study (No. 55). A self-administered questionnaire was used to collect anthropometric information, previous or current diseases, MS pain and disorders and work tasks performed. All students attended a training course. Three months after the training they completed a follow-up questionnaire. Results: All students reported MS pain: higher at cervical level (91%), lower at lumbosacral level (64.2%), shoulders (43.6%), and wrist/hand level (41.8%). Forty-nine percent of students reported an improvement in pain symptoms (p

BackgroundIrritant exposure may be a contributory cause or the sole cause of (occupational) hand dermatitis. However, the documentation of irritant exposures in clinical practice is not standardized.ObjectivesTo examine the feasibility and usefulness of a form with different items addressing both occupational and non-occupational irritant exposures in a semiquantitative way.MethodsBetween May 2016 and May 2017, successive patients with work-related hand dermatitis, irrespective of aetiology, were examined in 9 specialized European departments. Department-specific investigation was supplemented with the above proforma. The results were recorded by use of an anonymized secured online documentation system in a pilot study.ResultsAltogether, 193 patients were included; 114 females and 79 males, with a mean age of 40years (range 18-68years). The most common occupational group comprised healthcare workers (n =35); occupational exposure of the hands to gloves, dusts and water without detergents of >2hours/day was seen in 54.5%, 24.4% and 24.3% of patients, respectively. Non-occupational exposures rarely exceeded 2hours/day.ConclusionsIt is hoped that the set of descriptors will offer a basis for (clinical) epidemiological studies assessing the role of irritant exposures in occupational hand dermatitis, and to support a high level of quality and consistency in daily patient care.

Background Colophonium is a natural substance derived from Pineaceae trees. It is used in a wide range of consumer and occupational products because of its tackiness, and is a known sensitizer. Objectives To analyse the temporal trend of contact allergy to colophonium in north-eastern Italy, and to evaluate the associations with occupations in our geographical area. Methodology From 1996 to 2016, 27 381 patients with suspected allergic contact dermatitis were patch tested in north-eastern Italy. Individual characteristics were documented by use of a standardized questionnaire in 6 departments of dermatology or occupational medicine. Results The overall prevalence of colophonium sensitization was 1.67%; the prevalence was significantly higher in women (1.75%) than in men (1.49%). No significant differences among departments were observed. We found significant associations between colophonium sensitization and being a student (odds ratio [OR] 4.64; 95% confidence interval [CI]: 1.04-20.6), being a farmer or fishermen (OR 3.63; 95%CI: 1.21-10.84), being a housekeeper (OR 2.02; 95%CI: 1.08-3.77), and being retired (OR 2.06; 95%CI: 1.08-3.92). Conclusion Our study showed that contact allergy to colophonium is still relevant in north-eastern Italy. The frequency of sensitization has dropped significantly over a period of 10 years, but students and farmers/fishermen still have sensitization prevalences above 3.5%. Our results are in line with European data.

Growing warnings on health effects related to electronic cigarettes have met inconclusive findings at present. This study analyzed the in vitro percutaneous absorption of nicotine resulting by skin contamination with two e-liquids (refill 1 and 2) containing nicotine at 1.8%. Donor chambers of 6 Franz cells for each refill liquid were filled with 1 mL of nicotine e-liquid for 24 h; at selected intervals, 1.5 mL of the receptor solutions were collected for nicotine concentration analysis by mean gas chromatography–mass spectrometry (LOD: 0.01 μg/mL). The experiment was repeated removing the nicotine donor solution after 10 min from the application and rinsing the skin surface three times with 3.0 mL of milliQ water. A total of 12 cells with 24 h exposure and 12 cells washed were studied. The mean concentration of nicotine in the receiving phase at the end of the experiment was 54.9 ± 29.5 and 30.2 ± 18.4 μg/cm2 for refill 1 and 2 respectively and significantly lower in washed cells (4.7 ± 2.4 and 3.5 ± 1.3 μg/cm2). The skin absorption of nicotine can lead to minor health illness in vapers, while caution must be paid to dermal contamination by e liquids in children. The skin cleaning significantly reduced the transdermal absorption kinetic and intradermal deposition of nicotine.

