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Biomedical subjects

H J Schwanitz

Publications and source records attributed to H J Schwanitz.

At least 19 recordsLinked to original sources
PubMed2002

[Current status of dermatomicrobiology. An overview].

The new German laws dealing with protection against infectious diseases (Infektionsschutzgesetz of 1.1.2001) have reconfirmed the importance of microbiology as a basic science and infectiology as a multi-disciplinary clinical discipline. Concerning dermatological diagnosis and therapy, the implementation of molecular biological techniques has a decisive influence. The discovery of new (e.g. Helicobacter pylori) and the better detection of known organisms (e.g. Chlamydia, Borrelia) suggested findings in questions of causality and therapeutic developments. Concerning the infections of the skin this synopsis provides the state of the art of diagnostic process and treatment in mycology, bacteriology and virology.

Anti-Infective Agents↗
PubMed2001

[Preventing skin damage in beauticians].

The incidence of occupational dermatitis of the hands is particularly high in the hairdressing trade. To elucidate the role of various risk factors, and to ultimately improve primary prevention of occupational hand dermatitis, a prospective cohort study was conducted between 1992 and 1997, including 2352 hairdressing trainees. Already six weeks after the start of training (median) 35.4% had--usually mild--irritant skin changes, mainly involving the interdigital web spaces. These were associated with subsequent, possibly more severe, hand dermatitis. Reduced exposure to wet work, i.e., improved skin protection with gloves, often led to the resolution of dermatitis of the hands. In conclusion, early irritant skin damage is a sentinel event that heralds possibly disabling occupational skin disease and should prompt adequate preventive measures.

Beauty Culture↗
PubMed2001

Glyoxal is an important allergen for (medical care) cleaning staff.

While disinfection is essential in medical practice, it carries the risk of serious adverse effects, including allergic contact dermatitis. To assess the current importance of glyoxal [CAS 107-22-2] as occupational allergen, a retrospective descriptive analysis of records of an occupational dermatitis clinic in Osnabrück and of national surveillance data of the Information Network of Departments of Dermatology (IVDK) in Germany and Austria was performed. Of 189 highly selected patients with occupational dermatitis tested with glyoxal (1% in water or, as trimer, 1% in petrolatum) in Osnabrück, 11 had positive reactions to glyoxal, which were occupationally relevant in 9 cases. Causative occupations included mainly nursing and room cleaning. In a less selected population of 2626 additional patients tested in other centres of the IVDK, 40 further positive reactions to glyoxal were observed. Concomitant sensitisation to glutardialdehyde and formaldehyde, respectively, was frequently observed. In conclusion, glyoxal should be tested in all patients with contact dermatitis working in occupations with possible exposure to respective disinfecting/cleaning agents.

Adult↗
PubMed2001

Atopic signs and symptoms: assessing the 'atopy score' concept.

BACKGROUND: Score concepts have been suggested for the standardised diagnosis of atopic dermatitis, incorporating various anamnestic and clinical minor criteria of atopy, including the 'Erlangen Score', developed in the hospital-based setting of a dermatitis clinic. OBJECTIVE: To evaluate the properties of this score in the context of a population-based epidemiological study. METHODS: The association between relevant atopic criteria and previous or current flexural eczema was evaluated in 2,352 hairdressing apprentices. RESULTS: The association was not as strong as in the patient-based studies, comparing the respective odds ratios. Accordingly, the discriminating power of the Erlangen Score was poor, resulting in low sensitivity (55.7%) and specificity (73.8%) for, e.g., 8 points as cutpoint. CONCLUSION: While the score appears useful to summarise minor criteria, the individual relevance of its point values should not be overestimated in view of a low positive predictive value in a population (compared to a clinical) setting.

Adolescent↗
PubMed2001

Occupational contact urticaria and late-phase bronchial asthma caused by compositae pollen in a florist.

Insect-pollinated members of the plant family Compositae (Asteraceae) rarely cause immediate-type hypersensitivity disease; however, this may have quite disabling consequences, which is shown by the case of a 42-year-old female florist. She developed contact urticaria later accompanied by rhinoconjunctivitis and bronchial asthma with maximum obstruction occurring some hours after the end of occupational exposure to the causative Compositae pollens of, for example, dandelions, blazing star, golden rod, yarrow, Aster ssp, chrysanthemums, and marguerite. Skin testing revealed immediate-type hypersensitivity to several members of the above-mentioned plant family confirmed by demonstration of specific IgE antibodies. Bronchial provocation testing yielded a positive response with all 4 pollen extracts tested. The patient had to give up work in a flower shop, because sufficient avoidance of airborne inhalant exposure was not considered practical.

Adult↗
PubMed2000

Multicentre study for the development of an in vivo model to evaluate the influence of topical formulations on irritation.

