A case study of dermatitis based on a collaborative approach between occupational physicians and industrial...

An example of interdisciplinary problem solving by occupational health professionals is presented. Approximately one dozen employees in an aircraft wire harness assembly line complained of dermatitis, alleging workplace exposures as causation. The plant's and consulting industrial hygienists prepared toxicology and exposure assessments for all process materials, manufacturing procedures, and protective equipment used. They identified no common elements in the work environment that may have caused the dermatitis, suggesting multiple causation and possible individual worker sensitivities. An investigative team composed of the industrial hygienists and physicians in outside practice, including dermatologists and occupational medicine physicians, conducted a review of plant operations and proposed that workers with dermatitis complaints receive diagnostic medical examinations. An initial examination medically documented each worker's complaint, and a follow-up included patch testing for selected process materials. The physicians diagnosed a variety of mainly nonoccupationally induced illnesses such as fungal infections, skin cancer (solar induced), acne, etc., confirming the industrial hygienists' original assessment. One case appeared directly work-related and to be a specific assembly component sensitivity. Although several cases with a nonoccupational origin could have been aggravated by working conditions, these workers showed no sensitivity to the component when patch tested.