Visual fatigue and discomfort are very common complaints for video display operators (VDTs). The aim of our study was to study work-related visual symptoms in relation to refractive disorders and psychosocial factors in 3054 public employees by way of follow-ups for 10 years with periodic medical examinations with eye evaluation in the period 2000&ndash, 2009. Factors related to visual fatigue were evaluated in the follow-up using generalized equation estimation. Visual fatigue was very common in VDT operators (64.03%). During the follow-up, no relationship between visual fatigue and age, sex, seniority of work, visual acuity and refractory disorders was found. Visual fatigue was significantly associated with anxiety perception in a dose-related matter (odds ratio (OR) 7.40, confidence interval (CI) 95% 1.77&ndash, 31.3), psychosocial factors (OR 1.03, CI 95% 1.01&ndash, 1.07), use of lenses (OR 1.34, CI 95% 1.09&ndash, 1.64) and time of VDT usage (OR 1.27, CI 95% 1.04&ndash, 1.53). This study confirmed that visual fatigue is common in VDT users and is related to anxiety perception, time of VDT usage, use of lenses and stress. No relationship was found between visual fatigue and refractory disorders or visual acuity.

Background Atopic diseases have increased since the second half of the previous century. Atopic workers are at higher risk to be sensitized to latex, and the first years of exposure are supposed to be especially risky. Objective To assess atopic status and rate of latex sensitization in health care students starting their exposure to latex gloves. Methods We analyzed medical surveillance data from 1,628 health care students from 2010 to 2016. Students completed a questionnaire focused on their previous and current latex exposure and personal and family histories of allergic diseases; underwent skin prick testing with common allergens and latex extract (and/or total and latex-specific immunoglobulin E in serum); and underwent a medical examination. Results Skin prick test results for common inhalant allergens showed that 807 of 1,628 students (49.6%) had atopy. Atopy by skin prick testing was associated with male sex (odds ratio 1.49, 95% confidence interval 1.18–1.86), a personal history of oculorhinitis or asthma (odds ratio 10.22, 95% confidence interval 7.4–14.13), and atopic eczema (odds ratio 1.87, 95% confidence interval 1.05–3.36) at multivariate regression analysis. Eleven students (0.7% of total population) were found to be sensitized to latex and all had atopy. Conclusion Despite the high prevalence of atopy in health care students of Trieste, the latex sensitization rate is very low and comparable to general population. This is reasonably due to the low exposure to latex gloves at the time of the evaluation and to low latex release from the gloves currently used in our hospital.

BACKGROUND: Formaldehyde is a widely used organic compound, used in several applications (hard thermoset resins, adhesives, disinfectants, tissue fixatives, etc), in its free form or released by formaldehyde releaser products. Its use is under control due to its toxic, carcinogenic, and allergenic properties. OBJECTIVE: The aim of this study was to investigate the frequency of formaldehyde sensitization, time trend, and correlation to occupations. METHODS: This study is a cross-sectional study on a population of 23,774 patients tested from 1996 to 2012 in Northeastern Italy. RESULTS: Frequency of sensitization was 3.3%, without any significant time trend. Hands (39.8% overall) and face (25.6% females, 15.5% males) were mainly involved. We found a trend toward decrease by age in females (3.11% in first quintile [14-26 years], 2.29% in fifth quintile [59-97 years], P < 0.01). On a logistic regression analysis (control group: white-collar workers), we found associations in health care (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.04-1.81), wood (OR, 2.14; 95% CI, 1.30-3.51), and textile (OR, 1.79; 95% CI, 1.14-2.79) sectors and professional drivers (OR, 1.94; 95% CI, 1.05-3.60). We found a high rate of cosensitization to formaldehyde in patients with positive patch test reactions to quaternium-15 (OR, 18.7; 95% CI, 12.6-27.7). CONCLUSIONS: Sensitization to formaldehyde is relevant in our population, especially in the health care sector, wood and textile industries, and professional drivers. No significant time trend was found.

Background 4,4′-Diaminodiphenylmethane (DDM) is an aromatic amine used as a hardener, insulator and anticorrosive. Exposure implies risk of being sensitized and developing contact dermatitis. Objective The aim of this study was to determine the occurrence of contact sensitization to DDM among patients with contact dermatitis and the role of occupational exposure. Patients and Methods From 1996 to 2012, 24 056 consecutive patients with suspected allergic contact dermatitis were patch tested in north-eastern Italy. Individual characteristics were collected through a standardized questionnaire in eight departments of dermatology and occupational medicine. Results The overall prevalence of DDM sensitization was 2.5% (n = 599) with a decreasing trend in considered years. Trieste area had the higher prevalence of sensitization (3.2%). Mechanics and chemical industry workers had a significant higher risk of being sensitized to DDM. Conclusion DDM sensitization is decreasing in years and is associated with some occupational exposures.

