title: Occupational relevance of positive standard patch-test results in employed persons with an initial report of an occupational skin disease.
abstract: OBJECTIVE
  It is commonly accepted that the standard screening tray is an essential diagnostic test in patch testing supporting the diagnosis of contact dermatitis, the most common type of occupational skin disease (OSD). In this study standard patch-test results of employed persons with an initial report of an OSD were analyzed within 24 occupational groups.
  
  
  METHODS
  An evaluation was made of employed persons recorded in the Register of Occupational Skin Diseases in Northern Bavaria (Berufskrankheitenregister Haut-Nordbayern; BKH-N) between 1990 and 1999, catering for those standard screening tray allergens tested over the 10-year period.
  
  
  RESULTS
  Nickel sulfate was the most common sensitizer (29.5%), showing occupational relevance in only 11% of the cases sensitized. Other common sensitizers were cobalt chloride (13.5%), p-phenylenediamine free base (10.7%), potassium dichromate (9.8%), fragrance mix (5.4%), thiuram mix (4.2%), balsam of Peru (4.0%), chloromethylisothiazolinone/methylisothiazolinone (4.0%), and formaldehyde (4.0%). The most occupationally relevant sensitizers were thiuram mix (71%), epoxy resin (67%), p-phenylenediamine free base (59%), p-phenylenediamine-black-rubber mix/ N-isopropyl- N'-phenyl- p-phenylenediamine (53%), potassium dichromate (48%), formaldehyde (38%), chloromethylisothiazolinone/methylisothiazolinone (37%), and mercapto-mix/mercaptobenzothiazole (35%). Occupational groups at risk of acquiring delayed-type sensitization were, in particular, electroplaters, tile setters and terrazzo workers, construction and cement workers, solderers, wood processors, and leather and fur processors.
  
  
  CONCLUSIONS
  The standard series contributes valuable information and asserts its position in clarifying the causes of OSDs. Based on the study results, the rate of occupationally relevant sensitization to each single allergen is demonstrated, and the difficulties in verifying the occupational relevance are discussed.
authors.affiliation: Department of Clinical Social Medicine, Center of Occupational and Environmental Dermatology, University Hospital of Heidelberg, Thibautstrasse 3, 69115 Heidelberg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Dickel
authors.forename: O
authors.initials: O
authors.lastname: Kuss
authors.forename: A
authors.initials: A
authors.lastname: Schmidt
authors.forename: T L
authors.initials: TL
authors.lastname: Diepgen
mesh_terms: D000328:Adult; D000485:Allergens / Q000009:adverse effects / Q000145:classification; D003877:Dermatitis, Contact / Q000145:classification / Q000175:diagnosis*; D005260:Female; D005858:Germany; D006801:Humans; D007221:Industry; D008137:Longitudinal Studies; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis*; D016273:Occupational Exposure / Q000032:analysis*; D009790:Occupations / Q000145:classification; D010328:Patch Tests / Q000592:standards*; D012042:Registries; D018570:Risk Assessment
chemical_list: D000485:Allergens