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EN
In recent years occupational skin and respiratory diseases have been more and more frequently diagnosed in small production and service enterprises. The awareness of occupational exposure and its possible health effects among their workers and employers is not sufficient. Beauty salons, in addition to hairdressers and beauticians, frequently employ manicurists and pedicurists. The workers often happen to perform various activities interchangeably. The health status of beauty salons workers has rarely been assessed. The most numerous reports concern hairdressers. In this occupational group, the occurrence of skin lesions induced by wet work and frequent allergy to metals, hair dyes and bleaches and perm solutions has been emphasized, while information about health hazards for being a manicurist or pedicurist in beauty salons is seldom reported. The aim of this paper is to present professional activities (manicure and pedicure, methods of nail stylization), occupational exposure and literature data on work-related adverse health effects in manicurists and pedicurists. Wet work and exposure to solvents, fragrances, resins, metals, gum, detergents may cause skin disorders (contact dermatitis, urticaria, angioedema, photodermatoses), conjunctivitis, anaphylaxis, respiratory tract diseases, including asthma. The discussed occupations are also associated with the increased incidence of bacterial (particularly purulent), viral and fungal infections and cancer. Med Pr 2013;64(4):579–591
PL
W ostatnich latach choroby zawodowe skóry i układu oddechowego rozpoznaje się coraz częściej w małych zakładach produkcyjnych i usługowych. Wśród pracowników i pracodawców tych zakładów wiedza na temat narażenia zawodowego oraz ewentualnych skutków zdrowotnych wynikających z tego narażenia jest niewystarczająca. W salonach fryzjersko-kosmetycznych oprócz fryzjerów i kosmetyczek zatrudnione są również manikiurzystki i pedikiurzystki. Często te same osoby wykonują zamiennie różne usługi. Ocenę stanu zdrowia pracowników tych salonów prowadzono rzadko. Najwięcej opisów dotyczy fryzjerek i fryzjerów. Podkreślano występowanie zmian skórnych spowodowanych pracą w środowisku mokrym oraz bardzo częste uczulenia na metale, środki do barwienia i odbarwiania włosów oraz płyny do trwałej ondulacji. Z kolei informacje o skutkach zdrowotnych pracy osób zatrudnionych na stanowiskach manikiurzystek i pedikiurzystek w zakładach fryzjersko-kosmetycznych są nieliczne i fragmentaryczne. Celem pracy jest prezentacja wykonywanych czynności (manikiur i pedikiur kosmetyczny i leczniczy, metody stylizacji paznokci), narażenia zawodowego oraz danych literaturowych o niepożądanych reakcjach chorobowych, związanych z pracą na tych stanowiskach. Praca w mokrym środowisku oraz narażenie na rozpuszczalniki, środki zapachowe, żywice syntetyczne, metale, gumę, barwniki, detergenty może stwarzać ryzyko powstawania zmian skórnych (kontaktowe zapalenie skóry, pokrzywka, obrzęk naczynioruchowy, fotodermatozy), zapalenia spojówek, reakcji anafilaktycznych i chorób układu oddechowego, w tym astmy. W zawodach tych możliwe są również infekcje bakteryjne, zwłaszcza ropne, oraz wirusowe i grzybicze, a także choroby nowotworowe. Med. Pr. 2013;64(4):579–591
EN
Chloromethylisothiazolinone (MCI) and methylisothiazolinone (MI) have been widely used as preservatives in cosmetics, household products and industrial products since the late 1970s. First cases of contact allergy to the MCI/MI combination were noted in 1980–1982 in Sweden. Then, a significant increase in the frequency of sensitization to these compounds was observed in many European centers. The increase has been stopped by the introduction of legislation on their maximum concentrations in consumer and industrial products in Europe and in some non-European countries. But approval of the use of MI alone without limits in industrial products (from 2000) and at a maximum concentration of 100 ppm in cosmetics (from 2005) resulted in an unprecedented increase in the number of individuals sensitized to this compound. Allergic contact dermatitis due to MI occurs in both adults and children. It is often manifested by severe symptoms, which may be also induced by airborne exposure. The most important sources of sensitization include cosmetic products and paints. To counteract the increasing problem of contact allergy epidemic to MI, the recommendations have been developed, suggesting the ban on the use of MI in “leave-on” cosmetics and maximum concentration of 15 ppm in “rinse-off” products. These recommendations are likely to be implemented in 2014. Med Pr 2014;65(4):543–554
