©fioh, riitta jolanki 27-28.8.2003 risk occupations riitta jolanki, d.tech. (chem.eng.), docent...
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©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
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
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.
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
Methods (3)
Age-standardized rate ratio (SRR) was calculated with reference to the total study population.
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
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
’
©FIOH, Riitta Jolanki27-28.8.2003
Most common allergens in occupations with the highest risk of ACD
Rubber chemicals Plastic chemicals Metals and metal compounds Formaldehyde and other
antimicrobials
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
Most common allergens in occupations with the highest risk of CU/PCD
Flours Cow dander NRL proteins Foodstuffs
©FIOH, Riitta Jolanki27-28.8.2003
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.
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
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)
©FIOH, Riitta Jolanki27-28.8.2003
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
» natural rubber latex
» protein-based shampoos and conditioners
©FIOH, Riitta Jolanki27-28.8.2003
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
» natural rubber latex
©FIOH, Riitta Jolanki27-28.8.2003
Assembly work
Diagnoses/causes
– allergic contact dermatitis» nickel
» anaerobic adhesives (methacrylates)
» epoxy glues
» colophony (soldering)
– irritant contact dermatitis» cyanocrylate adhesives
– contact urticaria» phthalic anhydrides
©FIOH, Riitta Jolanki27-28.8.2003
Plywood and fiberboard work
Diagnoses/causes
– allergic contact dermatitis» phenol formaldehyde resin
» urea formaldehyde resin
» formaldehyde
– irritant contact dermatitis» plywood glues (pH > 9)
©FIOH, Riitta Jolanki27-28.8.2003
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
©FIOH, Riitta Jolanki27-28.8.2003
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)
©FIOH, Riitta Jolanki27-28.8.2003
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.