title: Occupational irritant contact dermatitis diagnosed by analysis of contact irritants and allergens in the work environment.
abstract: BACKGROUND
  Irritant contact dermatitis (ICD) is a common diagnosis in patients with occupational contact dermatitis (OCD). Studies are lacking on the usefulness of material safety data sheets (MSDSs) in making the diagnosis of ICD.
  
  
  OBJECTIVE
  To characterize irritant exposures leading to the diagnosis of occupational ICD (OICD), and to evaluate the occurrence of concomitant exposures to contact allergens.
  
  
  METHODS
  We included 316 patients with suspected occupational hand dermatitis, referred to the Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Denmark during January 2010-August 2011, in a programme consisting of a clinical examination, exposure assessment, and extensive patch/prick testing.
  
  
  RESULTS
  OCD was diagnosed in 228 patients. Of these patients, 118 were diagnosed with OICD. The main irritant exposures identified were wet work (n = 64), gloves (n = 45), mechanical traumas (n = 19), and oils (n = 15). Exposure to specific irritant chemicals was found in 9 patients, and was identified from MSDSs/ingredients labelling in 8 of these patients. Review of MSDSs and ingredients labelling showed that 41 patients were exposed to 41 moderate to potent contact allergens, and 18 patients were exposed to 25 weak workplace contact allergens.
  
  
  CONCLUSIONS
  In the present study, the systematic exposure assessment did not reveal any new irritants. MSDSs have a limited role in the investigation of ICD.
authors.affiliation: Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark.
authors.forename: Ulrik F
authors.initials: UF
authors.lastname: Friis
authors.forename: Torkil
authors.initials: T
authors.lastname: Menné
authors.forename: Jakob F
authors.initials: JF
authors.lastname: Schwensen
authors.forename: Mari-Ann
authors.initials: MA
authors.lastname: Flyvholm
authors.forename: Jens P E
authors.initials: JP
authors.lastname: Bonde
authors.forename: Jeanne D
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D000328:Adult; D000485:Allergens / Q000009:adverse effects; D017453:Dermatitis, Irritant / Q000175:diagnosis* / Q000209:etiology; D009783:Dermatitis, Occupational / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006229:Hand Dermatoses / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D007509:Irritants / Q000009:adverse effects; D008297:Male; D010328:Patch Tests
chemical_list: D000485:Allergens; D007509:Irritants
keywords: exposure analysis; irritants; occupational; occupational irritant contact dermatitis; systematic exposure assessment; systematic stepwise exposure assessment