LAUSR

Allergic and irritative-toxic contact dermatitis belong to the most common occupational diseases in many countries of the world – along with other conditions like infectious skin diseases and an increasing incidence of skin cancer induced by occupational exposure to UV radiation. Estimates go to more than 5 billion € per year of socioeconomic costs due to these diseases. Therefore, already in 2009, the theme of prevention of occupational skin diseases was declared a top priority problem by the European Union. In the meantime, several programmes have been instituted and successfully performed; one of them – the COST action StanDerm – has defined the minimum standards on prevention, diagnosis and treatment of occupational and work-related skin diseases in Europe in a position paper which is part of an actual supplement issue in JEADV. This is remarkable in that often supplements are arising in the context of new drugs promoted by pharmaceutical industry on the basis of special events or satellite symposia at large congresses. This supplement is sponsored solely by a research project without any industrial support. Furthermore, it is published with ‘open access’ to everybody thus promoting the distribution of the message worldwide. One of the problems of occupational skin disease is that often the causal relationships between a given work environment and a skin disease is only recognized after a certain time and needs highly qualified and trained dermatologists. In 2013, the 2020 COST action on implementation of European standards of occupational skin diseases (StanDerm) was launched within the ‘Horizon’ frame programme by the European Union. In this interdisciplinary network consisting of 31 European countries, recommendations were developed. One special problem is the diversity of regulatory aspects dealing with occupational skin diseases in different European countries. This makes common prevention programmes often difficult. Apart from the immanent problems of continuously appearing new substances in the environment due to the progress in chemical and pharmaceutical industry and the limited possibilities for preventive testing also the lack of information in affected individuals or persons at risk is immense. Therefore, educational programmes should be developed and implemented. Only recently the physical environmental factor UV radiation has been recognized as another cause of occupational skin disease namely in the form of non-melanoma skin cancer in workers exposed to very high doses of UV radiation at working place; this fact is not yet generally accepted over whole Europe. In contact dermatitis, the continuous registration and interpretation of epicutaneous test results at specialized – mostly university – departments plays a major role as ‘sentinel’ in detecting new allergens or hazards. Still many problems remain for research such as the determination of relevant doses or concentrations for allergic sensitization especially with regard to substances in short time contact with the skin (e.g. ‘rinse off’ products in cosmetics). The standard preparations for patch testing for various occupations at risk have to be updated continuously. There are always new trends also with regard to ‘natural allergens’ (phytoallergens) which by many people are regarded to be absolutely safe. Also in chemical and manufacturing industry, there is an increasing spectrum of new epoxy resins with partly rather high sensitization potential. It is the merit of the project coordinators and guest editors of the supplement Sven Malte John and Sonja Kezic to have put together this excellent summary of papers illustrating the actual state of the art in this field and highlight the chances for prevention of occupational skin diseases in the future.