BACKGROUND: Natural and synthetic rubbers containing rubber accelerators are well-known causes of occupational skin disease. Allergic contact dermatitis caused by rubber gloves is frequent and has almost exclusively been attributed to contact sensitization to accelerators. OBJECTIVE: This study aimed to evaluate the frequency of rubber accelerators sensitization in the population living in northeastern Italy, to find time trend and a correlation with occupations, and to investigate co-sensitization between rubber accelerators. METHODS: A population of 23,774 subjects was patch tested in 6 cities in northeastern Italy in the years 1996 to 2012 using carba mix 3%, thiuram mix 1%, benzothiazole (MBT) mix 1%, and isopropyl phenyl paraphenylamine diamine (IPPD) mix 0.6%. RESULTS: The overall frequency of carbamates, MBT, thiurams, and IPPD mix sensitization was 3.4%, 0.65%, 1.75%, and 0.83%, respectively. On a logistic regression analysis (control group: white-collar workers), we found a statistically significant association to carbamates (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.03-1.7) and thiurams (OR, 1.6; 95% CI, 1.1-2.3) for health care workers. Thiuram sensitivity was also significantly associated with dermatitis in maids and restaurant workers (OR, 2.2; 95% CI, 1.4-3.6), hairdressers (OR, 3.6; 95% CI, 1.8-7.1), shop assistants (OR, 2.9; 95% CI, 1.2-6.8), construction workers (OR, 2.7; 95% CI, 1.7-4.1), mechanics (OR, 2.1; 95% CI, 1.3-3.4), and professional drivers (OR, 2.6; 95% CI, 1.2-5.9). CONCLUSIONS: In conclusion, our results demonstrated that rubber accelerators have an important role in allergic contact dermatitis in the northeast of Italy and their sensitization is associated significantly with occupations that wear gloves or use chemical substances. Between rubber accelerators tested, carbamates sensitization is prevalent and increasing during considered years.

BackgroundAllergic contact dermatitis caused by p-phenylenediamine (PPD) is common among all age groups and both sexes. Monitoring of prevalence and intensity of sensitization is important. ObjectiveTo evaluate contact allergy to PPD in Europe, and to compare reaction intensities in different European regions. MethodsData collected by the European Surveillance System on Contact Allergies (ESSCA) network between 2002 and 2012 from 12 European countries were analysed regarding prevalence, grading of positive reactions to PPD, and relevance. ResultsA total of 99926 PPD-positive patients from 63 departments were included for analysis. The overall (2002-2012) prevalence of PPD sensitization in Europe is approximate to 4%. Stratified for country, the highest overall standardized prevalence was found in Lithuania, and the lowest in Slovenia. The prevalence of PPD sensitization did not decline over the years. In the southern European countries, higher numbers of strong and extremely strong reactions were registered. The clinical relevance of PPD sensitization varied from half to three-quarters. ConclusionThe prevalence of PPD sensitization has not changed over time. Strong and extremely strong patch test reactions are seen more often in the South, probably because of the higher number of PPD-containing hair dye products.

Background: Exposure to nickel, cobalt and chromate are important causes of occupational contact dermatitis. Objectives: To estimate the prevalence of nickel, cobalt and chromate allergy in a population of consecutive patients and to investigate the possible association with individual and occupational risk factors. Patients/Methods: A total of 14 464 patients (67.6% women and 32.4% men) with suspected allergic dermatitis underwent patch tests. The associations between patch test results and occupations were studied by multivariate logistic regression analysis. Results: About 24.6% of the patients reacted positively to nickel sulphate, 10.2% to cobalt chloride and 8.7% to potassium dichromate. Nickel sensitization was higher in women aged 26–35 years in comparison with the youngest group (15–25 years) and the older group (> 45 years). In women, the prevalence of positive reactions to nickel was positively associated with metal and mechanical work (OR 1.54; 95%, CI 1.16–2.05). Chromate sensitization was more prevalent in building trade workers for both women (OR 1.58; 95% CI 1.00–2.49) and men (OR 2.24; 95% CI 1.55–3.22). Cobalt sensitization was associated with textile and leather work in women (OR 1.52; 95% CI 1.09–2.12) and with cleaning work in men (OR 1.86; 95% CI 1.18–2.93). Conclusions: Our study showed interesting associations between some occupations and nickel, chromate and cobalt allergy.

