title: Occupationally related contact dermatitis in North American food service workers referred for patch testing, 1994 to 2010.
abstract: BACKGROUND
  Contact dermatoses are common in food service workers (FSWs).
  
  
  OBJECTIVE
  This study aims to (1) determine the prevalence of occupationally related contact dermatitis among FSWs patch tested by the North American Contact Dermatitis Group (NACDG) and (2) characterize responsible allergens and irritants as well as sources.
  
  
  METHODS
  Cross-sectional analysis of patients patch tested by the NACDG, 1994 to 2010, was conducted.
  
  
  RESULTS
  Of 35,872 patients patch tested, 1237 (3.4%) were FSWs. Occupationally related skin disease was significantly more common in FSWs when compared with employed non-FSWs. Food service workers were significantly more likely to have hand (P < 0.0001) and arm (P < 0.0006) involvement. The rates for irritant and allergic contact dermatitis in FSWs were 30.6% and 54.7%, respectively. Although the final diagnosis of irritant contact dermatitis was statistically higher in FSWs as compared with non-FSWs, allergic contact dermatitis was lower in FSWs as compared with non-FSWs. The most frequent currently relevant and occupationally related allergens were thiuram mix (32.5%) and carba mix (28.9%). Gloves were the most common source of responsible allergens. The NACDG standard tray missed at least 1 occupationally related allergen in 38 patients (4.3%).
  
  
  CONCLUSIONS
  Among FSWs patch tested by the NACDG between 1994 and 2010, the most common allergens were thiuram mix and carba mix. Gloves were the most common source of responsible allergens.
authors: Department of Dermatology, Veterans Affairs Medical Center, University of Minnesota, Minneapolis, MN 55417, USA. erin.warshaw@va.gov
authors: Erin M
authors: EM
authors: Warshaw
authors: Gina P
authors: GP
authors: Kwon
authors: C G Toby
authors: CG
authors: Mathias
authors: Howard I
authors: HI
authors: Maibach
authors: Joseph F
authors: JF
authors: Fowler
authors: Donald V
authors: DV
authors: Belsito
authors: Denis
authors: D
authors: Sasseville
authors: Kathryn A
authors: KA
authors: Zug
authors: James S
authors: JS
authors: Taylor
authors: Anthony F
authors: AF
authors: Fransway
authors: Vincent A
authors: VA
authors: Deleo
authors: James G
authors: JG
authors: Marks
authors: Melanie D
authors: MD
authors: Pratt
authors: Frances J
authors: FJ
authors: Storrs
authors: Matthew J
authors: MJ
authors: Zirwas
authors: Joel G
authors: JG
authors: Dekoven
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000209:etiology*; D005260:Female; D005511:Food Handling; D005522:Food Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America; D016273:Occupational Exposure / Q000009:adverse effects*; D010328:Patch Tests / Q000379:methods*
chemical_list: D000485:Allergens