Occupational contact dermatitis in North American production workers referred for patch testing: Retrospective analysis of cross-sectional data from the North American contact dermatitis group 1998 to 2014

Background: Little is known about the epidemiology of contact dermatitis in production workers (PWs). Objective: The aims of this study were to estimate the prevalence of contact dermatitis and characterize clinically relevant and occupationally related allergens among North American PWs undergoing patch testing. Methods: This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1998 to 2014. Results: Of 39,332 patch-tested patients, 2732 (7.0%) were PWs. Among PWs, most were men (62.4%) and white (83.9%). A history of childhood eczema was uncommon (11.3%). Prevalent occupations included machine operators (27.3%); fabricators, assemblers, and hand-working occupations (16.8%); and precision metalworking occupations (16.1%). The most frequent sites of dermatitis were the hands (53.8%) and arms (29.4%), which were significantly more commonly affected compared with non-PWs (P G 0.0001). Occupationally related skin disease, allergic contact dermatitis, and irritant contact dermatitis were also significantlymore common in PWs (49.9%vs 10.6%, 58.9%vs 53.7%, and 32.7%vs 25.7%, respectively; all Ps G 0.0001). Epoxy (15.3%), thiuram mix (8.3%), carbamix (8.1%), formaldehyde (6.3%), and cobalt (5.9%)were themost frequent occupationally related allergens.The top allergensources includedadhesives/glues (16.0%), metalworking fluids/cutting oils (6.8%), and coatings (6.3%). Conclusions: Production workers had a high rate of occupationally related skin disease, as well as irritant and allergic contact dermatitis. Involvement of exposed body areas was common. Frequently identified allergens included adhesives/glues, rubber accelerators, metals, and preservatives.