BACKGROUND: One of the main health concerns of epoxy resins is their role as skin sensitizer. This sensitization is not uncommon, because the prevalence ranges around 1-12% of the general population. OBJECTIVES: Perform a cross sectional study in a patch test population from Northeastern Italy to investigate the prevalence of epoxy resins sensitization among patients with suspected contact dermatitis. Subsequently, relate findings to patients' occupation and evaluate time trend of prevalence. METHODS: The final study database included 19 088 consecutive patients, tested from 1996 to 2010 in Northeastern Italy. RESULTS: The overall prevalence of epoxy resins sensitization was 0·89%. Dermatitis most frequently involved hands (40·25%). In both sexes, we find a significant correlation in mechanics, woodworkers, and chemical industry workers; and in males only, among farmers and fishers, construction workers, and unemployed. We found significant increase of sensitization in construction workers in the analyzed period. CONCLUSIONS: The overall prevalence of sensitization to epoxy resins in Northeastern Italy is in line with other European countries, but we found an increased risk of sensitization in some professions and an increasing trend of prevalence in construction workers. Better preventive actions are strongly advised in higher risk professions, with particular attentions towards building sector.

BACKGROUND: Primin is the main contact allergen found in the ornamental plant Primula obconica Hance. OBJECTIVE: To analyse the temporal trend of sensitivity to primin in north-eastern Italy and to evaluate the associations with occupations in our geographical area. METHODOLOGY: From 1996 to 2012, 24 052 consecutive patients with suspected allergic contact dermatitis were patch tested in north-eastern Italy. Individual characteristics were collected through a standardized questionnaire in eight departments of dermatology or occupational medicine. RESULTS: The overall prevalence of primin sensitization was 1.9%; the prevalence was significantly higher in women (2.6%) than in men (0.5%). The Pordenone area had the higher prevalence of sensitization, which reached 6% in 1999-2001. We found a significant association between primin sensitization and household workers [odds ratio (OR) 2.3; 95% confidence interval (CI): 1.61-3.35], retired people (OR 1.8; 95%CI: 1.22-2.81), woodworkers (OR 2.1; 95%CI: 1.10-6.18), and chemical industry workers (OR 2.9; 95%CI: 1.05-8.29). CONCLUSION: Our study showed that contact allergy to primin is still relevant in north-eastern Italy. The frequency of sensitization is decreasing, but for retired and household workers it is still >4%. Our results suggest the need to promote the use of primin-free P. obconica in Italy.

Human data on dermal absorption of silver under “in use” scenario are scarce which hampers health risk assessment. The main objective of the present study was to determine percutaneous penetration of silver after dermal exposure to silver containing garment in healthy individuals and atopic dermatitis (AD) patients. Next to assess pro-inflammatory effect of silver in the skin. Healthy subjects (n = 15) and patients with AD (n = 15) wore a sleeve containing 3.6% (w/w) silver on their lower arms for 8 h during 5 consecutive days. The percutaneous penetration parameters were deduced from the silver concentration-depth profiles in the stratum corneum (SC) collected by adhesive tapes. Furthermore, silver was measured in urine samples collected before and after exposure. Inflammatory response was assessed by measuring IL-1a and IL- 1RA in the exposed and non-exposed skin sites. Dermal flux of silver in healthy subjects and AD patients was respectively 0.23 and 0.20 ng/cm2/h. The urine silver concentrations showed no increase after exposure. Furthermore, exposure to silver did not lead to the changes in the profiles of IL-1a and IL-1RA. Dermal absorption of silver under “real life scenario” was lower than the current reference dose. Furthermore, dermal exposure did not lead to altered expression of inflammatory IL-1 cytokines in the skin.

BACKGROUND: Occupational contact dermatitis is one of the most common occupational diseases in Europe. In order to develop effective preventive measures, detailed and up-to-date data on the incidence, main causes and professions at risk of occupational contact dermatitis are needed. OBJECTIVES: To describe the pattern of patch test reactivity to allergens in the European baseline series of patients with occupational contact dermatitis in different occupations. METHODS: We analysed data collected by the European Surveillance System on Contact Allergy (ESSCA) network from 2002 to 2010, from 11 European countries. RESULTS: Allergens in the European baseline series associated with an at least doubled risk of occupational contact dermatitis include: thiuram rubber chemical accelerators, epoxy resin, and the antimicrobials methylchloroisothiazolinone/methylisothiazolinone, methyldibromo glutaronitrile, and formaldehyde. The highest risk of occupational contact dermatitis was found in occupations classified as 'other personal services workers', which includes hairdressers, nursing and other healthcare professionals, precision workers in metal and related materials, and blacksmiths, tool-makers and related trades workers. CONCLUSIONS: In the planning and implementation of measures aimed at preventing occupational contact dermatitis, the focus should be on the identified high-risk occupational groups and the most common occupational allergies.