Although skin protective products to prevent irritant skin reactions are in wide use, neither standardized test models to prove differences in efficacy exist, nor has the quality or the reproducibility of results been evaluated in a multicentre approach. This should be mandatory when developing or testing skin care products. Therefore, we have designed a multicentre study in an approach to find a standardized test procedure for the evaluation of skin protective products. In this irritation study, a repeated short-time occlusive irritation test (ROIT) with a standardized protocol has been evaluated in 2 phases (12 days and 5 days protocol) in 4 (n=20) respectively 6 (n=33) skilled centres. The skin reaction was induced by 2 irritants (0.5% aq. SLS and toluene, 2x a day for 30 min). Its modification by 3 different cream bases with different hydrophilicity was analyzed. The irritation was monitored by bioengineering methods (TEWL measurement, colorimetry) and by clinical scoring. The evaluation showed that significant results could already be achieved with the 5-day protocol. Furthermore, in spite of the expected inter-centre variations due to heterogeneity of the individual threshold of irritation, interpretation of clinical score, and inter-instrumental variability, the ranking of the vehicles regarding reduction of the irritant reaction was consistent in all centres.

Administration, Topical↗
PubMed2000

Relevance of multiparametric skin bioengineering in a prospectively-followed cohort of junior hairdressers.

There is conflicting evidence concerning predictors of individual susceptibility to develop irritant contact dermatitis in wet work. A cohort of initially 92 hairdresser apprentices was prospectively followed for 3 years. The association between anamnestic and clinical findings, and multiparametric skin bioengineering data (transepidermal water loss [TEWL], microcirculation, capacitance, pH, sebum, temperature) was investigated. The observation intervals were 3 months in the 1st year of training and 12 months thereafter. Of the 92 apprentices, 6 had already developed hand dermatitis on 1st examination, 20 dropped out or had occupational exposure longer than 7 weeks prior to investigation. Of the remaining 66 participants considered here, 19 (29%) developed moderate or severe dermatitis ("cases"), 32 minimal skin changes, 15 none within the observation period. Average incidence rate of hand dermatitis was 21.1 cases per 100 person years. Atopy score was not associated with the development of dermatitis, nor were the investigated basal bioengineering parameters, including TEWL, in a multivariable model. However, there was a significant increase in TEWL within the 1st year of training in presumptive "cases". The aim to develop an objective and predictive instrumentary for pre-employment counselling in wet work, by a combination of (a) clinical and (b) relevant non-invasive bioengineering parameters, has not yet been accomplished. Skin-provocation tests employing bioengineering seem to be required. Notwithstanding, work-related monitoring of basal biophysical skin-functions may become useful in the secondary prevention of occupational dermatitis.

Adolescent↗
PubMed2000

Interdigital dermatitis: sentinel skin damage in hairdressers.

In the course of a cohort study, 2275 hair-dressing apprentices were examined a median of 6 weeks after the start of their training in the years 1992. 1993 and 1994. Skin changes were noted in 821 (36%). The site most often affected was the interdigital web space (664 of those with skin changes: 81%). The proportion of participants with a high atopy score and previous hand and flexural dermatitis was larger in the subset with interdigital dermatitis than in healthy persons, but was particularly elevated in those affected by dermatitis involving other sites. Interdigital dermatitis can be regarded as a potential precursor of more severe hand dermatitis in hairdressers, and probably of irritant hand dermatitis in wet work occupations in general. Thus, it is an important sentinel for secondary prevention. e.g. regular and thorough application of emollients.

Barbering↗
PubMed1999

Hand dermatitis in a prospectively-followed cohort of hairdressing apprentices: final results of the POSH study. Prevention of occupational skin disease in hairdressers.

The incidence of hand dermatitis is high in the hairdressing trade; the individual disease burden is substantial, as are the costs of treatment, workers compensation and retraining programs. To evaluate the risk of developing occupational irritant hand dermatitis associated with several potential risk factors, namely constitution (atopy) and occupational exposure, an observational prospective population-based cohort study set in vocational training schools in northwest Germany, recruiting 2352 hairdressing apprentices, was performed. Unprotected wet work of more than 2 h per day is the major significant risk factor; low ambient absolute humidity is equally associated with a significantly increased risk. Compared to the youngest age group, risk diminishes with increasing age. Constitutional risk factors are difficult to evaluate because of selective dropout of atopic participants. For primary prevention, a population approach, improving working conditions and skin protection for all exposed, appears to be the most beneficial.

Adolescent↗
PubMed1999

Risk of hand dermatitis among hairdressers versus office workers.

