Social Status May Interfere in the Prognosis of Frontal Fibrosing Alopecia in Female Patients: An Observational Study.

INTRODUCTION: Frontal fibrosing alopecia (FFA) is a cicatricial alopecia whose incidence has greatly increased worldwide over the last years. The main purpose of the study was to investigate the possible association of the social status of FFA patients with the prognosis of the disease. METHODS: A total of 100 female patients with FFA, monitored at Andreas Sygros Hospital, Athens, Greece, during the last 3 years, were recruited in this observational study. The age of the women ranged from 29 to 92 years with a mean age of 61.2 years (SD = 10.3); 97% of them were Greek, with skin type II and III. RESULTS: In total, 46% of the patients were intermediate graduates, and 42% had received tertiary education; 82% were married and 21% had 1 child. The duration of the disease ranged from 0.5 to 20 years with a mean duration of 5.2 years. In 53% of the women, the frontal hairline recession was <1 cm, in 26% it was 1-2 cm, and in 15% it was 3-4.99 cm. Overall, 55.6% of patients were professionals, 26% were technicians and associate professionals, 23% were office workers, 9% were service and sales workers, and 13% were at elementary occupations. The severity of the disease was higher in lower-educated patients, who belong to the category of unskilled or with elementary occupation. CONCLUSIONS: Women with high educational level and social status are more likely to be diagnosed earlier, resulting in sufficient therapeutic response.

Introducing Greek Guidelines for the Diagnosis and Treatment of Adverse Health Effects of Occupational Exposure to Metals.

Background Aim: Implementing guidelines in the practice of occupational health is a high-priority need, since their use can reduce the variability in practice and increase professional efficiency, resulting in higher quality of health care services. The aim of this report is to provide information regarding the development process of the first series of national guidelines for the diagnosis and treatment of adverse health effects occurring after occupational exposure to hazardous metals in Greece. This task was recently initiated in Greece as part of the health care reform system in the context of the ongoing financial crisis. METHODS: The following metals: arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), and nickel (Ni), which are the most commonly encountered in Greece, were selected to be studied. A systematic review of medical literature resulted in 94 review papers of the initial 3,932 eligible according to the inclusion criteria. RESULTS: For each metal, an extensive report was produced, including physical and chemical properties, routes of exposure, health hazards, medical surveillance, occupational exposure limits, protection and control measures, first aid and rescue, and waste management. Special attention was paid to environmental exposure data, effects on children health, and necessary laboratory examinations. CONCLUSIONS: The first series of guidelines, regarding diagnosis and treatment of individuals who have been occupationally exposed to metals is available; it was recently published in Greece by the National School of Public Health, aiming at helping occupational health practitioners enhance the quality of their provided services.

Occupational exposure to inhalable wood dust in the member states of the European Union.

The aim of this study was to estimate occupational exposure to inhalable wood dust by country, industry, the level of exposure and type of wood dust in 25 member states of the European Union (EU-25) for the purposes of hazard control, exposure surveillance and assessment of health risks. National labour force statistics, a country questionnaire (in 15 member states, EU-15), a company survey (in Finland, France, Germany and Spain), exposure measurements (from Denmark, Finland, France, Germany, The Netherlands and the United Kingdom) and expert judgements were used to generate preliminary estimates of exposure to different types of wood dust. The estimates were generated according to industrial class (six wood industries, four other sectors) and level of exposure (five classes). These estimates were reviewed and finalized by national experts from 15 member states. Crude estimates were generated also for 10 new member states (EU-10). The basic data and final estimates were included in the WOODEX database. In 2000-2003, about 3.6 million workers (2.0% of the employed EU-25 population) were occupationally exposed to inhalable wood dust. Of those, construction employed 1.2 million exposed workers (33%), mostly construction carpenters. The numbers of exposed workers were 700,000 (20%) in the furniture industry, 300,000 (9%) in the manufacture of builders' carpentry, 200,000 (5%) in sawmilling, 150,000 (4%) in forestry and <100,000 in other wood industries. In addition, there were 700,000 exposed workers (20%) in miscellaneous industries employing carpenters, joiners and other woodworkers. The numbers of exposed workers varied by country ranging from <3,000 in Luxembourg and Malta to 700,000 in Germany. The highest exposure levels were estimated to occur in the construction sector and furniture industry. Due to limited exposure data there was considerable uncertainty in the estimates concerning construction woodworkers. About 560,000 workers (16% of the exposed) may be exposed to a level exceeding 5 mg m(-3). Mixed exposure to more than one species of wood and dust from wooden boards was very common, but reliable data on exposure to different species of wood could not be retrieved. This kind of assessment procedure integrating measurement data, company data, country-specific data and expert judgement could also serve as one model for the assessment of other occupational exposures.