Laboratory animal allergy (LAA) is frequent in exposed workers despite working conditions and exposure to these allergens having improved over the last decade. The aim of this study was to assess LAA in students and workers in a research facility within the framework of a prevention programme.Students and researchers working with laboratory animals underwent medical surveillance every year from 2001 to 2012. They filled in a standardized questionnaire for the assessment of allergic respiratory symptoms and exposure conditions. Skin prick tests with common allergens, latex and hair extract from laboratory animals were performed at the first control and after three years of exposure.198 women and 120 men with a mean age of 29.1 +/- 7.3 years and a work seniority of 3.1 +/- 6.5 years participated in the study. Sensitization to laboratory animals ranged between 11.8 and 14.8% according to work seniority. Sixteen subjects (5%) reported asthma and 25 (7.9%) rhinitis when working with laboratory animals. LAA was associated with the female gender (OR 3.1; IC 95% 2.3-5.8), with atopy by prick test (OR 7.0; IC 95% 2.9-16.9), and with sensitization to laboratory animals (OR 2.7; IC 95% 1.1-6.7).This study revealed a low level of sensitization and symptoms of allergy to laboratory animals as a result of the preventive measures adopted to reduce exposure, but there is nonetheless a need to improve prevention so as to completely avoid the onset of LAA in students and workers.

OBJECTIVES: To assess the incidence of sensitization and gloves-related symptoms in 10-year follow-up in a group of health care workers (9,660 person-years) using non-powdered latex gloves from 2000 to 2009 and to examine related factors. MATERIALS AND METHODS: We studied 2,053 health care workers in Trieste Hospitals by means of skin prick test for latex extract, patch tests and medical examinations. We report the incidence of latex sensitization among workers using non-powdered latex gloves. RESULTS: The incidence of latex sensitization, rhinitis, asthma, urticaria, irritant and allergic contact dermatitis were 1.0; 0.12; 0.21; 0.72; 2.39 and 2.50 cases per 1,000 person-years, respectively. Respiratory symptoms and urticaria were positively related with latex sensitization (OR = 8.0; 95 % CL 1.27-48.6), with common allergic respiratory symptoms (OR = 4.19; 95 % CL 1.04-16.8) and with familial atopy (OR = 4.47; 95 % CL 1.1-17.9). CONCLUSION: The incidence of latex sensitization and latex-related symptoms were very low but subjects with allergic symptoms related to common allergens are at higher risk. The use of non-latex gloves is suggested for them.

BACKGROUND: Cosensitization to nickel, cobalt and chromium occurs in the general population and in some occupational groups. OBJECTIVES: To estimate the isolated and concurrent occurrence of nickel, cobalt and chromium contact sensitization and their association with individual and occupational risk factors. PATIENTS/METHODS: Twelve thousand four hundred and ninety-two patients were patch tested with the European baseline series between 1997 and 2004 in north-eastern Italy. The associations between patch test results and patient characteristics and occupations were investigated by means of multinomial logistic regression analysis. RESULTS: Of the patients, 34.7% (4334 patients) had one or more positive patch test reactions to metals. As compared with those with negative reactions to all three metals, nickel sensitization was significantly higher in females than in males, not only as monosensitization, but also as cosensitization with cobalt, with chromium, or with both metals. Building and related trades workers showed positive reactions to chromium + nickel [odds ratio (OR) 1.99; 95% confidence interval (CI) 1.05-3.76) and chromium + cobalt (OR 2.61; 95% CI 1.46-4.67]. Cleaning workers showed a high prevalence of nickel, chromium, nickel + chromium and nickel + cobalt + chromium cosensitization (ORs 1.29, 1.66, 2.11, and 1.79, respectively). An excess risk for cosensitization to all three metals was found in textile and leather workers (OR 2.19; 95% CI 1.10-4.33), and in bartenders (OR 2.10; 95% CI 1.03-4.26). CONCLUSIONS: Some occupational groups are more likely to develop nickel, cobalt and chromium cosensitization.

