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Contact allergy in construction workers: results of a multifactorial analysis
Wolfgang Uter1, Reinhold Rühl, Ammette Pfahlberg
1Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 6, 91054 Erlangen, Germany. wolfgang.uter@rzmail.uni-erlangen.de
Objectives:
To quantify the risk of contact allergy (CA) to important ubiquitous allergens associated with certain occupations, in particular the construction industry, and to identify possible time trends, controlling for potential confounding variables.
Methods:
Bivariate as well as Poisson regression analysis of standardized anamnestic and patch test data comprising 82,561 patients assessed in the 33 German and Austrian contact dermatitis units of the Information Network of Departments of Dermatology (IVDK) between 1992 and 2000.
Results:
CA to five of the 18 (groups of) allergens considered here were observed significantly more often in construction workers: dichromate, epoxy resin (BADGE), cobalt, thiurams and N-isopropyl-p-phenylenediamine (IPPD). Multifactorial analysis confirmed an increased risk of CA to these allergens in construction workers, compared with other occupations. A very strong association between cobalt and chromate allergy was found in construction workers (OR 39.1, 95% CI 21.1-79.6).
Conclusions:
Dichromate is still an prominent allergen in construction workers; as yet, there is only weak evidence of a decrease in Germany. Therefore, the addition of ferrous sulphate to cement, which has been a successful intervention in other countries, should be promoted further. Although CA to other important occupational allergens like thiurams, IPPD and epoxy resin or cobalt (very often associated with dichromate CA) is less frequent, prevention should address these allergens, too. The use of protective gloves with minimal intrinsic CA risk, e.g. due to thiurams in (synthetic) rubber or chromate in leather gloves, should be promoted.