Skin diseases affecting a population occupationally exposed to terrestrial fauna and flora in Brittany over a 15-year period
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Centre Hospitalier Régional (CHU) Morvan, France
Loddé Brice   

CHU Morvan, 2, avenue Foch, 29609, Brest, France
Introduction and objective:
Brittany is the leading agricultural production region of France where many workers are exposed to the local flora and fauna. The aim of the study is to describe the different skin diseases found among the workers occupationally exposed to the terrestrial fauna and flora in Brittany, and to assess the possible over-representation of some work environments.

Material and methods:
This was a retrospective, descriptive study carried out between 1 October 2002 – 30 April 2017, based on the coding of files from a multi-disciplinary occupational dermatology clinic at the Brest University Hospital

The study population of 84 patients was drawn from a total 788 patients seen during this period. Allergic contact dermatitis was the most frequently coded diagnosis with 35 cases (42%). There were 13 cases of irritant contact dermatitis (15%). Infectious diseases were poorly represented with only 5 cases (6%).The 6 most frequently represented occupations were packers in the agri-food industry (12.0%), cattle farmers and tomato greenhouse workers (both 10.7%), maintenance workers of parks and gardens (9.5%), agri-food factory cleaning operatives (8.3%) and pig farmers (7.1%).

There was a marked incidence of allergic contact dermatitis and irritative contact dermatitis, mostly occupational in origin. While no specific diseases were found among these workers, some of the allergens and irritants identified may be specific to certain work environments. Overall, there did not seem to be a major risk of occupational dermatoses among workers exposed to Brittany’s terrestrial fauna and flora in this population, compared with other professional sectors, such as hairdressing or care work. The incidence rate of the cases of occupational skin diseases in this population is assessed from 3 – 5 cases per 100,000 workers.

Lachapelle JM, Frimat P, Tennstedt D, Ducombs G. Précis de dermatologie professionnelle et de l’environnement. Paris: Masson, 1992:1-400.
Crepy MN, Rosenberg N. Allergies en milieu professionnel, Dossier INRS, 2005 :1-12.
Loddé B, Roguedas AM. Dermatoses professionnelles. EMC-Dermatologie 2014; 9: 1-14.
Garçon-Michel N, Paul M, Loddé B, Roguedas-Contios AM, Misery L. Consultation spécialisée de dermatologie professionnelle: bilan de cinq ans d’activité. Place de l’atopie. Annales de Dermatologie et de Vénéréologie 2010; 11: 681-7.
Mathias CG.Contact dermatitis and workers' compensation: criteria for establishing occupational causation and aggravation. J Am Acad Dermatol. 1989 May; 20(5 Pt 1): 842-8.
Potin F, Dubois M. Recencement agricole 2010. Agreste Bretagne2011.
Spiewak R. Farmers and farm workers. In: John SM, Johansen JD, Rustemeyer T, Elsner P, Maibach H, editors. Kanerva's Occupational Dermatology. Cham: Springer; 2018.
Susitaival P, Husman L, Hollmen A, Horsmanheimo M. Dermatoses determined in a population of farmers in a questionnaire-based clinical study including methodology validation. Scand J Work Environ Health. 1995; 21(1): 30-5.
Spiewak R, Gora-Florek A, Horoch A, Jarosz M, Dorynska A, Golec M, et al. Risk factors for work-related eczema and urticaria among vocational students of agriculture. Ann Agric Environ Med. 2017; 24(4): 716-21.
Susitaival P, Beckman R, Samuels SJ, Schenker MB. Self-reported dermatitis and skin cancer in California farm operators. Am J Ind Med. 2004; 46(2): 136-41.
Caisse Nationale de l’Assurance Maladie des Travailleurs Salariés. Principales pathologies non cancéreuses du revêtement cutané indemnisées en 2000, statistiques financières et technologiques des accidents de travail, Années 1998-1999-2000. Paris, 2002: 1-410.
Paul M, Loddé B, Roguedas-Contios AM, Eniafe-Eveillard MB, Misery L, Dewitte JD. Dermatoses professionnelles induites par les désinfectants, détergents et antiseptiques. A propos de 50 patients d’une consultation de dermatologie professionnelle. Archives des Maladies professionnelles et de l’environnement, 2009.
Corazza M, VIRGILI A. Airborne allergic contact dermatitis from benzalkonium chloride. Contact dermatitis 1993; 28: 195-6.
MadanV, Walker SL, BECK MH. Sodium metabisulfite allergy is common but is it relevant? Contact Dermatitis 2007; 57: 173–6.
Ueda A, Obamai K, Aoyama K, Ueda T, Xul BH, LI Q, Huang J, Kitand T, lnaoka T. Allergic contact dermatitis in shiitake (Lentinus edodes (Berk) Sing) growers. Contact Dermatitis 1992; 26: 228-33.
Crépy MN, Bensefa L, Lauzier F, et al. Dermatoses professionnelles. Journées de l’institut interuniversitaire de médecine du travail de Paris Ile de France, Paris 15 March 2006. Document pour le médecin du Travail 2006; 106: 217-23.
Rietschel RL, Mathias CG, Fowler Jr JF, Pratt M, et al. Relationship of occupation to contact dermatitis: evaluation in patients tested from 1998 to 2000. Am J Contact Dermat. 2002; 13: 170-6.
Skoet R, Olsen J, Mathiesen B, Iversen L, et al. A survey of occupational hand eczema in Denmark. Contact Dermatitis. 2004; 51: 159-66.
Montgomery RL, Agius R, Wilkinson S, Carder M. UK trends of allergic occupational skin disease attributed to fragrances 1996-2015. Contact Dermatitis. 2017; 78: 33-40.
Spiewak R. Occupational dermatoses among Polish private farmers, 1991-1999. Am J Ind Med. 2003; 43(6): 647-55.
Li CY, Sung EC. A review of the healthy worker effect in occupational epidemiology. Occup Med. 1999; 49: 225-9.
Bédague P, Pelé A, Clappier P, Valenty M. Surveillance des maladies à caractère professionnel, résultat des quinzaines 2013 en région Bretagne, Les maladies à caractère professionnel 2014; 2.