PL
Chlorometyloizotiazolinon (chloromethylisothiazolinone – MCI) i metyloizotiazolinon (methylisothiazolinone – MI) od końca lat 70. XX w. do 2014 r. stanowiły konserwanty powszechnie stosowane w kosmetykach, artykułach chemii gospodarczej i produktach przemysłowych. Pierwsze przypadki alergii kontaktowej na mieszaninę MCI/MI odnotowano w latach 1980–1982 w Szwecji, a następnie w wielu ośrodkach europejskich obserwowano istotny wzrost częstości uczuleń na te związki. Został on zahamowany dzięki wprowadzeniu w Europie i niektórych krajach pozaeuropejskich regulacji prawnych dotyczących dopuszczalnego stężenia MCI i MI w produktach konsumenckich i przemysłowych. Zezwolenie od 2000 r. na stosowanie bez limitu samego MI w produktach przemysłowych i od 2005 w kosmetykach w stężeniu do 100 ppm spowodowało w ostatnich latach znaczący wzrost liczby uczulonych na ten związek. Alergiczne kontaktowe zapalenie skóry związane z MI występuje zarówno u dorosłych, jak i dzieci, charakteryzuje się często ciężkim przebiegiem, a do wywołania objawów nierzadko dochodzi na drodze powietrznopochodnej. Do najistotniejszych źródeł uczulenia na MI należą kosmetyki i farby. W odpowiedzi na narastający problem epidemii alergii kontaktowej na izotiazolinony opracowano rekomendacje sugerujące zakaz stosowania MI w kosmetykach typu „leave-on” oraz uznanie za dopuszczalne stężenia 15 ppm w produktach kosmetycznych „rinse-off”. Zalecenia te prawdopodobnie zostaną wprowadzone w życie w 2014 r. Med. Pr. 2014;65(4):543–554
EN
Background: Nurses are prone to develop hand eczema due to occupational exposure to irritants, including wet work. The aim of the study was to evaluate the impact of wet work on selected skin properties, reflecting epidermal barrier function – transepidermal water loss (TEWL) and stratum corneum hydration – and additionally skin viscoelasticity, in nurses. Material and Methods: Study subjects included 90 nurses employed in hospital wards. Measurements were carried out within the dorsal aspect of the dominant hand, using a Cutometer MPA 580 equipped with Tewameter TM 300 and Corneometer CM 825 (Courage&Khazaka, Germany) probes. Examinations took place on hospital premises. Similar measurements were performed in the control group of females non-exposed to irritants. Results: In the examined group of nurses, mean TEWL was 15.5 g/h/m² and was higher than in the control group (12.99 g/h/m²). After rejecting the extreme results, the difference between the groups proved to be statistically significant (p < 0.05). The mean value of stratum corneum hydration was lower in the examined group (37.915) compared with the control group (40.05), but the difference was not statistically significant. Also results of viscoelasticity assessment showed no significant differences between studied groups. Conclusions: The results of the assessment of skin biophysical properties show that wet work exerts a moderately adverse impact on skin condition. A higher TEWL value and a lower stratum corneum hydration in workers exposed to irritants reflect an adverse impact of these factors on the epidermal barrier function. Med Pr 2014;65(5):609–619
PL
Wstęp: Pielęgniarki narażone są na rozwój wyprysku rąk z powodu zawodowej ekspozycji na różne czynniki drażniące, w tym mokre środowisko pracy. Celem badania była ocena wpływu mokrego środowiska pracy na wybrane parametry bariery naskórkowej – przeznaskórkową utratę wody (transepidemal water loss – TEWL) i zawartość wody w naskórku – oraz lepkosprężystość skóry u pielęgniarek. Materiał i metody: W badaniu wzięło udział 90 pielęgniarek zatrudnionych na oddziałach szpitalnych. Pomiary zostały przeprowadzone w obrębie powierzchni grzbietowej ręki dominującej, przy użyciu urządzenia Cutometer MPA 580, wyposażonego w sondy Tewameter TM 300 i Corneometer CM 825 (prod. Courage&Khazaka, Niemcy). Wszystkie badania