Sensitization to textile dyes in Spain: Epidemiological situation (2019-2022)

BACKGROUND

Current frequency and features for positivity to textile dye mix (TDM) in Spain are unknown.

OBJECTIVES

To study the frequency, clinical features and simultaneous positivity between TDM, para-phenylenediamine (PPD) and specific disperse dyes.

MATERIALS AND METHODS

We analysed all consecutive patients patch-tested with TDM from the Spanish Contact Dermatitis Registry (REIDAC), from 1 January 2019 to 31 December 2022. Within this group, we studied all selected patients patch-tested with a textile dye series.

RESULTS

Out of 6128 patients analysed, 3.3% were positive to the TDM and in 34% of them, the sensitization was considered currently relevant. TDM positivity was associated with working as a hairdresser/beautician and scalp, neck/trunk and arm/forearm dermatitis. From TDM-positive patients, 57% were positive to PPD. One hundred and sixty-four patients were patch-tested with the textile dye series. Disperse Orange 3 was the most frequent positive dye (16%). One of every six cases positive to any dye from the textile dye series would have been missed if patch-tested with the TDM alone.

CONCLUSIONS

Positivity to TDM is common in Spain and often associated with PPD sensitization. TDM is a valuable marker of disperse dyes allergy that should be part of the Spanish and European standard series.

Occurrence of Textile Dyes and Metals in Tunisian Textile Dyeing Effluent: Effects on Oxidative Stress Status and Histological Changes in Balb/c Mice

Although it is known that textile wastewater contains highly toxic contaminants whose effects in humans represent public health problems in several countries, studies involving mammal species are scarce. This study was aimed to evaluate the toxicity profile of 90-days oral administration of textile dyeing effluent (TDE) on oxidative stress status and histological changes of male mice. The TDE was collected from the textile plant of Monastir, Tunisia and evaluated for the metals, aromatic amines, and textile dyes using analytical approaches. Metal analysis by ICP-MS showed that the tested TDE exhibited very high levels of Cr, As, and Sr, which exceeded the wastewater emission limits prescribed by WHO and Tunisian authority. The screening of TDE through UPLC-MS/MS confirmed the presence of two textile dyes: a triphenylmethane dye (Crystal violet) and a disperse azo dye (Disperse yellow 3). Exposure to TDE significantly altered the malondialdehyde (MDA), Conjugated dienes (CDs), Sulfhydryl proteins (SHP) and catalase levels in the hepatic and renal tissues. Furthermore, histopathology observation showed that hepatocellular and renal lesions were induced by TDE exposure. The present study concluded that TDE may involve induction of oxidative stress which ensues in pathological lesions in several vital organs suggesting its high toxicity. Metals and textile dyes may be associated with the observed toxicological effects of the TDE. These pollutants, which may have seeped into surrounding rivers in Monastir city, can cause severe health malaise in wildlife and humans.

Selection of homemade mask materials for preventing transmission of COVID-19: A laboratory study

The Coronavirus Disease 2019 (COVID-19) has swept the whole world with high mortality. Since droplet transmission is the main route of transmission, wearing a mask serves as a crucial preventive measure. However, the virus has spread quite quickly, causing severe mask shortage. Finding alternative materials for homemade masks while ensuring the significant performance indicators will help alleviate the shortage of masks. Referring to the national standard for the "Surgical Mask" of China, 17 materials to be selected for homemade masks were tested in four key indicators: pressure difference, particle filtration efficiency, bacterial filtration efficiency and resistance to surface wetting. Eleven single-layer materials met the standard of pressure difference (≤49 Pa), of which 3 met the standard of resistance to surface wetting (≥3), 1 met the standard of particle filtration efficiency (≥30%), but none met the standard of bacterial filtration efficiency (≥95%). Based on the testing results of single-layer materials, fifteen combinations of paired materials were tested. The results showed that three double-layer materials including double-layer medical non-woven fabric, medical non-woven fabric plus non-woven shopping bag, and medical non-woven fabric plus granular tea towel could meet all the standards of pressure difference, particle filtration efficiency, and resistance to surface wetting, and were close to the standard of the bacterial filtration efficiency. In conclusion, if resources are severely lacking and medical masks cannot be obtained, homemade masks using available materials, based on the results of this study, can minimize the chance of infection to the maximum extent.

Fabric Selection in Atopic Dermatitis: An Evidence-Based Review

BACKGROUND

Clothing fabrics interact closely with the skin to shape our cutaneous microenvironment. Cotton and silk have been traditionally recommended for patients with atopic dermatitis because of reported patient comfort. New synthetic fabrics combine anti-microbial, anti-inflammatory, moisture-wicking, and soothing properties that may augment conventional management strategies in atopic patients.

OBJECTIVE

We review existing and emerging evidence for fabric selection in patients with atopic dermatitis including cotton, wool, lyocell, silk, anionic, cellulosic/cellulose based, zinc oxide coated, citric acid coated, chitosan coated, silver coated, borage seed oil coated, ethylene vinyl, and polyurethane and offer practical suggestions for clothing and bedding choices.

