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Contact allergy to thiurams: multifactorial analysis of clinical surveillance data collected by the IVDK network.

Uter W, Hegewald J, Pfahlberg A, Lessmann H, Schnuch A, Gefeller O - Int Arch Occup Environ Health (2009)

Bottom Line: However, health care workers such as physicians and dentists (PR: 3.8, 95% CI: 3.0-4.8) or nursing staff (PR: 3.0, 95% CI: 2.5-3.6) as well as meat and fish processors (PR 3.5, 95% CI: 2.2-5.3) and cleaners (PR 3.1, 95% CI: 2.5-3.8) were found to have a high sensitisation risk as well.In case of health care workers, a significant downward trend during the study period was observed; while in food processors and cleaners, sensitisation prevalence remained largely stable.The adjusted multifactorial analysis identified occupations yet unknown to be associated with elevated thiuram contact allergy risk, e.g., food processors and cleaners.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Waldstr. 6, 91054 Erlangen, Germany. wolfgang.uter@imbe.med.uni-erlangen.de

ABSTRACT

Purpose: To analyse the association between occupation (represented by job title) and contact allergy to thiuram vulcanising agents based on data of a clinical registry (IVDK, www.ivdk.org ).

Methods: Clinical, demographic and allergy patch test data of all patients tested between 1992 and 2006 with the thiuram mix (1% in petrolatum) as part of the baseline series was analysed (n = 121,051). Poisson regression analysis was used to quantify the association between different occupations (and other relevant factors) and a positive patch test reaction to the thiuram mix. Furthermore, the time trend of sensitisation prevalence was analysed in high-risk occupational subgroups identified.

Results: In comparison to a largely unexposed reference group (office workers and teachers), rubber manufacturers had a significantly elevated risk (prevalence ratio (PR): 5.1, 95% confidence interval (CI) 2.0-10.5). However, health care workers such as physicians and dentists (PR: 3.8, 95% CI: 3.0-4.8) or nursing staff (PR: 3.0, 95% CI: 2.5-3.6) as well as meat and fish processors (PR 3.5, 95% CI: 2.2-5.3) and cleaners (PR 3.1, 95% CI: 2.5-3.8) were found to have a high sensitisation risk as well. In case of health care workers, a significant downward trend during the study period was observed; while in food processors and cleaners, sensitisation prevalence remained largely stable.

Conclusion: The adjusted multifactorial analysis identified occupations yet unknown to be associated with elevated thiuram contact allergy risk, e.g., food processors and cleaners. Thus, (i) further in-depth research can be targeted and (ii) efforts to prevent sensitisation to thiurams focussed, e.g., by limiting thiuram concentrations in products to a residual level which is technically inevitable.

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a Time trend of sensitisation to the thiuram mix in healthcare workers. Sensitisation prevalence is directly age standardised. Straight grey line represents the fitted regression line to represent a linear subgroup-specific trend. b Time trend of sensitisation to the thiuram mix in food handlers and cleaners, respectively. Sensitisation prevalence is directly age standardised. Straight grey lines represent fitted regression lines to represent a linear subgroup-specific trend
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Fig1: a Time trend of sensitisation to the thiuram mix in healthcare workers. Sensitisation prevalence is directly age standardised. Straight grey line represents the fitted regression line to represent a linear subgroup-specific trend. b Time trend of sensitisation to the thiuram mix in food handlers and cleaners, respectively. Sensitisation prevalence is directly age standardised. Straight grey lines represent fitted regression lines to represent a linear subgroup-specific trend

Mentions: After identifying three occupational subgroups with a relatively high risk of contact sensitisation to the thiurams, namely healthcare workers (physicians, nurses and related), food processors (cooks, meat and fish processors) and professional cleaners, the issue of a possible differential time trend was addressed. In view of (i) a distinct general risk gradient related to age (Table 2) and (ii) a weak, but significant association between age and year of patch test in the IVDK population (Uter et al. 2008), simple bivariate analyses of crude sensitisation prevalence across time were avoided. Instead, three separate Poisson regression models including age as confounder and the year of patch test as exposure of interest were used to identify a significant decline of sensitisation prevalence in case of healthcare workers (p for trend = 0.0008), but no significant trend for the other two subgroups. The time course of age-standardised sensitisation prevalences is shown in Fig. 1a for healthcare workers and in Fig. 1b for the two other occupational groups.Fig. 1


Contact allergy to thiurams: multifactorial analysis of clinical surveillance data collected by the IVDK network.

