Boris D. Lushniak

Occupational dermatitis causing days away from work in U.S. private industry, 1993

BACKGROUND Occupational skin disease is an important cause of disability in the workplace. The aim of this report is to estimate the incidence of occupational dermatitis cases that causes days away from work and to characterize the cases. METHODS The Annual Survey of Occupational Injuries and Illnesses from the Bureau of Labor Statistics collects employer reports on work-related dermatitis. Descriptive data are collected on a sample of the cases that result in days away from work. Estimates of the number of cases and days away from work were calculated by industry, occupation, and exposure source. RESULTS In 1993, there were an estimated 8,835 cases of occupational dermatitis, a rate of 1.12/10,000 workers. The largest number of cases was in health services, while the highest rate was in agricultural crops. The occupation with the largest number of cases was non-construction laborers. Cleaning/polishing agents caused the largest number of cases. Calcium hydroxide and oxides caused a median of nine days away from work. DISCUSSION/CONCLUSIONS The survey data show that the effect of occupational dermatitis is substantial in the lives of workers. These descriptive data should be used to target interventions.

Occupational skin diseases.

Primary care physicians will likely see a wide variety of occupational skin diseases in their practices, including allergic contact dermatitis, irritant contact dermatitis, contact urticaria, a variety of infectious diseases, and skin cancers. The ideal role of a medical practitioner involved in occupational dermatology is not only to diagnose and treat patients, but also to determine the cause of the occupational skin disease and to make recommendations for its prevention. Making the diagnosis and offering treatment, determining the cause, and recommending measures can be difficult undertakings.

Evaluation of self-reported skin problems among workers exposed to toluene diisocyanate (TDI) at a foam manufacturing facility.

Toluene diisocyanate, or TDI (CAS 584-84-9) is a well-known asthmagen and respiratory irritant. TDI is also known for its ability to irritate the skin and mucous membranes. To further investigate the dermal effects of TDI, NIOSH investigators conducted a cross-sectional study at a flexible foam manufacturing plant. A total of 114 workers participated in the study. Participants completed a medical questionnaire, provided blood for antibody testing to TDI and other allergens, and a subset of participants reporting skin symptoms underwent skin patch testing to a standard diisocyanate panel. Production line workers were more than twice as likely to report skin problems as those working in nonproduction areas (PRR = 2.66; 95% CI = 1.14–16.32; P = 0.02). Age, gender and duration of employment at the plant were comparable among participants working in production and nonproduction areas. Of the 100 participants who provided blood samples for antibody testing, specific IgG antibody to TDI was detected in two individuals, and none of the samples demonstrated specific IgE antibody to TDI. Of the 26 workers who underwent skin patch testing, none developed reactions to the diisocyanate allergens. These results suggest that the skin symptoms among study participants represent an irritant rather than an immunologic reaction to TDI, or to an unidentified allergen present in the foam.

The public health impact of irritant contact dermatitis

The public health impact of a disease can be measured using statistical, clinical, and economic measures. Three factors point out the importance of irritant contact dermatitis (ICD) as a disease having a public health impact→1) ICD is common; 2) ICD often has a poor prognosis; and 3) ICD results in a noteworthy economic impact for society and for an individual as it affects vocational and avocational activities. It is also a disease amenable to public health interventions.

The National Prevention Strategy: Leveraging Multiple Sectors to Improve Population Health

The authors reflect on the U.S. National Prevention Councils (NPCs) National Prevention Strategy for improving population health. They note the gaps between the U.S. and other developed countries across risks factors for diseases such as diabetes and declining life expectancy. They discuss U.S. tobacco use rates and the role of the U.S. Affordable Care Act (ACA) in promoting health, lowering medical costs, and improving health care quality. A list of NPC members is presented.

Surgeon general's perspectives.

470  Public Health Reports / November–December 2014 / Volume 129 Acting Surgeon General Boris D. Lushniak, MD, MPH, RADM, meets with Monique Bethell, PhD, a volunteer at Healing with CAARE, Inc., and Health Equity Coordinator, Community Transformation Grant for the North Carolina Division of Public Health, Department of Health and Human Services (center); and Dr. Sharon Elliott-Bynum, Founder of Healing with CAARE, Inc. (right). QUIET HEROES, DEAFENING IMPACTS

Utility of the Department of Defense Serum Repository in Assessing Deployment Exposure.

Objective: This paper describes why the research project was conducted in terms of demonstrating the utility of the Department of Defense Serum Repository in addressing deployment environmental exposures. Methods: The history deployment exposure surveillance was reviewed and the rationale for developing validated biomarkers that were detected in sera in postdeployment samples and compared with nondeployed controls was described. The goal was to find validated biomarkers that are associated with both exposures and health outcomes. Results: The articles in this supplement described novel serum biomarkers that were found to be associated with deployment exposures and weakly associated with some health outcomes. Conclusions: Future research must continue to validate the use of serum biomarkers when operational contingencies prevent the gold standard collection of real-time breathing zone samples in deployed service members.

National Institute for Occupational Safety and Health and the dermatologist*1

Abstract The National Institute for Occupational Safety and Health (NIOSH) is a federal agency responsible for conducting research and making recommendations for the prevention of work-related illnesses and injuries. NIOSH has a broad scope of activities, including activities that are of interest to the dermatologist. In addition, NIOSH supports extramural research and provides information on occupational exposures and health and safety issues.