OBJECTIVES: The risk of irritant skin damage associated with hairdressing was estimated with the individual occupational exposure and other relevant factors having been taken into consideration. METHODS: A cohort of 2352 hairdressing and 111 office apprentices was prospectively followed for the duration of their vocational training (3 years), 3 examinations having been made and 3 years of recruitment having been used [1992 (hairdressers only), 1993, 1994] in 15 vocational training schools in northwest Germany. The information of the final follow-up examination was used for the analysis. RESULTS: A multifactorial analysis taking several (constitutional) risk factors, which were unevenly distributed between the 2 groups, into account revealed a significantly increased risk for hairdressers when compared with office workers (odds ratio approximately 4.0) with a marked decline in the most recently recruited (1994) apprentice group. Other significant factors increasing the dermatitis risk were (i) low ambient absolute humidity, (ii) young age, and (iii) a certain higher range of "atopy score". If the individual profile of occupational exposure among hairdressers was also considered, unprotected wet work of more than 2 hours per day was found to be a significant risk factor. CONCLUSIONS: Good skin protection, as operationalized in the present study, can diminish, but not eliminate, the risk of occupational irritant hand dermatitis among hairdressers.

Adolescent↗
PubMed1998

Prevalence and incidence of hand dermatitis in hairdressing apprentices: results of the POSH study. Prevention of occupational skin disease in hairdressers.

OBJECTIVE: Occupational skin changes in hairdressers are very common. Morbidity, however, has not yet been quantified precisely. METHODS: A cohort of 2,352 hairdressing apprentices (of the 2,570 invited to participate, i.e., 91.5% response) was prospectively followed for the duration of their vocational training (3 years) by three examinations. Three waves (years) were recruited in 1992, 1993, and 1994 from 15 vocational training schools in northwestern Germany. RESULTS: The point prevalence of (mostly slight) irritant skin changes of the hands increased from 35.4% in the initial examination to 47.5% in the intermediate examination and to 55.1% in the final examination. Given a more conservative definition of a case of "hand dermatitis," these estimates were 12.9%, 23.5%, and 23.9%, respectively. Altogether, 34.3 and 15.2 cases of "skin changes (any degree)" and "hand dermatitis," respectively, in 100 person-years were observed during the study period. The incidence rate, i.e., the number of newly diseased study participants in relation to the person-time at risk contributed, decreased in the course of the study. The proportion of dropouts until final follow-up was 51.8%. CONCLUSION: The present results appear to lie in a range with those found in other, much smaller cohort studies. However, comparison of the results is hampered either by the lack of a clear definition or by a different definition of "person-time at risk" or "a case of hand dermatitis." As compared with an external control group of office apprentices, the incidence was several times higher in hairdressing apprentices, which points to the high risk for skin damage in this occupation.

Beauty Culture↗
PubMed1998

An epidemiological study of the influence of season (cold and dry air) on the occurrence of irritant skin changes of the hands.

In the course of an ongoing cohort study on constitutional and occupational risk factors for the development of irritant hand dermatitis in hairdressing apprentices, an increased prevalence of irritant skin changes was noted in a subgroup examined during particularly cold winter months. Prompted by this observation, the importance of several meteorological factors (day means of temperature, relative and absolute humidity) was assessed in extensive statistical analyses based on data of 742 participants, supplemented by meteorological information obtained from the German Meteorological Service (DWD). There were significant associations of existing hand dermatitis with low temperature and low absolute humidity (Mann-Whitney U-test, P < 0.0001), but not with relative humidity (P = 0.38). Logistic regression analysis, including known determinants of irritant hand dermatitis in this setting, showed that low temperature and low relative humidity tended to be risk factors (OR = 1.66 and 1.57, respectively, for the lower quartiles, P = 0.07 in both cases), and confirmed that absolute humidity significantly influenced the occurrence of irritant hand dermatitis (OR = 2.06 for < 4.8 mg/L, P < 0.01). Thus, these environmental factors must be regarded as possible confounders in the analysis of future epidemiological studies on irritant hand dermatitis and should be considered in multifactorial analyses.

Adolescent↗
PubMed1998

Hand eczema in a prospectively-followed cohort of office-workers.

A cohort of initially 111 office apprentices was prospectively followed for the duration of their training (2 and 3 years, respectively). The point prevalence of (slight) irritant or atopic hand eczema was 18.9% in the initial and 25.0% in the final examinations. Altogether, 37 cases of (slight) hand eczema were noted within the study period; of these, 10 qualified for a more conservative definition of "hand eczema". Expressed in a person-time-model, the incidence rates were 18.4 and 4.1 cases per 100 persons per year, respectively. The only significant risk factor for the development of (slight) irritant or atopic hand eczema within the study period was previous hand eczema--partly as a child, partly during a preceding occupation (e.g. hairdressing). Compared to one retrospective study in a cohort of older office employees and to a study sampling the general population, incidence rates were slightly higher in this study. Such differences may partly be due to different definitions of what has to be considered "a case of hand eczema". The necessity to (i) communicate on the method of case definition and (ii) develop guidelines for case definition in epidemiological studies is emphasised.

Adolescent↗