Workers in the printing industry serve as an example of a working population that is at high risk... more Workers in the printing industry serve as an example of a working population that is at high risk of developing occupational skin disease. Daily exposures include both irritants and sensitizing agents. While many substances have been associated with occupational contact dermatitis in this population, no detailed cases of allergic contact dermatitis (ACD) from propylene glycol (PG) have been reported to date. We present a case of a printing tradesman who developed work-related ACD from PG and who was subsequently able to return to work after a multidisciplinary team assessment that included a comprehensive worksite visit by a clinical occupational hygienist.
Isocyanates are widely used in the manufacturing of rigid and flexible foams, fibers, and coating... more Isocyanates are widely used in the manufacturing of rigid and flexible foams, fibers, and coatings such as paints, varnishes, and elastomers but are rarely reported as contact sensitizers. The aliphatic diisocyanate dicyclohexylmethane-4,4'-diisocyanate (DMDI) is known to be a strong cutaneous sensitizer. We report a 27-year-old woman who developed a severe eczematous eruption on the arms, trunk, and abdomen within 2 weeks of employment at a company using the product Chem-Dec 808 isocyanate (containing 40-70% weight per weight DMDI). Patch testing was performed with the North American screening series, an isocyanate series, and 1% Chem-Dec 808 isocyanate. At day 7, a +++ reaction to Chem-Dec 808 isocyanate and a ++ reaction to the aromatic isocyanate diphenylmethane-4,4'-diisocyanate were observed. DMDI has strong sensitizing potential and requires rigorous safety monitoring in the workplace.
Auto mechanics and machinists presenting with suspected allergic contact dermatitis (ACD) have tr... more Auto mechanics and machinists presenting with suspected allergic contact dermatitis (ACD) have traditionally been patch-tested with a standard screening tray and a specialty tray such as the Oil and Cooling Fluid Series. While this has proven useful for patch-testing the machinist, there is a need for the development of a more specific allergen testing tray for the auto mechanic. The objective of the study was to compare clinical features and patch-test results of auto mechanics and machinists with hand dermatitis to evaluate differences in allergen profiles. We performed a chart review of 33 auto mechanics and 24 machinists referred to our Occupational Contact Dermatitis Clinic from 2002 to 2005 for evaluation of hand dermatitis. With a panel of 84 allergens, 52 positive reactions were detected in 17 cases of ACD in mechanics. The profiles were different from the cases of ACD diagnosed in 10 of 24 machinists. Mechanics and machinists differ in the spectrum of occupational exposures. Patch testing with greater numbers of allergens likely identifies a larger proportion of mechanics with occupationally relevant ACD. Further study is needed to determine the most appropriate allergens to include in a clinically useful "mechanic's tray."
/ Thematic Poster Session / Monday, May 17/8:15 AM-4:00 PM / Area A, Hall G (First Level), B61 PU... more / Thematic Poster Session / Monday, May 17/8:15 AM-4:00 PM / Area A, Hall G (First Level), B61 PULMONARY REHABILITATION ... Preventative Practices In Occupational Asthma: An Educational Intervention In Farmers ... J. Kim , , IN Kudla , D. Van Dyk , A. Fulford , K. Mardell , T. ...
Contact dermatitis (CD) is the most common occupational skin disease and includes both irritant a... more Contact dermatitis (CD) is the most common occupational skin disease and includes both irritant and allergic forms (ICD and ACD). Smoking has been associated with all of CD, hand eczema and sensitisation in previous studies, but never explored in relation to work-related ACD and ICD specifically. This abstract describes differences in patients who have a work-related diagnosis of ICD, ACD or both ICD and ACD. Data from a study of patients with possible work-related skin or respiratory disease were used. Data included demographics, symptoms, smoking history and physician diagnoses. Differences between diagnosis groups (ICD, ACD, both) were investigated using chi square and ANOVA. In total 163 subjects were diagnosed with work-related CD. Of these, 44% were female, approximately half (51%) were ever smokers and 30% were atopic; the mean age was 44.9 years. ICD was diagnosed in 57% of subjects, ACD in 43% and both ICD and ACD in 14%. Current smoking was more common among subjects with ACD (40%) and those with both ACD and ICD (35%) compared to those with ICD (17%) (p = 0.02); no difference in pack-years was observed. The rate of smoking in this sample was similar to the Canadian population. Age, sex and atopy did not differ between diagnosis groups. Current smokers were more common among those with ACD and those with ACD and ICD. The mechanism by which smoking may be related to the development of allergic skin disease remains unclear (e.g., systemic inflammation, contact, behavioural differences) but deserves further attention.
