The true prevalence of allergic contact dermatitis (ACD) in children remains unknown. Our aim was to compare the results of patch tests in children with suspected ACD between two different periods of time and identify possible changes in emerging allergens. We compared contact allergens, gender, age distribution, and personal history of atopic dermatitis (AD), in correlation with the positivity of patch tests, between two equal periods of time (232 children tested during 1980-1993, period A, and 255 children during 1994-2007, period B) in the same region and in the same institution. Patch test positivity was 47.8% in period A, and 60% in period B (p = 0.083). The most common allergens in period A were: nickel sulfate (16.3%), cobalt chloride (8.6%), fragrance mix (7.3%), potassium dichromate (4.3%), and thimerosal only (1.7%). In period B, the allergen distribution was as follows: nickel sulfate (21.56%), thimerosal (18.03%), cobalt chloride (12.9%), potassium dichromate (9.4%), and fragrance mix (4.7%). Girls were more likely to have a positive patch test compared with boys, with reactions in 53% of girls and 39% of boys in period A (p = 0.003), and 61% of girls and 58% of boys in period B (p = 0.691). Twenty-nine per cent of patients with positive results had a personal history of AD in period A and 44% in period B (p = 0.015). Differences in the positivity of allergens between different time periods reflect changes in habits, of allergens exposure or preventive measures.
Aim To systematically describe and summarize the specific occupational health impact of tobacco farm working. Subjects and methods Qualitative systematic review applying a standardized electronic literature search strategy (MEDLINE, TOXNET, EMBASE, AGRICOLA, Science Citation Index; until January 2007) and hand search within eligible articles. Double assessment of eligibility and study results. Inclusion of all studies on specific work-related health risks of tobacco farm workers, e.g. risk factors for and frequency of green tobacco sickness (GTS) and other specific health risks, as well as intervention studies.Results We identified 31 relevant publications. Concerning GTS substantial heterogeneity was observed in terms of the case definition and frequency of disease occurrence. Seasonal prevalence ranged between 8 and 89%. Incidence was reported to be 1.9 cases per 100 person days. In the two studies included on primary prevention of GTS hand washing and the use of protective clothes were effective. Studies conducted on cancer as well as on urticaria and contact eczema in tobacco harvesters are scarce. Conclusion Health problems due to transdermal nicotine absorption are frequent among tobacco harvesters. GTS as well as chronic health effects in this population need to be further investigated. The toxicity to the cardiovascular system and carcinogenicity of chronic dermal nicotine exposure are likely to exist as non-smoking tobacco harvesters show similar cotinine and nicotine levels compared to active smokers in the general population. Effective intervention strategies addressing the specific needs of the tobacco harvesters in different regions around the world must be developed, evaluated and further improved. It is important to educate tobacco farm workers, farmers and health care providers on GTS and other health risks.
Patients with autoimmune urticaria (AIU) and positive autologous serum skin test (ASST) represent a more serious type of chronic urticaria that does not respond to treatment with antihistamines, but responds completely to systemic corticosteroids. Because of the chronic course of the disease, there is a risk of side-effects. Cyclosporin A (CsA) is an alternative treatment for patients with AIU. In order to determine the efficacy of CsA at the lowest possible dose in patients with chronic idiopathic urticaria and positive ASST, 30 patients were included in a 5-month study with a follow-up one year after the end of treatment. All patients had positive ASST before treatment and autoantibodies were present in 73%. Twenty- three patients completed the study and responded to low-dose CsA treatment. Three patients did not respond to a dose of 2.5 mg/kg CsA, and 4 patients dropped-out due to side-effects. After the first month of treatment, an improvement of 31% was noted, reaching 88% after the fifth month of treatment. The mean dose of CsA was 2.16 mg/kg for the first month and 0.55 mg/kg for the fifth month. Three to 6 months after the end of the study, the ASST was repeated and was negative in 78.3% of patients. At the one-year follow-up, 20 patients were symptom-free (87%) and 3 had relapsed (13%). CsA, even in low-doses, can be an effective and short-term treat- ment with minimum side-effects in patients with AIU.
Aim This study reviews the evidence on the association between working in greenhouses and the occurrence of muscelosckeletal, reproductive and respiratory disorders, dermal effects, cancer and neurobehavioral effects. Subjects and methods PUBMED, MEDLINE and EBSCO literature bases were searched to identify epidemiological studies conducted over 1996-2006 that focused on the health outcomes of greenhouse workers. Three exclusion criteria were used to limit the selection to studies with quantitative assessment of the association between workrelated risk factors and health disorders: lack of data on work-related risk factors, lack of a suitable risk estimate for work-related risk factors or of sufficient information that allowed calculation of a risk estimate and serious methodological concerns in relation to the purpose of this review (strong selection bias, very low response rate, recall bias). Results The analysis indicates that greenhouse exposure is associated with an increased risk of respiratory disorders, sensitization to allergens and skin reactions. Exposure to dust, bacteria, allergens, fungi and gases may cause or exacerbate asthma, asthma-like syndrome, mucous membrane irritation, chronic bronchitis and dermatitis. The results of the review showed that male workers employed in greenhouse horticulture for more than 10 years had a decreased median sperm concentration. The data on the effect of working in greenhouses on the time to pregnancy are unequivocal, but most of them indicate a relationship between a decreased fecundability ratio and greenhouse work, this referring mostly to pesticide exposure. There are also some indications that greenhouse work may contribute to musculoskeletal and neurobehavioral disorders, but only a few epidemiological studies have corroborated these
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