Uso de técnicas de aprendizado de máquina para classificação de fatores que influenciam a ocorrência de dermatites ocupacionais / Using machine learning techniques to classify factors that influence the occurrence of occupational dermatitis

Resumo Introdução: realizar a predição de doenças relacionadas ao trabalho é um desafio às organizações e ao poder público. Com as técnicas de aprendizado de máquina (AM), é possível identificar fatores determinantes para a ocorrência de uma doença ocupacional, visando direcionar ações mais efetivas à proteção dos trabalhadores. Objetivo: predizer, a partir da comparação de técnicas de AM, os fatores com maior influência para a ocorrência de dermatite ocupacional. Métodos: desenvolveu-se um código em linguagem R e uma análise descritiva dos dados e identificaram-se os fatores de influência de acordo com a técnica de AM que demonstrou melhor desempenho. O banco de dados foi disponibilizado pelo Serviço de Dermatologia Ocupacional da Fundação Oswaldo Cruz e contém informações de trabalhadores que apresentaram alterações cutâneas sugestivas de dermatite ocupacional no período de 2000-2014. Resultados: as técnicas com melhor desempenho foram: neural network, random forest, support vector machine e naive Bayes. As variáveis sexo, escolaridade e profissão foram as mais adequadas para os modelos de previsão de dermatite ocupacional. Conclusão: as técnicas de AM possibilitam predizer os fatores que influenciam a segurança e a saúde dos trabalhadores, os parâmetros que subsidiam a implantação de procedimentos e as políticas mais efetivas para prevenir a dermatite ocupacional.

Abstract Introduction: to predict work related diseases is a challenge for organizations and the governmental authorities. By means of machine learning (ML) techniques it is possible to identify factors that determine the occurrence of an occupational disease, aiming at taking more effective actions to protect workers. Objective: to predict, by comparing ML techniques, the factors which highly influence the occurrence of occupational dermatitis. Methods: we developed a code in R language and a descriptive analysis of the data and identified the influence factors according to the ML technique that presented the best performance. The database was made available by the Occupational Dermatology Service of Oswaldo Cruz Foundation and assembles information of the workers who experienced cutaneous alterations suggestive of occupational dermatitis between 2000-2014. Results: the techniques which presented the best performance were: neural network, random forest, support vector machine, and naive Bayes. Sex, schooling, and profession were the most adequate variables for the occupational dermatitis prediction models. Conclusion: ML techniques allowed to predict the factors that influence the workers' safety and health, as well as the parameters that subsidize the procedures implementation, and the most effective policies to prevent occupational dermatitis.

Occupational contact dermatitis caused by methyl chlorobutyrate:a clinical analysis of 5 cases / 中华全科医师杂志

The clinical data of 5 patients with occupational contact dermatitis caused by methyl chlorobutyrate treated in the Affiliated Hospital of Jining Medical College and Mamiao Township Hospital of Jinxiang County from September to October 2021 were retrospectively analyzed. Patients were all males aged 33-47 years with a history of exposure to methyl chlorobutyrate 1 to 4 d before the onset of symptoms. Three patients were hospitalized and 2 patients were treated in outpatient clinic. The clinical manifestations were erythema on the trunk or extremities of varying degrees, scattered with blisters and bullae of different sizes, with thin and clear blisters, local ulceration and exudation; no erosion or ulceration was found in the oral cavity and vulva. All 5 patients had elevated white blood cell counts, and 2 patients had abnormal liver function. All patients received symptomatic treatment with topical drugs. Three hospitalized patients were given methylprednisolone and loratadine; in addition, 1 case also received human immunoglobulin and moxifloxacin hydrochloride injection and 2 cases received hepatoprotective drugs. Two outpatients were given prednisone acetate and loratadine for treatment. Three hospitalized patients were all improved and discharged after 14-30 d of treatment. The rash of 2 outpatients subsided after 14 d of treatment, and there was no recurrence after 1-month follow-up. The occupational contact dermatitis caused by methyl chlorobutyrate is primary irritant contact dermatitis, often manifested as erythema and blisters on the trunk or limbs, and timely anti-allergic treatment can effectively control the disease.

[Occupational Dermatoses in Healthcare Workers during the COVID-19 Pandemic: A Narrative Review]. / Dermatoses Ocupacionais em Profissionais de Saúde durante a Pandemia de COVID-19: Revisão Narrativa.

