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Background: Occupational contact dermatitis (OCD) is a prevalent, often chronic disease that poses a risk for job loss and decreased quality of life. In Germany, a multi‐step prevention programme emphasising early detection and highly specialised multidisciplinary treatment has been implemented with great success. Objectives: To examine the effectiveness of a Danish‐adapted version of the German prevention effort on OCD severity, quality of life and occupational consequences at 3‐month follow‐up. Methods: Randomised, controlled trial. Participants were recruited after the first referral from General Practitioner to Dermatologist with suspected OCD. The intervention group (IG) received a Danish‐adapted, multidisciplinary intervention, while the control group (CG) navigated the Danish healthcare system without interference from the study. OCD severity, occupational consequences and quality of life were assessed at 3‐month follow‐up using self‐reported questionnaires. Results: A statistically significant decrease in the severity of eczema was found at 3‐month follow‐up in the IG compared to the CG. The IG were statistically significantly more likely to have seen a dermatologist at 3‐month follow‐up. Higher treatment level in the IG was indicated by the results but was not statistically significant. No significant difference was found in quality of life or occupational consequences. Conclusions: These initial findings suggest that early and specialised treatment of OCD improves OCD prognosis. [ABSTRACT FROM AUTHOR]

Background: Occupational contact dermatitis (OCD) is a common occupational disease. Atopic dermatitis (AD) is a known risk factor for OCD. Objectives: To determine the prevalence of previously diagnosed AD among young workers with recognized OCD and assess its impact on OCD prognosis. Methods: A retrospective cohort study. A questionnaire was sent to 6251 workers with recognized OCD who were under 35 years at notification (response rate: 47%). Of the respondents, 2392 answered a question about previous doctor‐diagnosed AD and were included in the study. Eczema severity, occupational consequences and quality of life were examined using statistical analyses comparing workers with and without previously diagnosed AD. Results: The prevalence of previously diagnosed AD was 41.8% (95% CI: 39.8–43.8). Women had a higher AD prevalence, and workers with AD reported OCD at a younger age. Workers with AD reported more frequent and severe eczema symptoms and had a higher risk of OCD negatively affecting job and occupation choices. Health‐related quality of life was more adversely affected in workers with AD. Conclusions: AD significantly impacts severity and has long‐term consequences for young people with OCD. Targeted prevention strategies need to be developed. [ABSTRACT FROM AUTHOR]

Background: Compliance with glove use and safe work practices are important factors in primary prevention of occupational hand eczema (OHE) in hairdressers. Objective: To assess the risk OHE and compliance with skin protective measures in hairdressers trained before and after implementation of a nationwide skin protection program in Danish hairdressing vocational schools in 2011. Methods: A repeated cross‐sectional study was performed. A questionnaire was sent in 2009 and 2020. The Danish Labour Market Supplementary Pension Scheme provided information on yearly payments from the hairdressing profession. Results: A response rate of 66.6% (305/460) was obtained in the 2009 survey and of 29.9% (363/1215) in the 2020 survey. The career time prevalence of OHE decreased from 42.8% to 29.0% (adjusted odds ratio 0.55 95% confidence interval [CI] 0.40‐0.77) and the incidence rate of OHE decreased from 57.5 (95%CI 48.4‐68.4) to 42.0 (95%CI 34.6‐50.9) per 1000 person years (incidence rate ratio 0.73 [95%CI 0.56‐0.95] between the two surveys). A statistically significant (P <.05) increase in glove use when doing wet‐work and when handling hair dyes, permanent wave solutions and bleaching products was observed in the 2020 compared to the 2009 survey. Conclusion: Our data suggest that skin protection training during apprenticeship reduces the risk of OHE in hairdressers. The lack of primary prevention of OHE in hairdressing vocational schools may be a missed opportunity in the prevention of the disease. [ABSTRACT FROM AUTHOR]

In Germany, a stepwise multidisciplinary approach has been established to prevent occupational skin diseases (OSDs), primarily occupational contact dermatitis. This review aims to perform a systematic evaluation of the short‐ and long‐term effects of the German secondary and tertiary individual prevention programmes (SIP and TIP, respectively) for OSDs. Primary outcomes were continuation of employment, severity of hand dermatitis, and quality of life (QoL). The PubMed and Embase databases were searched for studies reporting the effects of the SIP and TIP. A total of 19 studies encompassing 5527 patients with OSDs were included: 11 studies evaluated the SIP and 8 evaluated the TIP. Following the SIP, approximately 70% to 90% and 60% to 70% of patients remained in their occupation after 1 and 5 years, respectively. At 3 years after the TIP, 82.7% of patients remained in their occupation and exhibited a significant decrease in hand dermatitis severity, as well as an increase in QoL. Most of these studies were uncontrolled and the interventions, outcomes, and measurement instruments used were heterogeneous. The SIP and TIP lead to decreased disease severity, improved QoL, and enabled most patients to continue working in their chosen professions. Implementing a similar multidisciplinary approach across Europe may be beneficial. [ABSTRACT FROM AUTHOR]

