©FIOH, Riitta Jolanki 27-28.8.2003 Risk occupations Riitta Jolanki, D.Tech. (Chem.Eng.), Docent Senior Research Scientist, Dermatotoxicologist Finnish

©FIOH, Riitta Jolanki27-28.8.2003

Risk occupations

Riitta Jolanki, D.Tech. (Chem.Eng.), Docent

Senior Research Scientist, Dermatotoxicologist

Finnish Institute of Occupational Health (FIOH)

Department of Occupational Medicine

Section of Dermatology

[email protected]


0 2 4 6 8 10 12 14 16 18 20

All occupations 1027

Printing and photographic work 7

Service work 179

Textile, sewing, shoe and leather work 15

Electrical, radio and television work 40

Health care and social work 242

Metal, foundry and engineering work 116

Chemical processing, pulp and paper making work 27

Agriculture, forestry and fishing 138

Manufacturing work not elsewhere classified 51

Food and beverage manufacturing 32

SKIN DISEASES (Cases/10 000 employed persons)

Lea Aalto

N

Most common occupations in 2001

Finnish Register of Occupational Diseases FIOH


Risk of occupational dermatoses by occupation


Methods (1)

The data of the Finnish ROD and the Finnish Population Census Registry were linked by the unique personal identification code assigned to everyone residing in Finland.


Methods (2)

The analyses were restricted to all wage earners and agricultural workers aged 25-64 years.

The occupation of the study subjects was obtained from the 1985 population census.

Follow-up time: beginning of 1986 to end of 1991. Subjects excluded from the study population:

those

– having contracted an occupational dermatosis

– turned 65 years of age

– deceased


Methods (3)

Age-standardized rate ratio (SRR) was calculated with reference to the total study population.


General findings

22372020

5144

412

0

1000

2000

3000

4000

5000

6000

Number of cases

39

58

48

0

10

20

30

40

50

60

70

cases / 100 000 person years

OCD

ICD ACD

Total

Men

Women

CU/PCD


The highest SRR of ICD (95% confidence interval) (N=2237, number of cases >10)

Occupation / workergroup SRR Cases1 Reinforcement concrete workers, cast concrete

product workers (construction) 6.2 (3.7-10) 152 Plywood and fibreboard workers 5.6 (3.6-8.8) 203 Oil refinery and chemical process operators 5.6 (3.8-8.1) 274 Cast concrete product workers (industry) 4.6 (2.7-8.1) 135 Kitchen and restaurant workers 4.3 (3.5-5.4) 866 Machinists and toolmakers 4.2 (3.4-5.2) 857 Welders, flame cutters, other foundry workers, etc. 4.1 (2.2-7.6) 108 Floor layers, building painters, other painters and

lacquerers 4.0 (3.1-5.2) 599 Rubber product workers 4.0 (2.1-7.4) 1010 Maintenance workers 3.9 (2.2-6.9) 1211 Chefs, cooks, cold buffet managers, etc. 3.7 (2.9-4.6) 7712 Cleaners, etc. 3.7 (3.2-4.2) 27513 Plastic product workers 3.3 (2.2-5.1) 2214 Machine and engine mechanics, etc. 3.3 (2.6-4.1) 7915 Machine and metal product assemblers 3.3 (2.4-4.5) 42


Most common irritants in occupations with the highest risk of ICD

Organic solvents Detergents Oils and lubricants, including metal-

working fluids Cement-based products Foodstuffs Plastic chemicals


The highest SRR of ACD (95% confidence interval) (N=2020, number of cases >10)

Occupation / workergroup SRR Cases

1 Dentists 6.4 (3.8-11) 152 Plywood and fibreboard workers 6.1 (3.9-9.6) 213 Dental nurses and assistants 6.1 (4.3-8.7) 484 Cast concrete product workers 5.4 (3.3-9.1) 155 Reinforcement concreters, cast concrete product

workers 4.5 (2.5-8.2) 126 Plastic product workers 4.1 (2.8-6.2) 257 Bricklayers, plasterers, tilers 3.9 (2.5-6.2) 208 Floor layers, building painters, other painters and

lacquerers 3.5 (2.6-4.7) 469 Machine and metal product assemblers 3.4 (2.5-4.7) 3910 Electrical and teletechnical equipment assemblers 3.3 (2.2-5.1) 22

’


