title: Metalworking exposures and persistent skin symptoms in the ECRHS II and SAPALDIA 2 cohorts.
abstract: BACKGROUND
  Diseases of the skin are important and often preventable conditions occurring among workers with dermal exposures to irritant and sensitizing agents.
  
  
  OBJECTIVE
  We conducted this analysis to assess the associations between metalworking exposures and current and persistent skin symptoms among male and female participants in two population-based epidemiologic studies.
  
  
  METHODS
  We pooled data from the European Community Respiratory Health Survey II (ECRHS II) and the Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults 2 (SAPALDIA 2), two prospective cohort studies in Europe. Each participant completed interviewer-administered questionnaires to provide information about symptoms and exposures related to selected occupations, including metalworking, during the follow-up periods. We assessed associations between skin symptoms and the frequency of metalworking exposures among 676 ECRHS II/SAPALDIA 2 respondents.
  
  
  RESULTS
  Current skin symptoms were reported by 10% of metalworkers and were associated with frequent use, defined as four or more days per week, of oil-based metalworking fluids [prevalence ratio (PR): 1.76, 95% confidence interval (CI): 1.25-2.49)] and organic solvent/degreasing agents (PR: 2.06, 95% CI: 1.21-3.50).
  
  
  CONCLUSIONS
  Skin symptom prevalence is associated with increasing frequency of oil-based metalworking fluid and degreasing agent use. Our findings justify assessing strategies for reducing the frequency of metal-related exposures.
authors.affiliation: Centre for Research in Environmental Epidemiology, Barcelona, Spain. mmirabelli@creal.cat
authors.forename: Maria C
authors.initials: MC
authors.lastname: Mirabelli
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: Zock
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Bircher
authors.forename: Debbie
authors.initials: D
authors.lastname: Jarvis
authors.forename: Dirk
authors.initials: D
authors.lastname: Keidel
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.forename: Dan
authors.initials: D
authors.lastname: Norbäck
authors.forename: Mario
authors.initials: M
authors.lastname: Olivieri
authors.forename: Estel
authors.initials: E
authors.lastname: Plana
authors.forename: Katja
authors.initials: K
authors.lastname: Radon
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Peter
authors.initials: P
authors.lastname: Schmid-Grendelmeier
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
authors.forename: Simona
authors.initials: S
authors.lastname: Villani
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
mesh_terms: D000328:Adult; D003877:Dermatitis, Contact / Q000453:epidemiology* / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000453:epidemiology* / Q000209:etiology*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008420:Manufactured Materials / Q000633:toxicity; D008669:Metallurgy; D019216:Metals, Heavy / Q000633:toxicity; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D012307:Risk Factors; D012997:Solvents / Q000633:toxicity; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D019216:Metals, Heavy; D012997:Solvents