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as they probably represent the part of the population that most often seeks medical care&#44; but is significantly lower in the occupational group&#44; perhaps because there are more male workers in activities subject to exposure to sensitizers and irritating substances&#46; Moreover&#44; women tend to be more adept at using personal protective equipment and preventive care&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The most prevalent occupations in the OCD group are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> and involve professionals performing wet activities &#40;contact with water &#62;2&#8239;hours daily&#44; or handwashing &#62;20 times a day&#41; or exposure to known sensitizers and irritant substances&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The time of disease evolution in OCD was 29&#46;2 months&#44; while in NOCD was 39&#46;5 months &#40;p&#8239;&#60;&#8239;0&#46;005&#41;&#46; The difficulty in maintaining working activities may have favored the earlier search for help among OCD cases&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">As for the location of the dermatosis&#44; there was a statistical difference in relation to OCD for hands &#40;palmar and back regions&#41; and forearms &#40;p&#8239;&#60;&#8239;0&#46;001&#41;&#44; while in patients with NOCD&#44; the face was the most affected site &#40;582&#47;66&#46;7&#37;&#41;&#46; This difference is expected since OCD mainly affects the hands&#44; which directly manipulate irritating or sensitizing products&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The main relevant sensitizers observed in both groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; with nickel being the most important one&#44; present in occupational activities or not&#46; The hands are affected due to contact with working tools such as sewing needles&#44; tweezers&#44; cuticle nippers&#44; keys&#44; and scissors&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Potassium bichromate is related to bricklayers&#44; due to its presence in cement &#40;as a contaminant&#44; resulting from the manufacturing process&#41;&#44; being an important occupational allergen in similar studies&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The thiuram and carba mix and 2-mercaptobenzothiazole &#40;MBT&#41; groups are rubber vulcanizing agents&#44; commonly found in gloves&#44; used in several production sectors&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Epoxy resin is a material used in several products such as paints&#44; floor finishes&#44; fiberglass&#44; adhesives for metals&#44; wood&#44; and concrete&#46; Therefore&#44; injuries occur in multiple locations and protective measures are difficult&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Quaternium 15 &#40;formaldehyde-releasing preservative&#41;&#44; present in children&#39;s products&#44; cosmetics&#44; veterinary shampoos&#44; polishing materials&#44; and waxes&#44; is an ubiquitous allergen&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Some allergens showed high frequencies in both groups &#40;with no statistical difference&#41;&#44; including Kathon CG&#58; OCD &#40;24&#47;6&#46;9&#37;&#41; and NOCD &#40;84&#47;8&#46;2&#37;&#41;&#44; a mixture of preservatives in aqueous products&#44; such as cosmetics&#44; cleaning articles &#40;detergents&#44; soaps&#44; lubricating oils&#41; and paints&#44; with occupational cases occurring in cleaning workers&#44; hairdressers and painters&#59; and paraphenylenediamine&#44; present in hair dyes&#58; OCD &#40;27&#47;7&#46;8&#37;&#41; and NOCD &#40;110&#47;10&#46;7&#37;&#41;&#44; with occupational cases occurring in hairdressers&#44; affecting the hands due to the inappropriate use of PPE&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">During the study period&#44; OCD represented 25&#46;3&#37; of the cases submitted to patch tests&#44; with the group of young male individuals being the most affected&#44; with an impact on workers&#39; health and the country&#39;s economy&#46; The study of OCD in the country is fundamental for the planning of preventive actions and diagnostic training in dermatological centers&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0105" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; contributions</span><p id="par0110" class="elsevierStylePara elsevierViewall">Rosana Lazzarini&#58; Design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Mariana de Figueiredo Silva Hafner&#58; Design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Nathalie Mie Suzuki&#58; Effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Isabela Marangon Pasotti&#58; Drafting and editing of the manuscript&#59; obtaining&#44; analyzing&#44; and interpreting the data&#59; approval of the final version of the manuscript&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Maria Regina de Paula Leite Kraft&#58; Elaboration and writing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0135" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Professional activity&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Housemaids&#47;cleaning services&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Building &#47;bricklayer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Health care workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Painter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Hairdressers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">38&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">349&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">100&#46;0&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Allergens&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">152 with OCD</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Nickel sulfate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">360&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p&#8239;&#61;&#8239;0&#46;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Potassium bichromate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">25&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#46;4&nbsp;\t\t\t\t\t\t\n
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Research Letter
Occupational contact dermatitis: analysis of cases observed in a service not specialized in occupational dermatosis between 2004 and 2017
Rosana Lazzarinia,
Corresponding author
rosana.fototerapia@gmail.com

Corresponding author.