Current cosmetic regulations primarily focus on protecting consumers, not the professional user who is subjected to a partly different, and certainly more intense exposure to hazardous substances. Against this background, this systematic review aims to compile and appraise evidence regarding skin toxicity of 2-hydroxyethyl methacrylate (HEMA; CAS no. 212-782-2) and ethyl cyanoacrylate (ECA; CAS no. 7085-85-0) contained in cosmetic glues used among hairdressers and beauticians who perform nail treatments and eyelash extension as well as hair extension applications. This systematic review followed the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) 2020 recommendations for reporting systematic reviews and meta-analysis. In total, six publications from six countries were eligible for this systematic review. A meta-analysis revealed that hairdressers and beauticians have a ninefold increased risk of developing contact allergy to HEMA compared with controls who are not hairdressers and beauticians. Results for ECA are lacking. The results of this systematic review clearly show that--regarding contact allergy to acrylates--it is not appropriate to apply risk assessment for consumers to hairdressers and beauticians who occupationally handle cosmetic glues. The regulations in existence do not adequately address occupational risks for hairdressers and beauticians connected with the use of acrylate-containing cosmetic substances and need reconsideration. [ABSTRACT FROM AUTHOR]

Hairdressers are at high risk of developing occupational hand eczema. Opinions on the health and safety concerns of nonfood consumer products, such as cosmetics and their ingredients, consider the exposure of a "common consumer," which may not account for occupational exposure of hairdressers. As a result, there is a parlous scenario in which serious safety concerns about occupational exposures are present. The purpose of this review is to compare the frequency of exposure to various types of hair cosmetic products among hairdressers and consumers. Database searches for this review yielded a total of 229 articles; 7 publications were ultimately included. The analysis showed that—dependent on the task—hairdressers were exposed 4 to 78 times more than consumers to a wide spectrum of hair cosmetic products used in their daily working life, ranging from shampoos, conditioners, oxidative and nonoxidative hair colors, to bleaching agents. The highest frequency was found for coloring hair with oxidative hair color. Consumer use frequency does not appear to be appropriate for representing hairdresser exposure. The current standards do not effectively address the occupational risks associated with hairdressers' use of cosmetics. The findings of this study should cause current risk‐assessment procedures to be reconsidered. [ABSTRACT FROM AUTHOR]

Objectives: To review recent epidemiological studies investigating carcinogenic or reprotoxic effects among hairdressers who seem to be at greater risk for systemic adverse effects of chemicals released from hair care products than consumers. Methods: A systematic review according to the PRISMA‐P guidelines was performed and included studies published from 2000 to August 2021, in which cancer or adverse reproductive effects were diagnosed in 1995 and onward. Data were synthetized qualitatively due to the small number of studies, heterogeneity of study designs, outcomes, and methods. Results: Four studies investigating cancer frequencies and six studies investigating effects on reproduction among hairdressers were identified. All were of good quality and with low risk of bias. Only one of the four studies found an increased risk of cancer reporting nine times higher odds for bladder cancer in hairdressers than the population‐based controls. Three other studies investigating bladder and lung cancer, and non‐Hodgins lymphoma did not find an increased risk in hairdressers. Regarding reprotoxic effects, numerous outcomes were investigated including menstrual disorders, congenital malformations, fetal loss, small‐for‐gestational age newborns, preterm delivery, and infertility. Increased risk was found for ventricular septal defect in newborns of fathers working as hairdressers. Furthermore, several indices of poor neonatal or maternal health were significantly associated with mothers working as hairdresser. Conclusions: Despite the scarce evidence that hairdressers are at increased risk of carcinogenic or reprotoxic effects related to their trade, such health risks cannot be ruled out. Therefore, preventive efforts to diminish occupational exposures to hairdressing chemicals should be targeted. [ABSTRACT FROM AUTHOR]