Uter W, Hegewald J, Pfahlberg A, Lessmann H, Schnuch A, Gefeller O - Int Arch Occup Environ Health (2009)

a Time trend of sensitisation to the thiuram mix in healthcare workers. Sensitisation prevalence is directly age standardised. Straight grey line represents the fitted regression line to represent a linear subgroup-specific trend. b Time trend of sensitisation to the thiuram mix in food handlers and cleaners, respectively. Sensitisation prevalence is directly age standardised. Straight grey lines represent fitted regression lines to represent a linear subgroup-specific trend
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2902739&req=5

Fig1: a Time trend of sensitisation to the thiuram mix in healthcare workers. Sensitisation prevalence is directly age standardised. Straight grey line represents the fitted regression line to represent a linear subgroup-specific trend. b Time trend of sensitisation to the thiuram mix in food handlers and cleaners, respectively. Sensitisation prevalence is directly age standardised. Straight grey lines represent fitted regression lines to represent a linear subgroup-specific trend
Mentions: After identifying three occupational subgroups with a relatively high risk of contact sensitisation to the thiurams, namely healthcare workers (physicians, nurses and related), food processors (cooks, meat and fish processors) and professional cleaners, the issue of a possible differential time trend was addressed. In view of (i) a distinct general risk gradient related to age (Table 2) and (ii) a weak, but significant association between age and year of patch test in the IVDK population (Uter et al. 2008), simple bivariate analyses of crude sensitisation prevalence across time were avoided. Instead, three separate Poisson regression models including age as confounder and the year of patch test as exposure of interest were used to identify a significant decline of sensitisation prevalence in case of healthcare workers (p for trend = 0.0008), but no significant trend for the other two subgroups. The time course of age-standardised sensitisation prevalences is shown in Fig. 1a for healthcare workers and in Fig. 1b for the two other occupational groups.Fig. 1

Bottom Line: However, health care workers such as physicians and dentists (PR: 3.8, 95% CI: 3.0-4.8) or nursing staff (PR: 3.0, 95% CI: 2.5-3.6) as well as meat and fish processors (PR 3.5, 95% CI: 2.2-5.3) and cleaners (PR 3.1, 95% CI: 2.5-3.8) were found to have a high sensitisation risk as well.In case of health care workers, a significant downward trend during the study period was observed; while in food processors and cleaners, sensitisation prevalence remained largely stable.The adjusted multifactorial analysis identified occupations yet unknown to be associated with elevated thiuram contact allergy risk, e.g., food processors and cleaners.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Waldstr. 6, 91054 Erlangen, Germany. wolfgang.uter@imbe.med.uni-erlangen.de

ABSTRACT

Purpose: To analyse the association between occupation (represented by job title) and contact allergy to thiuram vulcanising agents based on data of a clinical registry (IVDK, www.ivdk.org ).

Methods: Clinical, demographic and allergy patch test data of all patients tested between 1992 and 2006 with the thiuram mix (1% in petrolatum) as part of the baseline series was analysed (n = 121,051). Poisson regression analysis was used to quantify the association between different occupations (and other relevant factors) and a positive patch test reaction to the thiuram mix. Furthermore, the time trend of sensitisation prevalence was analysed in high-risk occupational subgroups identified.

Results: In comparison to a largely unexposed reference group (office workers and teachers), rubber manufacturers had a significantly elevated risk (prevalence ratio (PR): 5.1, 95% confidence interval (CI) 2.0-10.5). However, health care workers such as physicians and dentists (PR: 3.8, 95% CI: 3.0-4.8) or nursing staff (PR: 3.0, 95% CI: 2.5-3.6) as well as meat and fish processors (PR 3.5, 95% CI: 2.2-5.3) and cleaners (PR 3.1, 95% CI: 2.5-3.8) were found to have a high sensitisation risk as well. In case of health care workers, a significant downward trend during the study period was observed; while in food processors and cleaners, sensitisation prevalence remained largely stable.

Conclusion: The adjusted multifactorial analysis identified occupations yet unknown to be associated with elevated thiuram contact allergy risk, e.g., food processors and cleaners. Thus, (i) further in-depth research can be targeted and (ii) efforts to prevent sensitisation to thiurams focussed, e.g., by limiting thiuram concentrations in products to a residual level which is technically inevitable.

Show MeSH
Related in: MedlinePlus