, Mariana de Figueiredo Silva Hafnera, Nathalie Mie Suzukiab,c, Isabela Marangon Pasottic, Maria Regina de Paula Leite Kraftc
a Dermatology Clinic, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
b Dermatology Clinic, Hospital Santa Casa de São Paulo, São Paulo, SP, Brazil
c Escola de Medicina da Santa Casa de São Paulo, São Paulo, SP, Brazil
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which can spread&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The diagnosis involves occupational history&#59; synchrony between the start of the picture and exposure period&#59; the correlation between the location of lesions and contact&#59; improvement with absence from work and worsening with the return to it&#59; and the patch test&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The following were analyzed&#58; the frequency of OCD in patients submitted to patch tests in a non-specialized outpatient clinic between 2004 and 2017&#59; the distribution by age&#44; sex&#44; professional activity&#44; and location of the dermatosis&#59; the diagnoses&#59; and the most common sensitizers&#46; Data were compared with those of non-OCD patients &#40;NOCD&#41; &#40;Research Ethics Committee approval&#44; 08077219&#46;1&#46;0000&#46;5479&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Data were retrospectively collected from 1&#44;405 patients tested with the Brazilian standard test battery &#40;FDA-Allergenic&#47;Brazil&#41; and fixed with appropriate retainers&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Data were analyzed using the software SPSS&#44; version 13&#46;0&#46; and the results of the two groups were compared using the Chi-square test &#40;p&#8239;&#60;&#8239;0&#46;005&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Of the 1&#44;405 tested patients&#44; 349 &#40;25&#46;3&#37;&#41; were OCD and 1&#44;031 &#40;74&#46;4&#37;&#41; were NOCD&#46; The higher frequency of OCD when compared to a previous publication &#40;10&#46;9&#37;&#41; may reflect the increase in the number of tested substances and the involvement of Occupational Medicine in the diagnostic conclusion&#46; However&#44; the number is below the national frequency &#40;34&#46;2&#37;&#41; of OD cases&#44; probably because it is a non-specialized service in these types of dermatoses&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Among the OCDs&#44; 152 &#40;43&#46;6&#37;&#41; were ACD&#44; 55 &#40;15&#46;8&#37;&#41; were ICD&#44; 8 &#40;2&#46;3&#37;&#41; were atopic dermatitis &#40;AD&#41; and 215 &#40;61&#46;6&#37;&#41; were other dermatoses&#46; Among the NOCD&#44; 455 &#40;44&#46;1&#37;&#41; were ACD&#44; 70 &#40;6&#46;8&#37;&#41; were IDC&#44; 54 &#40;5&#46;2&#37;&#41; AD and 452 &#40;43&#46;8&#37;&#41; were other dermatoses&#46; ACD was the most common diagnosis in both groups&#46; However&#44; ICD is the most common subtype worldwide&#44; especially in occupational cases&#44; showing a statistically higher frequency in this group &#40;p&#8239;&#60;&#8239;0&#46;001&#41;&#46; The proportion of these diagnoses varies by region&#44; due to differences in industry types&#44; regulatory standards&#44; notification systems&#44; and availability of centers qualified for the performance of the patch test&#46; On the other hand&#44; AD can be considered an OD&#44; since many workers experience worsening of the condition after contact with allergens and irritants in the working environment&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Among the patients with OCD&#44; the mean age was 42&#46;1 years&#44; while in the NOCD it was 47&#46;5 years &#40;p&#8239;&#60;&#8239;0&#46;005&#41;&#44; resulting in losses to the production systems and social security&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In the OCD group there were 182 &#40;52&#46;1&#37;&#41; women and 167 &#40;47&#46;9&#37;&#41; men&#44; while among the NOCD there were 797 &#40;77&#46;3&#37;&#41; women and 234 &#40;22&#46;7&#37;&#41; men&#46; The frequency of women was higher among the NOCD &#40;p&#8239;&#60;&#8239;0&#46;005&#41;&#44; as they probably represent the part of the population that most often seeks medical care&#44; but is significantly lower in the occupational group&#44; perhaps because there are more male workers in activities subject to exposure to sensitizers and irritating substances&#46; Moreover&#44; women tend to be more adept at using personal protective equipment and preventive care&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The most prevalent occupations in the OCD group are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> and involve professionals performing wet activities &#40;contact with water &#62;2&#8239;hours daily&#44; or handwashing &#62;20 times a day&#41; or exposure to known sensitizers and irritant substances&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The time of disease evolution in OCD was 29&#46;2 months&#44; while in NOCD was 39&#46;5 months &#40;p&#8239;&#60;&#8239;0&#46;005&#41;&#46; The difficulty in maintaining working activities may have favored the earlier search for help among OCD