Abstract Objective: Work-related asthma (WRA) is under-recognized and delays in recognition contr... more Abstract Objective: Work-related asthma (WRA) is under-recognized and delays in recognition contribute to long-term morbidity. The objective of the project was to develop a WRA screening questionnaire for use by primary care providers in the assessment of individuals with asthma, and to evaluate the respondent burden, test re-test reliability and face validity of the questionnaire. Methods: A literature search was undertaken and an expert advisory committee was convened. A questionnaire was drafted and assessed for feasibility of use and content validity. The study enrolled patients with asthma attending outpatient clinics and an asthma education center. Participants were asked to respond to the questionnaire on two occasions, and comment on the content (face validity) and ease of completion (respondent burden). Ethics approval was obtained from an institutional review board. Results: A 14-item self-administered screening questionnaire was created. Thirty-nine participants were recruited, and 26 participants completed a second administration of the questionnaire. The items on the relation of asthma symptoms to work demonstrated substantial agreement between testings. The workplace exposures items were found to have good reproducibility. The majority of participants denied that items were repetitive, not useful or difficult to understand. Conclusions: We have developed a WRA screening questionnaire designed to aid primary care providers in the recognition of possible WRA. The tool exhibited content and face validity, good test re-test reliability and low respondent burden. Participant feedback is being considered in revisions of the questionnaire.
Workers in the printing industry serve as an example of a working population that is at high risk... more Workers in the printing industry serve as an example of a working population that is at high risk of developing occupational skin disease. Daily exposures include both irritants and sensitizing agents. While many substances have been associated with occupational contact dermatitis in this population, no detailed cases of allergic contact dermatitis (ACD) from propylene glycol (PG) have been reported to date. We present a case of a printing tradesman who developed work-related ACD from PG and who was subsequently able to return to work after a multidisciplinary team assessment that included a comprehensive worksite visit by a clinical occupational hygienist.
Isocyanates are widely used in the manufacturing of rigid and flexible foams, fibers, and coating... more Isocyanates are widely used in the manufacturing of rigid and flexible foams, fibers, and coatings such as paints, varnishes, and elastomers but are rarely reported as contact sensitizers. The aliphatic diisocyanate dicyclohexylmethane-4,4'-diisocyanate (DMDI) is known to be a strong cutaneous sensitizer. We report a 27-year-old woman who developed a severe eczematous eruption on the arms, trunk, and abdomen within 2 weeks of employment at a company using the product Chem-Dec 808 isocyanate (containing 40-70% weight per weight DMDI). Patch testing was performed with the North American screening series, an isocyanate series, and 1% Chem-Dec 808 isocyanate. At day 7, a +++ reaction to Chem-Dec 808 isocyanate and a ++ reaction to the aromatic isocyanate diphenylmethane-4,4'-diisocyanate were observed. DMDI has strong sensitizing potential and requires rigorous safety monitoring in the workplace.
