title: Outbreak of eczema and rhinitis in a group of office workers in Greenland.
abstract: BACKGROUND
  Disturbed indoor climate may in some cases be associated with illness. In the present paper, we report the results from a thorough investigation of office workers in Greenland, who developed skin and/or airway problems after moving into renewed offices.
  
  
  METHODS
  In 2009 the office of the Bank of Greenland had a total renovation of the building, including new furniture and carpets. Symptoms developed within the first year after moving back into the renewed buildings. After removal of carpets in the building, symptoms significantly improved. Workers were examined in 2009 and re-examined in 2013, including clinical examination, patch test and when relevant also skin prick tests and histamine release test. Isothiazolinones and fumarates, both able to cause airway as well as skin symptoms, were isolated from carpets before testing, and included in the test series.
  
  
  RESULTS
  In total, 32 out of 80 workers (40%) developed symptoms; 27 reported eczema, 20 rhinitis and 4 urticaria. Eczema was located on the hands and/or lower arms in 18 workers, on the face in 10 workers and on legs/trunk in 12 workers. After intervention in the office, 22 workers with eczema reported significant improvement, all cases of hand eczema cleared and 16 workers with rhinitis also improved. Positive patch tests to carpet extracts were found significantly more frequent in the worker cohort than in a control group comprising 47 dermatitis patients (p<0.001). Only few workers reacted with a positive response to skin prick test or in the HR test, no obvious pattern in reactions was found, and no conclusions can be made from these reactions.
  
  
  CONCLUSIONS
  The results indicate that the reported symptoms are related to exposures from the building after renovation in 2009. A specific triggering exposure could not be identified, although chemicals from the glued carpets are suspected. The study is an example of a work place investigation, and illustrates the diversity of symptoms and exposures involved in "Sick Building" cases.
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Niels E
authors.initials: NE
authors.lastname: Ebbehøj
authors.affiliation: Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; t.agner@dadlnet.dk.
authors.forename: Tove
authors.initials: T
authors.lastname: Agner
authors.affiliation: Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, Malmø, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Zimerson
authors.affiliation: Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, Malmø, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D004196:Disease Outbreaks; D004485:Eczema / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006116:Greenland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D010328:Patch Tests; D015995:Prevalence; D012220:Rhinitis / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D014581:Urticaria / Q000175:diagnosis / Q000453:epidemiology*; D017132:Workplace
keywords: eczema; indoor climate; patch test; rhinitis; urticarial; work place study