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Johannes Geier - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of secondary prevention in Metalworkers with work related skin diseases and comparison with participants of a tertiary prevention program a prospective cohort study
Contact Dermatitis, 2020Co-Authors: Richard Brans, Anna Reich, C Skudlik, Annika Wilke, Elke Rodriguez, Nicole Boraczynski, Stephan Weidinger, Johannes Geier, Michael P Schon, Swen Malte JohnAbstract:BACKGROUND In Germany, a multistep approach has been established to prevent work-related skin diseases (WRSDs). OBJECTIVES To evaluate the effect of a secondary individual prevention program (SIP) in Metalworkers with WRSD and to compare their characteristics with those of participants of a tertiary individual prevention program (TIP). PATIENTS AND METHODS In a prospective cohort study, Metalworkers with WRSD of the hands participating either in the SIP (n = 114) or in the TIP (n = 83) were recruited. At baseline and at the respective follow-up 8-12 weeks after the SIP or at dismissal from the TIP (3-4 weeks later), questionnaires were completed and the severity of WRSD was assessed. Saliva samples were collected for assessment of filaggrin (FLG) mutations and an explorative genome-wide association study (GWAS). RESULTS Ninety-three SIP patients (81.6%) attended the follow-up. Disease severity was significantly reduced, and knowledge and protective behavior were significantly improved compared to baseline. Significant differences between SIP and TIP patients were found regarding duration and severity of symptoms, work absenteeism, tobacco smoking, and presence of atopic dermatitis, but not regarding FLG mutations and by GWAS. CONCLUSIONS The SIP was effective in Metalworkers with WRSDs. Individual factors may influence the course of the disease and the need for the TIP.
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assessment of occupational exposure and spectrum of contact sensitization in Metalworkers with occupational dermatitis results of a cohort study within the occuderm project
Journal of The European Academy of Dermatology and Venereology, 2020Co-Authors: Steffen Schubert, Richard Brans, Anna Reich, Timo Buhl, C Skudlik, A Hansen, Martin Mempel, Margarete Schon, S M John, Johannes GeierAbstract:Background Metalworkers occupationally exposed to metals, tools, metalworking fluids (MWFs), technical oils, gloves, skin care products etc. frequently suffer from occupational dermatitis (OD). Objectives To investigate occupational exposure and to identify relevant occupational sensitizers in Metalworkers with OD, and to evaluate suitability of current German patch test recommendations for this occupational group. Patients and methods As part of the OCCUDERM project, occupational exposure of 230 Metalworkers with suspected OD patch tested in the departments of dermatology in Gottingen and Osnabruck (both Lower Saxony, Germany) in 2012-2017 was recorded by questionnaire. These data, as well as results, of patch testing with standardized allergens and with workplace material were analysed. Results Metalworking fluids and skin care products were the most important exposures. Among MWF allergens, most frequently sensitizations to formaldehyde and formaldehyde releasers, colophony/abietic acid and monoethanolamine were observed. Sensitization to methylisothiazolinone (MI) was frequent, probably as part of the general European epidemic of contact allergy to MI in leave-on cosmetics. Sensitization to glove ingredients only played a minor role. Conclusions The known occupational allergen spectrum could largely be confirmed. In order not to miss relevant sensitizations, patch testing with material from the patients' workplaces in parallel to baseline and MWF series is recommended. Sensitizations diagnosed could not always be linked to particular occupational exposures.
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skin sensitizing properties of the ethanolamines mono di and triethanolamine data analysis of a multicentre surveillance network ivdk and review of the literature
Contact Dermatitis, 2009Co-Authors: Holger Lessmann, Wolfgang Uter, Axel Schnuch, Johannes GeierAbstract:Numerous publications address the skin sensitizing potential of the short chain alkanolamines triethanolamine (TEA), diethanolamine (DEA), monoethanolamine (MEA), which are not skin sensitizing according to animal studies. Regarding TEA, we analysed patch test data of 85 098 patients who had been tested with TEA 2.5% petrolatum by Information Network of Departments of Dermatology (IVDK) to identify particular exposures possibly associated with an elevated risk of sensitization. Altogether, 323 patients (0.4%) tested positive. The profile of patch test reactions indicates a slightly irritant potential rather than a true allergic response in many cases. Although used widely, no exposure associated with an increased risk of TEA sensitization was identified. Therefore, the risk of sensitization to TEA seems to be very low. MEA and DEA were patch tested in a much more aimed fashion in 9602 and 8791 patients, respectively when prevalence of contact allergy was 3.8% and 1.8%. MEA is the prominent allergen in Metalworkers with exposure to water-based metalworking fluids (wbMWFs); DEA is probably used in cutting fluids less frequently nowadays. Chronic damage to the skin barrier resulting from wbMWF, the alkalinity of ethanolamines (increasing from TEA to MEA), and other cofactors may contribute to a notable sensitization risk.