METHODS

A systematic search was conducted on PubMed and EMBASE electronic databases for articles from 1 January, 1994 to 1 January, 2020. Studies were included based on the following inclusion criteria: clinical trial, published in English, and fabric as the main agent being evaluated. Case reports, case series, conference abstracts, reviews, animal studies, and duplicates were excluded. Studies were then manually screened by title, abstract, and full-text articles and selected to specifically describe the effects of fabrics in patients with atopic dermatitis. Both adult and pediatric patient studies were included.

RESULTS

There appears to be an advantage to modern fabric manufacturing and processing techniques that have created smaller diameter, smoother fibers such as super- and ultrafine merino wool and anti-microbial finishes. Traditional cotton and silk fabrics have mixed evidence in improving atopic dermatitis symptoms and severity but have shown to be generally safe. Large-diameter wool has been shown to induce itching and irritation; ultra- or superfine merino wool is non-pruritic and may be recommended as an alternative. Emerging fabrics with potential efficacy in reducing atopic dermatitis severity and Staphylococcus aureus burden include silver-coated, chitosan-coated, and cellulose-based fabrics. Zinc oxide-coated, acid-coated, polyurethane-coated, borage seed oil-coated, anionic, lyocell, and ethylene vinyl fabrics have sparse evidence and require further study before conclusions can be made.

CONCLUSIONS

Appropriate fabric selection can reduce the symptom severity and exacerbations of atopic dermatitis.

Filtration Efficiencies of Nanoscale Aerosol by Cloth Mask Materials Used to Slow the Spread of SARS-CoV-2

Filtration efficiency (FE), differential pressure (ΔP), quality factor (QF), and construction parameters were measured for 32 cloth materials (14 cotton, 1 wool, 9 synthetic, 4 synthetic blends, and 4 synthetic/cotton blends) used in cloth masks intended for protection from the SARS-CoV-2 virus (diameter 100 ± 10 nm). Seven polypropylene-based fiber filter materials were also measured including surgical masks and N95 respirators. Additional measurements were performed on both multilayered and mixed-material samples of natural, synthetic, or natural-synthetic blends to mimic cloth mask construction methods. Materials were microimaged and tested against size selected NaCl aerosol with particle mobility diameters between 50 and 825 nm. Three of the top five best performing samples were woven 100% cotton with high to moderate yarn counts, and the other two were woven synthetics of moderate yarn counts. In contrast to recently published studies, samples utilizing mixed materials did not exhibit a significant difference in the measured FE when compared to the product of the individual FE for the components. The FE and ΔP increased monotonically with the number of cloth layers for a lightweight flannel, suggesting that multilayered cloth masks may offer increased protection from nanometer-sized aerosol with a maximum FE dictated by breathability (i.e., ΔP).

Effects of humidity on skin friction against medical textiles as related to prevention of pressure injuries

Sustained pressure, shear forces, and friction, as well as elevated humidity/moisture, are decisive physical factors in the development of pressure injuries (PIs). To date, further research is needed in order to understand the influence of humidity and moisture on the coefficient of friction (COF) of skin against different types of medical textiles. The aim of this work was to investigate the effects of moisture caused by sweat, urine, or saline on the resulting COF of skin against different textiles used in the medical setting in the context of PI prevention. For that purpose, we performed physical measurements of static COFs of porcine skin followed by finite element (FE) computational modelling in order to illustrate the effect of increased COF at the skin on the resulting strains and stresses deep within the soft tissues of the buttocks. The COF of dry skin obtained for the 3 textiles varied between 0.59 (adult diaper) and 0.91 (polyurethane dressing). In addition, the COF increased with the added moisture in all of the tested cases. The results of the FE simulations further showed that increased COF results in elevated strain energy density and shear strain values in the skin and deeper tissues and, hence, in an increased risk for PI development. We conclude that moisture may accelerate PI formation by increasing the COF between the skin and the medical textile, regardless of the type of the liquid that is present. Hence, reduction of the wetness/moisture between the skin and fabrics in patients at a high risk of developing PIs is a key measure in PI prevention.

Cyclodextrin modified PLLA parietal reinforcement implant with prolonged antibacterial activity

The use of textile meshes in hernia repair is widespread in visceral surgery. Though, mesh infection is a complication that may prolong the patient recovery period and consequently presents an impact on public health economy. Such concern can be avoided thanks to a local and extended antibiotic release on the operative site. In recent developments, poly-l-lactic acid (PLLA) has been used in complement of polyethyleneterephthalate (Dacron®) (PET) or polypropylene (PP) yarns in the manufacture of semi-resorbable parietal implants. The goal of the present study consisted in assigning drug reservoir properties and prolonged antibacterial effect to a 100% PLLA knit through its functionalization with a cyclodextrin polymer (polyCD) and activation with ciprofloxacin. The study focused i) on the control of degree of polyCD functionalization of the PLLA support and on its physical and biological characterization by Scanning Electron Microscopy (SEM), Differential Scanning Calorimetry (DSC) and cell viability, ii) on the understanding of drug/meshes interaction using mathematic model and iii) on the correlation between drug release studies in phosphate buffer saline (PBS) and microbiological evaluation of meshes and release medium against E. coli and S. aureus. All above mentioned tests highlighted the contribution of polyCD on the improved performances of the resulting antibacterial implantable material.

