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Contact allergy to dental allergens is a well-studied subject, more so among dental professionals than dental patients. 1632 subjects had been patch tested to either the dental patient series or dental personnel series at the department of Occupational and Environmental Dermatology, Malmö, Sweden. Positive patch tests to (meth)acrylate allergens were seen in 2.3% (30/1322) of the dental patients and 5.8% (18/310) of the dental personnel. The most common allergen for both groups was 2-hydroxyethyl methacrylate (2-HEMA), followed by ethyleneglycol dimethacrylate (EGDMA), triethyleneglycol dimethacrylate, and methyl methacrylate. 47 (29 dental patients and 18 dental personnel) out of these 48 had positive patch tests to 2-HEMA. All 30 subjects who had a positive reaction to EGDMA had a simultaneous positive reaction to 2-HEMA. One dental patient reacted only to 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy) phenyl]propane (bis-GMA). From our data, screening for (meth)acrylate contact allergy with 2-HEMA alone would have picked up 96.7% (29/30) of our (meth)acrylate-allergic dental patients and 100% (18/18) of our (meth)acrylate-allergic dental personnel. The addition of bis-GMA in dental patients would increase the pick-up rate to 100%.

Background: Contact allergy to plastic gloves is rare. Benzisothiazolinone is a biocide that is mainly used in industrial settings. We first suspected delayed-type contact allergy to benzisothiazolinone from polyvinyl chloride (PVC) gloves in 2004. We looked through our medical records from 1991 to 2005 to find similar cases., Observations: We found a total of 8 patients who are allergic to benzisothiazolinone and who had had exacerbations of their hand dermatitis while using PVC gloves. Patch testing revealed that 3 of them had weak allergic or doubtful reactions to the glove materials. Six of them had used Evercare Soft, Medi-Point, or Derma Grip PVC gloves, which in chemical analysis were shown to contain 9 to 32 ppm of benzisothiazolinone. Seven of the patients worked in dentistry or health care and 1 in farming. All of them had had hand dermatitis for many years., Conclusions: To our knowledge, there have been no previous reports of contact allergy to antimicrobial agents in plastic gloves. Benzisothiazolinone is widely used as a biocide in the manufacture of disposable PVC gloves. Small amounts of benzisothiazolinone in the gloves may sensitize those who already have hand dermatitis. We recommend that all patients with hand dermatitis while using PVC gloves should be patch tested with benzisothiazolinone.

A group of industrial painters employed in 6 companies of the Norwegian oil industry was followed to assess the incidence of allergic contact dermatitis (ACD) caused by exposure to epoxy resin systems. The study lasted from 1 September 1997 to 31 August 2001 and included 2236 workers, contributing 5113 person years. Commercially available patch test series were supplemented with a special study series based on known or suspected sensitizers present at the workplaces. Of 57 patch-tested workers, 23 with ACD caused by epoxy resin systems were found, indicating an incidence rate of 4.5/1000 person years. In our study patch test series, 4 workers (17%) were identified solely by patch tests to 2,4,6-tris-(dimethylaminomethyl)phenol (tris-DMP), m-xylene-alpha,alpha-diamine (XAD), and/or 2,2,4 trimethylhexamethylenediamine. Positive patch tests to tris-DMP and XAD were seen in 7 and 8 workers, respectively, indicating that the 2 chemicals are important sensitizers in industrial painters. They are, however, not classified as skin sensitizers according to the European regulations on the classification and labelling of dangerous chemicals. The results show the usefulness of including patch tests based on an investigation of known and suspected skin sensitizers present at the workplaces.