Background: Recent population‐based studies on the incidence rates (IRs) of occupational contact dermatitis (OCD) are sparse. Objectives: To determine the IRs of OCD and development thereof between 2007 and 2018 in known risk occupations. Methods: Data on all recognized cases of OCD were used to calculate IRs as the number of recognized OCD cases per 10 000 workers per year. Asymptotic chi‐square test was used to compare the IRs between 2007‐2012 and 2013‐2018. Results: The median age at notification of OCD was below 30 years for several of the examined occupations. Hairdressers and beauticians, bakers, dentists and dental assistants, and manufacturing of windmills had the highest overall IRs of OCD. We found a statistically significant increase in the IRs of OCD for child/nursery care workers. Conclusions: The median age at notification of OCD was low for several of the occupations, signifying the need for further preventive strategies among young people. Based on the IRs of OCD, future preventive efforts should be directed at hairdressers and beauticians, bakers, dentists and dental assistants, and manufacturing of windmills. Furthermore, the statistically significant increase in IRs of OCD among child/nursery care workers highlights the need for further preventive strategies in this field. [ABSTRACT FROM AUTHOR]

Background: Occupational contact dermatitis (OCD) is the most commonly recognized occupational disease in Denmark. Objectives: To examine the impact of recognized OCD on degree of employment, sick leave, unemployment, and job change. Methods: Data on all recognized individuals with OCD notified in Denmark between 2010 and 2015 (n = 8940) were linked to information on social transfer payments in the years before and after notification. The number of weeks on unemployment benefits or sick leave and the degree of employment during the 2 years prior to notification was compared with the 2 years following notification. Results: The degree of employment decreased on average 8.9 work‐hours/month, corresponding to an average annual loss of income per worker of approximately €1570. The average number of weeks that workers were receiving unemployment benefits and paid long‐term sick leave rose by 2.5 and 3.4 weeks, respectively, corresponding to an average additional annual cost per worker of approximately €420 and €770, respectively. Longer case‐processing time was significantly associated with lower degree of employment and higher levels of unemployment and sick leave. Conclusions: OCD has a significant negative impact on employment and economics, thus highlighting the need for a national, strategic action plan for effective prevention of OCD. [ABSTRACT FROM AUTHOR]

This study examined trends in prevalence of HEMA allergy as well as the characteristics of patients with contact allergy to HEMA. Because there was only one male patient with contact allergy to HEMA during the study period, we studied all female patients who were patch tested with HEMA between January 1, 2017 and July 1, 2019. GLO:FQV/01apr20:cod13439-fig-0001.jpg PHOTO (COLOR): A history of using UV nail polish in patch test HEMA-positive and HEMA-negative patients. [Extracted from the article]

Background Hairdressing is one of the professions with the highest risk of occupational skin and respiratory diseases. The incidence of these diseases in hairdressing apprentices has been studied only sparsely. Objective To determine the incidence of skin and respiratory diseases in hairdressing apprentices, and to explore whether hairdressing apprentices leave the trade during training because of these diseases. Methods A 3-year follow-up questionnaire study was conducted among 248 hairdressing apprentices and a control group comprising 816 young adults from the general population. Results The incidence rate ratios (IRRs) for contact urticaria (IRR 4.7, 95%CI: 2.6-8.6), hand eczema (IRR 1.7, 95%CI: 1.1-2.6) and rhinitis symptoms (IRR 1.6, 95%CI: 1.2-2.2) were significantly increased in the hairdressing apprentices, whereas wheezing was similar between groups. During the follow-up period, 21.8% of the hairdressing apprentices had left the trade, and 70.3% of these had left because of health complaints. The most frequently reported reasons for leaving were musculoskeletal pain (47.4%) and skin diseases (47.4%), followed by respiratory symptoms (23.7%). Conclusions Hairdressing apprentices are at increased risk for contact urticaria, hand eczema and rhinitis symptoms compared with the general population, and a substantial proportion leave the trade because of these diseases, causing a 'healthy worker survivor effect.' [ABSTRACT FROM AUTHOR]

Background Irritant contact dermatitis ( ICD) is a common diagnosis in patients with occupational contact dermatitis ( OCD). Studies are lacking on the usefulness of material safety data sheets ( MSDSs) in making the diagnosis of ICD. Objective To characterize irritant exposures leading to the diagnosis of occupational ICD ( OICD), and to evaluate the occurrence of concomitant exposures to contact allergens. Methods We included 316 patients with suspected occupational hand dermatitis, referred to the Department of Dermato- Allergology, Copenhagen University Hospital Gentofte, Denmark during January 2010- August 2011, in a programme consisting of a clinical examination, exposure assessment, and extensive patch/prick testing. Results OCD was diagnosed in 228 patients. Of these patients, 118 were diagnosed with OICD. The main irritant exposures identified were wet work (n = 64), gloves (n = 45), mechanical traumas (n = 19), and oils (n = 15). Exposure to specific irritant chemicals was found in 9 patients, and was identified from MSDSs/ingredients labelling in 8 of these patients. Review of MSDSs and ingredients labelling showed that 41 patients were exposed to 41 moderate to potent contact allergens, and 18 patients were exposed to 25 weak workplace contact allergens. Conclusion In the present study, the systematic exposure assessment did not reveal any new irritants. MSDSs have a limited role in the investigation of ICD. [ABSTRACT FROM AUTHOR]

