1. ©FIOH, Riitta Jolanki 27-28.8.2003 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 riitta.jolanki@ttl.fi

2. ©FIOH, Riitta Jolanki 27-28.8.2003 02468101214161820 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

3. ©FIOH, Riitta Jolanki 27-28.8.2003 Risk of occupational dermatoses by occupation

4. ©FIOH, Riitta Jolanki 27-28.8.2003 Methods (1) l 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.

5. ©FIOH, Riitta Jolanki 27-28.8.2003 Methods (2) l The analyses were restricted to all wage earners and agricultural workers aged 25-64 years. l The occupation of the study subjects was obtained from the 1985 population census. l Follow-up time: beginning of 1986 to end of 1991. l Subjects excluded from the study population: those –having contracted an occupational dermatosis –turned 65 years of age –deceased

6. ©FIOH, Riitta Jolanki 27-28.8.2003 Methods (3) l Age-standardized rate ratio (SRR) was calculated with reference to the total study population.

7. ©FIOH, Riitta Jolanki 27-28.8.2003 General findings OCD ICD ACD Total Men Women CU/PCD

8. ©FIOH, Riitta Jolanki 27-28.8.2003 The highest SRR of ICD (95% confidence interval) (N=2237, number of cases >10)

9. ©FIOH, Riitta Jolanki 27-28.8.2003 Most common irritants in occupations with the highest risk of ICD l Organic solvents l Detergents l Oils and lubricants, including metal- working fluids l Cement-based products l Foodstuffs l Plastic chemicals

10. ©FIOH, Riitta Jolanki 27-28.8.2003 The highest SRR of ACD (95% confidence interval) (N=2020, number of cases >10) ’

11. ©FIOH, Riitta Jolanki 27-28.8.2003 Most common allergens in occupations with the highest risk of ACD l Rubber chemicals l Plastic chemicals l Metals and metal compounds l Formaldehyde and other antimicrobials

12. ©FIOH, Riitta Jolanki 27-28.8.2003 The highest SRR of CU/PCD (95% confidence interval) (N=412, number of cases >5)

13. ©FIOH, Riitta Jolanki 27-28.8.2003 Most common allergens in occupations with the highest risk of CU/PCD l Flours l Cow dander l NRL proteins l Foodstuffs

14. ©FIOH, Riitta Jolanki 27-28.8.2003 Conclusion l The study gave new information on the relative risk to develop an occupational skin disease in various occupations. l The differences in the risk of developing an occupational disease were very great. l Dental care workers had the highest risk of allergic contact dermatitis.

15. ©FIOH, Riitta Jolanki 27-28.8.2003 Detergent dermatoses - risk occupations l Cleaners l Hospital attendants l Bath workers l Chefs, cooks, cold buffet managers l Food and beverage manufacture workers l Cattle tenders l Barbers, hairdressers l Nurses l Dental assistants l Dentists, surgeons

16. ©FIOH, Riitta Jolanki 27-28.8.2003 Cleaning work l Diagnoses/causes –50% irritant contact dermatitis »detergents »wet and dirty work –25% allergic contact dermatitis »rubber and rubber chemicals »metals »formaldehyde and other antimicrobials

17. ©FIOH, Riitta Jolanki 27-28.8.2003 Kitchen and restaurant workers l Diagnoses/causes –irritant contact dermatitis »handling of foodstuffs »wet work »detergents –protein contact dermatitis »foodstuffs »natural rubber latex –allergic contact dermatitis »foodstuffs »rubber chemicals

18. ©FIOH, Riitta Jolanki 27-28.8.2003 Laboratory work l 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)

19. ©FIOH, Riitta Jolanki 27-28.8.2003 Barbers, hairdressers l 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

20. ©FIOH, Riitta Jolanki 27-28.8.2003 Garden and florist's work l Diagnoses/causes –allergic contact dermatitis »vegetables »flowers »rubber chemicals –irritant contact dermatitis »vegetables »flowers »dirty work –protein contact dermatitis »vegetables »flowers »natural rubber latex

21. ©FIOH, Riitta Jolanki 27-28.8.2003 Assembly work l Diagnoses/causes –allergic contact dermatitis »nickel »anaerobic adhesives (methacrylates) »epoxy glues »colophony (soldering) –irritant contact dermatitis »cyanocrylate adhesives –contact urticaria »phthalic anhydrides

22. ©FIOH, Riitta Jolanki 27-28.8.2003 Plywood and fiberboard work l Diagnoses/causes –allergic contact dermatitis »phenol formaldehyde resin »urea formaldehyde resin »formaldehyde –irritant contact dermatitis »plywood glues (pH > 9)

23. ©FIOH, Riitta Jolanki 27-28.8.2003 Machinists l Diagnoses/causes –allergic contact dermatitis »components in metal working fluids l formaldehyde and other antimicrobials l ethanolamines l colophony »metals (cobalt, nickel, chromium compounds) –irritant contact dermatitis »metal working fluids »oils and lubricants

24. ©FIOH, Riitta Jolanki 27-28.8.2003 Allergic contact dermatitis caused by plastic chemicals - risk occupations l Dentists l Dental assistants l Plywood and fiberboard workers l Plastic product workers l Painters and lacquerers l Electrical, radio and television workers (assemblers)

25. ©FIOH, Riitta Jolanki 27-28.8.2003 Occupational allergic dermatoses caused by chemicals in 1995-96 (cases/100 000 work years) l All plastic chemicals –all occupations4 l Epoxy compounds –all occupations 2 –exposed workers*1 000 l (Meth)acrylates, etc. –all occupations 1 –dentists100 –dental assistants200 * Työperäinen kemikaalialtistuminen Suomessa (Wor- related chemical exposure in Finland), FIOH & Finnish Work Environment Fund, Helsinki 1992.