STATEMENT OF SIGNIFICANCE

1. We managed for the first time, with well-defined parameters in terms of temperature and time of treatment, to functionalize a bio-absorbable synthetic material to improve drug sorption and drug release properties without affecting its mechanical properties. 2. We analyzed for the first time the degradation of our coating products by mass spectroscopy to show that only citrate and cyclodextrin residues (and glucose units) without any cytotoxicity are formed. 3. We managed to improve the mechanical properties of the PLA with the cyclodextrin polymer to form a composite. The assembly (cyclodextrin polymer and PLLA) remains biodegradable.

Textile industrial effluent induces mutagenicity and oxidative DNA damage and exploits oxidative stress biomarkers in rats

Exposure to complex mixtures like textile effluent poses risks to animal and human health such as mutations, genotoxicity and oxidative damage. Aim of the present study was to quantify metals in industrial effluent and to determine its mutagenic, genotoxic and cytotoxic potential and effects on oxidative stress biomarkers in effluent exposed rats. Metal analysis revealed presence of high amounts of zinc, copper, chromium, iron, arsenic and mercury in industrial effluent. Ames test with/without enzyme activation and MTT assay showed strong association of industrial effluent with mutagenicity and cytotoxicity respectively. In-vitro comet assay revealed evidence of high oxidative DNA damage. When Wistar rats were exposed to industrial effluent in different dilutions for 60 days, then activities of total superoxide dismutase and catalase and hydrogen peroxide concentration were found to be significantly lower in kidney, liver and blood/plasma of effluent exposed rats than control. Vitamin C in a dose of 50 mg/kg/day significantly reduced oxidative effects of effluent in rats. On the basis of this study it is concluded that industrial effluent may cause mutagenicity, in-vitro oxidative stress-related DNA damage and cytotoxicity and may be associated with oxidative stress in rats. Vitamin C may have ameliorating effect when exposed to effluent.

Occupational exposure to textile dust increases the risk of rheumatoid arthritis: results from a Malaysian population-based case-control study

Objectives

Lung exposures including cigarette smoking and silica exposure are associated with the risk of rheumatoid arthritis (RA). We investigated the association between textile dust exposure and the risk of RA in the Malaysian population, with a focus on women who rarely smoke.

Methods

Data from the Malaysian Epidemiological Investigation of Rheumatoid Arthritis population-based case–control study involving 910 female early RA cases and 910 female age-matched controls were analysed. Self-reported information on ever/never occupationally exposed to textile dust was used to estimate the risk of developing anti-citrullinated protein antibody (ACPA)-positive and ACPA-negative RA. Interaction between textile dust and the human leucocyte antigen DR β-1 (HLA-DRB1) shared epitope (SE) was evaluated by calculating the attributable proportion due to interaction (AP), with 95% CI.

Results

Occupational exposure to textile dust was significantly associated with an increased risk of developing RA in the Malaysian female population (OR 2.8, 95% CI 1.6 to 5.2). The association between occupational exposure to textile dust and risk of RA was uniformly observed for the ACPA-positive RA (OR 2.5, 95% CI 1.3 to 4.8) and ACPA-negative RA (OR 3.5, 95% CI 1.7 to 7.0) subsets, respectively. We observed a significant interaction between exposure to occupational textile dust and HLA-DRB1 SE alleles regarding the risk of ACPA-positive RA (OR for double exposed: 39.1, 95% CI 5.1 to 297.5; AP: 0.8, 95% CI 0.5 to 1.2).

Conclusions

This is the first study demonstrating that textile dust exposure is associated with an increased risk for RA. In addition, a gene–environment interaction between HLA-DRB1 SE and textile dust exposure provides a high risk for ACPA-positive RA.

Biochemical response of crayfish Astacus leptodactylus exposed to textile wastewater treated by indigenous white rot fungus Coriolus versicolor

The discharge of textile effluents into the environment without appropriate treatment poses a serious threat for the aquatic organisms. The present study was undertaken to investigate biochemical response of crayfish Astacus leptodactylus exposed to textile wastewater (TW) treated by indigenous white rot fungus Coriolus versicolor. Glutathione S-transferase (GST), cytochrome P450 1A1 (CYP1A1), and acetylcholinesterase (AchE) levels in hepatopancreas and abdomen tissues of crayfish exposed to untreated, treated, and diluted rates (1/10) in both TW during 24 and 96 h were tested. Physiochemical parameters (electrical conductivity (EC), chemical oxygen demand (COD), pH, and total dissolved solid (TDS)) of TW were determined before and after treatment. Physiochemical parameters of TW decreased after treatment. The GST activity and AchE were generally increased, but CYP1A1 activity was decreased in hepatopancreas tissue of crayfish exposed to different kinds of untreated TW. After treatment by indigenous white rot fungus (C. versicolor), GST and CYP1A1 activities were returned to control values, while AchE activities were increasing further. In this study, only GST and CYP1A1 activities of A. leptodactylus confirmed the efficiency of TW treatment with C. versicolor.