An easy-to-use standardized instrument is needed for the clinical assessment of the severity of occupational hand eczema by dermatologists as well as occupational physicians. The Osnabrueck hand eczema severity index (OHSI) was developed for this purpose and the interobserver reliability investigated. The clinical severity was evaluated on the basis of the extension or clinical characteristics of six morphological characteristics. For the validation of the OHSI, hand eczema in 28 patients was investigated independently by one dermatologist and 2 occupational physicians. The agreement between the observers was determined by using kappa values, Kendall's coefficient of concordance, the intraclass correlation coefficient (ICC) and the 95% limits of agreement. The ICC for the total OHSI was 0.80 and the estimated limits of agreement (-3.6 and 3.0) were sufficiently small to expect that ratings according to OHSI performed by independent observers of different medical specialities should produce similar results. It could be demonstrated that the use of the OHSI is simple and practicable. The interobserver reliability for the summary score is good. OHSI seems a reliable tool for assessing the severity of occupational hand eczema.

Skin irritants and contact allergens reduce the number of Langerhans cells (LCs). It has been assumed that this reduction is due their migration to the draining lymph node (LN) for initiating immune sensitization in a host. Skin irritation, however, as opposed to contact allergy is not considered to be an immunological disease. Nevertheless, skin irritants are also known for their adjuvant-like effects on contact allergy, resulting in skin hypersensitivity reactions like toxic dermatitis. The human organotypic skin explant culture (hOSEC) model is used to study the characteristics of chemical-induced migration of CD1a(+) LCs out of the epidermis in relation to irritancy or toxicity. We analysed cells emigrating out of hOSEC for CD1a(+) LCs, CD83(+) mature dendritic cells (DCs) and CCR7(+) LN homing cells. After exposure to a toxic concentration of a non-immunogenic irritant, an increase of CD1a(+)CD83(+) LCs was found in the culture medium. A non-toxic concentration of an sensitizer induced an increase of CD1a(+) cells. About 50% of skin emigrating CD1a(+) LCs were CD83(-) (immature) but all were CCR7(+). Skin irritation by both non-allergenic and allergenic compounds induces LC migration and maturation. In contrast, only allergenic compounds induced LC migration with partial maturation at subtoxic concentration. This effectively demonstrates that irritation is physiologically needed stimuli for inducing LC maturation.

A 46-year-old woman, who worked as a laminator of spa baths, presented with hand dermatitis, which was suspected to be related to her occupation. Patch testing revealed strong reactions to both cobalt chloride and a polyester resin that the patient had been using at her workplace. She also reacted to latex and had been wearing cotton gloves underneath rubber gloves at work. It was later discovered that cobalt octoate (synonym: cobalt-2-ethylhexanoate), a compound not listed on the manufacturer's material safety data sheet, was included as an accelerator in the polyester resin. She was then tested to cobalt octoate, which was also strongly positive. Her successful treatment included protection of her hands at work with cotton lined PVC gloves. This case highlights the role of cobalt salts as sensitizers and their presence as accelerators used in polyester resins, and the importance of recognizing concomitant latex allergy that may complicate occupational dermatitis. It also illustrates the difficulties in relying on material safety data sheets to identify all possible allergens.

The aim was to study self-reported skin exposure in individuals from the general population with or without hand eczema. In a population-based study in 1996 using postal questionnaires to 3000 individuals, 215 of 2218 (9.7%) reported hand eczema during the past 12 months. 182 (85%) of those with hand eczema and 182 without hand eczema, matched for age and sex, participated in telephone interviews in 1997 regarding exposure to skin irritants at work and in leisure time. No differences were shown in occupational exposure to water, hand washing or chemicals in individuals with or without hand eczema. Women reported more wet exposure than men at work and in leisure time. A correlation was found between occupational wet exposure and wet work at home. Persons in high-risk occupations reported more frequent exposure to skin irritants. However, 53% in high-risk occupations reported exposure to water and detergents for less than half-hour a day and 11% in low-risk occupations for more than half-hour a day. In conclusion, individuals with or without hand eczema seem to have similar exposure to skin irritants. Using job titles as a proxy for exposure gives misclassification, which may result in underestimation of the hand eczema risk.

