Contact dermatitis is the most frequent occupational
dermatosis and non-specific irritants in addition to specific Type IV sensitization are involved. We reviewed our database for data from 1994 to 1998 and selected 360 consecutive patients working in healthcare environments and experiencing
contact dermatitis at their hands, wrists and forearms. We found that
allergic contact dermatitis and
irritant contact dermatitis were considered to be work-related in 16.5% (72/436) and 44.4% (194/436) of diagnoses, respectively. Occupational
irritant contact dermatitis is due to exposure to a wide range of irritants in the workplace, such as
soaps,
solvents, cleansers and
protective gloves, which conspire to remove the surface
lipid layer and/or produce cellular damage. In this study the major relevant aetiological agents that induced occupational
allergic contact dermatitis were:
nickel sulphate (41 patch positivities), components of
disinfectants [
glutaraldehyde (5) and
benzalkonium chloride (7)] and rubber chemicals [
thiuram mix (15),
carba mix (9) and tetramethylthiuram monosulphide (6)]. The best treatment for
allergic contact dermatitis is to avoid those
allergens causing the
rash. Whenever this is not possible, contact with them needs to be reduced using properly selected
protective gloves. Finally, subjects with
atopic dermatitis should avoid 'wet work' and contact with irritants, because
atopic dermatitis is significantly associated with
irritant contact dermatitis.