Salivary cortisol offers a novel approach to understand the relationship between psychosocial environment and health. This study examines the intra-individual relationships among indicators of the cortisol circadian rhythm and investigates the influence of determinants affecting the day-to-day variability of the cortisol measures. Over three weekdays, 87 healthy subjects (63 females and 24 males) collected saliva samples at seven time points to assess the cortisol awakening response (CAR), and to evaluate the post morning cortisol profile. The generalized estimating equations method was used to explore the relations between repeated cortisol measures and potential determinants (sociodemographic, health, and sampling factors) influencing salivary cortisol levels. Younger age, being smoker, and sampling on a working day were associated with higher at awakening and total cortisol excretion in the morning period. Higher overall cortisol excretion and cortisol increase in the first hour of the day were found for adherents to sampling procedure. Higher educational level was found associated with greater total cortisol excretion in the morning and post morning period, while a flatter diurnal slope was found in smokers. Results are consistent with the knowledge that the circadian cortisol rhythm is differentially determined by situational factors and that results obtained in the early morning hour are of crucial importance corroborating the evidence that the CAR is a highly state-dependent phenomenon. These data indicate that many confounding factors need to be controlled when using salivary cortisol as biomarker of the mind-health interrelationship.

Background. Sensitization to nickel, cobalt and chromium is frequent in patch test populations. The prevalence is affected by geographical and socio-cultural factors. Objectives. To investigate the temporal trend of nickel, cobalt and chromium contact sensitization between 1996 and 2010 in north-eastern Italy. Patients/methods. Nineteen thousand and eighty-eight patients (67.2% women and 32.8% men) with suspected allergic dermatitis underwent patch testing with the European baseline series. The associations between nickel, cobalt and chromium sensitization and patient age (in quintiles) and year of patch testing were investigated by means of multivariate logistic regression analysis. Results. The prevalence of nickel sensitization decreased significantly among younger women (≤26 years), from 38.3% (1996–1998) to 31.9% (2002–2004), 28.3% (2005–2007) and 29.0% (2008–2010), whereas an increase was observed in the 36–45-year and 46–58-year age groups. The overall prevalence of chromium sensitization dropped from 10.2% (1996–1998) to 4.6% (2008–2010) among women, and from 11.3% (1996–1998) to 5.9% (2008–2010) among men. The prevalence of cobalt sensitization increased among younger men (≤26 years), from 2.7% (1996–1998) to 7.3% (1999–2001), 9.6% (2002–2004), and 6.6% (2005–2007). Conclusions. Our study showed a decreasing trend of nickel sensitization (only among younger women) and of chromium sensitization in both sexes.

Job satisfaction and work ability are important in the nursing profession to ensure good working conditions and to reduce work-related diseases and illness. Psychosocial factors such as social support and decision latitude (autonomy) could have a role in cardiovascular diseases, low back pain, injuries and sick leave.To evaluate work ability, job satisfaction, psychosocial factors and diseases in 10 departments of the Monfalcone Hospital.The Work Ability Index (WAI) questionnaire and Karasek Job Content Questionnaire with other questions related to working conditions and diseases were administered to 160 nurses working in 10 departments. The response rate was 90%. SPSS Statistic packaging was used for statistical analysis.The study population had a mean age of 41.1 ± 7 years and the majority were female (81.25%). WAI gave a rating of over 37 points (good and excellent) for 86.4%, with an average of 39.9 ± 5.9 in women and 40.6 ± 6.4 in men. The WAI differences between the departments were significant with Medicine and Surgery showing lower values (p=0.012). WAI was significantly lower in subjects with sick leave higher than 10 days per year (p=0.000) and in subjects with cardiovascular diseases (p=0.031).Our study showed very good working conditions for nurses. A follow-up of the analyzed population over time will add further information on this aspect.

Summary Background. p-Phenylenediamine (PPD) is an extreme delayed-type skin sensitizer, and is relevant in both occupational and non-occupational exposures. Objectives. To estimate the prevalence of PPD sensitization in a population of consecutive patients with suspected allergic contact dermatitis who attended units of dermatology or occupational medicine in north-eastern Italy and to investigate the association between their PPD sensitization and occupation. Patients/Materials/Methods. A total of 14 464 patients (67.6% women and 32.4% men) with suspected allergic dermatitis underwent patch testing. The associations between patch test results and occupations were studied by multivariate logistic regression analysis. Results. In both sexes, PPD sensitization was significantly associated with hairdressing and beauty occupation [women, odds ratio (OR) 6.58, 95% confidence interval (CI) 3.76–11.50; men, OR 22.3, 95% CI 4.18–119]. In the female group, PPD sensitization was also significantly higher in professional drivers (OR 5.31, 95% CI 1.76–16.1), barmaids (OR 1.89, 95% CI 1.04–3.44), and cleaners (OR 1.82, 95% CI 1.24–2.68). In the male group, PPD sensitization was significantly higher in bakers and waiters (OR 13.0, 95% CI 1.38–123), household workers (OR 8.46, 95% CI 1.68–42.8), and printers (OR 5.68, 95% CI 1.50–21.5). Conclusions. Our study showed that workers in several occupations may be at higher risk of developing sensitization to PPD. It is of importance to reduce possible exposure to PPD-crossreacting substances in these occupations.