With almost 65 million women in the workforce, their representation in various occupational sectors is crucial, as is their health and safety. Female-dominated occupations in health care and cosmetology along with their potential cutaneous exposures are reviewed. Proper evaluation and management are necessary to minimize the disability that can result from these illnesses.

An outbreak of suspected contact dermatitis among subway construction workers was suspected to be due to a new bisphenol A/F-based epoxy resin system (ERS). The construction workers used ERSs during the insertion of iron bars into concrete walls. The objective of the study was to determine the components (if any) of the ERS responsible for the contact allergy. Patch testing was performed on 20 of the 22 construction workers who had had contact with the ERS, and to the various subcomponents of component A on 5 of the 7 who reacted to this component. 9 patients (9/22, 40.9%) had clinical symptoms and signs of suspected contact dermatitis at presentation. 7 of these 9, but none of the 11 asymptomatic individuals, were positive to component A, while all were negative to component B. Of the 5 cases receiving further patch testing, all reacted to m-xylylene diamine, 4 to 1,6-hexanediol diglycidyl ether, 3 to epoxy resins of the bisphenol F-type and trimethylolpropane triglycidyl ether 0.25% petrolatum, and only 1 to epoxy resins of the bisphenol A-type. Contact allergy to ERSs may involve hardeners and diluents as well as resins, and patch testing for reaction to all components should be performed.

Hairdressers are prone to developing occupational skin diseases, particularly hand eczema of different origins. Rather uncommon, however, is the so-called barber's hair sinus that is caused by hair fragments penetrating the skin preferably in the interdigital spaces of their hands. Whereas, to date, the disease has almost exclusively been reported to occur on the hands of male hairdressers, we herein present the first case of a female hairdresser who developed a barber's hair sinus on one of her feet.

Occupational hand eczema (OHE) is the most frequently recognized occupational disease in Denmark, and despite governmental attempts to reduce exposure to harmful occupational allergens, the number of new cases has remained almost unchanged since the mid-1990s. Some studies have indicated that OHE has considerable impact on quality of life (QoL) and may lead to depression. The aims of the study were to determine risk factors for low QoL, the frequency and severity of depression among OHE patients and changes in QoL and depression after 12 months of follow up. The study population, 758 patients, comprised all new recognized cases from the Danish National Board of Industrial Injuries Registry between October 2001 and November 2002. All patients received a questionnaire to determine impairment of QoL and depressive symptoms. A similar follow-up questionnaire was posted after 1 year. The response rate was 82% at baseline and 91% at follow up. The mean Dermatology Life Quality Index total score was 5.5 for all patients and 7.8 for severe OHE cases. Severe OHE cases and lower socioeconomic status were independently associated with low QoL. The prevalence of moderate-to-severe depression was 9%. Only minor changes in QoL and depressive symptoms were found after 12 months of follow up.

The study presented is a randomized, controlled intervention study with the purpose of implementing an evidence-based skin disease prevention programme. The hypothesis explored in this article is whether a high-fat petrolatum-based moisturizer can be an alternative to protective gloves in wet-work occupations. The study population was all gut cleaners in Danish swine slaughterhouses, and data were collected by telephone interviews using a standardized questionnaire - The Nordic Occupational Skin Questionnaire (NOSQ-2002). At baseline, 644 (88%) gut cleaners responded and at 1-year follow-up 622 (72%). 135 gut cleaners in the intervention and 277 in the comparison group responded at both telephone interviews. In the intervention group, the eczema frequency was reduced significantly. Detailed analyses revealed that protective gloves are the overall most effective protective means and did not indicate that a high-fat moisturizer could be an alternative. Furthermore, the most extensive improvements could not be explained by combinations of protective behaviour but was found among those who had received information on, and was having discussions on prevention of skin problems. This only applied to the intervention group. A continuous focus on prevention of skin problems with information and discussions on the shop floor therefore seemed to be most important for reducing skin problems.

