SOME STUDIES ON CONTACT DERMATITIS AND OCCUPATIONAL DERMATOSE IN LAGOS

Abstract

A study was conducted on contact dermatitis and occupational dermatoses to identify causal factors and advance proposals on how best to humanize occupational life, and to form a base line for future studies as industrialisation advances in Nigeria. Among the 453 patients in the study group of hospital patients, 269 (59.4%) had allergic contact dermatitis, 159(35.1%) had irritant contact dermatitis and the causes of the dermatitis, for various reasons, could not be identified in 25 (5.5%) of the patients studied. 88 (19.4%) of the patients had occupational dermatitis; of this number 20 (22.7%) were due to irritants. The three most important sensitisers were nickel, chromate and the various rubber chemicals. Sources of sensitisation to nickel were predominantly from non occupational sources while sensitisation to chromate was predominantly from occupational sources. These corroborates with findings in various studies in Europe and N America. The main difference was that men and women in this study were equally reactive to nickel because of the ubiquity of nickel plated wrist watches and the wearing of necklaces by men. Cement was the single most important occupational source of chromate sensitisation, while shoe constitute the single most important source of non-occupational sensitisation to chromate and rubber chemicals.. Masons with chromate dermatitis had the most severe and chronic type of dermatitis, but because of non-availability of suitable alternative jobs, sensitised patients should as much as possible be retained on their jobs while every precautionary measure is taken to minimise contact with the on ending allergen. There was an indication of significant exposure to organic mercury in cosmetics and toiletries which is most undesirable, and regulations should be made in Nigeria to eliminate the sources of unnecessary contact.. Irritant dermatitis was predominantly from herbal concoctions and abuse and misuse of disinfectants, antiseptics and soaps containing irritants which are heavily advertised as panacea for skin diseases. There is need for public enlightenment on the possible indications, side effects and method of use of these agents. Housewife's eczema was found to be a rarity contrary to findings in developed countries. This was thought to be due to hardening and it is probably advisable to continue to let our children continue to carry out domestic chores with ungloved hands. From the results of this study, cobalt and ethylenediamine could be dropped from the International Contact Dermatitis Research Group (ICDRG) Screening tray, while ammoniated mercury which is not included in the ICDRG tray is introduced for testing Nigerian patients. Excessive environmental heat exposes the worker to the development or not only malaria, but also contact dermatitis and infective dermatomes ,like tinea versicolor, which should not be seen in isolation but as indicators of heat stress inimical to health and maximum working capacity. Working clothes for the factory worker should be made from lighter shades of fabrics which reduce radiant heat and bleed less sensitising dyes. The existing factory Act is grossly inadequate as regards protection against occupational skin diseases which are protean and may be indicators of serjour systemic toxicity.