Background The diagnosis of combined allergic and irritant contact dermatitis is an accepted subdiagnosis for hand dermatitis, and it is often considered in a patient with contact dermatitis, a positive and relevant patch test result, and wet work exposure. We therefore hypothesize that it is arbitrary for wet work exposure to be taken into consideration in a patient with newly diagnosed relevant contact allergy. Furthermore, an overestimation of the diagnosis will probably occur if the criteria for wet work exposure are applied correctly, as many occupations have an element of wet work. Objectives To find the statistically expected number of combined allergic and irritant contact dermatitis cases in 1000 patients, and to evaluate the diagnostic criteria for the diagnosis. Methods One thousand consecutive patients with occupational contact dermatitis from a hospital unit in Denmark were assessed. Results The expected number of cases with the diagnosis of combined allergic and irritant contact dermatitis was 0.33%, as compared with the observed number of 6.4%. Females occupied in wet occupations were often diagnosed with combined allergic and irritant contact dermatitis ( p < 0.005). Conclusion The diagnosis of combined allergic and irritant contact dermatitis should be used critically to avoid misclassification, and possible criteria for the diagnosis are proposed. [ABSTRACT FROM AUTHOR]

Background Blue-collar workers have a high risk of occupational contact dermatitis, but epidemiological studies are scarce. Objectives To investigate allergic contact dermatitis in blue-collar workers with dermatitis registered by the Danish Contact Dermatitis Group. Methods A retrospective analysis of patch test data from 1471 blue-collar workers and 1471 matched controls tested between 2003 and 2012 was performed. A logistic regression was used to test for associations. Results The blue-collar workers often had occupational hand dermatitis ( p < 0.001). Atopic dermatitis was less commonly observed among blue-collar workers (19.6%) than among controls (23.9%) ( p = 0.005). Allergens with a statistically significant association with the occupational group of blue-collar workers were epoxy resins, methyldibromo glutaronitrile, 2-bromo-2-nitro-1,3-propanediol, potassium dichromate, and methylchloroisothiazolinone ( MCI)/methylisothiazolinone ( MI). The following occupations were additionally identified as risk factors for contact sensitization to MCI/ MI and MI, epoxy resins, and potassium dichromate, respectively: painting, construction work, and tile setting/terrazzo work. Conclusion Contact allergy is a major problem among blue-collar workers. The data indicate a healthy worker effect among blue-collar workers diagnosed with dermatitis, as blue-collar workers were diagnosed significantly less often with atopic dermatitis than were controls. [ABSTRACT FROM AUTHOR]

Background In recent years, the prevalence of contact allergy to isothiazolinones has reached epidemic levels. Few studies have presented data on occupations at risk of developing contact allergy to isothiazolinones. Objectives To present demographics and examine risk factors for sensitization to methylisothiazolinone ( MI), methylchloroisothiazolinone ( MCI) in combination with MI and benzisothiazolinone ( BIT) in Danish dermatitis patients. Materials and methods A retrospective epidemiological analysis of data from three Danish hospitals departments was conducted. All patients consecutively patch tested with MI, MCI/ MI and BIT between 2009 and 2013 were included. Results MI contact allergy showed a significantly increased trend in prevalence from 1.8% in 2009 to 4.2% in 2012 ( p < 0.001). Females with facial dermatitis mainly drove the increase in 2012. Adjusted logistic regression analysis showed that MI sensitization was significantly associated with occupational exposures, hand and facial dermatitis, age > 40 years, and the occupational groups of tile setters/terrazzo workers, machine operators, and painters. MCI/ MI contact allergy was significantly associated with the following high-risk occupations: painting, welding (blacksmiths), machine operating, and cosmetology. The occupational group of painting was frequent in the group of patients with BIT contact allergy. Conclusion Several high-risk occupations for sensitization to isothiazolinones exist. Regulation on the allowed concentration of isothiazolinones, and especially MI, in both consumer products and industrial products is needed. [ABSTRACT FROM AUTHOR]