INTRODUCTION: On the 11th March 2020, the World Health Organization declared the novel coronavirus outbreak as a pandemic. Preventive measures such as the appropriate use of personal protective equipment and proper hand hygiene are essential in decreasing transmissibility. Healthcare workers have been required to wear personal protective equipment and to wash their hands even more frequently. These preventive measures are associated with an increased risk of skin conditions, namely, contact dermatitis and exacerbation of pre-existing skin lesions such as acne and seborrheic dermatitis. The aim of this article is to provide an overview of the main skin lesions, and highlighting the role in occupational dermatology and preventive measures. METHODS: A search was conducted on PubMed and some guidelines from organizations like World Health Organization and Portuguese General Directorate of Health were included. RESULTS: Most skin conditions seen in healthcare professionals throughout the pandemic were associated with hand hygiene and the use of personal protective equipment and comprised hand eczema, mask-induced contact dermatitis, personal protective equipment related irritant contact dermatitis, cheilitis and exacerbation of pre-existing conditions such as acne and seborrheic dermatitis. Prevention and early recognition of dermatitis associated with personal protective equipment and hand hygiene are essential to maximize work performance, healthcare workers' safety and the adherence to preventive measures. CONCLUSION: Protection of healthcare workers' health and safety is an essential measure in the fight against the pandemic. Occupational Health has a fundamental role, acting in terms of disease prevention and health promotion, for example, through educational sessions and orientation of skin conditions associated with work, thus maximizing workers' well-being.

Introdução: A 11 de março de 2020, a Organização Mundial da Saúde declarou a doença provocada pelo novo coronavírus uma pandemia. As medidas de prevenção, nomeadamente, o uso apropriado de equipamento de proteção individual e a higienização das mãos, são essenciais na diminuição da transmissibilidade. Os profissionais de saúde têm particular indicação para o seu uso e para o aumento da frequência e duração da lavagem e desinfeção das mãos. Estas medidas estão associadas a um maior risco de desenvolvimento de patologias cutâneas como a dermatite de contacto e a exacerbação de lesões cutâneas pré-existentes, tais como a acne e a dermatite seborreica. O objetivo deste artigo é apresentar uma descrição das principais lesões cutâneas, e salientar o papel da dermatologia ocupacional e medidas preventivas.Métodos: Foi realizada uma pesquisa na PubMed e incluídas orientações de organizações como a Direção-Geral da Saúde e a Organização Mundial da Saúde.Resultados: As principais patologias cutâneas observadas nos profissionais de saúde ao longo da pandemia associam-se à higienização das mãos e à utilização de equipamentos de proteção individual, consistindo, sucintamente, em eczema das mãos, dermatite de contacto induzida por máscaras, dermatite de contacto irritativa por traumatismo do equipamento de proteção individual, queilite e exacerbação de condições pré-existentes como acne e dermatite seborreica. A prevenção e o reconhecimento atempado das dermatites associadas ao uso de equipamento de proteção individual e ao reforço da higiene das mãos são fundamentais para otimizar o desempenho laboral e a segurança dos profissionais de saúde e maximizar a adesão às medidas preventivas.Conclusão: A proteção da saúde e da segurança dos profissionais de saúde constitui uma medida essencial no combate da pandemia, pelo que a Medicina do Trabalho assume um papel fundamental, atuando a nível da prevenção da doença e promoção da saúde, por exemplo, através da realização de sessões de educação e orientação das várias patologias cutâneas associadas ao trabalho, maximizando o bem-estar do trabalhador.

[Research progress on the immunological pathogenesis of occupational medicamentosa-like dermatitis due to trichloroethylene].

Occupational exposure to trichloroethylene can induce a series of immune diseases which include systemic rash, multiple system and organ damage, which are defined as occupational medicamentosa-like dermatitis due to trichloroethylene (OMLDT) . This article reviews the research progress of the role of T cell immunity, humoral immunity and complement system in the immunological pathogenesis of OMLDT to provide theoretical basis for the diagnosis and treatment of OMLDT.

Aseptic Folliculitis in Freshwater and Marine Fishermen.

Folliculitis is a common skin disease, usually benign, which causes inflammation and eventual infections of hair follicles. They may have an infectious etiology, mainly due to the bacteria Staphylococcus aureus; it also occurs due to localized irritation, such as in areas of skin friction and for long periods of immersion in water, as in athletes and workers who are continuously exposed to the aquatic environment. Herein, we report on two fishermen, from fluvial and maritime environments, who presented with chronic aseptic folliculitis associated with daily immersion of their lower extremities while exercising the profession and that regressed when there was a decrease in their contact with water.