[The study of properties of textile wipes "LNR"]

The aim of the research was to investigate the toxicity of textile wipes "LNR". The wipes coated with polymer as well as wipes coated with polymer and drug substance were studied on CBA mice. It was found that both types of "LNR " napkins do not cause any toxic effect, mortality or changes of internal organs of mice in acute and in chronic experiments. The study of the cytotoxic effect of "LNR" wipes according to test of cell survival in tissue culture showed that during contact exposure of the samples on cell wipes "LC" significant inhibition of culture growth observed in sample 1. If to accept for pronounced effect on the growth inhibition of 50% or more, such action has the napkin 1. If to accept for pronounced effect on the growth inhibition of 50% or more, such action has the napkin 1. If to accept for pronounced effect on the growth inhibition of 50% or more, such action has the napkin 1.

A strategy for in vitro safety testing of nanotitania-modified textile products

Titanium dioxide nanomaterials are extensively used in many applications, also for modification of textile materials. Toxicological assessment of such textile materials is currently seldom performed, mainly because of lack of appropriate guidelines. The aim of the study was to assess cytotoxic and genotoxic potential of commercially available TiO2 and TiO2/Ag NMs in pristine form as well as polypropylene fibers modified with the NMs. Both titania NMs showed a cytotoxic effect on BALB/3T3 clone A31 and V79 fibroblasts after 72-h exposure. Both NMs induced a weak genotoxic effect in comet assay, with TiO2/Ag being more active. In vitro micronucleus test on human lymphocytes revealed a weak mutagenic effect of both materials after 24h of exposure. In contrast, no significant increase in micronuclei frequency was observed in the in vitro micronucleus test on V79 fibroblasts. The 24-h extracts prepared from polypropylene fibers modified with TiO2/Ag induced a cytotoxic effect on BALB/3T3 cells which strongly depended on the mode of the fibers manufacturing. The study presents a comprehensive approach to toxicity assessment of textile fibers modified with NMs. Proposed approach may form a good "starting point" for improved future testing strategies.

Application of optical methods to characterize textile materials and their influence on the human skin

The skin is not only the largest organ of the human body, but it is also a barrier to the environment. The major part of the human skin is in constant contact with textile materials. The objective of this study was to characterize textile materials and to investigate their influence on the skin properties. For this purpose, two different textile materials (polyamide and polyester) were objectively characterized by optical coherence tomography and surface structure 3D-profilometry. In addition, subjective textile properties like haptic sensation and stiffness, as tactile characteristics felt by volunteers, were analyzed. The objective textile characteristics and subjective parameters were compared to the barrier properties measured by in vivo laser scanning microscopy . Comparable results were achieved between barrier properties and subjective assessment in relation to the textile characteristics in favor of the polyester fabric. Consequently, the optical method used in dermatology for the analysis of the skin can be applied to characterize and evaluate textile fabrics and their interaction with human skin in vivo.

Diaper area and disposable diapers

Since the 1960s, cloth diapers have been replaced by disposable diapers. The evolution of healthier skin in the diaper area has been demonstrated in parallel to that of disposable diapers. The improvements of disposable diapers--fit, dryness, comfort--have been based on the understanding of factors playing a role in the development of diaper dermatitis.

Allergic contact dermatitis from formaldehyde textile resins

Formaldehyde-based resins have been used to create permanent-press finishes on fabrics since the 1920s. These resins have been shown to be potent sensitizers in some patients, leading to allergic contact dermatitis. This review summarizes the history of formaldehyde textile resin use, the diagnosis and management of allergic contact dermatitis from these resins, and current regulation of formaldehyde resins in textiles.

[Clinical epidemiologic study of occupational risks in small- and mid-size businesses in Bacău County]

The aim of the study was to identify and quantify the health risk factors in small and middle enterprises (SME) in Bacău, which represent 5.5% of the total number of enterprises, employing about 29% of the total workforce in Bacău.

MATERIAL AND METHOD

Two questionnaires have been administered, first asking for general information about the company and second, asking for data about current exposure, according to the reports required by the Ministry of Health. Workplaces were visited and analyzed through direct observation.

RESULTS

The most important risk factors, found in 22% of the employees in small enterprises and 31% of employees in middle enterprises, are visual strain, musculoskeletal strain and exposure to textile dust. The measurements showed exposure over the threshold limit for silica dust, wood dust, noise and organic solvents in 35% of cases.

CONCLUSION

The study resulted in a useful database for increasing the quality of occupational health services provided to employees in SMEs and offered the possibility to compare data with other geographical areas of our country and worldwide.

Textiles and Human Skin, Microclimate, Cutaneous Reactions: An Overview

This article overviews research in the interdisciplinary area of textile/skin interaction and related cutaneous intolerance. Microclimate in the skin/clothing system and especially the skin responses relates to the moisture and heat transfer within this system and plays a critical role in skin irritation from textiles. A discussion is then given on skin irritation reactions to textiles, including intolerance caused by chemicals (dyes and finishes) and physical contact/friction. Finally, two skin injuries, blisters and pressure ulcers, which are caused by physical contact, pressure, and friction, are documented. Despite the prevalent problems caused by ill textile/skin interactions, minimal efforts have been devoted to this field. In addition, the in vivo experimental studies infrequently lead to a solid conclusion. The cause may lie in the dramatic variation of skin conditions among individuals as well as among different anatomic sites of the same person. Another reason might be the lack of communications between researchers in the areas of textiles and dermatology.

