Risk factors for work-related dermatoses among farming students

Background: Farmers are at highest risk of occupational skin diseases. Ideally, the prevention should start at the earliest phase of vocational training. In order to identify risk factors for farm work-related skin diseases, a nationwide study of Polish farming students was carried out in 2001 and 2002.

Study group: 304 random students of 11 agricultural schools consented to participate in the study (participation rate 98%). The schools were at least 100 km from each another. The participants were 160 men and 144 women, aged from 17 - 21 years.

Methods: The examinations included questionnaire, skin prick tests, patch tests, total IgE, farm-animal specific IgE and Phadiatop. For each of 144 variables, odds ratios were calculated (Mantel-Haenszel). Logistic regression model was used for the determination main determining factors.

Results: Work-related dermatoses were identified in 18 of 304 study participants. Contact dermatitis was diagnosed in 10 students, contact urticaria in 4, and both dermatitis and urticaria in remaining 4 students. Main risk factors for work-related dermatitis were: history of atopic dermatitis before entering school (OR=7.64; 95%CI: 1.84-31.72; p=0.005), history of contact dermatitis before entering school (OR=5.20; 1.63-16.59; p=0.005), and history of respiratory allergy before entering school (OR=3.80; 1.21-11.95; p=0.022). Main risk factors for work-related urticaria were: positive skin prick tests to farm allergens (OR = 6.56; 1.52-28.20; p=0.012), history of contact dermatitis before entering school (OR=5.32; 1.21-23.38; p=0.027), and positive Phadiatop test (OR=5.00; 1.17-21.43; p=0.030).

Discussion: 5.9% farming students have developed occupational skin disease before finishing their vocational training. Asking simple questions at the initial health check would be sufficient for identifying students at risk for work-related dermatitis, whereas simple allergy tests would be sufficient for identifying those at risk for work-related urticaria.

Related articles:

1. Spiewak R, Gora A, Horoch A, Dutkiewicz J. Atopy, allergic diseases and work-related symptoms among students of agricultural schools: first results of the Lublin Study. Ann Agric Environ Med 2001; 8 (2): 261-267.
2. Spiewak R. Occupational dermatoses among Polish private farmers, 1991-1999. Am J Ind Med 2003; 43 (6): 647-655.
3. Spiewak R. Atopy and contact hypersensitivity: a reassessment of the relationship using objective measures. Ann Allergy Asthma Immunol 2005; 95 (1): 61-65.
4. Spiewak R, Dutkiewicz J. A farmer's occupational airborne contact dermatitis masqueraded by coexisting rosacea: delayed diagnosis and legal acknowledgement. Ann Agric Environ Med 2004; 11 (2): 329-333.
5. Spiewak R. Köbnerizing occupational contact allergy to thiuram in a farmer with psoriasis. Contact Dermatitis 2004; 51 (4): 214-215.

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