Dermatoses associadas ao trabalho em profissionais de saúde de um centro hospitalar português / Occupational dermatoses among healthcare workers in a hospital center in Portugal

Introdução: As patologias cutâneas representam mais de 35% das doenças relacionadas com o trabalho, afetando anualmente 1/1.000 trabalhadores. Objetivos: Caracterizar as dermatoses associadas ao trabalho em profissionais de um centro hospitalar e identificar possíveis agentes desencadeantes e fatores de suscetibilidade. Métodos: Estudo transversal com recolha da informação registrada no processo clínico eletrônico dos trabalhadores observados em exame de saúde periódico no período de um ano. Resultados: Nos 1.741 trabalhadores estudados, 3,56% tinham registro de dermatoses associadas ao trabalho, a maioria mulheres (76,85%). Dos profissionais com dermatoses, 34 (54,84%) tinham dermatite de contato irritativa, 17 (27,42%) urticária ao látex, seis (9,68%) dermatite de contato alérgica e cinco (8,06%) duas dermatoses concomitantes. Encontrou-se diferença estatisticamente significativa entre os vários grupos profissionais (p=0,008), sendo os auxiliares de enfermagem os mais afetados (5,11%). Verificou-se também maior prevalência (8,47%) em profissionais de blocos operatórios (p=0,001). Os principais agentes desencadeantes foram desinfetantes cutâneos, látex, luvas de nitrilo e contato prolongado com água (4,84%). Conclusões: Por tratar-se de um estudo baseado em registros clínicos, a informação está dependente da qualidade destes. Para além disso, os auxiliares de enfermagem foram a maioria representada na amostra no que se refere à população do centro hospitalar, o que limita a extrapolação dos resultados. Este estudo encontrou prevalência de dermatoses de somente 3,56%, o que talvez se deva à implementação de medidas preventivas. Os profissionais mais afetados foram os de blocos operatórios e os auxiliares de enfermagem. Os desinfetantes cutâneos foram os principais agentes apontados como desencadeantes.

Background: Skin diseases account for more than 35% of occupational diseases, affecting 1/1,000 workers annually. Objective: To characterize occupational dermatoses affecting hospital workers and identify possible triggers and susceptibility factors. Methods: Cross-sectional study in which we analyzed information extracted from electronic medical records of workers who performed periodic examinations in the course of one year. Results: About 3.56% of 1,741 included workers had a diagnosis of occupational dermatosis, being mainly women (76.85%). Thirty-four (54.84%) of the affected workers had irritant contact dermatitis, 17 (27.42%) latex allergy, 6 (9.68%) allergic dermatitis, and 5 (8.06%) two concomitant conditions. We found significant difference in prevalence as a function of occupational group (p=0.008), being highest for nursing assistants (5.11%). Prevalence was also higher for employees allocated to surgery departments (8.47%, p=0.001). Main triggers were skin disinfectants, latex, nitrile gloves, and prolonged contact with water (4.84%). Conclusion: The quality of the analyzed data depends on the quality of the analyzed medical records. Most subjects were nursing assistants, which fact hinders the generalization of the results. The prevalence of occupational dermatosis was just 3.56%, which might be explained by previously implemented preventive measures. The employees most frequently affected were those allocated to surgery departments and nursing assistants. Skin disinfectants were the most frequent triggers.

Sociodemographic and clinical profile of patients with occupational contact dermatitis seen at a work-related dermatology service, 2000 - 2014

Abstract: BACKGROUND: Occupational dermatoses are common, especially contact dermatitis. Epidemiological studies on these dermatoses are scarce in Brazil and they are necessary as part of the public policy to protect workers' health. OBJECTIVES: To identify sociodemographic and clinical profile of patients with occupational contact dermatitis seen between 2000 and 2014 at an occupational dermatology service. METHODS: It is a cross-sectional and retrospective study, based on information obtained from the service's database. RESULTS: Of 560 patients with conclusive patch test, 289 (46.9%) presented occupational dermatoses and 213 occupational contact dermatitis with predominance of the allergic type in relation to the irritative type (149:64 respectively). The odds of occupational dermatoses were higher among men and lower among patients aged 50 years or older and with higher level of education. Regarding the possibility of presenting occupational allergic contact dermatitis, only the gender variable was statistically significant. The professions most seen were cleaners, construction workers, painters, mechanics/metallurgists and cooks. The commonest allergens were nickel sulfate, potassium dichromate, cobalt chloride, carba-mix and formaldehyde. STUDY LIMITATIONS: The main limitations of this study are the fact that it was carried out in a tertiary service of occupational dermatoses and the lack of access to some allergens outside the patch test baseline series. CONCLUSIONS: It was possible to identify the sociodemographic and clinical profile of patients with suspected occupational contact dermatitis seen at the Service, beyond the professional groups and allergens related to a high risk of occupational contact dermatitis in this population.

Occupational dermatoses among healthcare workers in a hospital center in Portugal.