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patch test reactions to biobans in Metalworkers are often weak and not reproducible
Contact Dermatitis, 2002Co-Authors: Thomas Brinkmeier, Johannes Geier, Jeanpierre Lepoittevin, Peter J FroschAbstract:Contact allergy to the industrial preservative group of Biobans has been reported in individual cases. We have performed a prospective study on 408 Metalworkers who were tested with 6 different Biobans, formaldehyde and 5 other preservatives. Furthermore, retesting was performed after a time interval of 6 months to 4 years. The test results were also compared with those of the multicentric data provided by the Information Network of Departments of Dermatology in Germany and Austria (IVDK), particularly with regard to cross-reactivity between the various Biobans and formaldehyde. In 408 Metalworkers 14 (3.4%) showed positive reactions to Biobans (2.2% P 1487, 2.0% CS 1246, 1.5% CS 1135), the majority being + reactions. On retesting 10 patients, the reactions were confirmed in only 2 cases (P 1487 and CS 1135). 4 patients showed positive reactions to 3 Biobans (P 1487, CS 1135, CS 1246), while 9 patients had only solitary sensitizations. Concomitant sensitization to formaldehyde was present in 5 out of 10 patients, being reproducible in 3 of them. In the IVDK data, sensitization prevalence in 3400 patients ranged from 1.8% (P 1487) to 0.8% (CS 1246). A high proportion of doubtful or irritant reactions as well as weak + reactions was observed. Cross-reactivity between the various Biobans was low, moderate agreement being calculated for CS 1135 and CS 1246 (kappa coefficient 0.43). The consensus pattern between formaldehyde and the tested Biobans was even lower. In conclusion, patch test reactions to Biobans are not rare among Metalworkers but are often weak and not reproducible. Simultaneous reactivity to various Biobans and formaldehyde may be due to cross-reactivity or cosensitization from common exposure.
C Skudlik - One of the best experts on this subject based on the ideXlab platform.
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contact sensitization in Metalworkers data from the information network of departments of dermatology ivdk 2010 2018
Contact Dermatitis, 2020Co-Authors: Steffen Schubert, Richard Brans, Elke Weisshaar, Anna Reich, Timo Buhl, C Skudlik, Claudia Schroderkraft, Michal Gina, Vera MahlerAbstract:BACKGROUND Metalworkers are exposed to a variety of contact allergens by handling tools, metals, metalworking fluids (MWFs), oils and greases, rubber materials, and so on. Most large-scale reports on contact allergy due to MWFs are more than 10-years-old, and there are only few studies on contact allergy in mechanics and other metal workers not exposed to MWFs. OBJECTIVES To describe a current spectrum of contact sensitization in Metalworkers with occupational dermatitis (OD). PATIENTS AND METHODS Retrospective analysis of patch test data collected by the Information Network of Departments of Dermatology (IVDK; 2010-2018), stratifying for 804 cutting Metalworkers, 2197 mechanics, and 355 other Metalworkers. RESULTS Cutting Metalworkers were most frequently sensitized to monoethanolamine (12.6%), colophonium/abietic acid (11.4%) and formaldehyde releasers (up to 8.5%) from the MWF series, and formaldehyde (4.6%) and iodopropynyl butylcarbamate (4.6%) from the baseline series. Sensitization among mechanics and other Metalworkers indicates possible occupational exposure to MWFs, glues, and resins, although this may not be expected from their job titles. CONCLUSIONS The spectrum of MWF contact allergens remained largely unchanged during the last years. Taking a comprehensive occupational history is indispensable in order to not miss relevant allergen exposures.
