Contact dermatitis in the textile industry: a review of 72 patients.

BACKGROUND: Occupational skin disease can cause significant morbidity in textile industry workers. Both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) have been reported.

OBJECTIVE: The purpose of this study was to characterize and determine the relative frequency of work-related ACD and ICD in textile workers.

METHODS: Seventy-two textile industry workers seen during a 5-year period were evaluated for possible work-related contact dermatitis. All patients underwent patch testing with a screening series. Many patients (70%), depending on occupational exposures, also underwent testing with a textile dye and finish series and additional patch tests of specific workplace materials.

RESULTS: Twenty-one patients (29%) were diagnosed as having a predominantly work-related ACD. Relevant allergens included textile dyes, textile finishes, and rubber allergens. Twenty-seven patients (38%) were diagnosed as having primarily a work-related ICD. Five patients (7%) were believed to have combined work-related ACD and ICD. Nineteen patients (26%) were believed to have purely non-work-related allergens, irritants, atopy, or other dermatoses as the major factors in their skin disease. The hands were the most common site of involvement. Of the 40 patients with occupational exposure to raw textile products 36 (90%) had a work-related dermatitis and only 4 (10%) had a non-work-related dermatitis.

CONCLUSION: In the 72 textile workers evaluated in our clinic, occupational exposures were an important cause of skin disease (74% in our series). Textile workers with job exposures to raw textile materials are at highest risk for work-related dermatitis. Textile industry workers with essentially no textile product exposure were more likely to have non-work-related dermatoses. ICD was only slightly more frequent than ACD. The hands were the most common site of involvement. Because relevant allergens (work-related and non-work-related) were more common than expected, we emphasize the importance of patch testing with standard screening allergens in the diagnostic evaluation of patients with dermatitis who work in the textile industry. In addition, textile dye and finish allergens should also be tested in this patient population, particularly those patients with any textile product exposure.