Occupational Diseases / / August 12, 2017
Factors that may cause occupational diseases of the skin, are extremely diverse.The most frequent cause of occupational diseases of the skin are the chemicals, organic and inorganic.In action on the skin are 4 groups of chemicals:
1. Substances obligate action, or unconditioned stimuli.This group includes mineral acids, alkalis and salts of change immediately after their contact with the skin.
2. The substances that cause a state of increased reactivity - sensitizers.Repeated skin contact substances - sensitizers cause no visible changes, but gradually led to the development of hypersensitivity - sensitization, which can manifest itself clinically dermatitis or eczema.Timing of sensitization vary depending on the state of reactivity, the properties of the active ingredient and the conditions under which this effect occurs.Sensitization persists for a long time and causes relapse at renewal even minimal contact with the irritant.Typical sensitizers skin are turpentine, nickel, hexavalent chromium, Urs
3. Substances combined effect of combining the characteristics of obligate sensitizers and irritants, such as chromium salts.
4. Hydrocarbons of oil and coal.Volatile fractions (. Kerosene, gasoline, etc.) cause dermatitis banal, average - destruction of the follicular unit, solid - photodermatitis, hyperkeratosis, skin tumors.
most common clinical forms of occupational dermatitis
1. Professional dermatitis - acute inflammation of the skin that occurs at the site of contact with the production irritant and has no tendency to spread along the periphery (contact, banal dermatitis), or with a slight tendency to such an extension (allergic dermatitis).For occupational dermatitis is characterized by a relatively rapid regression of the termination of the stimulus.
2. Occupational eczema occurs under the influence of the production of chemical substances with sensitizing properties.Clinically, significantly different from the true eczema.It is characterized by a tendency to spread, prolonged course with frequent relapses and exacerbations, even after the elimination of exposure to an irritant.
3. Professional toxicoderma rare.Their main feature is a violent inflammatory reaction to the minimal impact of the stimulus.Morphologically, the disease appears widespread erythema, often with edema and bullous elements.After removing the stimulus inflammation subsides and disappears quickly, but just as quickly it appears at the resumption of at least a minimum of contact with an irritant.Quickly reverse the development process after the termination of the stimulus and the lack of relapse bring together toxicoderma with dermatitis.
4. folliculitis occur when working with oil and coal oil, cutting fluids, tar, etc. (mostly on the extensor surfaces of the forearms, at least - on the abdomen, thighs and legs)..
5. Toxic melasma caused by hydrocarbons that are part of coal, oil and distillates.It affects mainly the face, neck, upper limbs, abdomen, armpits, lower limbs.
6. Professional skin ulceration develops in individuals working with acids, alkalis, soda, calcium carbide, chrome, etc. D.
7. Professional hyperkeratoses and epithelioma caused by chemical substances (products of coal, oil shale and oil, soot,coal tar, creosote, tar), are carcinogenic.
8. Radiation skin lesions caused by ionizing radiation (X-rays, radioactive substances).There are acute and chronic radiation dermatitis.
9. Professional photodermatitis arise from skin sensitization to ultraviolet rays, developing under the influence of some chemical substances and mixtures: tar, asphalt, creosote oil, pitch, coal tar.
In setting depending on the diseases of the skin of the work should be guided by the following data:
1. Terms of the work performed and the degree of skin contact with an irritant.It is necessary to find out exactly what a skin-irritating substances currently working sick if he had contact with them in the past, there are more patients among those engaged in similar work.
2. A history.Terms of the disease, whether it came to carrying out this work or during it;Do not coincided with the onset of the disease changes in the process and application of new chemical substances.It does not hurt in the past allergic diseases.
3. lesion localization.Professional dermatoses localized predominantly in the open field, which acts directly irritating agent.
4. The clinical course of the disease.Continuity of the disease in the patient's finding at work, a rapid improvement or disappearance of the painful phenomenon when leaving work during holidays or long breaks in the work suggests a direct connection with the profession of the disease.Long-term course of the disease with exacerbations, are taking more abrupt appearance of new foci of the disease after removal from work (during treatment), badly pronounced tendency to regress speak against the disease due to the profession.
5. Additional methods of clinical examination.To identify the ensuing sensitization are intended method of application of the allergen on the skin (testing).The most widely used methods received compress and drip coating substance on intact skin.
compress method is applied to the clinically healthy skin shoulder gauze pieces, consisting of 4 layers in size 1,5x1,5 cm, moistened with a solution of the expected stimulus.Gauze covered with compress paper size 4x4 cm, followed by the imposition of bandages.Samples are usually removed the next day.response evaluation is performed at 2 days after application of the sample.
Drip method is more simple (easy to apply in the outpatient setting).For the application of drip samples prepared alcoholic solutions of different production stimuli, which presumably could cause sensitization of the skin of the patient.If the substance is not soluble in 96% ethanol, 60% of the alcohol used.The prepared solution was applied to clinically healthy skin of the upper half of the abdomen using a moistened with them the usual traffic jams, which closed vials with the solution.Place the sample application does not treated, but only circled indelible pencil.
With a positive response to the application site erythema samples found varying intensity, edema, single or multiple papular or vesicular eruptions.
disability When contact (non-allergic) dermatitis, as well as oil folliculitis - a temporary transfer to another job that is not related to the impact of skin-irritating substances, for 1-2 months.In the case of recurrence - permanent employment.
If sensitization to chemicals requires transfer to another permanent job.When expressed and disseminated forms of the disease should begin treatment with full exemption from work on sick leave, and then employ the patient.Temporary transfer to another job in these forms ineffective.In those cases where the transfer is related to deskilling, the patient has the right to professional disability for a period of retraining.
Technological hygienic measures (sealing, mechanization of production processes, and so on. D.).
Personal protective equipment. main protective barrier for external factors acting on the skin (professional and others.), Is an intact stratum corneum.Therefore, any treatment is necessary in the production process of small skin injuries 1% solution of brilliant green.After 1.5-2 minutes after applying it to the injured area formed film that protects the covered area of the skin from external influences.
In cases of severe dry skin, it is advisable to rub the ointment at night.
12 Aug, 2017