Search

A survey is given of the actual causes of occupational dermatoses and the variation in their incidence in a series of 4,529 patients seen at the out-patient clinic for skin diseases in the Institute of Occupational Health, Helsinki, and its precursor, during the 27-year period from 1946 to 1972. The overall incidence was highest for alkalis and detergents, cement, oil of turpentine and other solvents. Due to the increased use of synthetic resins in recent years a rise was seen in the frequency of eczema caused by these substances. Nevertheless, eczema due to rubber chemicals has also increased. The decreased incidence of turpentine eczema reflects its reduced use. In 45% of the cases the diagnosis was verified by positive epicutaneous tests. Of the 8,057 patients admitted because of a suspected occupational skin disorder, a non-occupational skin disease was diagnosed or the occupational origin remained unproved in 3,528 cases. The most important differential diagnoses and the differences in the location of the skin changes in the non-occupational as compared with the occupational group are discussed.

A follow-up study was performed of the medical and social condition of 164 patients with an occupational allergic contact dermatitis. A change of work did not always lead to an improvement of the dermatitis. A number of patients improved without changing their job. It is suggested that a change of occupation can only be advised to these patients if the causal allergen can be avoided completely by doing so and only by doing so; at the same time one must reckon with other aetiologic factors and the social situation after change of work. Moreover it is pointed out that patients who changed their occupation did hardly use the possibilities, created by the Dutch law, to obtain expert advice or to be retrained for another job at the expense of the community.