Introduction
Occupational allergic contact dermatitis (OACD) is one of the
two main types of occupational contact dermatitis, the other
being occupational irritant contact dermatitis (OICD). Aworker may experience both OACD and OICD. Occupational
contact dermatitis is the most common occupational disease
in many countries [1]. Much work has been done on understanding the impact of occupational skin disease. The impacts
include the disease itself and its symptoms of itching and pain,
but also functional outcomes which lead to impacts on quality
of life including work and social functioning and the resulting
costs [2–6].
A challenge with occupational skin disease, as with many
other occupational diseases such as asthma, is that they are not
recognized nor reported as being work-related. This means
they are under-estimated in administrative statistics that often
drive prevention strategies. Therefore, it is important to raise
awareness of occupational skin diseases, not only with
workers, employers, and compensation authorities but also
with health care providers. Of particular relevance to health
care providers is that, if the occupational cause is not identified, the management will likely be sub-optimal as the workplace factors will not be addressed. Thus, both the accurate
diagnosis and appropriate management are of critical importance if good outcomes are to be achieved.
Because of the problems of under-recognition and underreporting, it is challenging to find good prevalence and incidence data that usually come from regulatory agencies such as
insurance schemes or government reporting [7]. There are
some workplace-based studies that provide useful information. Recent studies of health care workers who have exposure
to both workplace irritants and allergens found 1-year prevalence rates of 21 and 22 % [8••, 9]. Similar results have been
found in hairdressers [10••]. While these provide a sense of the
magnitude of the problem of occupational skin disease, they
do not differentiate between OACD and OICD.
Patch test databases are available and provide information
about important occupational contact allergens. These databases can provide both snapshots in time as well as trends in
particular allergen positivity over time [11••, 12••, 13••]. For
example, there can be both decreases in sensitivity due to
preventive strategies (chromium in cement) and increases in
sensitivity due to new exposures, often of known allergens in