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effectiveness of secondary prevention in Metalworkers with work related skin diseases and comparison with participants of a tertiary prevention program a prospective cohort study
Contact Dermatitis, 2020Co-Authors: Richard Brans, Anna Reich, C Skudlik, Annika Wilke, Elke Rodriguez, Nicole Boraczynski, Stephan Weidinger, Johannes Geier, Michael P Schon, Swen Malte JohnAbstract:BACKGROUND In Germany, a multistep approach has been established to prevent work-related skin diseases (WRSDs). OBJECTIVES To evaluate the effect of a secondary individual prevention program (SIP) in Metalworkers with WRSD and to compare their characteristics with those of participants of a tertiary individual prevention program (TIP). PATIENTS AND METHODS In a prospective cohort study, Metalworkers with WRSD of the hands participating either in the SIP (n = 114) or in the TIP (n = 83) were recruited. At baseline and at the respective follow-up 8-12 weeks after the SIP or at dismissal from the TIP (3-4 weeks later), questionnaires were completed and the severity of WRSD was assessed. Saliva samples were collected for assessment of filaggrin (FLG) mutations and an explorative genome-wide association study (GWAS). RESULTS Ninety-three SIP patients (81.6%) attended the follow-up. Disease severity was significantly reduced, and knowledge and protective behavior were significantly improved compared to baseline. Significant differences between SIP and TIP patients were found regarding duration and severity of symptoms, work absenteeism, tobacco smoking, and presence of atopic dermatitis, but not regarding FLG mutations and by GWAS. CONCLUSIONS The SIP was effective in Metalworkers with WRSDs. Individual factors may influence the course of the disease and the need for the TIP.
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assessment of occupational exposure and spectrum of contact sensitization in Metalworkers with occupational dermatitis results of a cohort study within the occuderm project
Journal of The European Academy of Dermatology and Venereology, 2020Co-Authors: Steffen Schubert, Richard Brans, Anna Reich, Timo Buhl, C Skudlik, A Hansen, Martin Mempel, Margarete Schon, S M John, Johannes GeierAbstract:Background Metalworkers occupationally exposed to metals, tools, metalworking fluids (MWFs), technical oils, gloves, skin care products etc. frequently suffer from occupational dermatitis (OD). Objectives To investigate occupational exposure and to identify relevant occupational sensitizers in Metalworkers with OD, and to evaluate suitability of current German patch test recommendations for this occupational group. Patients and methods As part of the OCCUDERM project, occupational exposure of 230 Metalworkers with suspected OD patch tested in the departments of dermatology in Gottingen and Osnabruck (both Lower Saxony, Germany) in 2012-2017 was recorded by questionnaire. These data, as well as results, of patch testing with standardized allergens and with workplace material were analysed. Results Metalworking fluids and skin care products were the most important exposures. Among MWF allergens, most frequently sensitizations to formaldehyde and formaldehyde releasers, colophony/abietic acid and monoethanolamine were observed. Sensitization to methylisothiazolinone (MI) was frequent, probably as part of the general European epidemic of contact allergy to MI in leave-on cosmetics. Sensitization to glove ingredients only played a minor role. Conclusions The known occupational allergen spectrum could largely be confirmed. In order not to miss relevant sensitizations, patch testing with material from the patients' workplaces in parallel to baseline and MWF series is recommended. Sensitizations diagnosed could not always be linked to particular occupational exposures.
Jukka Uitti - One of the best experts on this subject based on the ideXlab platform.
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Quality of life (EQ-5D) and hand-arm vibration syndrome
International archives of occupational and environmental health, 2009Co-Authors: Riitta Sauni, Rauno Pääkkönen, Esko Toppila, Pauliina Virtema, Ilmari Pyykkö, Jukka UittiAbstract:Background The aim of this study was to investigate the quality of life of a population of Finnish Metalworkers who were exposed to hand-arm vibration (HAV) and who suffered from white fingers, tingling, or numbness of the fingers, musculoskeletal disorders of the upper extremities, or symptoms of carpal tunnel syndrome (CTS).
