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Nickel dust-induced occupational contact dermatitis by welding and grinding work in shipyard workers: a report of nine cases

  • Daehwan Kim (Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • A Ram Kim (Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Hanjun Kim (Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Sunghee Lee (Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Byeonghak Seo (Department of Dermatology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Ho Seok Suh (Department of Dermatology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Chang Sun Sim (Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Heun Lee (Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Cheolin Yoo (Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine)
  • Received : 2021.09.10
  • Accepted : 2022.03.08
  • Published : 2022.12.31

Abstract

Background: Occupational skin diseases are skin conditions that occur or worsen in relation to work and known to be the second most common type of occupational disease affecting individuals in the United States. In Korea, epidemiological reports related to occupational skin diseases are rare. But, no cases of occupational contact dermatitis caused by welding and grinding work have been reported previously. Case presentation: Nine male workers working in the production department for liquefied natural gas (LNG) ships in Ulsan complained of erythematous papules/patches and itching in various areas of the body after welding and grinding work. The work environment monitoring report revealed that the amount of nickel dust exceeded the time weighted average (TWA) and poor local ventilation status. Based on the symptoms and the overall results of surveys, several tests, and work environment monitoring report, the 2 workers who had positive patch-test reactions to nickel were diagnosed with nickel dust-induced allergic contact dermatitis. The other 7 workers were diagnosed that there was a high probability that they had nickel dust-induced irritant contact dermatitis. The 2 workers who had nickel dust-induced allergic contact dermatitis were recommended to switch their jobs. Conclusions: Nickel is one of the most common cause of allergic contact dermatitis. In this case, the dust was assumed to be created by welding work with a high nickel content new welding rod and subsequent grinding work, and the concentration of this dust exceeded the time weighted average. Thus, it is thought that the nickel dust may have caused contact dermatitis through continuous contact with the workers' exposed skin in a poorly ventilated space. Currently, several domestic shipbuilding companies are manufacturing LNG tankers using a new construction method. Consequently, it is highly likely that similar cases will occur in the future, which makes this case report meaningful.

Keywords

References

  1. The National Institute for Occupational Safety and Health (NIOSH). Skin exposures and effects. https://www.cdc.gov/niosh/topics/skin/. Updated 2010. Accessed January 26, 2022.
  2. Clark SC, Zirwas MJ. Management of occupational dermatitis. Dermatol Clin 2009;27(3):365-83. https://doi.org/10.1016/j.det.2009.05.002
  3. Korean Dermatological Association. Textbook of Dermatology. Vol. 1. 6th ed. Seoul: Medbook; 2014.
  4. Nassau S, Fonacier L. Allergic contact dermatitis. Med Clin North Am 2020;104(1):61-76. https://doi.org/10.1016/j.mcna.2019.08.012
  5. Ministry of Employment and Labor. Analysis of the Current Status of Industrial Accidents in 2019. 1st ed. Sejong, Korea: Ministry of Employment and Labor; 2020.
  6. Majoie IM, van Weelden H, Sybesma IM, Coenraads PJ, Sigurdsson V. Polymorphous light eruption-like skin lesions in welders caused by ultraviolet C light. J Am Acad Dermatol 2010;62(1):150-1. https://doi.org/10.1016/j.jaad.2009.01.041
  7. Shehade SA, Roberts PJ, Diffey BL, Foulds IS. Photodermatitis due to spot welding. Br J Dermatol 1987;117(1):117-9. https://doi.org/10.1111/j.1365-2133.1987.tb04100.x
  8. Zamanian Z, Mortazavi SM, Asmand E, Nikeghbal K. Assessment of health consequences of steel industry welders' occupational exposure to ultraviolet radiation. Int J Prev Med 2015;6(1):123.
  9. Susitaival P, Flyvholm MA, Meding B, Kanerva L, Lindberg M, Svensson A, et al. Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Dermat 2003;49(2):70-6. https://doi.org/10.1111/j.0105-1873.2003.00159.x
  10. Lampel HP, Powell HB. Occupational and hand dermatitis: a practical approach. Clin Rev Allergy Immunol 2019;56(1):60-71. https://doi.org/10.1007/s12016-018-8706-z
  11. Ahlstrom MG, Thyssen JP, Wennervaldt M, Menne T, Johansen JD. Nickel allergy and allergic contact dermatitis: a clinical review of immunology, epidemiology, exposure, and treatment. Contact Dermat 2019;81(4):227-41.  https://doi.org/10.1111/cod.13327
  12. Shah M, Lewis FM, Gawkrodger DJ. Nickel as an occupational allergen. A survey of 368 nickel-sensitive subjects. Arch Dermatol 1998;134(10):1231-6.
  13. Torres F, das Gracas M, Melo M, Tosti A. Management of contact dermatitis due to nickel allergy: an update. Clin Cosmet Investig Dermatol 2009;2:39-48.
  14. Schubert HJ. Airborne nickel dermatitis. Contact Dermat 2000;42(2):118-9.
  15. Schroder C, Uter W, Schwanitz HJ. Occupational allergic contact dermatitis, partly airborne, due to isocyanates and epoxy resin. Contact Dermat 1999;41(2):117-8. https://doi.org/10.1111/j.1600-0536.1999.tb06251.x
  16. Mann E, Ranft U, Eberwein G, Gladtke D, Sugiri D, Behrendt H, et al. Does airborne nickel exposure induce nickel sensitization? Contact Dermat 2010;62(6):355-62. https://doi.org/10.1111/j.1600-0536.2010.01725.x
  17. Yu DS, Kim HJ, Park YG, Bae JM, Kim JW, Lee YB. Patch-test results using Korean standard series: a 5-year retrospective review. J Dermatolog Treat 2017;28(3):258-62. https://doi.org/10.1080/09546634.2016.1219015
  18. Bains SN, Nash P, Fonacier L. Irritant contact dermatitis. Clin Rev Allergy Immunol 2019;56(1):99-109. https://doi.org/10.1007/s12016-018-8713-0
  19. Chaudhry HM, Drage LA, El-Azhary RA, Hall MR, Killian JM, Prakash AV, et al. Delayed patchtest reading after 5 days: an update from the Mayo Clinic Contact Dermatitis Group. Dermatitis 2017;28(4):253-60. https://doi.org/10.1097/DER.0000000000000297
  20. Davis MD, Bhate K, Rohlinger AL, Farmer SA, Richardson DM, Weaver AL. Delayed patch test reading after 5 days: the Mayo Clinic experience. J Am Acad Dermatol 2008;59(2):225-33. https://doi.org/10.1016/j.jaad.2008.04.022
  21. Estlander T, Kanerva L, Tupasela O, Keskinen H, Jolanki R. Immediate and delayed allergy to nickel with contact urticaria, rhinitis, asthma and contact dermatitis. Clin Exp Allergy 1993;23(4):306-10. https://doi.org/10.1111/j.1365-2222.1993.tb00327.x