Common misconceptions in contact dermatitis counseling

Both physicians and patients hold many misconceptions when it comes to allergen avoidance. Ten commonly held misconceptions are exposed, allowing more accurate approach to the individual with cutaneous allergies.

Airborne irritant contact dermatitis and conjunctivitis after occupational exposure to chlorothalonil in textiles

Chlorothalonil (tetrachloro-1,3-benzenedicarbonitrile, CAS 1897-45-6) is a pesticide that has been on the market for many years. It is used as a fungicide in agriculture, horticulture, and floriculture; as a wood preservative; and in paint. We report an epidemic of airborne irritant contact dermatitis, conjunctivitis, and upper airway complaints among seamstresses in a Portuguese trailer tent factory, which we attribute to chlorothalonil. All exposed workers had work-related skin symptoms. After patch testing, we showed that none of these were of allergic origin. Instead of allergic reactions, we noticed a delayed type of irritation after 72 hr to chlorothalonil and to the textile extracts containing high concentrations of chlorothalonil. Although allergic and irritant contact dermatitis from chlorothalonil has been described before, this is, as far as we know, the first time that a delayed type of dermatitis, conjunctivitis, and upper airway irritation after exposure to chlorothalonil in tent-cloth is described.

Occupational allergic contact dermatitis from 2-N-octyl-4-isothiazolin-3-one

2-N-octyl-4-isothiazolin-3-one (OIT) is an antimicrobial agent that is mainly used in industrial settings. The objective of the study was to find the significance of OIT contact allergy at our clinic of occupational dermatology. We looked through our patient material from 1991 for allergic reactions to OIT and analysed the clinical records. We found 8 patients with ordinary allergic reactions to OIT and 1 late reaction. 2 workers in the manufacture of paints had occupational allergic contact dermatitis from OIT in biocides. 2 patients were machinists and 3 were female farmers: in these cases, however, we could not find any exposure. A sewing machine operator had patch test reactions to 2 of her mattress textiles, and chemical analysis of them showed 40-50 parts per million OIT. In conclusion, OIT is a rare sensitizer, and its contact allergies occur mainly in paint manufacturing. It is infrequently used in metal-working fluids and possibly sensitizes machinists. Although it is also used in some biocides recommended for use in the textile industry, there are no previous reports of contact allergy in this field. Our sewing machine operator with OIT contact allergy had probably been sensitized from mattress textiles.

Allergic contact dermatitis from formaldehyde textile resins in surgical uniforms and nonwoven textile masks

Despite a trend for reduction in the concentration of free formaldehyde in textiles, formaldehyde textile resin (FTR) allergic contact dermatitis (ACD) remains an important clinical issue and is likely underdiagnosed. Patients with FTR ACD may react to formaldehyde released from the resin or to the resin itself. Screening with formaldehyde and ethyleneurea/melamine formaldehyde resin will uncover most cases. Patch testing with the suspected offending fabric most often leads to false-negative results. We present a case of a 49-year-old pediatrician who developed a severe widespread dermatitis caused by contact with FTRs from her hospital "greens" ("scrubs") and mask.

Pulmonary fibrosis and ferruginous bodies associated with exposure to synthetic fibers

Exposure to synthetic fibers with employment in textile mills can be associated with an elevated risk of interstitial lung disease (ILD). A mechanism of injury has not been determined. ILD can follow exposures to inorganic fibers (e.g., asbestos) which are associated with a mobilization of iron and catalysis of an oxidative stress. We describe 2 patients with ILD associated with exposure to synthetic textile fibers who demonstrated carbon-based ferruginous bodies suggesting an in vivo accumulation of iron by synthetic fibers after deposition in the lung. These iron-laden bodies varied from perfectly linear fibers to almost particulate matter. Linear structures were irregularly interrupted by deposition of iron-abundant material. The capacity of these synthetic fibers to complex iron and generate an oxidative stress is confirmed in vitro.

Effect of different types of textiles on pregnancy

PURPOSE OF INVESTIGATION

The effect of different types of textiles on pregnancy was studied in 35 pregnant bitches divided equally into one control and four experimental groups.

METHODS

During pregnancy, the test groups were dressed in a garment made of either pure polyester, cotton or wool, or of a 50/50% polyester-cotton mix. Serum estradiol 17 B and progesterone were measured before and every 15 days during pregnancy. Electrostatic potential (EP) was assessed on the skin before and after wearing the garment.

RESULTS

The bitches wearing cotton, wool and polyester-cotton mix as well as five of the seven wearing pure polyester garments had normal serum estradiol and progesterone during pregnancy and produced normal offspring. The remaining two animals of the group wearing pure polyester showed low serum progesterone levels in the first month of pregnancy and had spontaneous abortions. Mating was attempted in these two bitches during the subsequent estrous cycle without making them wear polyester garments. Serum levels of reproductive hormones were normal and they produced normal offspring. EP was detected on the skin of only the polyester-dressed groups, and was higher in the pure than in the mixed polyester groups.