BACKGROUND: Skin diseases account for more than 35% of occupational diseases, affecting 1/1,000 workers annually. OBJECTIVE: To characterize occupational dermatoses affecting hospital workers and identify possible triggers and susceptibility factors. METHODS: Cross-sectional study in which we analyzed information extracted from electronic medical records of workers who performed periodic examinations in the course of one year. RESULTS: About 3.56% of 1,741 included workers had a diagnosis of occupational dermatosis, being mainly women (76.85%). Thirty-four (54.84%) of the affected workers had irritant contact dermatitis, 17 (27.42%) latex allergy, 6 (9.68%) allergic dermatitis, and 5 (8.06%) two concomitant conditions. We found significant difference in prevalence as a function of occupational group (p=0.008), being highest for nursing assistants (5.11%). Prevalence was also higher for employees allocated to surgery departments (8.47%, p=0.001). Main triggers were skin disinfectants, latex, nitrile gloves, and prolonged contact with water (4.84%). CONCLUSION: The quality of the analyzed data depends on the quality of the analyzed medical records. Most subjects were nursing assistants, which fact hinders the generalization of the results. The prevalence of occupational dermatosis was just 3.56%, which might be explained by previously implemented preventive measures. The employees most frequently affected were those allocated to surgery departments and nursing assistants. Skin disinfectants were the most frequent triggers.

INTRODUÇÃO: As patologias cutâneas representam mais de 35% das doenças relacionadas com o trabalho, afetando anualmente 1/1.000 trabalhadores. OBJETIVOS: Caracterizar as dermatoses associadas ao trabalho em profissionais de um centro hospitalar e identificar possíveis agentes desencadeantes e fatores de suscetibilidade. MÉTODOS: Estudo transversal com recolha da informação registrada no processo clínico eletrônico dos trabalhadores observados em exame de saúde periódico no período de um ano. RESULTADOS: Nos 1.741 trabalhadores estudados, 3,56% tinham registro de dermatoses associadas ao trabalho, a maioria mulheres (76,85%). Dos profissionais com dermatoses, 34 (54,84%) tinham dermatite de contato irritativa, 17 (27,42%) urticária ao látex, seis (9,68%) dermatite de contato alérgica e cinco (8,06%) duas dermatoses concomitantes. Encontrou-se diferença estatisticamente significativa entre os vários grupos profissionais (p=0,008), sendo os auxiliares de enfermagem os mais afetados (5,11%). Verificou-se também maior prevalência (8,47%) em profissionais de blocos operatórios (p=0,001). Os principais agentes desencadeantes foram desinfetantes cutâneos, látex, luvas de nitrilo e contato prolongado com água (4,84%). CONCLUSÕES: Por tratar-se de um estudo baseado em registros clínicos, a informação está dependente da qualidade destes. Para além disso, os auxiliares de enfermagem foram a maioria representada na amostra no que se refere à população do centro hospitalar, o que limita a extrapolação dos resultados. Este estudo encontrou prevalência de dermatoses de somente 3,56%, o que talvez se deva à implementação de medidas preventivas. Os profissionais mais afetados foram os de blocos operatórios e os auxiliares de enfermagem. Os desinfetantes cutâneos foram os principais agentes apontados como desencadeantes.

Dermatoses ocupacionais registradas em sistema de notificação na região Sul do Brasil (2007 a 2016) / Occupational dermatoses registered in a notification system in the southern region of Brazil (2007 to 2016)

Introdução: As dermatoses ocupacionais são doenças de notificação compulsória no Brasil. Objetivo: Caracterizar a notificação das dermatoses ocupacionais no Sul do Brasil e descrever o perfil desses trabalhadores. Método: Descritivo, retrospectivo de 396 casos de dermatoses ocupacionais entre 2007-e 2016 no Sistema de Informação de Agravos de Notificação. Resultados: Em relação ao sexo, houve 3,6 casos a cada 10 mil trabalhadores/ano do sexo masculino e 2,2 casos a cada 10 mil trabalhadores/ano do sexo feminino. A faixa etária com maior incidência foi entre 50 e 64 anos, com 1,8 caso a cada 10 mil trabalhadores/ano. Destacaram-se os trabalhadores de manutenção e reparação, com 3,6 casos a cada 10 mil trabalhadores/ano. Em relação à raça/cor, houve predomínio de trabalhadores brancos (77%); já a escolaridade mais acometida foi entre trabalhadores com Ensino Fundamental incompleto (37,9%). O teste de contato foi realizado em apenas 11,4% dos casos. Conclusão: Torna-se necessário reforçar medidas para o uso de equipamentos de proteção individual, bem como aprimoramento das notificações e sensibilização dos profissionais de saúde para o registro correto nos sistemas oficiais

Background: Occupational dermatoses must be mandatorily reported in Brazil. Objective: To characterize the reporting of occupational dermatoses in the Brazilian South region, and describe the profile of the involved workers. Method: Retrospective and descriptive study of 396 cases of occupational dermatoses reported from 2007 through 2016 via the Information System for Notifiable Diseases. Results: 3.6 and 2.2 cases / 10,000 workers / year were of men and women, respectively. The highest incidence of occupational dermatoses corresponded to age range 50 to 64 years old, 1.8 cases / 10,000 workers / year, and to maintenance and repair workers, 3.6 cases / 10,000 workers / year. Most cases involved whites (77%) and workers not having completed elementary school (37.6%). Patch testing was only performed for 11.4% of cases. Conclusion: Reinforcing measures to promote the use of personal protective equipment is necessary, as well as to improve reporting and sensitize professionals to perform accurate reports in official systems.

