Occupational Contact Dermatitis

By Dr. Lizbeth Dosal Salgado

Overview

Occupational contact dermatitis is one of the most common occupational diseases in clinical practice. Its prevalence varies depending on work activities and types of exposure. Its origin can be irritating or allergic. Its risk factors include atopy and frequent hand washing or wet jobs, with controversial evidence for factors such as sex, tobacco use, among others. It has been associated with a decrease in labor productivity, absenteeism and changes in occupation, as well as significant decreases in the quality of life of patients. Prevention is fundamentally based on education and limiting exposure. These strategies are shared with treatment, to which is added the use of drugs such as topical steroids and calcineurin inhibitors. The great diversity of tasks, jobs, and work activities with exposure to substances that can cause skin diseases in exposed workers, as well as the large number of agents present in the workplace capable of producing them.

Definition

Occupational contact dermatitis is defined as an inflammatory process of the skin evoked as a result of exposure to an exogenous agent, it is generally classified into irritant contact dermatitis (INN) and allergic contact dermatitis (ACD). In the occupational field, the exogenous agent is one that is found in the work environment.

Current Status

The prevalence is estimated between 4% and 37% of workers, with an incidence of 5.5 cases per 1,000 people per year. Among the most affected jobs are health workers, with an estimated prevalence of the disease that varies between 21.1% and 70.6%, followed by cleaning services (64%), jobs in that there is food handling (10% to 34%), workers in metal industries (30%), textile workers (24%), and stylists or cosmetologists (6.8% to 21%).

Results

The most frequently affected sites are the hands (65% to 70% of the cases) and secondly the wrists, followed by the arms (18% to 30% of the cases), face (15.6%) and legs (12 %). However, the exact location of the lesions will depend significantly on the characteristics of the exposure. The most frequently found lesion is lichenification in 98.8% of patients, followed by erythema in 95.8% of cases and scabs in 70%.

Conclusions

In my experience with employees of different companies of the Business Medical Service, dermal injuries are very frequent in the daily consultation since in the work environment there are different agents that can cause different reactions. Because employees use their hands to perform different tasks, they are exposed to these agents, therefore the hands are the main route of direct contact. It is important that employees are aware of the agents to which they are exposed to take the necessary safety measures and that this type of injury is avoided.

Bibliography

Bustos, C. (2013). Dermatitis, an approach from occupational medicine. Medwave, 13, 45-56.

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