Abstract

An examination has been made of the medical records of a group of white-skinned men, new starters in a works manufacturing dyestuffs and related chemicals. One thousand, four hundred and fifty-two such men started employment in the works in the five years 1955-59; 745 were employed as chemical process workers, 266 as chemical plant maintenance engineering workers, 335 as non-plant engineering workers, and 106 in various miscellaneous jobs. The process and plant engineering workers have considerable contact with chemicals; the non-plant engineering and miscellaneous workers have little or no chemical contact.

The numbers of men having one or more attacks of occupational dermatitis were 92 (12·35%) process workers, 20 (7·52%) plant engineering workers, 16 (4·77%) non-plant engineering workers, and two (1·88%) miscellaneous workers. The first attack of occupational dermatitis usually occurred within 12 months of starting in the works. Of the 130 first attacks of occupational dermatitis, 17 (13·1%) were caused by the mis-use of sodium hypochlorite (which is used as a means of cleaning the skin), 98 (75·2%) by other primary irritants, and 15 (11·6%) by cutaneous sensitizers.

One hundred and thirty men had their first attacks of occupational dermatitis and of these 85 (64·5%) had no recurrence, 32 (24·6%) had one recurrence, seven (5·4%) had two recurrences, three (2·3%) had three recurrences, two (1·5%) had four recurrences, and one (0·8%) had five recurrences. There was no evidence to suggest that the number of recurrences was related to the length of service. The data may be expressed as the number of recurrences per hundred average population of persons who have had an attack of dermatitis for each year after the first attack. In process workers the number of recurrent attacks for the year following the first episode was 37·8/100 average population, falling in the second to sixth years to 13·0 to 16·7/100. The number of men having a recurrence was 31·9/100 average population in the first year, and 5·3 to 7·7/100 in the second to sixth years. No recurrences occurred after the sixth year. In plant engineering workers the number of recurrences was 61·0/100 average population in the first year, and 7·7 and 7·8/100 in the second and third years. The number of men having a recurrence was 40·1/100 in the first year, and 7·7 and 7·8/100 in the second and third years. There were no recurrences after the third year. In non-plant engineers no man had more than one recurrence, so that the number of recurrences and the number of men having a recurrence are the same in each yearly period. The two rates are in the range 10·7 to 14·2/100 average population in the three years following the first episode of dermatitis, and 7·2 and 8·3/100 in the fourth and fifth years. There were no recurrences after the fifth year.

There were no differences in age at the time of the first attack of occupational dermatitis between those who developed a recurrence and those who did not.

In 17 men the first attack of occupational dermatitis was due to hypochlorite and of these three had one or more recurrences. Thirty-six of the 98 men whose first attack was due to other primary irritants had a recurrence, and six of the 15 men whose first attack was due to sensitizers had a recurrence.

A permanent change of work was necessary in 16 cases; all these men were found jobs within the works and none was obliged to accept work at a lower rate of pay. Four men are known to have left because of occupational dermatitis. The case of occupational dermatitis in this works have a generally favourable prognosis.