Occupational dermatoses reported in Brazil from 2007 to 2014

Abstract: Background: Occupational diseases are very prevalent in the world, especially in developing countries. Occupational dermatoses are responsible for most of these cases. However, epidemiological studies are rare in Brazil. Objectives: To verify the panorama of occupational skin diseases in Brazil describing frequencies of work-related dermatoses and their sociodemographic and occupational patterns. Methods: We used retrospective data from the Notifiable Diseases Information System, (from 2007-2014) tabulated with the Tab program for Windows - TabWin12. We used intentional non-probability sampling and sequential selection, considering all notified occupational dermatoses. Results: All cases of occupational dermatoses referred to in the period were analyzed (n = 4710). Males and the age group of 35-49 years were the most affected. The most affected body area was the upper limb (34.2%) and the hand (25.4%). The "causative agent" field in the forms was not filled in 69.4% of cases, with chrome as the most prevalent cause reported (11.8%). ICD-10 codes more prevalent were L23, L24, and L25, corresponding to 34.2% of the sample. In total, 29% of patients needed to take a sick leave. No cases evolved to death and there were 0.2% of total as permanent disability. Study limitations: The amount of missing information for various items in the system draws attention. Conclusions: Treatment of patients with occupational dermatitis include the identification and removal of the causative agent and specific treatment of the disease. Diagnosis delay in cases of occupational dermatoses brings social and financial consequences to the work and life of workers.

Occupational dermatoses in the Brazilian South region recorded in a reporting system (2007 to 2016).

BACKGROUND: Occupational dermatoses must be mandatorily reported in Brazil. OBJECTIVE: To characterize the reporting of occupational dermatoses in the Brazilian South region, and describe the profile of the involved workers. METHOD: Retrospective and descriptive study of 396 cases of occupational dermatoses reported from 2007 through 2016 via the Information System for Notifiable Diseases. RESULTS: 3.6 and 2.2 cases / 10,000 workers / year were of men and women, respectively. The highest incidence of occupational dermatoses corresponded to age range 50 to 64 years old, 1.8 cases / 10,000 workers / year, and to maintenance and repair workers, 3.6 cases / 10,000 workers / year. Most cases involved whites (77%) and workers not having completed elementary school (37.6%). Patch testing was only performed for 11.4% of cases. CONCLUSION: Reinforcing measures to promote the use of personal protective equipment is necessary, as well as to improve reporting and sensitize professionals to perform accurate reports in official systems.

INTRODUÇÃO: As dermatoses ocupacionais são doenças de notificação compulsória no Brasil. OBJETIVO: Caracterizar a notificação das dermatoses ocupacionais no Sul do Brasil e descrever o perfil desses trabalhadores. MÉTODO: Descritivo, retrospectivo de 396 casos de dermatoses ocupacionais entre 2007-e 2016 no Sistema de Informação de Agravos de Notificação. RESULTADOS: Em relação ao sexo, houve 3,6 casos a cada 10 mil trabalhadores/ano do sexo masculino e 2,2 casos a cada 10 mil trabalhadores/ano do sexo feminino. A faixa etária com maior incidência foi entre 50 e 64 anos, com 1,8 caso a cada 10 mil trabalhadores/ano. Destacaram-se os trabalhadores de manutenção e reparação, com 3,6 casos a cada 10 mil trabalhadores/ano. Em relação à raça/cor, houve predomínio de trabalhadores brancos (77%); já a escolaridade mais acometida foi entre trabalhadores com Ensino Fundamental incompleto (37,9%). O teste de contato foi realizado em apenas 11,4% dos casos. CONCLUSÃO: Torna-se necessário reforçar medidas para o uso de equipamentos de proteção individual, bem como aprimoramento das notificações e sensibilização dos profissionais de saúde para o registro correto nos sistemas oficiais.

