title: Evaluation of two self-administered questionnaires to ascertain dermatitis among metal workers and its relation with exposure to metal working fluids.
abstract: We performed an exploratory study to evaluate 2 self-administered questionnaires assessing hand dermatitis and to investigate a possible exposure-response relation between dermal exposure to semi-synthetic metal working fluids (SMWF) and dermatitis. In a cross-sectional survey on dermatitis, a symptom-based questionnaire and a picture-based skin-screening list were applied in 80 SMWF-exposed workers and 67 referents. To evaluate accuracy of the questionnaires, 47 subjects were examined by a dermatologist. Dermal exposure levels to SMWF were assessed on the hands, forearms, and face with an observational method that was validated with a fluorescent-tracer method. The symptom-based questionnaire had a relatively high sensitivity (0.86) but moderate specificity (0.64), the skin-screening list had a low sensitivity (0.36) and a relatively high specificity (0.84). The skin-screening list seemed to represent the more severe cases of dermatitis and showed a significant relation to exposure, for dermatitis on hands, forearms, or face. In epidemiological surveys where workers are not seen by a dermatologist, the skin-screening list seems to be more appropriate to detect cases of dermatitis, as its higher specificity results in less false positives. Alternatively, it would be preferable to apply the symptom-based questionnaire; workers with symptoms should be seen by a dermatologist to identify false positives.
authors.affiliation: Risk Assessment in the Work Environment, a collaborative centre between TNO Quality of Life and IRAS Utrecht University, Utrecht, the Netherlands. bvanwen@una.ac.cr
authors.forename: Berna
authors.initials: B
authors.lastname: van Wendel de Joode
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.forename: Kees
authors.initials: K
authors.lastname: van Ginkel
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
mesh_terms: D003430:Cross-Sectional Studies; D009783:Dermatitis, Occupational / Q000453:epidemiology* / Q000209:etiology; D003952:Diagnostic Imaging; D006801:Humans; D007219:Industrial Oils / Q000009:adverse effects*; D008669:Metallurgy; D008670:Metals; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
chemical_list: D008670:Metals