odbyły się na terenie szpitali. Podobne badania przeprowadzono w grupie porównawczej osób nienarażonych na czynniki drażniące. Wyniki: W badanej grupie pielęgniarek średnia wartość TEWL wynosiła 15,5 g/godz./m² i była wyższa niż w grupie porównawczej (12,99 g/godz./m²). Po odrzuceniu skrajnych wyników różnica między grupami okazała się istotna statystycznie (p < 0,05). Średnia zawartość wody w naskórku była niższa w grupie pielęgniarek (37,915) w zestawieniu z grupą porównawczą (40,05), jednak nie była to różnica znacząca statystycznie. Również wyniki pomiaru lepkosprężystości wskazywały na brak istotnych różnic między badanymi grupami. Wykazano słabą zależność parametrów lepkosprężystości od wieku badanych. Wnioski: Wyniki przeprowadzonej instrumentalnej oceny cech biofizycznych skóry wskazują, że praca w mokrym środowisku w umiarkowanym stopniu wywiera negatywny wpływ na stan skóry. Wyższy w porównaniu z grupą porównawczą wskaźnik TEWL i niższa zawartość wody w naskórku u pracowników narażonych na czynniki drażniące odzwierciedla niekorzystne oddziaływanie tych czynników na funkcjonowanie bariery naskórkowej. Med. Pr. 2014;65(5):609–619
EN
Background Preservatives present in cosmetics and other industrial products can cause allergic contact dermatitis. The aim of the study was to assess the frequency of allergy to selected preservatives in consecutive patients examined due to contact dermatitis in the Nofer Institute of Occupational Medicine, Łódź, and to establish whether individuals sensitized to formaldehyde react simultaneously to formaldehyde releasers. Material and Methods A group of 405 patients (308 females and 97 males) was examined in 2011–2013. In all participants patch tests with a series of 13 preservatives (paraben mix, formaldehyde, Quaternium 15, chloromethylisothiazolinone/methylisothiazolinone mix, methyldibromoglutaronitrile, diazolidinyl urea, imidazolidinyl urea, DMDM hydantoin, 2-bromo-2-nitropropane-1,3-diol, iodopropynyl butylcarbamate, benzalkonium chloride, sodium metabisulfite, produced by Chemotechnique Diagnostics, Sweden) were performed. Results Of the 405 patients 74 (including 52 females) showed positive results of patch tests. Contact allergy to at least 1 preservative was noted in 47 (11.6%) patients, including 34 (11%) females and 13 (13.4%) males. Methylisothiazolinone proved to be the most frequent sensitizer – 4.7% (5.2% females, 3.1% males) while parabens, 2-bromo-2-nitropropane-1,3-diol and imidazolidinyl urea (0.2%) were found to be the least frequent. Fourteen (3.4%) participants, 10 women and 4 men, were allergic to formaldehyde and/or formaldehyde releasers. In 11 (78.6%) of them monovalent hypersensitivity was observed. In 13 (3.2% of the examined group) patients allergy to preservatives might have been of occupational origin. Conclusions Preservatives, particularly isothiazolinones, are significant causal factors of allergic contact dermatitis, including occupational cases. Individuals sensitized to formaldehyde may react simultaneously to formaldehyde releasers, however, such reactions are relatively rare. Med Pr 2015;66(3):327–332
PL
Wstęp Konserwanty zawarte w kosmetykach i wielu innych produktach przemysłowych mogą być przyczyną alergicznego kontaktowego zapalenia skóry. Celem pracy było określenie częstości uczulenia na wybrane konserwanty u kolejnych pacjentów Instytutu Medycyny Pracy im. prof. J. Nofera w Łodzi diagnozowanych z powodu kontaktowego zapalenia skóry oraz ustalenie, czy osoby uczulone na formaldehyd reagują jednocześnie na donory formaldehydu. Materiał i metody U 405 osób (308 kobiet, 97 mężczyzn), diagnozowanych w latach 2011–2013, przeprowadzono serię testów płatkowych z 13 środkami konserwującymi (mieszanina parabenów, formaldehyd, Quaternium 15, mieszanina chlorometyloizotiazolinon/metyloizotiazolinon, metyloizotiazolinon, metylodibromo- glutaronitryl, diazolinydylomocznik, imidazolidynylomocznik, DMDM hydantoina, 2-bromo-2-nitropropano-1,3-diol, butylokarbaminian jodopropynylu, chlorek benzalkonium, pirosiarczan sodowy – prod. Chemotechnique Diagnostics, Szwecja). Wyniki U 405 pacjentów stwierdzono 74 dodatnie wyniki testów płatkowych, w tym 52 u kobiet. Uczulenie na przynajmniej jeden z badanych konserwantów zaobserwowano u 47 osób (11,6%), w tym 34 kobiet (11%) i 13 mężczyzn (13,4%). Najczęściej uczulał metyloizotiazolinon (4,7%, w tym 5,2% kobiet, 3,1% mężczyzn), a najrzadziej parabeny, 2-bromo-2-nitropropano-1,3-diol i imidazolidynylomocznik (0,2%). Czternaście osób (3,4%), w tym 10 kobiet (3,2%) i 4 mężczyzn (4,1%), było uczulonych na formaldehyd lub/i donory formaldehydu. Aż u 11 z nich (78,6%) uczulenie miało charakter jednoważny. U 13 osób (3,2% ogółu badanych) uczulenie na konserwanty mogło mieć charakter zawodowy. Wnioski Środki konserwujące, szczególnie pochodne izotiazolinonu, są istotnymi czynnikami przyczynowymi alergicznego kontaktowego zapalenia skóry, w tym o pochodzeniu zawodowym. Osoby uczulone na formaldehyd mogą reagować jednocześnie na niektóre donory formaldehydu, ale reakcja ta zachodzi stosunkowo rzadko. Med. Pr. 2015;66(3):327–332
EN
Objectives: Evaluation of the allergenic properties of the metal knee or hip joint implants 24 months post surgery and assessment of the relation between allergy to metals and metal implants failure. Materials and Methods: The study was conducted in two stages. Stage I (pre-implantation) - 60 patients scheduled for arthroplasty surgery. Personal interview, dermatological examination and patch testing with 0.5% potassium dichromate, 1.0% cobalt chloride, 5.0% nickel sulfate, 2.0% copper sulfate, 2.0% palladium chloride, 100% aluminum, 1% vanadium chloride, 5% vanadium, 10% titanium oxide, 5% molybdenum and 1% ammonium molybdate tetrahydrate were performed. Stage II (post-surgery) - 48 subjects participated in the same procedures as those conducted in Stage I. Results: Stage I - symptoms of "metal dermatitis" were found in 21.7% of the subjects: 27.9% of the females, 5.9% of the males. Positive patch test results were found in 21.7% of the participants, namely to: nickel (20.0%); palladium (13.3%); cobalt (10.0%); and chromium (5.9%). The allergy to metals was confi rmed by patch testing in 84.6% of the subjects with a history of metal dermatitis. Stage II - 10.4% of the participants complained about implant intolerance, 4.2% of the examined persons reported skin lesions. Contact allergy to metals was found in 25.0% of the patients: nickel 20.8%, palladium 10.4%, cobalt 16.7%, chromium 8.3%, vanadium 2.1% Positive post-surgery patch tests results were observed in 10.4% of the patients. The statistical analysis of the pre- and post-surgery patch tests results showed that chromium and cobalt can be allergenic in implants. Conclusions: Metal orthopedic implants may be the primary cause of allergies. that may lead to implant failure. Patch tests screening should be obligatory prior to providing implants to patients reporting symptoms of metal dermatitis. People with confi rmed allergies to metals should be provided with implants free from allergenic metals.
EN
Objectives: To evaluate sensitization to chemicals present in work environment after an outbreak of contact dermatitis in workers of vehicle equipment factory, exposed to polyurethane foam, based on 4,4'-diphenylmethane diisocyanate (MDI). Material and Methods: From among 300 employees, 21 individuals reporting work-related skin and/or respiratory tract symptoms underwent clinical examination, patch testing, skin prick tests, spirometry and MDI sIgE measurement in serum. Patch tests included isocyanates series, selected rubber additives, metals, fragrances, preservatives, and an antiadhesive agent. Results: Clinical examination revealed current eczema in the area of hands and/or forearms in 10 workers. Positive patch test reactions were found in 10 individuals, the most frequent to diaminodiphenylmethane and 4-phenylenediamine (7 persons). Reactions to an antiadhesive agent were assessed as irritant (5 workers). Except for sensitization to common aeroallergens, no significant abnormalities were found in the remaining tests. Occupational allergic contact dermatitis was diagnosed in 7 workers, irritant contact dermatitis in 10 and coexisiting allergic and irritant contact dermatitis in 3 workers. Conclusions: In workers manufacturing products from polyurethane foam, attention should be paid to the risk of developing contact dermatitis. Skin problems in our study group were attributable probably to insufficient protection of the skin.