CONCLUSIONS

The cause of low serum progesterone and abortion in the two bitches is unknown. Abortion seemed to be due to the low serum progesterone which may have resulted from the injurious effect of EP on the ovarian or placental function.

Bathing suit mesh entrapment: an unusual case of penile injury

Penile injury is a rare chief complaint in the pediatric emergency department. The most common penile injuries are iatrogenic or postsurgical complications, blunt trauma, tourniquet injuries, fractures, and zipper injuries. We report a series of 3 cases of penile foreskin entrapment within the mesh lining of bathing suits as a new, recognized form of penile injury.

Identification of occupational cancer risks in British Columbia: a population-based case-control study of 1129 cases of bladder cancer

OBJECTIVE

We collected information on lifetime occupational histories, smoking, and alcohol consumption from 15,463 incident cancer cases. Occupational risk factors for bladder cancer are presented in this report.

METHOD

A matched case-control design was used. All cases were diagnosed with bladder cancers, with controls being internal controls consisting of all other cancer sites, excluding lung and unknown primary. Data were analyzed using conditional logistic regression for matched sets data and the likelihood ratio test.

RESULTS

Excess bladder cancer risks was observed in a number of occupation and industries, particularly those involving exposure to metals, including aluminum, paint and solvents, polycyclic aromatic hydrocarbons, diesel engine emissions, and textiles.

CONCLUSIONS

The results of our study are in line with those from the literature and further suggest that exposure to silica and to electromagnetic fields may carry an increased risk of bladder cancer.

Contact allergy to textile dyes in southern Sweden

Contact allergy to disperse dyes in textiles is documented in prevalence studies from southern Europe. To evaluate the prevalence of allergic patch test reactions to different textile dyes in southern Sweden, and to look at the sites of dermatitis in individuals hypersensitive to textile dyes, we retrospectively investigated 3325 consecutively patch-tested patients. They had all been patch tested with the standard test series supplemented with a textile dye mix (TDM) consisting of 8 disperse dyes, i.e. Disperse (D) Blue 35, 106 and 124, D Yellow 3, D Orange 1 and 3 and D Red 1 and 17. All but 3 of the TDM-positive patients were additionally tested with the separate dyes included in the mix. The frequency of contact allergy to TDM was 1.5%, which is comparable with studies from southern Europe. The most common dye allergen was D Orange 1. The high prevalence of allergic reactions to D Orange 1 was unexpected, whereas test reactions to D Blue 106 and 124 were lower than expected from other studies. Compared to all tested patients, the TDM-positive patients more often had dermatitis on their arms, face, neck and axillary folds, and women also had a higher frequency of hand dermatitis.

Use of textiles in atopic dermatitis: care of atopic dermatitis

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease which usually starts during the first years of life. In the management of AD, the correct approach requires a combination of multiple treatments to identify and eliminate trigger factors, and to improve the alteration of the skin barrier. In this article we try to explain the importance of skin care in the management of AD in relation to the use of textiles: they may be useful to improve disrupted skin but they are also a possible cause of triggering or worsening the lesions. Garments are in direct contact with the skin all day long, and for this reason it is important to carefully choose suitable fabrics in atopic subjects who have disrupted skin. Owing to their hygienic properties fabrics produced from natural fibres are preferential. Wool fibres are frequently used in human clothes but are irritant in direct contact with the skin. Wool fibre has frequently been shown to be irritant to the skin of atopic patients, and for this reason wool intolerance was included as a minor criterion in the diagnostic criteria of AD by Hanifin and Rajka in 1980. Cotton is the most commonly used textile for patients with AD; it has wide acceptability as clothing material because of its natural abundance and inherent properties like good folding endurance, better conduction of heat, easy dyeability and excellent moisture absorption. Silk fabrics help to maintain the body temperature by reducing the excessive sweating and moisture loss that can worsen xerosis. However, the type of silk fabric generally used for clothes is not particularly useful in the care and dressing of children with AD since it reduces transpiration and may cause discomfort when in direct contact with the skin. A new type of silk fabric made of transpiring and slightly elastic woven silk is now commercially available (Microair Dermasilk) and may be used for the skin care of children with AD. The presence of increased bacterial colonization has been demonstrated in patients with AD. Such colonization has been included in the group of trigger factors for eczema in AD. Silver products have recently been demonstrated to offer two advantages in the control of bacterial infections. Textiles may be used not only for clothes, but also to prevent dust mite sensitization in atopic patients. A marked clinical improvement of AD was observed in a group of adults and children with positive skin tests (not necessarily towards mites), after an intensive eradication programme for mite allergens. Skin treatment with acaricide and house dust mite control measures can decrease AD symptoms. Different textiles have various potential worsening links with allergies: e.g. clothing has been proposed as an additional source of exposure to mite and cat allergens. On the other hand, special textiles can be used to prevent dust mite sensitization.

