Background: Farmers are at highest risk of occupational skin diseases. Knowing risk factors for these diseases would allow identifying risk groups and introducing preventive measures. 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 nation-wide 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 methodology was built-up on observations from previous studies of farmers and farming students (Spiewak R et al. Ann Agric Env Med 2001, 8, 261-7; Spiewak R, Am J Ind Med 2003, 43, 647-55), and comprised standardised questionnaire, skin prick tests, patch tests, total IgE, farm-animal specific IgE and Phadiatop. Obtained data (144 variables) were tested statistically as possible risk factors for work-related dermatoses. For each variable, odds ratios were calculated (Mantel-Haenszel). A logistic regression model was also used for determining the main determining factors.
Results: Work-related dermatoses were identified in 18 of 304 study participants, which means that 5.9% farming students have developed occupational skin disease even before finishing their vocational training. Contact dermatitis was diagnosed in 10 students, contact urticaria in 4, and both dermatitis and urticaria in remaining 4 students. The provoking factors were grain dust (13 students), hay dust (9), cow dander (1), fertilisers (1), and petrol (1). The main risk factors for work-related dermatitis were: history of atopic dermatitis before entering the vocational 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). The 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).
Conclusions: History of allergic diseases is the main risk factor for work-related dermatitis among farming students. This means that asking simple questions at the initial health check would be sufficient for identifying the risk group. Also risk group for work-related urticaria could be identified, though simple allergy tests would be needed in this case. Identifying risk groups would enable appropriate counselling before and during the vocational training, thus preventing the development of occupational skin diseases in later professional life.
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Institute of Dermatology, Krakow, Poland
Instytut Dermatologii w Krakowie
© Radoslaw Spiewak (contact).
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Document created: 30 September 2006, last updated: 1 September 2007.