Background: The role of physical friction as an irritant in the causation of contact dermatitis is under-recognized. Frictional dermatitis is defined as an eczematous process in which physical frictional trauma contributes to the induction of a dermatitis process., Objectives: To examine the clinical background of patients in whom friction was contributing to dermatitis., Methods: Over a 30-month period during which 2700 new patients were seen, frictional irritancy was identified as playing a role in the dermatosis in 31 cases: in 27 of these, case notes were evaluated for a range of parameters., Results: Physical friction was identified as causing or contributing to the dermatitis in 18 men and nine women, mean age at onset 42 years. The hands, usually the fingers of the dominant hand, were affected in all but two cases. Occupational frictional activities were found in 25 cases: commonly handling small metal components, paper, cardboard or fabric, and driving. Potential frictional activities in hobbies were noted in 12 cases. Wet work irritancy contributed in four cases (15%). Patch testing showed relevant contact allergies as cofactors in seven of 25 subjects tested (26%). Psoriasis was a cofactor in four (15%), and atopic dermatitis in 11. The study was selective, being based in a teaching hospital clinic with a special interest in contact dermatitis. Frictional irritancy is often one of several factors contributing to dermatitis., Conclusions: The contribution of friction to contact dermatitis is under-recognized probably because dermatologists do not think about the potential for physical forces to induce eczematous changes in the skin.

Dermatitis is a common problem both in the workplace and in the general community. Airline personnel represent a novel occupational group as they are also exposed to a wide range of potential chemical irritants and other aggravating factors, such as low relative humidity and airborne pollutants. Common skin irritants include dielectric fluids from electrodischarge machining, 'prepreg' materials and sealants in aircraft manufacture, kerosene and various jet-fuel components. Commercial jet fuel is a complex mixture of aliphatic and aromatic compounds, and there is potential for dermal exposure among refueling and maintenance crew. Low relative humidity appears to exacerbate dermatitis amongst aircrew, especially on longer flight durations. Pilots may also be exposed to additional skin irritants outside of the cabin environment, such as ethylene glycol, hydraulic fluid or jet fuel, all of which may be encountered during routine inspections of aircraft before and after flight. Given these factors, preventive measures must carefully consider the undoubted potential for contact with irritants and allergens, which may lead to dermatitis in airline personnel.

Cutting fluids are widely used in the metal-machining industry to lubricate and reduce heat generation when metals are cut by a metal-cutting tool. These cutting fluids have caused occupational irritant contact dermatitis (OICD), and many of the additives used in these cutting fluid mixtures are thought to be responsible for OICD in workers. The purpose of this study was to assess single or various combinations of these additives in initiating the OICD response following an acute 8-hour exposure in porcine skin in vivo and in vitro using the isolated perfused porcine skin flap (IPPSF) and human epidermal keratinocytes (HEK). Pigs (n = 4) were exposed to 5% mineral oil (MO) or 5% polyethylene glycol (PEG) aqueous mixtures containing various combinations of 2% triazine (TRI), 5% triethanolamine (TEA), 5% linear alkylbenzene sulfonate (LAS), or 5% sulfurized ricinoleic acid (SRA). Erythema and edema were evaluated and skin biopsies for histopathology were obtained at 4 and 8 hours. IPPSFs (n = 4) were exposed to control MO or PEG mixtures and complete MO or PEG mixtures, and perfusate samples were collected hourly to determine interleukin- (IL-) 8 release. The only significant (p < 0.05) mixture effects observed in IPPSFs were with SRA + MO that caused an increase in IL-8 release after 1 or 2 hours' exposure. In vivo exposure to TRI alone appeared to increase erythema, edema, and dermal inflammation compared to the other additives, while SRA alone was least likely to initiate a dermal inflammatory response. In 2-component mixture exposures, the presence of TRI appeared to increase the dermal inflammatory response at 4 and 8 hours especially with the PEG mixtures. In the 3- and 4-component mixtures, MO mixtures are more likely to incite an inflammatory response than PEG mixtures. TRI exhibited the highest toxicity toward HEK, which correlates well to the in vivo irritation and morphology results. In summary, these preliminary studies suggest that the biocide, TRI, is the more potent of the 4 performance additives in causing dermal irritation, and this may vary depending on whether the worker is exposed to a synthetic (PEG)- or MO-based fluid. These findings will however require further clinical studies to validate these acute dermal effects as well as human cumulative irritation following exposure to similar cutting fluid formulations in the workplace.

