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published_or_final_version / Medicine / Master / Doctor of Medicine

Photoallergic contact dermatitis (PACD) is a clinical problem that has often been poorly understood and neglected by dermatologists over recent years. This can be partly attributed to its investigation by photopatch testing (PPT) falling between the expertise of photobiologists and contact dermatitis clinicians. One result of this situation was that no European Baseline PPT series had been agreed on. To redress this, the European multi centre photopatch test study (EMCPPTS) was conceived to provide up to date information on which photoallergens are of greatest clinical relevance. Its conduct and results form the core research project of this thesis. To enable the EMCPPTS to proceed and its results to be viewed in a wider context, the other Chapters of this thesis explore important related aspects of PACD and PPT in Europe. The introduction examines the nature of PACD and PPT and reviews current photoallergens. Then, the investigation of the two photoallergens carprofen and chlorproethazine by PPT is recounted. These studies highlight deficiencies within the current European regulatory system for preventing photoallergens from reaching the marketplace, as well as providing templates for the investigation of new photoallergens in the human environment. This is followed by a pilot PPT study which provides new information on the optimum non-irritating concentration of the 19 ultraviolet sunscreen absorbers to be used in the EMCPPTS. The issue of attempting to determine the photoallergenic potential of the EMCPPTS agents with respect to exposure patterns is addressed by conducting a sunscreen survey in the UK. The EMCPPTS itself is then detailed, as well as the difficulties that can be encountered when conducting a large clinical study of this nature. The results from the EMCPPTS and other presented studies were shown to be of importance in deciding upon a new European Baseline PPT series. The process involved in deciding this series, as well as its content are described before overall conclusions and possible future studies in the domain of PACD and PPT are discussed.

"April 1999." Includes bibliographical references (leaves 46-51). Aims to collect information about the numbers of dental workers who are sensitive or allergic to nickel and to help identify signs which might predict those people who are most likely to be sensitive to nickel. Uses a standard patch test to identify sensitive subjects.

Thesis (doctoral)--Lund University, 1994. / Added t.p. with thesis statement inserted.

Thesis (doctoral)--Lund University, 1994. / Added t.p. with thesis statement inserted.

A study of hypersensitivity of high school students to the oleoresins of fifty common North Texas plants.

Orientador: Jaime Olbrich Neto / Resumo: Os cabelos são um importante componente de identidade social e sedução, favorece o mercado de cosméticos, notadamente o capilar, que busca inovações e novidades destinadas a obter um resultado desejado. Mulheres e homens dão importância para a saúde e aparência dos mesmos, empenhando cuidados que vão além dos habituais de higiene. A procura pelo cabelo ideal expõe a riscos de doenças, tanto os profissionais dos salões de beleza e como seus clientes. São doenças ocupacionais, em muitos casos, negligenciadas. Entre estes riscos encontra-se a dermatite de contato. No Brasil, a chamada escova progressiva é a mais conhecida e utilizada para alisamento. Neste processo o uso de formaldeído (FA) em concentrações não permitidas tem sido prática comum, expondo cabeleireiros e clientes a risco de doenças relacionadas ao contato com FA. O FA é permitido na concentração de até 0,2% como conservante de produtos. O presente estudo objetivou avaliar indivíduos expostos ao FA ao realizarem alisamento capilar, se estavam sensibilizados ao FA. Para identificar FA em produtos de alisamento capilar, usado pelos cabeleireiros participantes desta pesquisa, utilizou-se um kit comercialmente disponível. Foram incluídos profissionais expostos ao FA, clientes (esporadicamente expostos) e indivíduos nunca expostos. Foram realizados patch teste com a bateria brasileira para dermatite de contato, e um participante apresentou teste cutâneo positivo para formol, onze para bicromato de potássio e oito para s... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Hair is an important component of social identity and seduction, it favors the cosmetics market, notably the capillary, which seeks innovations and novelties designed to obtain a desired result. Women and men give importance to their health and appearance, engaging in care that goes beyond the usual hygiene. The search for the ideal hair exposes the risks of diseases, both the professionals of the beauty salons and their clients. Occupational diseases that are, in many cases, neglected. Contact dermatites is one of the risks. In Brazil, the so-called brazilian hair straightening is the preferred for straightening. In this process, the use of formaldehyde (FA) in unallowed concentrations has been common practice, exposing hairdressers and clients to the risk of diseases related to contact with FA. At a concentration of up to 0.2%, as a p preservative, FA is permitted. The present study aimed to evaluate individuals exposed to FA when performing hair straightening, and if they were sensitized to FA. To identify FA in hair straightening products, used by hairdressers participating in this research, a commercially available kit was used. Professionals exposed to the FA, clients (sporadically exposed) and individuals never exposed were included. Patch tests were performed with the Brazilian battery for contact dermatitis, and one participant presented a positive skin test for formaldehyde, eleven for potassium bichromate and eight for nickel sulfate. Clinical symptoms were more se... (Complete abstract click electronic access below) / Mestre