Doença alérgica ocupacional: aspectos socioepidemiológicos em ambulatório especializado na cidade de São Paulo / Occupational allergic disease: socio-epidemiological aspects from a specialized outpatient clinic at the city of Sao Paulo

Introdução: Doença ocupacional envolvendo o sistema imunológico é considerada doença alérgica ocupacional (DAO). Das doenças ocupacionais, 15% são alérgicas. As consequências sociais do diagnóstico de DAO são importantes para o trabalhador e empregador. Objetivos: Descrever características demográficas e clínicas dos pacientes estudados com DAO e seus desfechos sociais. Métodos: Estudo descritivo, retrospectivo dos prontuários de pacientes do ambulatório de alergia ocupacional de hospital universitário em São Paulo, com diagnóstico de DAO. Resultados: 72 pacientes apresentaram DAO, com idades entre 21 e 89 anos; 52% do sexo masculino. Antecedentes atópicos foram descritos em 35% dos pacientes. A maioria dos pacientes trabalhava nas áreas de indústria química (17%), limpeza (15%), construção civil (11%) e saúde (8%). Rinite ocupacional foi vista em 26% dos pacientes; asma relacionada ao trabalho, em 18%; asma e rinite, em 25%; dermatite de contato alérgica, em 13%. Sobre o desfecho social, 36 (50%) mantiveram-se em seus cargos, 19 (26%) mudaram de função, 7 (10%) mudaram de área, 7 (10%) foram afastados e 3 (4%) se aposentaram. Conclusões: Na casuística estudada, a DAO prevaleceu no sexo masculino, em faixa etária condizente com faixa trabalhadora; com maior número de casos de rinite ocupacional. Metade dos pacientes continuou exercendo a mesma função mesmo após o diagnóstico.

Background: Occupational diseases involving the immune system are considered as occupational allergic diseases (OAD); 15% of occupational diseases are allergic. The social consequences of OAD are significant for both workers and employers. Objectives: To describe demographic and clinical characteristics of patients with OAD and their social outcomes. Methods: Descriptive and retrospective study of the medical records of patients diagnosed with OAD and cared at the occupational allergy clinic of a university hospital in São Paulo, Brazil. Results: A total of 72 patients exhibited OAD, with age from 21 to 89 years old; 52% were male. Atopic antecedents were described for 35% of patients. Most patients worked in the chemical industry (17%), cleaning (15%), construction (11%) and health (8%). Occupational rhinitis was found in 26% of the patients, work-related asthma in 18%, asthma and rhinitis in 25%, and allergic contact dermatitis in 13%. In regard to the social outcomes, 36 (50%) remained in their job, 19 (26%) changed function, 7 (10%) changed work area, 7 (10%) were fired and 3 (4%) retired. Conclusions: In the present study, OAD prevailed in males and the economically active age; cases of occupational rhinitis were the most frequent. Half of the employees remained in the same function even after diagnosis.

Pés de imersão em água morna entre trabalhadores de lavagem de automóveis / Warm-water immersion feet among car wash workers

Introdução: O quadro clínico de pés de imersão em água morna (PIAM) está relacionado ao contato prolongado com água em temperaturas elevadas. Uma categoria profissional com possibilidade de exposição frequente à umidade é a dos prestadores de serviço de lavagem de automóveis (lava a jato). Não foram encontrados estudos científicos sobre doenças que acometam os trabalhadores dessa área. Objetivo: Avaliar a frequência de quadros de PIAM entre trabalhadores de um lava a jato. Métodos: O estudo foi realizado em um lava a jato na cidade de Jundiaí (SP), em 2013. Um grupo de 30 trabalhadores foi submetido a anamnese e exame físico dermatológico. Foram realizados testes estatísticos para avaliar associação entre quadros de PIAM e variáveis independentes. Resultados: Todos os participantes eram do sexo masculino, com idade média de 23 anos, e a maioria (60%) trabalhava na empresa há mais de um ano. Sessenta por cento dos participantes apresentaram lesões compatíveis com PIAM. A faixa etária e o tempo de trabalho estiveram associados ao quadro. Havia exposição frequente e permanente à umidade durante o trabalho, sem uso de vestuário impermeável. Conclusão: A maioria dos trabalhadores que fizeram parte da pesquisa tinha diagnóstico de PIAM; os com idade superior a 30 anos e que trabalhavam há menos de 1 ano na função tiveram maior probabilidade de apresentar o quadro clínico por exposição ocupacional à umidade.

Introduction: The diagnosis of warm-water immersion foot (WWIF) is related to prolonged contact with water at high temperatures. Car wash workers are exposed to humidity, but there are not studies about diseases that affect workers in this area. Objective: To evaluate the frequency of WWIF among car wash workers and associated factors. Methods: The study was carried out in a car wash service in the city of Jundiaí, in the state of São Paulo, Brazil, in 2013. A group of 30 workers was submitted to an interview and skin medical examination. Statistical tests were performed to evaluate the association between WWIF and independent variables. Results: All participants were males, average 23 years old, and the majority (60%) have worked in the company for over a year. Sixty percent of the participants presented injuries similar to WWIF. Age and working time were associated with the outcome. There was frequent and permanent exposure to humidity in the working hours, without the use of impermeable clothes. Conclusion: Most of the participants had diagnosis of WWIF; those over 30 years old and who had been working less than 1 year were more likely to have the diagnosis due to occupational exposure to humidity.