Recently, the preservative methyldibromo glutaronitrile (MDBGN) at 0.5% w/w in petrolatum was included in the European standard patch test series based on the studies on chemical stability and consideration of rates of contact allergy, doubtful and irritant reactions as well as information on clinical relevance represented by results of a repeated open application test (ROAT) and patch test concentrations required to diagnose allergic contact dermatitis from MDBGN in individual cases. In this report, a case with a clinically relevant contact allergy to MDBGN, which on the mandatory reading occasion on D3 only was traced by a patch test with MDBGN at 1.0% (0.32 mg/cm2), is presented. The patient suffered from a chronic hand dermatitis, and when the patient stopped using a liquid soap containing MDBGN, the hand dermatitis substantially improved. A ROAT performed in a blinded and controlled way with applications twice daily on the hands with 2 moisturizers with and without MDBGN resulted in a deterioration of the hand dermatitis on the hand to which the MDBGN-preserved moisturizer had been applied.

Persistent post-occupational dermatitis is a phenomenon that is well-recognized by occupational dermatologists, but there have been few studies on it. In view of this, we proposed to assess the prevalence of this phenomenon in an English setting and ascertain the characteristics of the patients affected. Using modified criteria adapted from previous studies, details of 1100 patients seen in a contact dermatitis clinic were screened. Persistent post-occupational dermatitis was diagnosed in 5 patients out of 1100 seen over a 35-month period in a contact clinic (4 women, 1 man; age of onset 19-52 years). All had hand dermatitis that persisted despite removal of the apparent causative agents. Four patients were nickel-allergic on patch testing, though nickel was thought to be a potential causative agent in only one case and 2 patients were allergic to thiuram-mix on patch testing, and in both thiuram had a possible causative role. In all 5 cases, irritant exposure seemed important, with allergic factors contributing in 3 cases. Two patients had had eczema in childhood. Persistent post-occupational dermatitis is uncommon, affecting less than 0.5% of patients seen in a contact dermatitis clinic, but when diagnosed it has major implications for the future employment prospects of the individuals concerned.

After the start of heroin (diacetylmorphine)-assisted treatment to a selected group of chronic treatment-resistant heroin-dependent patients in the Netherlands, we reported about work-related eczema and positive patch tests to heroin in some nurses and nasal and respiratory complaints. To investigate the prevalence of heroin contact allergy, we started a questionnaire-based study with follow-up by allergological examinations. Of 120 questionnaires sent, 101 (84%) was returned: 67 from nurses and 34 from other employees. Of 101 workers, 38 (38%) had reported work-related complaints: 33 of 67 (49%) nurses and 5 of 34 (15%) other employees. Patch tests to heroin were performed in 24 nurses and were positive in 8 (33%). All the 8 had eyelid or facial eczema and, in 6, accompanied by mucosal or respiratory complaints. The prevalence of heroin contact allergy in this study was 8% (8/101) among all employees and 12% (8/67) among nurses. Respiratory and mucosal complaints could not be ascribed to a contact allergy, and in these cases, serum was analysed for specific immunoglobulin E to heroin. A type 1 allergy to heroin could not be shown. These complaints are possibly due to the histamine-liberating effect of heroin, to atopic constitution, to a combination of these factors or - less likely - to other non-allergic factors.