Most common allergens in occupations with the highest risk of ACD

Rubber chemicals Plastic chemicals Metals and metal compounds Formaldehyde and other

antimicrobials


The highest SRR of CU/PCD (95% confidence interval) (N=412, number of cases >5)

Occupation / workergroup SRR Cases

1 Bakers and confectioners 14 (7.8-27) 112 Farmers, silviculturalists, etc. 10 (8.0-13) 833 Physicians 4.1 (1.8-9.2) 64 Chefs, cooks, cold buffet managers, etc. 3.1 (1.5-6.7) 75 Nurses, midwives 1.8 (0.9-3.4) 9


Most common allergens in occupations with the highest risk of CU/PCD

Flours Cow dander NRL proteins Foodstuffs


Conclusion

The study gave new information on the relative risk to develop an occupational skin disease in various occupations.

The differences in the risk of developing an occupational disease were very great.

Dental care workers had the highest risk of allergic contact dermatitis.


Detergent dermatoses- risk occupations

Cleaners Hospital attendants Bath workers Chefs, cooks, cold buffet managers Food and beverage manufacture workers Cattle tenders Barbers, hairdressers Nurses Dental assistants Dentists, surgeons


Cleaning work

Diagnoses/causes

– 50% irritant contact dermatitis» detergents

» wet and dirty work

– 25% allergic contact dermatitis» rubber and rubber chemicals

» metals

» formaldehyde and other antimicrobials


Kitchen and restaurant workers

Diagnoses/causes

– irritant contact dermatitis» handling of foodstuffs

» wet work

» detergents

– protein contact dermatitis» foodstuffs

» natural rubber latex

– allergic contact dermatitis» foodstuffs

» rubber chemicals


Laboratory work Diagnoses/causes

– irritant contact dermatitis» wet work

» detergents

» gloves (occlusion)

– protein contact dermatitis» natural rubber latex

» enzymes

» laboratory animals

– allergic contact dermatitis» rubber chemicals

» plastic chemicals

» nickel

» antimicrobials

» chemicals (reactive)


Barbers, hairdressers Diagnoses/causes

– allergic contact dermatitis» permanent dyes for hair, eyebrows and eyelashes

» permanent wave chemicals

– irritant contact dermatitis» shampoos

» permanent wave chemicals

» wet work

» persulfates (hair bleaching agents)

– contact urticaria/protein contact dermatitis» persulfates


» protein-based shampoos and conditioners


Garden and florist's work

Diagnoses/causes

– allergic contact dermatitis» vegetables

» flowers

» rubber chemicals

– irritant contact dermatitis» vegetables

» flowers

» dirty work

– protein contact dermatitis» vegetables

» flowers



Assembly work

Diagnoses/causes

– allergic contact dermatitis» nickel

» anaerobic adhesives (methacrylates)

» epoxy glues

» colophony (soldering)

– irritant contact dermatitis» cyanocrylate adhesives

– contact urticaria» phthalic anhydrides


Plywood and fiberboard work

Diagnoses/causes

– allergic contact dermatitis» phenol formaldehyde resin

» urea formaldehyde resin

» formaldehyde

– irritant contact dermatitis» plywood glues (pH > 9)


Machinists

Diagnoses/causes

– allergic contact dermatitis» components in metal working fluids

formaldehyde and other antimicrobials

ethanolamines colophony

» metals (cobalt, nickel, chromium compounds)

– irritant contact dermatitis» metal working fluids

» oils and lubricants


Allergic contact dermatitis caused by plastic chemicals - risk

occupations

Dentists Dental assistants Plywood and fiberboard workers Plastic product workers Painters and lacquerers Electrical, radio and television workers

(assemblers)


Occupational allergic dermatoses caused by chemicals in 1995-96

(cases/100 000 work years)

All plastic chemicals– all occupations 4

Epoxy compounds– all occupations 2– exposed workers* 1 000

(Meth)acrylates, etc.– all occupations 1– dentists 100– dental assistants 200

* Työperäinen kemikaalialtistuminen Suomessa (Wor-related chemical exposure in Finland), FIOH & Finnish Work Environment Fund, Helsinki 1992.

Documents

©FIOH, Riitta Jolanki 27-28.8.2003 Risk occupations Riitta Jolanki, D.Tech. (Chem.Eng.), Docent Senior Research Scientist, Dermatotoxicologist Finnish