[Recombinant human tumor necrosis factor receptor type â ¡-IgG Fc fusion protein for treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene].

Objective: To investigate the efficacy and safety of the recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein (rhTNFR: Fc, etanercept) for the treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene (OMLDT) . Methods: In September 2011 to February 2016, 12 patients with OMLDT were treated with etanercept 25 mg, subcutaneous injection, twice per week, doubling of first dose. The course of treatment was 6 weeks. The drug eruption area and severity index (DASI) score, the proportion of patients achieving a 50%, 75% and 90% reduction in DASI (DASI50, DASI75, DASI90) and the serum level of TNF-α were used to assess the efficacy at different times. Adverse reactions were also recorded and evaluated. The results were statistically analyzed by nonparametric Friedman test and repetitive measurement ANOVA using the software SPSS19.0. Results: After 4 weeks treatment, the DASI score decreased form 56.33±7.02 to 0.50±0.91 (P<0.01) . The DASI50, DASI75 and DASI90 were all increased to 12 (100%) . The serum level of TNF-α decreased form (43.74±41.62) pg/ml to (3.03±0.47) pg/ml (P<0.01) . Statistically significant difference was observed from the above indexes. There were no adverse reactions in clinical application. Conclusion: Recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein may be a safe and effective drug in the treatment of OMLDT.

[Prediction of occupational allergic contact dermatitis induced by formaldehyde by IL17/IL22 secretion cell rest combined with patch test].

Objective: To investigate the possible role of IL17-and IL22-secreting cells combined with patch test for the prediction of formaldehyde-induced occupational allergic contact dermatitis(OACD). Methods: From October 2014 to October 2016, totally 131 formaldehyde-exposed workers(49 cases with inflammatory skin lesions,82 ones without inflammatory skin lesions)and 63 non-exposed health controls were recruited. Patch-test was performed in 49 cases of formaldehyde-exposed workers with inflammatory skin lesions. Circulating IL17+and IL22+Tcell subsets were assessed by flow cytometry(FCM). Results: Among 49 cases of formaldehyde-exposed workers with inflammatory skin lesions,32 cases were with positive patch-test while 17 cases with negative patch-test. The proportions of circulating CD3+CD8-IL17+ and CD3+CD8-IL22+ cells from patch-test(+) formaldehyde-exposed workers were significantly higher than that of patch-test(-)group, formaldehyde-exposed workers without skin lesions and non-exposed controls(P<0.05). The proportions of circulating CD3+CD8-IL17+ and CD3+CD8-IL22+cells from patch-test(-)group and formaldehyde-exposed workers without skin lesions were also higher than that of non-exposed controls(P<0.05). But there was no significant difference between patch-test(-)group and formaldehyde-exposed workers without skin lesions(P>0.05). Peripheral CD3+CD8+IL17+and CD3+CD8+IL22+cells were also detected in spite of small amounts. The percentages of CD3+CD8+IL17+and CD3+CD8+IL22+ cells inperipheral blood from patch-test(+)formaldehyde-exposed workers were enhanced significantly, compared to patch-test(-)group, formaldehyde-exposed workers without skin lesions and non-exposed controls(P<0.05). The proportions of circulating CD3+CD8+IL17+ and CD3+CD8+IL22+ cells from patch-test(-)group and formaldehyde-exposed workers without skin lesions were significantly higher than that of non-exposed controls(P<0.05). But there was no significant difference between patch-test(-) group and formaldehyde-exposed workers without skin lesions(P>0.05). Conclusion: The proportions of circulating IL17+ and IL22+T cells(both CD8-and CD8+)are enhanced in formaldehyde-exposed workers at proposed OEL, possibly involved in the development of formaldehyde-induced OACD.The detection of IL17-and IL22-secreting cells combined with formaldehyde patch test help to screen the workers with allergy property and prevent OACD.

Warm-water immersion foot among car wash workers.

BACKGROUND: Warm-water immersion foot (WWIF) is associated with prolonged contact with water at high temperature. Car wash workers are frequently exposed to humidity, however, there are not studies targeting diseases affecting this category of employees. OBJECTIVE: To investigate the frequency of WWIF among car wash workers. METHODS: The study was carried out in 2013 at a car wash service in Jundiaí, São Paulo, Brazil. A group of 30 workers was subjected to clinical interview and dermatological examination. Statistical tests were performed to assess the association between WWIF and independent variables. RESULTS: All the participants were male, their average age was 23 years old, and the most (60%) had worked at the investigated company for more than one year. Sixty percent of the participants exhibited lesions compatible with WWIF. Age and length of work at the company were associated with the assessed outcome. The participants were frequently and permanently exposed to humidity along the working day without wearing impermeable clothes. CONCLUSION: Most participants exhibited WWIF; the ones over 30 years old and having worked less than 1 year at the investigated company exhibited higher odds of WWIF due to occupational exposure to humidity.