Irritant dermatitis and eczema are the most prevalent occupational skin diseases. Less common are immediate contact reactions such as contact urticaria and protein contact dermatitis. Occupational contact urticaria can be subdivided into two categories, immunological and non immunological. However, some agents can induce these two types of reactions. Contact urticaria to natural rubber latex is particularly frequent among health care personnel, but contact urticaria to a wide variety of other substances occurs in many other occupations. Among those at risk are cooks, bakers, butchers, restaurant personnel, veterinarians, hairdressers, florists, gardeners, and forestry workers. Protein contact dermatitis in some of these occupations is caused principally by proteins of animal or plant origin, especially among individuals with a history of atopic dermatitis. Diagnosis requires careful interrogation, clinical examination and skin tests (open tests and prick tests with immediate lecture) to identify a particular contact allergen.

Background: Severity assessment of occupational hand eczema (OHE) is important not only in clinical settings but also in research. Questionnaires with self-rated assessment of severity may be an attractive tool for assessing severity because of their cost efficiency in comparison with expensive clinical examinations., Objectives: To evaluate the relation between self-rated severity and severity assessment based on standardized medical certificates issued by dermatologists in a population of patients with OHE., Methods: Between October 2001 and November 2002 (58 weeks) we identified all new cases of recognized OHE from the Danish National Board of Industrial Injuries (DNBII) registry. Each patient was examined by a dermatologist, who issued a standardized medical certificate. The severity assessment in the DNBII registry was based on this medical certificate, which comprised information on morphology and extent of eczema, and frequency of eruptions. All participants received a self-administered questionnaire and were asked to classify severity of their OHE on a visual analogue scale from 0 to 10. The relation between DNBII-assessed and self-rated severity was illustrated by a receiver operating characteristic analysis., Results: Of 758 patients included in the study, 621 returned the questionnaire and 602 (79%) provided information on self-rated severity. The proportion of severe cases was significantly higher among patients' assessments compared with the rating by the DNBII. Almost 18% were categorized as severe cases by the DNBII while 40% of patients had assessed themselves as having severe eczema. The optimal cut-off point had a sensitivity and specificity of self-rated severity according to the DNBII assessment of 65% and 66%, respectively. The positive predictive value was 29% and the negative predictive value was 90%., Conclusions: The low positive predictive value suggests major differences in the criteria for self-rated severity vs. DNBII-rated severity. We recommend researchers to include ratings from both patients and physicians in future investigations of severity. The methods may address different aspects of OHE.

The aim of this study was to establish whether those working in certain occupations had skin with a Lower moisture content than would be considered normaL. Skin moisture levels were measured as well as visual assessment. Results indicated that all occupational groups studied had skin that was less well hydrated than would be considered normal, although there were significant inter-individual variations within any one group. These variations were at least as significant as occupation. Awareness of the need to use gloves as protection against chemicals and to use emollients to restore condition was low, as was compliance.

Parthenium dermatitis is one of the most common causes of airborne contact dermatitis in India. Eczema herpeticum has been reported in association with various eczematous conditions, including Parthenium dermatitis. We report a case of eczema herpeticum in association with Parthenium dermatitis. Because Parthenium dermatitis is a common condition in this region, one should be aware of this complication so that appropriate treatment is not delayed.

Chronic actinic dermatitis (CAD) is a persistent ultraviolet radiation- or visible light-induced eczema of predominantly the exposed areas of usually elderly people. We now present the case of a young pilot with atopic eczema who developed CAD, regularly exacerbated by exposure to visible light through his aircraft cockpit window.

A 30-year-old man presented with eyelid dermatitis and was diagnosed with occupational allergic contact dermatitis to an epoxy resin based on the monomer diglycidyl ether of bisphenol F. He did not react to the standard epoxy resin based on bisphenol A, but reacted to a diluted sample of epoxy resin taken from his workplace, an adhesives manufacturing plant. The diagnosis would not have been made had he not brought samples from work, which were patch tested after appropriate dilution. The material safety data sheet provided additional evidence that the epoxy was not based on bisphenol A. The patient's symptoms subsided after avoidance of the identified product.

