Occupational eyelid dermatitis: A public health perspective

Occupational eyelid dermatitis (ED) is a much-neglected issue in public health, with important ramifications for patients' quality of life, employment and facial aesthetics. Patients with occupational ED are often younger, male and with an atopic background compared with those with non-occupational ED. Common contact allergens include rubber additives, acrylates, isothiazolinones, fragrances, epoxy resins, potassium dichromate, colophonium, metals and topical medications. Contact allergens and irritants may cause occupational ED by direct or indirect exposure, for example, through transfer by hands, airborne exposure or connubial contact. At-risk occupations include healthcare workers, hairdressers, industrial workers, electricians, cleaning staff, gardeners and florists as well as artists and craftsmen. The diagnostic work-up should include medical and employment history and exposure analysis in addition to clinical manifestations according to Mathias' diagnostic criteria. Patch testing with standardized series as well as consideration of semi-open or use tests with the patient's own work-related materials are essential. The differential diagnosis requires a multidisciplinary approach to exclude ED of other aetiologies. Occupational ED is an important issue in public health meriting better reporting, medical surveillance and public health policies to ensure the safety and well-being of the employees.