OBJECTIVES: To examine the association between two job stress models-the job strain (JDC) and the effort-reward imbalance (ERI) model-and ambulatory blood pressure monitoring in call handler operators. METHODS: Participants included 74 women (age, 34.9 ± 9.9 years) and 26 men (age 36.0 ± 10.8 years) who were monitored on 2 workdays for ambulatory blood pressure. Measures of both job stress models were related to blood pressure by the generalized estimating equations (GEE) method while adjusting for potential confounders (gender, age, cigarette smoking, alcohol consumption, educational level, marital status, time of day, and work schedule). RESULTS: Workshifts were associated with an increase of 3-4 and 14 mmHg in mean arterial pressure (MAP) compared with diurnal activities out of work and sleeping period, respectively (P < 0.001). Ambulatory blood pressure was also significantly related with work schedule preference: unpleasant work schedule was associated with an increase of 2 mmHg in MAP compared with pleasant work schedule (P = 0.013). In the ERI model, subjects scoring high in work stress have higher ambulatory blood pressure at work, at home, and during sleep. Work stress by time interaction was not longer significant when controlling for potential confounders: generalized estimating equations revealed that MAP was influenced by BMI (>25 vs.

The bioavailability of metals, which are known as important contact allergens, is decisive for the development and the maintenance of contact dermatitis. The aim of this study was to evaluate the percutaneous penetration of metal powders of cobalt (Co), nickel (Ni) and chromium (Cr) and the effect of skin lesions on skin absorption. In vitro permeation experiments were performed using the Franz diffusion cells with intact and damaged human skin. Physiological solution was used as receiving phase and metal powders (Co, Ni and Cr) dispersed in synthetic sweat at pH 4.5 were applied as donor phase to the outer surface of the skin for 24h. The amount of each metal permeating the skin was analysed by electro-thermal atomic absorption spectroscopy (ETAAS). Donor solution analysis demonstrated that metals were present as ions. Measurements of metals skin content were also exploited. Median Co and Ni concentrations found in the receiving phase were significantly higher when Co and Ni powders were applied on the abraded skin than after application on the intact skin (3566 and 2631ngcm(-2) vs. 8.4 and 31ngcm(-2), respectively). No significant difference was found in Cr permeation through intact and damaged skin. The measurement of metals skin content showed that Co, Ni and Cr concentrations were significantly higher in the damaged skin than in the intact skin. Co and Ni ions concentrations increased significantly when the donor solutions were applied on the damaged skin, while Cr ions concentrations did not increase. This study demonstrated that Co and Ni powders can permeate through damaged skin more easily than Cr powder, which has probably a stronger skin proteins binding capacity. Therefore, our results suggest that is necessary to prevent skin contamination when using toxic substances because a small injury to the skin barrier can significantly increase skin absorption.

Background Experimental and clinical evidence suggest that stress can lead to ill-health through the disregulation of the hypothalamic–pituitary–adrenal (HPA) axis. Studies to date have produced equivocal results likely due to different methodologies and failure to account for confounding factors. This investigation aimed to assess the relation between self-reported work-related stressors and salivary cortisol and to clarify the role of the potential confounders. Methods Thirty-six call-handlers completed a self-administered job content questionnaire and collected seven daily salivary samples on two workdays and a weekend. The diurnal salivary cortisol output was expressed as cortisol awakening response (CAR), and cortisol output in the rest of the day. Salivary cortisol data were normalized by means of square root transformation. The generalized estimating equations method was used to assess the relation between job strain and cortisol levels after adjusting for gender, weekdays and adherence to the sampling schedule. Results Job strain significantly influenced the total amount of cortisol response to waking (high strain vs. low strain: 1.1 (0.3–2.0) nmol/L). The cortisol response to waking showed gender-specific differences [women excreting greater cortisol than men: 1.1 (0.3–1.9) nmol/L], and weekday differences [workdays vs. weekend: 1.0 (0.3–1.6) nmol/L]. Noncompliance with the sampling protocol was associated with lower salivary cortisol than in adherent subjects. Conclusions Our results provide further evidence for the HPA axis involvement in the physiological response to work stress. The measure of the CAR showed to be the sensitive index to assess the physiological response to psychosocial factors. Gender, weekday, and protocol compliance were confounding factors. Am. J. Ind. Med. 52:251–260, 2009. 2008 Wiley-Liss, Inc.