Granuloma annulare is a benign idiopathic disorder of the dermis that has various clinical presentations and an unknown etiology. We discuss a patient who presented with a contact dermatitis that demonstrated granuloma annulare on biopsy. The most likely etiologic agent was a substance known as FAZ (an exhaust product of Kodak DryView laser imaging film), to which the patient was exposed in his occupation.

Cyanamide (carbimide or calcium carbimide) has been used to treat chronic alcoholism for more than 45 years. The skin reactions provoked by this medication are very rare and are generally associated with systemic reactions after ingestion of the product. However, allergic contact dermatitis has also been detected on persons who prepare cyanamide for administration to patients. We present a case of work-related allergic contact dermatitis from cyanamide that was confirmed by patch testing.

Background: Many health care workers are sensitized to the proteins in natural rubber latex and get contact dermatitis as a result of wearing latex gloves., Objective: The aim of the study was to evaluate a topical formulation containing a zinc gel (Allergy Guard) as a prophylactic against latex glove-related contact dermatitis., Methods: The study was carried out with volunteers who exhibited mild to moderate contact dermatitis (type IV) after wearing latex gloves as per the protocol., Results: Allergy Guard significantly reduced skin irritation in volunteers who exhibited type IV hypersensitivity when exposed to latex gloves. Allergy Guard also exhibited a barrier effect as shown by the permeation of chlorophyllin dye into the skin of volunteers. Allergy Guard prevented dermal irritation induced by sodium lauryl sulfate., Conclusion: Topical formulations containing a zinc gel may be used to delay or prevent latex sensitivity, especially among health care professionals.

Background: In the last 20 years, the hairdressing profession has undergone important modifications, mainly because of a change in the substances and techniques used and improved occupational education., Objective: To evaluate the modifications in the hairdressing profession and its actual risk of occupational allergic contact dermatitis (OACD)., Methods: We studied all 300 hairdressers seen in our department from 1994 to 2003 and compared the results with those of a previous study of 379 hairdressers who attended our department from 1980 to 1993. All were patch-tested with the European Standard series and specific hairdressing products. As previously, most of the workers were women (93%), with a mean age (23.7 years) slightly higher than that of the workers in our previous study., Results: We found a significant increase in the frequency of positive patch-test responses (78.3% vs 58.8%) and OACD (58% vs 48.8%) with respect to our previous study. We also observed a significant increase in sensitization to most allergens, including p-phenylenediamine base (54% vs 45.9%), 4-aminobenzene (40.7% vs 31.9%), ammonium thioglycolate (2.7% to 12.3%), ammonium persulfate (7.9% to 14.3%), p-toluenediamine sulfate (6.8% to 15.3%), p-aminodiphenylamine (2.9% to 7.7%), o-nitro-4-phenylenediamine (2.1% to 7.3%), and aminophenols (0% to 9%), whereas a decrease was found in sensitization to Disperse Orange (17% vs 32.7%) and thioglycolic acid (15.3% to 3%)., Conclusion: The high frequency and increase of sensitizations among hairdressers require urgent measures to improve protective measures and their application.

Dermatitis complaints are frequently encountered among workers in the microelectronics industry and have been associated with a variety of physical, chemical and psychosocial causes. Employees working in the silk-screening and kiln-drying areas of a printed-circuit board manufacturer complained of recurrent itching and rashes. This case report describes those symptoms and the results of a brief survey of the affected employees, which provided useful data regarding the likely aetiology. A brief epidemiological survey instrument was used to gain information regarding the pattern, duration and frequency of employee symptoms. Data from the survey were used to identify seasonal variations in symptoms that correlated with specific environmental factors in the plant. A brief epidemiological investigation using a self-reported symptom survey was an efficient tool to catalogue the character, pattern, duration and frequency of complaints that correlated with specific environmental factors in the plant (temperature and low humidity), which were likely causes of the outbreak.