INTRODUÇÃO: O quadro clínico de pés de imersão em água morna (PIAM) está relacionado ao contato prolongado com água em temperaturas elevadas. Uma categoria profissional com possibilidade de exposição frequente à umidade é a dos prestadores de serviço de lavagem de automóveis (lava a jato). Não foram encontrados estudos científicos sobre doenças que acometam os trabalhadores dessa área. OBJETIVO: Avaliar a frequência de quadros de PIAM entre trabalhadores de um lava a jato. MÉTODOS: O estudo foi realizado em um lava a jato na cidade de Jundiaí (SP), em 2013. Um grupo de 30 trabalhadores foi submetido a anamnese e exame físico dermatológico. Foram realizados testes estatísticos para avaliar associação entre quadros de PIAM e variáveis independentes. RESULTADOS: Todos os participantes eram do sexo masculino, com idade média de 23 anos, e a maioria (60%) trabalhava na empresa há mais de um ano. Sessenta por cento dos participantes apresentaram lesões compatíveis com PIAM. A faixa etária e o tempo de trabalho estiveram associados ao quadro. Havia exposição frequente e permanente à umidade durante o trabalho, sem uso de vestuário impermeável. CONCLUSÃO: A maioria dos trabalhadores que fizeram parte da pesquisa tinha diagnóstico de PIAM; os com idade superior a 30 anos e que trabalhavam há menos de 1 ano na função tiveram maior probabilidade de apresentar o quadro clínico por exposição ocupacional à umidade.

Occupational allergic disease: socio-epidemiological aspects from a specialized outpatient clinic in the city of Sao Paulo, Brazil.

BACKGROUND: Occupational diseases involving the immune system are considered to be occupational allergic diseases (OAD); 15% of occupational diseases are allergic. The social consequences of OAD are significant for both workers and employers. OBJECTIVES: To describe demographic and clinical characteristics of patients with OAD and their social outcomes. METHODS: Descriptive and retrospective study of the medical records of patients diagnosed with OAD cared at the occupational allergy clinic of a university hospital in São Paulo, Brazil. RESULTS: A total of 72 patients exhibited OAD, with age 21 to 89 years old; 52% were male. Atopic antecedents were described for 35% of patients. Most patients worked in the chemical industry (17%), cleaning (15%), construction (11%) and health care (8%). Occupational rhinitis was found in 26% of the patients, work-related asthma in 18%, asthma and rhinitis in 25%, and allergic contact dermatitis in 13%. In regard to the social outcomes, 36 (50%) workers remained in their jobs, 19 (26%) changed function, 7 (10%) changed occupation, 7 (10%) were fired and 3 (4%) retired. CONCLUSIONS: In the present study, OAD prevailed among males and within the economically active age; cases of occupational rhinitis were the most frequent. Half of the employees remained in the same job position even after diagnosis.

INTRODUÇÃO: Doença ocupacional envolvendo o sistema imunológico é considerada doença alérgica ocupacional (DAO). Das doenças ocupacionais, 15% são alérgicas. As consequências sociais do diagnóstico de DAO são importantes para o trabalhador e empregador. OBJETIVOS: Descrever características demográficas e clínicas dos pacientes estudados com DAO e seus desfechos sociais. MÉTODOS: Estudo descritivo, retrospectivo dos prontuários de pacientes do ambulatório de alergia ocupacional de hospital universitário em São Paulo, com diagnóstico de DAO. RESULTADOS: 72 pacientes apresentaram DAO, com idades entre 21 e 89 anos; 52% do sexo masculino. Antecedentes atópicos foram descritos em 35% dos pacientes. A maioria dos pacientes trabalhava nas áreas de indústria química (17%), limpeza (15%), construção civil (11%) e saúde (8%). Rinite ocupacional foi vista em 26% dos pacientes; asma relacionada ao trabalho, em 18%; asma e rinite, em 25%; dermatite de contato alérgica, em 13%. Sobre o desfecho social, 36 (50%) mantiveram-se em seus cargos, 19 (26%) mudaram de função, 7 (10%) mudaram de área, 7 (10%) foram afastados e 3 (4%) se aposentaram. CONCLUSÕES: Na casuística estudada, a DAO prevaleceu no sexo masculino, em faixa etária condizente com faixa trabalhadora; com maior número de casos de rinite ocupacional. Metade dos pacientes continuou exercendo a mesma função mesmo após o diagnóstico.