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P.2.17 Case report: three occupational diseases in a nail technician
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  1. Shlomo Moshe1,2,
  2. Ayala Krakov1,2
  1. 1Maccabi Healthcare Services, Holon, Israel
  2. 2Sackler Faculty of Medicine, School of Public Health, Tel-Aviv University, Tel Aviv, Israel

Abstract

Introduction In cosmetics, acrylic glues are used to apply nail and eyelash extensions. Acrylates are highly irritant materials and may cause local irritation (Contact Dermatitis – CD), respiratory irritation (Asthma) and systemic irritation (Urticaria). This case report describes these three occupational diseases.

Clinical presentation A 48-year-old female, normally healthy, has been working in the nail beauty field for 11 years. Lately, following an increase of work, she started coughing every morning and feeling shortness of breath which was worsen at the start of work, and improved on vacations. In addition, the patient suffered from skin tenderness in her fingers. An examination of the hands showed a typical picture of CD in left hand fingers 4–5.

Methods and results Specific Patch Tests showed sensitivity to Hydroxyethyl Methacrylate and Hydroxypropyl Methacrylate. A methacholine challenge test showed a 22% decrease in FEV1 at 3.94μmol methacholine (i.e. positive test). The patient performed a Peak Expiratory Flow test (PEF). After a week in the nail salon her respiratory and dermatological status worsened greatly, including development of contact urticaria. She was instructed to stop immediately the exposure and start taking p/o steroids. Due to her 3 occupational diseases she was removed from work and latter was recognized as having 3 occupational disease by the Israeli National Insurance which supported her vocational rehabilitation.

Discussion Acrylic glues are hazardous agents which can cause several occupational diseases and require occupational environment monitoring yearly according to Israeli regulations. The TLV-TWA is 2ppm. Small private businesses like the patients‘ place don’t perform environmental monitoring or use personal or environmental protective equipment which endanger its workers (usually low social class women) who are not aware of the dangers in this industry. More public attention should be given to the risk in this industry.

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