Cross Sectional Study on Occupational Hand Dermatitis

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ROYAL COLLEGE OF PHYSICIANS OF IRELAND

A CROSS SECTIONAL STUDY ON THE PREVALENCE OF OCCUPATIONAL CONTACT DERMATITIS AMONG THE STAFF OF A PRIVATE MEDICAL CENTER IN MALAYSIA

BY DR SUGUMAR SAMOGAM

FACULTY OF OCCUPATIONAL MEDICINE
2007/2008

ROYAL COLLEGE OF PHYSICIANS OF IRELAND

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A CROSS SECTIONAL STUDY ON THE PREVALENCE OF OCCUPATIONAL CONTACT DERMATITIS AMONG THE STAFF OF A PRIVATE MEDICAL CENTER IN MALAYSIA -------------------------------------------------

DR SUGUMAR SAMOGAM
FACULTY OF OCCUPATIONAL MEDICINE
2007/2008

As part of the requirement for admission to the Membership of the Faculty of Occupational Medicine (MFOM) of the Royal College of Physicians of Ireland (RCPI) 2007/2008

CONTENTS

No.| TITLE| PAGE|
1| Abstract| ii|
2| Acknowledgement| iii|
3| Table of content| iv|
4| List of tables| v|
5| List of figures| vi|

Chapter1

Introduction
1.1 History of Occupational Skin Disease
Ulcers caused by corrosive metals were first described by Celsus at about 100 AD. Historically this was the first recorded occupation related illness. Paracelsus(1498-1541) wrote about skin changes brought about by salt compounds in his work, the Morbis Metalicus. Similarly, Agricola who lived about the same period also described deep skin ulcers among the metal workers. In the 17th century Le Morbis Artifacium Diatriba was published, it was the work of Bernadino Ramazzini(1633-1714). He described several skin conditions affecting the workers of that era. One being, itchy dermatitis among millers and sievers of corn, which was attributed to an invisible parasite. This was quite an obervation in absence of microscopes at that era.There were also reference to hand dermatitis among midwives caused by genital secretions. (1,2).

In 1728, Henckel mentioned skin lesions called "Huttenkratze" appearing due industrial processing of arsenic. (1,2) Later in the 18th century in 1775, Percival Pott (1714 –1788) published observations on the high rate of scrotal cancers among London chimney sweeps (mainly pre-pubertal boys). Pott proposed that soot, which accumulated in the scrotal folds, caused the cancer.(3) There were other authors who had also noted other occupation related skin conditions; such as in 1839, Cazenave and Schedel of Germany had stated excessive perspiration could predispose to contact dermatitis. (1,2)

In the 19th century an Englishman, Robert Willan described dermatitis among shoemakers due to shoemaker's wax.Thomas Morrison Legge (1863–1932) who was the first medical inspector of factories, observed and documented a wide range of industrial ailments including cataracts among the glassblowers; others being skin cancer, liver disease and metal poisoning.(3)

After the first world war, in 1928, the United States Public Health Services organised the Office of Dermatoses Investigations. This establishment was concerned about the study of occupational and other kinds of contact dermatoses.(2) Since then many countries throughout the world, including Malaysia have increasingly acknowledged the importance of occupational related ailments in general and occupational contact dermatoses in particular and have developed their own laws, reporting systems, treatment and management protocols.

1.2 Background of Study

Occupational related illnesses have been tormenting workers of all categories without any discrimination. The nature of the illness as well as its severity may vary but they are omnipresent nevertheless. Occupational related illnesses arise from a variety of hazards which are ever present in any working environment. These may be related to the worker, work or the environment in which the worker is working. The element of hazards could be physical, chemical or biological. They may also be ergonomic or psycho-social in nature. Occupational skin...
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