Occupational ceramic fibres dermatitis in Poland

Our plain-English summary of Occupational ceramic fibres dermatitis in Poland, by M. Kieć-Swierczyńska, J. Wojtczak (Occupational Medicine, 2000).

The study

• Authors: M. Kieć-Swierczyńska, J. Wojtczak
• Journal: Occupational Medicine
• Published: 2000;50(5):337-42
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Recently, the use of asbestos has been considerably limited in Poland, with the simultaneous increase in the manufacture, processing and application of man-made mineral fibres, which includes ceramic fibres. The aims of this study were (1) to assess the type and frequency of dermal changes caused by the irritant activity of ceramic fibres among workers at the plants that manufacture packing and insulation products; and (2) to compare the irritant activity of Polish-made L-2 and L-3 ceramic fibres with that of the Thermowool ceramic fibres made in England. Workers (n = 226) who were exposed to ceramic fibres underwent dermatological examination. Patch tests with the standard allergen set, together with samples of the fibres L-2, L-3, and Thermowool fibres, were applied to all the workers. It has been shown that the Polish-made L-2 and L-3 fibres differed from Thermowool fibres in that the L-2 and L-3 fibres contained zirconium and were coarser. The proportion of filaments with diameters above 3 microns was 11.1% in the L-3 fibre and 6.3% in the L-2 fibre samples. The Thermowool fibre did not contain filaments thicker than 3 microns. Evident dermal changes, resulting from strong irritant activity of the fibres, were detected in 109 (48.2%) of the workers examined. Irritant contact dermatitis acuta (maculae, sometimes papulae and small crusts on the upper extremities, trunk, and lower extremities), disappearing after 2-3 days, was found in 50 (22.1%) workers. Irritant contact dermatitis chronica (diffuse permanent erythema with numerous telangiectasiae on the lateral portions of the face and neck, on the trunk, behind the auricles) was detected in 40 (17.7%) workers. The remaining 19 (8.4%) workers had both types of dermal change. All examined workers complained of very strong itching. The results of the patch tests confirmed the irritant activity of the ceramic fibres. Erythema without oedema, persisting for up to 96 h, appeared at the places where the fibres had been applied to the skin in 44 (19.5%) workers. In addition, the irritant activity of the fibres has been shown to be correlated with their thickness. The Thermowool fibre was the weakest irritant, because it did not contain filaments above 3 microns in diameter; the L-2 fibre containing 6.3% filaments above 3 microns caused somewhat stronger skin irritation; while the L-3 fibre, which contained 11.1% filaments thicker than 3 microns, was the strongest irritant. A few cases of allergy to nickel, chromium and colophony (rosin) were also detected.

In plain English

The study examined workers in six Polish factories making or processing ceramic fibres. Ceramic fibres are man-made mineral fibres whose use grew as asbestos use was limited in Poland. The study did not examine asbestos. The authors measured airborne dust and fibres and analysed Polish L-2 and L-3 and British Thermowool fibres. They examined and patch-tested 226 exposed workers; 43 same-area workers served as controls. Most workplaces were below Polish limits, but maximum total dust at some reached 4 to 17 times the limit. Occupational contact dermatitis was found in 109 (48.2%) exposed workers. Chronic irritant dermatitis with telangiectasiae (small visible blood vessels) affected 26.1% of exposed workers; 7.0% of controls had a different, rosacea-like, non-itching dermatitis with telangiectasiae. The difference was statistically significant overall and for women, and at the boundary of significance for men. In patch tests, 44 workers (19.5%) reacted to the fibres. L-3, with the most fibres thicker than 3 micrometres, gave the most positive results (24); L-2 gave 18 and Thermowool 6. The authors concluded that thick fibres were stronger irritants than thin ones.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional workplace study: air dust and fibre measurements, laboratory analysis of fibre samples, and dermatological examination with patch testing of exposed workers, compared with an unexposed control group
• Who was studied: 226 workers exposed to ceramic fibres (104 women, 122 men; ages 21 to 61, mean 41.2 years) in six Polish factories, plus 43 controls (23 women, 20 men) working as metal press operators, dyers or seamstresses in the same area; study dates not given
• Exposure: Ceramic fibres (man-made mineral fibres): Polish-made L-2 and L-3 fibres, which contained zirconium, and British-made Thermowool fibres, which did not. The fibres were used in the manufacture of packing and insulation products. Asbestos was not studied.
• Main results:
  • Air measurements: in most examined workplaces, total dust and respirable fibre concentrations were below the Polish maximum admissible concentrations (MAC: 2 mg/m3 total dust, 1 fibre/cm3 respirable fibres). Where values were higher, maximum total dust ranged from 4 to 17 times the MAC and respirable fibres from 0.6 to 2 times the MAC.
  • Among the 226 exposed workers, occupational contact dermatitis was found in 109 (48.2%): 50 (22.1%) had only acute irritant contact dermatitis, 40 (17.7%) had only chronic irritant contact dermatitis with telangiectasiae, and 19 (8.4%) had both.
  • All exposed workers who were examined reported very strong itching of the skin.
  • Irritant contact dermatitis chronica with frequent telangiectasiae was found in 26.1% of exposed workers (33.6% of women, 19.7% of men).
  • Among the 43 controls, dermatitis and telangiectasiae were found in 3 (7.0%): 2 women (8.7%) and 1 man (5.0%). In the controls these changes were on the central face and low neck, did not itch, and resembled rosacea. This pattern differed from the exposed workers' changes.
  • The authors compared the frequency of dermatitis and telangiectasiae in the two groups. The difference was statistically significant for the whole exposed group (P = 0.002) and for exposed women (P = 0.007 per Table 4). For men it was at the boundary of significance (P = 0.061).
  • In patch tests on exposed workers, 44 (19.5%) showed irritant reactions (erythema without oedema) to the ceramic fibres. L-3 gave the most positive results of the three fibres (24), L-2 gave 18 and Thermowool gave 6.
  • Fibres thicker than 3 micrometres made up 11.1% of L-3 and 6.3% of L-2, and were not found in Thermowool. L-3 was the strongest irritant and Thermowool the weakest.
  • The fibres contained trace trivalent chromium and cobalt but no hexavalent chromium or nickel.
  • Strongly positive allergy patch test results were found with nickel (two women), chromium (one woman, one man) and colophony (rosin) (one woman). In the authors' opinion, most positive allergen reactions were of non-occupational origin.
• The authors' conclusion: The authors concluded, from fibre measurements and erythema scores, that thick fibres were stronger irritants than thin ones. They also concluded that the Polish-made fibres containing thick fibres were stronger irritants than the British-made fibre without thick fibres.

Topics

Medical terms in this study, explained in our Lexicon: Erythema.

Related studies

• Occupational dermatoses and allergy to metals in Polish construction workers manufacturing prefabricated building units — M. Kieć-Swierczyńska (1990)
• Exposure to refractory ceramic fibres in the metal industry — M. Linnainmaa, J. Kangas, et al. (2007)
• Co-exposure to refractory ceramic fibres and asbestos and risk of pleural mesothelioma — A. Lacourt, M. Rinaldo, et al. (2014)
• Clinico-pathological features and somatic gene alterations in refractory ceramic fibre-induced murine mesothelioma reveal mineral fibre-induced mesothelioma identities — P. Andujar, C. Lecomte, et al. (2007)
• Health effects of refractory ceramic fibres: scientific issues and policy considerations — L.R. Glass, R.C. Brown, et al. (1995)
• The in vivo biological activity of ceramic fibres — R.C. Brown, J.A. Hoskins, et al. (1995)

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