Background Information on the presence of contact allergens and irritants is crucial for the diagnosis of occupational contact dermatitis. Ingredient lists and Material Safety DataSheets ( MSDSs) may be incomplete. Objectives To evaluate the workability of a systematic exposure assessment in consecutive patients with suspected occupational contact dermatitis, and to study how it could potentially aid correct diagnostic classification. Methods A tool for systematic stepwise assessment of exposures in the work environment was developed, consisting of six steps spanning medical history and workplace visits. The programme included 228 consecutive patients diagnosed with occupational contact dermatitis; all patients underwent a clinical examination, the stepwise exposure assessment, and extensive patch and prick testing. Results Of the participants, 48.2% were classified as having occupational allergic contact dermatitis. The diagnosis was made at the stepwise exposure assessment for 50.0% of patients at Step 1 (medical history) and for 34.5% at Step 2 (ingredient labelling/ MSDS). We found 132 different occupational allergens of relevance to the patients' eczema, of these, 78.0% were allergens not included in the European baseline series. Conclusions Systematic stepwise exposure assessment provides information that results in the identification of occupational allergies caused by allergens not included in the European baseline series in a substantial number of patients. [ABSTRACT FROM AUTHOR]

The preservative methyldibromo glutaronitrile (MDBGN) has caused an epidemic of contact allergy in Europe. However, most data concerning contact allergy comes from hospital departments of dermatology. As a part of the primary health care sector, Danish dermatologists in private practice provide the front line of care for patients with skin diseases. Data from this source may therefore better reflect trends in the general population than material from hospital departments of dermatology. In this study, the frequency of MDBGN allergy and the characteristics of patients seen by dermatologists in private practice were studied. In 1 year, 2146 patients were patch tested by the participating dermatologists from 4 clinics in various parts of Denmark. 5% (110) had positive patch tests to MDBGN, with no difference between the sexes. After adjustment was made for other background variables, multivariate analysis using logistic regression showed a significant association between hand eczema and MDBGN allergy (OR 2.5,P < 0.001). In 53 cases (52.4%), the patch test reaction to MDBGN was judged to be of current relevance. Creams and lotions accounted for 31% of the identified causative products and liquid soaps for 23%. It is concluded that contact allergy to MDBGN is frequent among patients seen by dermatologists in private practice. This is consistent with results from hospital departments of dermatology in Europe and indicates a general trend and ongoing epidemic in the general population. The significant relationship between hand eczema and MDBGN allergy is of concern, and the finding that wash-off products, especially liquid soaps, play a significant role in MDBGN allergy calls for a revision of the safety assessment of MDBGN in wash-off products. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 38-year old atopic woman with occupational allergic contact dermatitis. She experienced episodes of vesicular hand eczema after she returned to work. It mentions that the repeated skin exposure to undisclosed methylisothiazolinone (MI) in wet wipes resulted to severe hand eczema.

The article discusses five cases of isothiazolinones-induced chronic dermatitis. The patients include a 47-year-old male who does not have a previous skin disease's history, a 35-year-old male whose patch test reaction to benzisothiazolinone (BIT) was positive, and a 42-year-old healthy female. It suggests that the cases reveal the increasing problem with isothiazolinones-induced contact allergy.

The article presents a case study of a 28-year-old woman with a history of atopic dermatitis presented with a one-year history of hand eczema involving the second to fourth fingers on both hands. Topics discussed include occupational exposure to methylisothiazolinone in adhesive labels; diagnostic patch testing for allergens; and exposure assessment of methylisothiazolinone in consumer products.

The article presents a case study of a small case series of frictional dermatitis caused by occupational paper and cardboard. The patients were diagnosed with primary hand eczema characterized by initial skin dryness, scaling, and fissures. The article also discusses history of atopic dermatitis, occupational hyperkeratoses, and disease susceptibility of shoemakers.

The article presents a case study of 48 year old non-atopic women, suffering from hand eczema and periorbital dermatitis. The article reports that a patch test was performed on patient and found that contact dermatitis was due to air borne thiuram exposure from latex gloves used in the occupation. The patient was advised to use accelerator free nitrile gloves after which she had not reported any complaint of hand eczema and periorbital dermatitis.

The article presents case study of a 21-year-old male gardener having 4-day history of widespread dermatitis, which proved to be due to being in contact with common ivy or Hedera helix. It discusses symptoms of the patient as well as various tests and their results which eventually found that it was an airborne contact dermatitis caused by common ivy. It is noted that it was first report of airborne elicitation of dermatitis caused by common ivy.