Auto mechanics and machinists presenting with suspected allergic contact dermatitis (ACD) have tr... more Auto mechanics and machinists presenting with suspected allergic contact dermatitis (ACD) have traditionally been patch-tested with a standard screening tray and a specialty tray such as the Oil and Cooling Fluid Series. While this has proven useful for patch-testing the machinist, there is a need for the development of a more specific allergen testing tray for the auto mechanic. The objective of the study was to compare clinical features and patch-test results of auto mechanics and machinists with hand dermatitis to evaluate differences in allergen profiles. We performed a chart review of 33 auto mechanics and 24 machinists referred to our Occupational Contact Dermatitis Clinic from 2002 to 2005 for evaluation of hand dermatitis. With a panel of 84 allergens, 52 positive reactions were detected in 17 cases of ACD in mechanics. The profiles were different from the cases of ACD diagnosed in 10 of 24 machinists. Mechanics and machinists differ in the spectrum of occupational exposures. Patch testing with greater numbers of allergens likely identifies a larger proportion of mechanics with occupationally relevant ACD. Further study is needed to determine the most appropriate allergens to include in a clinically useful "mechanic's tray."
/ Thematic Poster Session / Monday, May 17/8:15 AM-4:00 PM / Area A, Hall G (First Level), B61 PU... more / Thematic Poster Session / Monday, May 17/8:15 AM-4:00 PM / Area A, Hall G (First Level), B61 PULMONARY REHABILITATION ... Preventative Practices In Occupational Asthma: An Educational Intervention In Farmers ... J. Kim , , IN Kudla , D. Van Dyk , A. Fulford , K. Mardell , T. ...
Contact dermatitis (CD) is the most common occupational skin disease and includes both irritant a... more Contact dermatitis (CD) is the most common occupational skin disease and includes both irritant and allergic forms (ICD and ACD). Smoking has been associated with all of CD, hand eczema and sensitisation in previous studies, but never explored in relation to work-related ACD and ICD specifically. This abstract describes differences in patients who have a work-related diagnosis of ICD, ACD or both ICD and ACD. Data from a study of patients with possible work-related skin or respiratory disease were used. Data included demographics, symptoms, smoking history and physician diagnoses. Differences between diagnosis groups (ICD, ACD, both) were investigated using chi square and ANOVA. In total 163 subjects were diagnosed with work-related CD. Of these, 44% were female, approximately half (51%) were ever smokers and 30% were atopic; the mean age was 44.9 years. ICD was diagnosed in 57% of subjects, ACD in 43% and both ICD and ACD in 14%. Current smoking was more common among subjects with ACD (40%) and those with both ACD and ICD (35%) compared to those with ICD (17%) (p = 0.02); no difference in pack-years was observed. The rate of smoking in this sample was similar to the Canadian population. Age, sex and atopy did not differ between diagnosis groups. Current smokers were more common among those with ACD and those with ACD and ICD. The mechanism by which smoking may be related to the development of allergic skin disease remains unclear (e.g., systemic inflammation, contact, behavioural differences) but deserves further attention.
Abstract Objective: Work-related asthma (WRA) is under-recognized and delays in recognition contr... more Abstract Objective: Work-related asthma (WRA) is under-recognized and delays in recognition contribute to long-term morbidity. The objective of the project was to develop a WRA screening questionnaire for use by primary care providers in the assessment of individuals with asthma, and to evaluate the respondent burden, test re-test reliability and face validity of the questionnaire. Methods: A literature search was undertaken and an expert advisory committee was convened. A questionnaire was drafted and assessed for feasibility of use and content validity. The study enrolled patients with asthma attending outpatient clinics and an asthma education center. Participants were asked to respond to the questionnaire on two occasions, and comment on the content (face validity) and ease of completion (respondent burden). Ethics approval was obtained from an institutional review board. Results: A 14-item self-administered screening questionnaire was created. Thirty-nine participants were recruited, and 26 participants completed a second administration of the questionnaire. The items on the relation of asthma symptoms to work demonstrated substantial agreement between testings. The workplace exposures items were found to have good reproducibility. The majority of participants denied that items were repetitive, not useful or difficult to understand. Conclusions: We have developed a WRA screening questionnaire designed to aid primary care providers in the recognition of possible WRA. The tool exhibited content and face validity, good test re-test reliability and low respondent burden. Participant feedback is being considered in revisions of the questionnaire.
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