EN
Objectives Manicurists are exposed to various chemicals in nail and skin care products and may develop ocular, nasal, respiratory or skin adverse reactions to them. To investigate the occurrence of ocular, nasal, respiratory and skin problems among manicurists and to identify their causal factors, particularly allergic etiology and occupational origin. Material and Methods Manicurists employed in beauty salons in the central region of Poland were invited to fill in the questionnaire and undergo medical examination, skin prick tests with common aeroallergens, patch tests with European Baseline Series and (Meth)Acrylates Series-Nails and spirometry. Results In the questionnaire adverse nasal symptoms were reported by 70%, ocular – by 58%, respiratory – by 42%, hand eczema – by 43% of manicurists. In the medical interview, the frequency of those complaints was lower: nasal ones – 41%, ocular – 24%, cough – 18%, hand skin dryness – 20%, hand eczema – 6%. Cough and hand skin dryness occurred significantly more frequently than in the case of controls. Contact allergy was found for 41% of manicurists and 35% of controls. The prevalence of nickel sensitization was high in both groups (38% and 27%, respectively). Only 3 manicurists reacted to (meth)acrylates. The frequency of atopic diseases was similar in compared groups. Irritant nasal and respiratory reactions were significantly more prevalent among manicurists (nasal – 18% vs. 2%, p < 0.01; respiratory – 18% vs. 1%, p < 0.001). Work-related nasal irritant reactions were finally diagnosed for 19%, ocular ones – for 13%, respiratory – for 18% and within hand skin – for 23% of manicurists. Conclusions The frequency of workattributed irritant mucosal and skin symptoms among manicurists is high. Exposure to acrylates is an important source of mucosal irritant reactions while occlusive gloves cause irritation of hand skin. The prevalence of nickel allergy among Polish females is high. Int J Occup Med Environ Health 2017;30(6):887–896
EN
Objectives: The aim of the study was the assessment of local tolerance to nickel implants during 9 months observation in guinea pigs sensitized to nickel before implantation and non-sensitized ones. Materials and Methods: Three groups of guinea pigs were included in the study: 10 sensitized to nickel by the guinea pig maximization test; 10 previously nonsensitized and 10 in control group. In 20 animals (except control group) the nickel implants were inserted in the muscle of the back. After 9 months of observation, the animals were patch-tested with 5% nickel sulfate. Also percentage of eosinophils in peripheral blood was examined. Next, the tissue surrounding the implant and skin from the area of patch tests were collected for the histological examination. Results: In 70% of previously sensitized animals, the patch test confirmed the sensitivity to nickel. In 60% of previously non-sensitized animals, a positive reaction to nickel occurred. The results of patch tests in control group were negative. Percentage of eosinophils in peripheral blood was fourfold higher in animals sensitized to nickel than in control group. In histological examination, in the tissue surrounding the implant a dissimilarity concerning the intensity of cellular infiltration was observed between animals previously allergic and non-allergic to nickel. In the 2 of 10 previously sensitized guinea pigs quite severe inflammatory reactions in the inside of connective tissue capsule were noted which may indicate a local allergic reaction. The histological images of skin collected from the positive patch test site corresponded with the typical allergic contact dermatitis. Conclusions: Nickel implants may cause primary sensitization to nickel. The nature of the histological changes in the tissues around the implants in guinea pigs sensitized to nickel may correspond to an allergic reaction. The examination of percentage of eosinophils in blood of guinea pigs may be useful in assessing the allergenic activity of metal alloys containing nickel.
EN
Para-phenylenediamine (PPD) can induce immediate or – more often – delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visit in a beauty parlour, where she had her eyelashes and eyebrows dyed with henna. Physical examination revealed prominent edema of the upper part of the face including forehead, cheeks and eyes causing severe narrowing of the palpebral chink. Skin prick tests (SPT) with common allergens were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and moulds, while the SPT with PPD was negative. Patch test to PPD was positive. Further investigations revealed eosinophilia in the tear fluid. To our knowledge, this is the first case of PPD-induced contact blepharoconjunctivitis (CB) with concomitant increased eosinophilia in the tear fluid.
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