title: Contact allergy to thiurams: multifactorial analysis of clinical surveillance data collected by the IVDK network.
abstract: OBJECTIVE
  To analyse the association between occupation (represented by job title) and contact allergy to thiuram vulcanising agents based on data of a clinical registry (IVDK, www.ivdk.org ).
  
  
  METHODS
  Clinical, demographic and allergy patch test data of all patients tested between 1992 and 2006 with the thiuram mix (1% in petrolatum) as part of the baseline series was analysed (n = 121,051). Poisson regression analysis was used to quantify the association between different occupations (and other relevant factors) and a positive patch test reaction to the thiuram mix. Furthermore, the time trend of sensitisation prevalence was analysed in high-risk occupational subgroups identified.
  
  
  RESULTS
  In comparison to a largely unexposed reference group (office workers and teachers), rubber manufacturers had a significantly elevated risk (prevalence ratio (PR): 5.1, 95% confidence interval (CI) 2.0-10.5). However, health care workers such as physicians and dentists (PR: 3.8, 95% CI: 3.0-4.8) or nursing staff (PR: 3.0, 95% CI: 2.5-3.6) as well as meat and fish processors (PR 3.5, 95% CI: 2.2-5.3) and cleaners (PR 3.1, 95% CI: 2.5-3.8) were found to have a high sensitisation risk as well. In case of health care workers, a significant downward trend during the study period was observed; while in food processors and cleaners, sensitisation prevalence remained largely stable.
  
  
  CONCLUSIONS
  The adjusted multifactorial analysis identified occupations yet unknown to be associated with elevated thiuram contact allergy risk, e.g., food processors and cleaners. Thus, (i) further in-depth research can be targeted and (ii) efforts to prevent sensitisation to thiurams focussed, e.g., by limiting thiuram concentrations in products to a residual level which is technically inevitable.
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Waldstr. 6, 91054 Erlangen, Germany. wolfgang.uter@imbe.med.uni-erlangen.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Uter
authors.forename: Janice
authors.initials: J
authors.lastname: Hegewald
authors.forename: Annette
authors.initials: A
authors.lastname: Pfahlberg
authors.forename: Holger
authors.initials: H
authors.lastname: Lessmann
authors.forename: Axel
authors.initials: A
authors.lastname: Schnuch
authors.forename: Olaf
authors.initials: O
authors.lastname: Gefeller
mesh_terms: D000328:Adult; D015984:Causality; D003877:Dermatitis, Contact / Q000453:epidemiology / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005659:Fungicides, Industrial / Q000009:adverse effects / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D016012:Poisson Distribution; D011159:Population Surveillance / Q000379:methods*; D013893:Thiram / Q000009:adverse effects / Q000276:immunology*
chemical_list: D005659:Fungicides, Industrial; D013893:Thiram