title: Occupational contact allergy in the building trade in Germany: influence of preventive measures and changing exposure.
abstract: OBJECTIVE
  Since 1993, assiduous efforts have been made in Germany to lower the incidence of allergic cement dermatitis by reducing the content of hexavalent chromium (Cr VI). Usage of epoxy resin systems has considerably increased in the building trade in the same period. We analysed data of the Information Network of Departments of Dermatology (IVDK) to evaluate the influence of these changing occupational exposures on frequencies of sensitization.
  
  
  METHODS
  IVDK data of 1,153 men working in the building trade (bricklayers, tile setters etc.) presenting with occupational skin disease in the years 1994-2008 were analysed, taking into consideration not only the year of patch testing, but also beginning and duration of work in the building trade.
  
  
  RESULTS
  While contact sensitization to chromate decreased from 43.1 to 29.0%, sensitization to epoxy resin increased from 8.4 to 12.4%. Logistic regression analysis revealed that, compared to those who had already worked before 1994, patients having started to work in building trade after 1999 had a significantly decreased risk of chromate sensitization (odds ratio 0.42) and a significantly increased risk of sensitization to epoxy resin (odds ratio 2.79). Additionally, risk of thiuram sensitization increased with the duration of employment.
  
  
  CONCLUSIONS
  Our data confirm that reducing Cr VI content of cement is useful in preventing allergic cement eczema, as previously found in Scandinavia. In contrast, the increasing prevalence of contact sensitization to epoxy resin components in the building trade is alarming. Preventive measures, which have already been implemented, have to be enforced.
authors.affiliation: Information Network of Departments of Dermatology, University of Göttingen, von-Siebold-Strasse 3, Göttingen, Germany. jgeier@ivdk.org
authors.forename: Johannes
authors.initials: J
authors.lastname: Geier
authors.forename: Andrea
authors.initials: A
authors.lastname: Krautheim
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Uter
authors.forename: Holger
authors.initials: H
authors.lastname: Lessmann
authors.forename: Axel
authors.initials: A
authors.lastname: Schnuch
mesh_terms: D000328:Adult; D002857:Chromium / Q000009:adverse effects; D003252:Construction Materials / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology / Q000209:etiology*; D004853:Epoxy Resins / Q000009:adverse effects; D005160:Facility Design and Construction; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D017751:Safety Management; D013893:Thiram / Q000009:adverse effects; D013997:Time Factors; D017132:Workplace
chemical_list: D004853:Epoxy Resins; D013893:Thiram; D002857:Chromium; C074702:chromium hexavalent ion