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The collapse of the World Trade Center (WTC) on 11 September 2001 exposed New York City firefighters to smoke and dust of unprecedented magnitude and duration. The chemicals and the concentrations produced from any fire are difficult to predict, but estimates of internal dose exposures can be assessed by the biological monitoring of blood and urine. We analyzed blood and urine specimens obtained from 321 firefighters responding to the WTC fires and collapse for 110 potentially fire-related chemicals. Controls consisted of 47 firefighters not present at the WTC. Sampling occurred 3 weeks after 11 September, while fires were still burning. When reference or background ranges were available, most chemical concentrations were found to be generally low and not outside these ranges. Compared with controls, the exposed firefighters showed significant differences in adjusted geometric means for six of the chemicals and significantly greater detection rates for an additional three. Arrival time was a significant predictor variable for four chemicals. Special Operations Command firefighters (n = 95), compared with other responding WTC firefighters (n = 226), had differences in concentrations or detection rate for 14 of the chemicals. Values for the Special Operations Command firefighters were also significantly different from the control group values for these same chemicals and for two additional chemicals. Generally, the chemical concentrations in the other firefighter group were not different from those of controls. Biomonitoring was used to characterize firefighter exposure at the WTC disaster. Although some of the chemicals analyzed showed statistically significant differences, these differences were generally small.

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Background Occupational skin disease is an important cause of disability in the workplace. The aim of this report is to estimate the incidence of occupational dermatitis cases that causes days away from work and to characterize the cases. Methods The Annual Survey of Occupational Injuries and Illnesses from the Bureau of Labor Statistics collects employer reports on work‐related dermatitis. Descriptive data are collected on a sample of the cases that result in days away from work. Estimates of the number of cases and days away from work were calculated by industry, occupation, and exposure source. Results In 1993, there were an estimated 8,835 cases of occupational dermatitis, a rate of 1.12/10,000 workers. The largest number of cases was in health services, while the highest rate was in agricultural crops. The occupation with the largest number of cases was non‐construction laborers. Cleaning/polishing agents caused the largest number of cases. Calcium hydroxide and oxides caused a median of nine days away from work. Discussion/Conclusions The survey data show that the effect of occupational dermatitis is substantial in the lives of workers. These descriptive data should be used to target interventions. Am. J. Ind. Med. 34:568–573, 1998. © 1998 Wiley‐Liss, Inc.

Occupational skin diseases and disorders (OSDs) are the most commonly reported non-trauma-related (acute or cumulative) category of occupational illnesses in the United States. This factor, along with their potential chronicity, their effect on an individual's vocational and avocational activities, and the fact that they are preventable, point out the public health importance of OSDs. It can be difficult to obtain accurate epidemiological data for OSDs in the US, and all sources have their limitations. OSD cases that result in days away from work are important categories to study, since days away from work may be used as an indicator of the severity of a case. Descriptive epidemiology may be used to provide further information on these "more severe" cases, to determine, for example, high-risk industries, occupations, and exposures, and then to use this information to target the high-risk, "more severe" cases for prevention strategies. The goal of the US Public Health Service for the year 2010, as established in its "Healthy People 2010: National Health Promotion and Disease Prevention Objectives", is to reduce national OSDs to an incidence of no more than 46 per 100,000 full-time workers. Both irritant and allergic contact dermatitis are considered to be priority research areas as outlined in the National Occupational Research Agenda introduced in 1996 by the National Institute for Occupational Safety and Health. Increased knowledge and awareness of occupational skin diseases will assist in the achievement of the national public health goals.

The dermatologist should be aware of the many facets of occupational skin diseases, which can be caused by physical, chemical, and biological insults. The most common manifestation of occupational skin diseases is contact dermatitis (both irritant and allergic). Three factors point out the importance of occupational skin diseases as diseases that have a public health impact: 1) occupational skin diseases are common; 2) they often have a poor prognosis; and 3) they result in a noteworthy economic impact for society and for an individual. They are also diseases amenable to public health interventions. Specific industries and exposures may put a worker at risk of occupational contact dermatitis. The accuracy of the diagnosis of occupational contact dermatitis is related to the skill level, experience, and knowledge of the medical professional who makes the diagnosis and confirms the relationship with a workplace exposure. Prevention of occupational contact dermatitis is important, and a variety of prevention strategies are available.

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