[Preventive measures against health damage due to chemicals in household products]

Chemicals in household products have been paid much attention as main cause of health damage on consumers, such as allergic contact dermatitis. Preventive measures against health damage due to chemicals in fabric, plastic and rubber products for household uses, are reviewed, focusing on (1) regulation and voluntary control by manufacturers, (2) incidence of health damage from household products, (3) causative product-chemical investigation, (4) case studies on skin damage and respiratory tract damage.

Testicular cancer, occupation and exposure to chemical agents among Finnish men in 1971-1995

OBJECTIVE

To find associations between testicular cancer, occupation and chemical exposure.

METHODS

A cohort of all economically active Finnish men born between 1906 and 1945 was followed-up for 19.7 million person-years during 1971-1995. Incident cases of testicular cancer (n=387) were identified in a record linkage with the Finnish Cancer Registry. The Census occupations in 1970 were converted to chemical exposures with a job-exposure matrix (FINJEM). Cumulative exposure (CE) was calculated as the product of prevalence, level, and duration of the exposure. Standardised incidence ratio (SIR) was calculated for each of the 393 occupations, and for CE categories of the 43 chemical agents, using average male population as reference. Relative risks (RR) comparing various CE-categories with unexposed ones were defined for selected agents by Poisson regression analysis.

RESULTS

Elevated SIRs were observed among railway traffic supervisors (5.8, 95% CI 1.6-14.7), programmers (4.3, 1.4-9.9), university teachers (4.1, 1.3-9.5) and electrical engineers (3.9, 1.1-10.1). A significant exposure-response trend (mainly contributed by seminoma) was observed for pesticides, textile dust, aliphatic and alicyclic hydrocarbons, and some other organic solvents.

CONCLUSIONS

Risk of testicular cancer increased only in four occupations. Pesticides, textile dust, and some organic solvents may be related to an excess risk of seminoma.

Occupational Exposures and Risk of Adenocarcinoma of the Lung in Uruguay

OBJECTIVES

To investigate occupational risks of lung adenocarcinoma in Uruguay and to confirm a previously reported increased risk among butchers.

METHODS

We conducted a case-control study among men in four major hospitals in Montevideo, based on interviews to 338 cases of lung adenocarcinoma and 1014 hospital-based controls. We calculated odds ratios (ORs) of lung adenocarcinoma for employment in 22 jobs, after adjustment for tobacco smoking and other potential confounders.

RESULTS

The OR was increased for employment as farmer, tractor driver, painter and medical worker, but no trend was suggested for duration of employment. Long-term employment as mason, glass worker or textile worker resulted in an increased OR. The OR for employment as butcher was 1.2 (95% confidence interval 0.7-2.1). The OR increased with increasing duration of self-reported exposure to formaldehyde.

CONCLUSIONS

Occupational exposures seem to play a limited role in causing lung adenocarcinoma among men in Uruguay. Employment as butcher was not confirmed as an important risk factor.

Meta-analysis of standard mortality ratio in cotton textile workers

BACKGROUND

Pulmonary function tests may reveal obstructive lung disease with altered forced expiratory volume in 1 s (FEV1) in cotton textile workers. Since 1930, many cohort studies have been performed to assess the disease mortality rate in cotton textile workers.

MATERIALS AND METHODS

The authors performed a meta-analysis of the SMR results of these studies.

RESULTS

From the meta-analysis, the SMRs were as follows: for all deaths, 0.792 in males and 0.873 in females; for cancers, 0.705 in males and 0.829 in females.

DISCUSSION

The male cotton textile workers were healthier than the general population. The healthy-worker effect may be one of the causes, in general workers in industry have a better mortality patterns than those not working.

Textile dye allergic contact dermatitis following paraphenylenediamine sensitization from a temporary tattoo

Textile dye allergy is frequently caused by azo dyes, which can cross-react with structurally similar compounds, including paraphenylenediamine. A case of allergic contact dermatitis to azo textile dyes, presenting principally as a sock dermatitis, is presented. The patient also gave a history of an episode of scalp dermatitis consistent with contact allergy to paraphenylenediamine in hair dye. It is proposed that paraphenylenediamine sensitization from a temporary skin tattoo may have been the primary sensitizing event for these reactions.

Textile dermatitis in patients with contact sensitization in Israel: a 4-year prospective study

BACKGROUND

The exact incidence of textile dermatitis is unknown because of the lack of controlled epidemiological studies. Nevertheless, the increasing frequency of contact dermatitis to clothing has been demonstrated, thus indicating the importance of further investigations in this field.

OBJECTIVE

To analyse the results from a 4-year prospective study of the clinical and aetiological features of contact dermatitis to textiles in Israel. We also aimed to assess the frequency and relevance of sensitization to textile dyes and resins in these patients.

METHODS

Six hundred and forty-four patients (441 female and 203 male), referred for the investigation of contact dermatitis, and suspected of having textile allergic contact dermatitis (ACD), were studied. All patients were patch tested with the standard series (TRUE Tests), textile colour and finish series (TCFS) clothing extracts and pieces of garment in some cases. Readings were performed on days 2, 3 and in many patients also on day 7.