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dose response relationship between exposure to hand arm vibration and health effects among Metalworkers
Annals of Occupational Hygiene, 2009Co-Authors: Riitta Sauni, Rauno Pääkkönen, Esko Toppila, Pauliina Virtema, Jukka UittiAbstract:Objectives: The aim of this study was to explore the relationship of exposure to hand-arm vibration (HAV) and vascular, sensorineural and musculoskeletal symptoms and symptoms of carpal tunnel syndrome (CTS) in a population of Finnish Metalworkers. Methods: A questionnaire on HAV exposure and symptoms was sent to 530 Metalworkers. Those who reported finger blanching, numbness or tingling of the fingers or symptoms of CTS were invited to further examinations (n 5 133). Their cumulative lifelong exposure to HAV, the level of current exposure and the history of use of tools causing impulse vibration were evaluated. The association of different symptoms with the HAV exposure was assessed with logistic regression analyses adjusted for age and smoking. The vibration perception thresholds (VPTs) were tested according to ISO 13091-1:2001. Results: The cumulative exposure index varied between 0 and 115 000 m 2 years d s 24 , the mean being 20 591 m 2 years d s 24 . The average of current daily vibration exposure was 1.6 m s 22 and 39% of the participants had a history of exposure to impulse vibration. Of the respondents, 49% reported white fingers, 66% neurosensory symptoms, 56% symptoms of CTS and 75% musculoskeletal symptoms. The cumulative exposure index was associated with symptoms of white fingers [odds ratio (OR) 2.4–4.5], with symptoms of CTS (OR 4.6–6.1), with neurosensory symptoms (OR 5.7–17.3) and with musculoskeletal symptoms (OR 4.7–5.4). The risk of all these symptoms increased as the cumulative vibration dose increased. The history of exposure to impulse vibration had a significant effect on the occurrence of neurosensory symptoms (P 5 0.024). The current exposure to HAV correlated significantly with all of the above-mentioned symptoms. The results of the VPT test were associated with the level of cumulative exposure to HAV. Conclusions: There seems to be a dose–response relationship between the cumulative lifetime vibration dose of the HAV and finger blanching, sensorineural symptoms, symptoms of CTS and musculoskeletal symptoms of upper limbs and neck in the group of Metalworkers of the study. The risk for neurosensory symptoms was the most significantly related to exposure to HAV and also to impulse vibration. Further studies are needed to confirm the present results also in other occupational groups taking into account the possible synergistic effect of workload as well.
Steffen Schubert - One of the best experts on this subject based on the ideXlab platform.
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contact sensitization in Metalworkers data from the information network of departments of dermatology ivdk 2010 2018
Contact Dermatitis, 2020Co-Authors: Steffen Schubert, Richard Brans, Elke Weisshaar, Anna Reich, Timo Buhl, C Skudlik, Claudia Schroderkraft, Michal Gina, Vera MahlerAbstract:BACKGROUND Metalworkers are exposed to a variety of contact allergens by handling tools, metals, metalworking fluids (MWFs), oils and greases, rubber materials, and so on. Most large-scale reports on contact allergy due to MWFs are more than 10-years-old, and there are only few studies on contact allergy in mechanics and other metal workers not exposed to MWFs. OBJECTIVES To describe a current spectrum of contact sensitization in Metalworkers with occupational dermatitis (OD). PATIENTS AND METHODS Retrospective analysis of patch test data collected by the Information Network of Departments of Dermatology (IVDK; 2010-2018), stratifying for 804 cutting Metalworkers, 2197 mechanics, and 355 other Metalworkers. RESULTS Cutting Metalworkers were most frequently sensitized to monoethanolamine (12.6%), colophonium/abietic acid (11.4%) and formaldehyde releasers (up to 8.5%) from the MWF series, and formaldehyde (4.6%) and iodopropynyl butylcarbamate (4.6%) from the baseline series. Sensitization among mechanics and other Metalworkers indicates possible occupational exposure to MWFs, glues, and resins, although this may not be expected from their job titles. CONCLUSIONS The spectrum of MWF contact allergens remained largely unchanged during the last years. Taking a comprehensive occupational history is indispensable in order to not miss relevant allergen exposures.