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13454号 / 論医博第2247号 / 新制||医||1055(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 竹内 理, 教授 杉田 昌彦, 教授 生田 宏一 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Contexte : Les dermatoses professionnelles sont l’une des principales causes de pathologies professionnelles en Europe, et dans près de 80% des cas, elles concernent des dermatites de contact professionnelles (DCP). Les DCP comprennent les dermatites allergiques de contact (DAC), les dermatites irritatives de contact (DIC) et les urticaires de contact (UC). En France, les secteurs et nuisances à risque de DCP et les tendances chronologiques de DCP sont très peu documentés. Objectifs : 1) étudier les tendances observées au fil du temps vis-à-vis du nombre de cas de dermatoses professionnelles, des secteurs d’activité concernés et des nuisances mises en cause, 2) mettre en évidence des secteurs ou des postes à risque de dermatoses professionnelles. Méthode : Ce travail de thèse s’appuie sur le réseau français RNV3P (Réseau national de vigilance et de prévention des pathologies professionnelles) qui assure le suivi des évènements de santé liés au travail sur l’ensemble du territoire, en centralisant les informations recueillies dans ses 32 centres de consultations de pathologies professionnelles (CCPP). Les analyses ont porté sur les DAC, les DIC et les UC en lien probable ou certain avec le travail et recensées dans le RNV3P entre 2001 et 2010. L’analyse des évolutions temporelles a été réalisée à partir des rapports de cote de signalement (Reporting Odds-Ratio, ROR). Deux méthodes statistiques ont été utilisées : le coefficient de corrélation de rang de Kendall sur les ROR estimés chaque année et le modèle logistique calculant la variation annuelle des cas. Résultats : Les 5990 cas de DCP notifiés touchent plus fréquemment les femmes, dans des tranches d'âges jeunes. Les principaux secteurs mis en cause pour les trois DCP se distribuent différemment en fonction du sexe et sont, par ordre décroissant de fréquence : santé et action sociale, services personnels, construction, métallurgie et travail des métaux, administrations publiques, services fournis principalement aux entreprises, commerce et réparation automobile, hôtellerie et restauration. Les DCP associées aux cosmétiques (savons ou substances parfumantes) et les biocides augmentent significativement dans le secteur de la santé et de l’action sociale ; les produits de coiffure et les cosmétiques (savons essentiellement) augmentent dans celui des services personnels, essentiellement parmi les coiffeuses. On observe une montée des cas de DAC aux résines époxy dans la construction sur la période et les DIC liées au ciment dans ce secteur ne baissent pas. Les cas de DAC aux métaux augmentent dans le secteur des services fournis aux entreprises (personnels de nettoyage). Nos résultats ont aussi montré une hausse des DAC liées aux isothiazolinones, quel que soit le secteur (+38%) et une baisse des DIC liées à l’action de lavage des mains (utilisation itérative des savons). Par ailleurs, nos données ont objectivé l’impact de mesures réglementaires ou de politiques visant à prévenir les DCP : la mise en place de la directive européenne « Ciment » (2003/53/CE) en 2005 s’est accompagnée d’une réduction de moitié des cas de DAC et une baisse similaire a été observée à partir des données du réseau britannique EPIDERM, confortant nos conclusions ; la campagne de substitution des gants en latex dans le secteur de soins au milieu des années 2000 est suivie d’une réduction significative de la notification des cas d’UC. Conclusion : Ces résultats démontrent, avec l’exemple des dermatoses professionnelles, la capacité du RNV3P à orienter les politiques nationales en matière de prévention des risques professionnels et à en évaluer l’efficacité. / Background: In Europe, occupational skin disease is one of the major causes of work-related diseases, among them occupational contact dermatitis (OCD) accounts for 80% of all cases of OSD reported, but data about sectors and agents at risk remains sparse. Objectives: 1) to study OCD trends in terms of industrial activities and main causal agents, 2) to describe industrial sectors or occupations at risk of OCD. Method: Data were collected from the French National Network of Occupational Disease Surveillance and Prevention (RNV3P) during 2001-2010 period, based on the 32 French Occupational and Environmental Disease Consultation Centres. All allergic contact dermatitis (ACD), irritative contact dermatitis (ICD) and contact urticaria (CU) probably or certainly work-related were included in the study. Trends were examined (i) on annual crude numbers of OCD and (ii) on reported odds-ratios of OCD calculated using logistic regression models. Results: 5990 OCD cases were included and concerned more frequently young age classes among women and older age classes among men. Industrial sectors more commonly involved in OCD concerned in decreasing order: health and social work activities, personal service activities, construction, metal industry, public administrations, other business activities, retail trade and repair of motor vehicles, and hotels and restaurants. According to trend analysis of OCD cases, cosmetics (including soaps and fragrances) and biocides increased significantly in health and social work activities; hairdressing products and cosmetics (mainly soaps) in personal service activities (including primarily hairdressers). In construction sector, ACD due to epoxy resins increased during the study period and concomitantly, ICD attributed to cement did not decrease underlying the lack of prevention in this sector at risk. ACD due to metals increased in other business activities mainly occupied by cleaning staff. We showed a rise of ACD due to isothiazolinone compounds whatever the sector. Besides, we have shown the impact of regulatory measures or prevention campaign on OCD: (i) a significant reduction by almost half in the occurrence of ACD attributed to chromate in cement which coincides with the implementation of the European Cement directive and we obtained similar results to a study based on the UK EPIDERM network; (ii) the effectiveness of latex exposure prevention measures for health care workers since half of 2000s and (iii) the wide use of disinfection with an alcohol-based solution in health and social work activity followed by a significant reduction of ICD due to iterative handwashing with soap. Conclusion: RNV3P data allowed to highlight causal agents involved in sectors most at risk of OCD. These results might help intervention policy in health and safety at work and allergy prevention. They also showed the effectiveness of preventative intervention on OCD, suggesting that RNV3P reporting scheme is useful in France to evaluate intervention policy in health and safety at work.