cases&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">As for the location of the dermatosis&#44; there was a statistical difference in relation to OCD for hands &#40;palmar and back regions&#41; and forearms &#40;p&#8239;&#60;&#8239;0&#46;001&#41;&#44; while in patients with NOCD&#44; the face was the most affected site &#40;582&#47;66&#46;7&#37;&#41;&#46; This difference is expected since OCD mainly affects the hands&#44; which directly manipulate irritating or sensitizing products&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The main relevant sensitizers observed in both groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; with nickel being the most important one&#44; present in occupational activities or not&#46; The hands are affected due to contact with working tools such as sewing needles&#44; tweezers&#44; cuticle nippers&#44; keys&#44; and scissors&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Potassium bichromate is related to bricklayers&#44; due to its presence in cement &#40;as a contaminant&#44; resulting from the manufacturing process&#41;&#44; being an important occupational allergen in similar studies&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The thiuram and carba mix and 2-mercaptobenzothiazole &#40;MBT&#41; groups are rubber vulcanizing agents&#44; commonly found in gloves&#44; used in several production sectors&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Epoxy resin is a material used in several products such as paints&#44; floor finishes&#44; fiberglass&#44; adhesives for metals&#44; wood&#44; and concrete&#46; Therefore&#44; injuries occur in multiple locations and protective measures are difficult&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Quaternium 15 &#40;formaldehyde-releasing preservative&#41;&#44; present in children&#39;s products&#44; cosmetics&#44; veterinary shampoos&#44; polishing materials&#44; and waxes&#44; is an ubiquitous allergen&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Some allergens showed high frequencies in both groups &#40;with no statistical difference&#41;&#44; including Kathon CG&#58; OCD &#40;24&#47;6&#46;9&#37;&#41; and NOCD &#40;84&#47;8&#46;2&#37;&#41;&#44; a mixture of preservatives in aqueous products&#44; such as cosmetics&#44; cleaning articles &#40;detergents&#44; soaps&#44; lubricating oils&#41; and paints&#44; with occupational cases occurring in cleaning workers&#44; hairdressers and painters&#59; and paraphenylenediamine&#44; present in hair dyes&#58; OCD &#40;27&#47;7&#46;8&#37;&#41; and NOCD &#40;110&#47;10&#46;7&#37;&#41;&#44; with occupational cases occurring in hairdressers&#44; affecting the hands due to the inappropriate use of PPE&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">During the study period&#44; OCD represented 25&#46;3&#37; of the cases submitted to patch tests&#44; with the group of young male individuals being the most affected&#44; with an impact on workers&#39; health and the country&#39;s economy&#46; The study of OCD in the country is fundamental for the planning of preventive actions and diagnostic training in dermatological centers&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0105" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; contributions</span><p id="par0110" class="elsevierStylePara elsevierViewall">Rosana Lazzarini&#58; Design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Mariana de Figueiredo Silva Hafner&#58; Design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Nathalie Mie Suzuki&#58; Effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Isabela Marangon Pasotti&#58; Drafting and editing of the manuscript&#59; obtaining&#44; analyzing&#44; and interpreting the data&#59; approval of the final version of the manuscript&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Maria Regina de Paula Leite Kraft&#58; Elaboration and writing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0135" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Professional activity&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Housemaids&#47;cleaning services&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Building &#47;bricklayer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Health care workers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Painter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Hairdressers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">38&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">349&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">100&#46;0&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Allergens&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Nickel sulfate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">360&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">p&#8239;&#61;&#8239;0&#46;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Potassium bichromate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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Article information
ISSN: 03650596
Original language: English
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