To investigate the association between two job stress models—the job demand-control model and the effort-reward imbalance model—and repeated measures of salivary cortisol among male and female call-centre operators. Daily cortisol profiles consisting of seven time points were measured across two workdays and one leisure day to determine the cortisol awakening response and the cortisol output in the day in 104 volunteers. The employees completed two self-administered questionnaire—the Karasek’s demand-control questionnaire and the Siegrist’s effort-reward imbalance questionnaire—to assess psychosocial hazards at work. The relations between the perceived workload measures and salivary cortisol levels were analyzed by means of generalized estimating equations method after adjusting for potential confounders (gender, age, educational level, marital status, morning awakening time, sleep duration and quality, weekdays, work schedule, adherence to sampling procedure). The total cortisol amount excreted in the awakening period was positively associated with the job strain measures (high strain vs. low strain: 1.4 (2.4–0.3) nmol/l). In contrast, individuals scoring higher in effort-reward imbalance at work had both lower cortisol awakening response (high imbalance vs. low imbalance: −0.7 (−1.3 to −0.2) nmol/l) and lower diurnal secretory activity (−9.2 (−17.7 to −0.7) nmol/l). Gender, weekday and adherence to sampling schedule significantly influenced the cortisol excretion in the morning period. Our results indicate that the two work stress models differentially affect salivary cortisol output. This finding suggests that combining the information from two complementary job stress models results in improved knowledge on the psychobiological correlates of the psychosocial work environment.

The present study tried to investigate, using a synthetic sweat at pH 4.5, whether metallic chromium can pass through the skin (in vitro) and the effect of rapid skin decontamination with a common detergent. A suspension of chromium powder in synthetic sweat at pH 4.5 was prepared and shaken with a stirring plate at room temperature for 30 min. Human skin membranes were set up in Franz-diffusion cells and 1 ml of the freshly made suspension was applied to the outer surface of the skin for 24h. The tests were performed without and with decontamination using the cleanser 30 min after the start of exposure. The appearance of metal ions in the aqueous receptor phase was quantified by Electro Thermal Atomic Absorption Spectroscopy (ETAAS) and Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES). Speciation analysis and measurements of chromium skin content were also performed. Chromium skin permeation was demonstrated in in vitro experiments using the Franz cell system, giving a permeation flux of 0.84+/-0.25 ng cm(-2)h(-1) and a lag time of 1.1+/-0.7h. The cleaning procedure stop Cr permeation but its concentration into the skin significantly increased (Mann-Whitney U test P

Polycyclic aromatic hydrocarbons have mutagenic and carcinogenic properties and some of them are classified as probable or possible human carcinogens. Aim of this study was to evaluate the genotoxic risk in workers exposed to diesel exaust. Environmental and biological monitoring exposure to polycyclic aromatic hydrocarbons was carried out on fifty-two workers exposed to diesel exhaust. Urinary 1-hydroxypyrene was employed as a biomarker of internal dose. Significant urinary 1-hydroxypyrene differences between smokers and non-smokers were found. Twenty per cent of urinary 1-hydroxypyrene values exceeded benchmark level for genotoxic effect, while the results of environmental monitoring excluded the existence of exposure to polycyclic aromatic hydrocarbons. In the absence of greater knowledge about the relationship between urinary 1-hydroxypyrene and genotoxic effects under the conditions of very low exposure, extreme caution is recommended when this biomarker of internal dose is employed as an indicator of genotoxic risk. Toxicology and Industrial Health 2007; 23: 55—59.

Health care workers are exposed to many agents that can cause irritant or allergic contact dermatitis. In nurses with eczema of the hands latex sensitivity can play an important role in the occurrence of urticaria, rhinitis and asthma.To determine the prevalence of irritant and allergic contact dermatitis and contact urticaria and the role of skin sensitization to common and occupational haptens and allergens in a group of health care workers with skin problems.Retrospective review of 204 health care workers assessed by prick and patch testing in an occupational health clinic.The diagnoses included 35.3% with irritant contact dermatitis, 64.7% with allergic contact dermatitis and 7.3% with contact urticaria to latex. Three workers complained of asthma and 5 complained of rhinitis related to latex sensitization. At present 12.9% of atopic subjects were sensitized to latex by skin prick against 21.9% in 1998, so sensitization showed a decline in the years considered.Contact dermatitis and sensitization to natural rubber latex is a significant problem and nurses should be tested for both types of hypersensitivity, as well as being patch tested to standard, rubber and disinfectants series. The need is stressed for preventive measures to prevent the onset of contact dermatitis and to avoid latex exposure.