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assessment of occupational exposure and spectrum of contact sensitization in Metalworkers with occupational dermatitis results of a cohort study within the occuderm project
Journal of The European Academy of Dermatology and Venereology, 2020Co-Authors: Steffen Schubert, Richard Brans, Anna Reich, Timo Buhl, C Skudlik, A Hansen, Martin Mempel, Margarete Schon, S M John, Johannes GeierAbstract:Background Metalworkers occupationally exposed to metals, tools, metalworking fluids (MWFs), technical oils, gloves, skin care products etc. frequently suffer from occupational dermatitis (OD). Objectives To investigate occupational exposure and to identify relevant occupational sensitizers in Metalworkers with OD, and to evaluate suitability of current German patch test recommendations for this occupational group. Patients and methods As part of the OCCUDERM project, occupational exposure of 230 Metalworkers with suspected OD patch tested in the departments of dermatology in Gottingen and Osnabruck (both Lower Saxony, Germany) in 2012-2017 was recorded by questionnaire. These data, as well as results, of patch testing with standardized allergens and with workplace material were analysed. Results Metalworking fluids and skin care products were the most important exposures. Among MWF allergens, most frequently sensitizations to formaldehyde and formaldehyde releasers, colophony/abietic acid and monoethanolamine were observed. Sensitization to methylisothiazolinone (MI) was frequent, probably as part of the general European epidemic of contact allergy to MI in leave-on cosmetics. Sensitization to glove ingredients only played a minor role. Conclusions The known occupational allergen spectrum could largely be confirmed. In order not to miss relevant sensitizations, patch testing with material from the patients' workplaces in parallel to baseline and MWF series is recommended. Sensitizations diagnosed could not always be linked to particular occupational exposures.
Malinauskiene Laura - One of the best experts on this subject based on the ideXlab platform.
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heavy metals and the skin sensitization patterns in lithuanian Metalworkers
Contact Dermatitis, 2020Co-Authors: Linauskiene Kotryna, Isaksson Marlene, Malinauskiene LauraAbstract:Background: Metalworkers are exposed to many sensitizing and irritant substances. There are no published data on contact allergy in this population in the Baltic countries. Objectives: To detect skin symptoms related to occupational exposure and to describe the reactivity pattern to the European baseline series in workers from two metal plants in Lithuania. Methods: In this cross-sectional study 185 Metalworkers (154 production workers and 31 office staff) filled an interviewer-administered questionnaire. Patch testing was performed in 135 Metalworkers and office staff, as a control group. Results: Metalworkers younger than 40 years complained statistically significantly more often of skin symptoms, especially on the hands and face, than older workers. Physician-diagnosed skin diseases were reported in 1.7% of cases. Metalworkers, working <20 years in the factory, more often had skin symptoms. Contact with chemicals at the workplace was suspected as the main factor provoking skin symptoms. Metalworkers were sensitized mainly to cobalt, and nickel was the most prevalent allergen among office staff. Conclusion: Younger Metalworkers more often had skin symptoms suspected of being work-related compared to older ones. Sensitization to cobalt was more prevalent in the Metalworkers than in the control group. (Less)
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Heavy metals and the skin: Sensitization patterns in Lithuanian Metalworkers.
Contact dermatitis, 2020Co-Authors: Linauskiene Kotryna, Isaksson Marlene, Malinauskiene LauraAbstract:Background: Metalworkers are exposed to many sensitizing and irritant substances. There are no published data on contact allergy in this population in the Baltic countries. Objectives: To detect skin symptoms related to occupational exposure and to describe the reactivity pattern to the European baseline series in workers from two metal plants in Lithuania. Methods: In this cross-sectional study 185 Metalworkers (154 production workers and 31 office staff) filled an interviewer-administered questionnaire. Patch testing was performed in 135 Metalworkers and office staff, as a control group. Results: Metalworkers younger than 40 years complained statistically significantly more often of skin symptoms, especially on the hands and face, than older workers. Physician-diagnosed skin diseases were reported in 1.7% of cases. Metalworkers, working