RESULTS

Eighty-three patients (12.9%) had an allergic reactions to a dye and/or resin allergen. Of them, 43 (51.8%) had positive patch tests to the textile dye allergens, 28 (33.7%) to the formaldehyde and textile finish resins and 12 (14.4%) to allergens from both groups. The highest incidence of sensitization from the dye group allergens was due to Disperse Blue (DB) 124 (30.6%), DB 106 (27.0%) and DB 85 (8.1%) and from the resin group to melamine formaldehyde and ethyleneurea melamine formaldehyde (20.7% each) and urea formaldehyde (18.3%). Present relevance of the patch tests was found in 81.4% of the cases. Concomitant sensitization with allergens from the standard series included nickel sulphate, potassium dichromate, formaldehyde, rubber additives and others. Although chronic dermatitis was the typical clinical presentation, less frequent forms such as purpuric, hyperpigmented and papulopustular lesions and atypical forms such as erythema multiforme-like, nummular-like lesions, lichenification and erythrodermia were observed in 24.4% of the cases. The atypical manifestations were provoked by sensitization to dye allergens and never to resins. Along with the typical distribution in areas of friction on the trunk and extremities, less frequent areas including the hands, face, genital area and the soles were affected too.

CONCLUSIONS

In view of the increasing frequency of contact dermatitis to clothing, the clinical assessment should include awareness of the classical as well as the unusual and atypical clinical forms and locations of ACD to textiles, for they are not infrequent. Although dyes and among them DB 106 and DB 124 are the most frequent allergens inducing textile dermatitis, concomitant testing with allergens from the textile dyes and resin groups is recommended when investigating patients with textile dermatitis.

Tourniquet syndrome--accident or abuse?

The tourniquet syndrome describes severe strangulations of appendages by hair, cotton or similar material mainly observed in young infants. The painful swellings of digits or external genitals are surgical emergencies because the strangulation can cause ischaemia and tissue necrosis. More than 100 cases of the tourniquet syndrome have been reported in most of which the aetiology was unclear. We have treated five patients with a tourniquet syndrome. Four of them presented with strangulations of one or more toes by hair or threads and one girl was diagnosed with a clitoral tourniquet syndrome. In each case the strangulating material could be removed in time avoiding permanent damage. The lack of any reasonable explanation and the meticulous wrapping made a non-accidental course very likely. Due to the lack of convincing explanations in our cases as well as in most of those described in the literature, we suggest that the tourniquet syndrome is often the result of child abuse, an aetiology overlooked for decades.

CONCLUSION

the tourniquet syndrome in childhood should be included in the list of possible forms of child abuse and should be considered as a differential diagnosis until another aetiology can be convincingly proven.

[Atopic eczema. Spectrum of provocation factors and possibilities for their effective reduction and elimination]

Atopic eczema forms together with extrinsic bronchial asthma and allergic rhinoconjunctivitis the classical atopic triad. Genetic predisposition is the crucial pathogenetic factor. The combination of genetic disposition and provocation factors leads to the clinical appearance of skin disease. In addition to therapy adjusted to the stage of the disease, modern management should include a search for relevant trigger factors and then their avoidance to reduce or even prevent flares of the disease. The spectrum of provocation factors ranges from simple measures such as appropriate clothing up to specific measures such as indoor aeroallergen reduction measures.

Treatment of the toe tourniquet syndrome in infants

INTRODUCTION

The "toe tourniquet syndrome" is the circumferential strangulation by human hair or fibers of one or more toes in infants, which may induce prolonged ischemic injury and tissue necrosis. Release of the strangulation is mandatory to avoid autoamputation of the digit. We recently encountered several incompletely treated cases and would like to emphasize the effective method of treatment.

METHODS

A retrospective analysis of pediatric emergency department records of patients treated for "toe tourniquet syndrome" during 1990 to 2001 was performed. Patients undergo a short, longitudinal, deep incision over the area of strangulation on the dorsal aspect of the toe, until the phalanx bone, which allows the complete section of the constricting fibers to be removed without injury to the anatomical structures of the toe.

RESULTS

Twenty-one infants (12 boys and nine girls), aged 0-11 months (average 4.6 months), were treated for tourniquet syndrome of one (15 infants) or two (six patients) toes. In 12 patients (57.1%) the right foot was involved. Eight patients (38.1%) had undergone an attempt in the previous few days to release constriction. No complications were encountered.

CONCLUSION

The above-described technique is simple and safe and secures the complete release of the strangulation by removal of all hairs or fibers without injury to the anatomical structures of the toe.

Atypical and unusual clinical manifestations of contact dermatitis to clothing (textile contact dermatitis): case presentation and review of the literature

Although the exact incidence of textile contact dermatitis is unknown, recent studies demonstrate that contact dermatitis produced by allergic or irritant reactions to clothing not only is more frequent than previously thought but also increasing. The clinical features of contact dermatitis (CD) caused by clothing may resemble common allergic contact dermatitis or may have atypical presentations. We report on several cases of clothing-induced contact dermatitis with atypical clinical presentations.