Publications by authors named "D Linn Holness"

161 Publications

Occupational Contact Dermatitis: An Individualized Approach to the Worker with Dermatitis.

Curr Dermatol Rep 2021 Sep 14:1-10. Epub 2021 Sep 14.

Toronto, Canada.

Purpose Of Review: To provide an up-to-date, customizable approach to the worker presenting with dermatitis.

Recent Findings: Occupational contact dermatitis (OCD) is often a result of combined allergic, irritant, and endogenous factors. Potential causes of OCD can be categorized in 3 main groupings: workplace materials, personal protective equipment, and skin care. Although patterns of dermatitis may provide some indication of the etiological factor(s), patch testing remains essential in the diagnosis of allergic OCD. Management of OCD may require changes in workplace practices to reduce worker exposure to the causative agents and improve skin care practices.

Summary: OCD is a multifaceted condition with significant consequences for affected workers and their families, employers, and insurers. A methodical and individualized approach to the patient with OCD should ensure timely and accurate diagnosis(es).
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http://dx.doi.org/10.1007/s13671-021-00339-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8439371PMC
September 2021

Occupational contact dermatitis: Return to work using a multidisciplinary clinic model.

Contact Dermatitis 2021 Jul 22. Epub 2021 Jul 22.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Background: Occupational contact dermatitis often results in work disruption. Return-to-work (RTW) is an important outcome.

Objective: The objective of this study was to determine RTW outcomes and factors associated with such outcomes using a multidisciplinary clinic model.

Methods: Chart abstraction was performed for 194 workers who received RTW assistance over a 6-year period. Elements abstracted included demographic and diagnostic information and information about the RTW program including principles, program components, barriers, and facilitators.

Results: Of the 902 workers seen for dermatologic assessment, 194 received RTW assistance. At initial assessment, 37% were not working because of their skin disease, and at follow-up, 7% were not working because of their skin disease. The RTW plan components included a graduated or trial of RTW, specific recommendations for avoiding exposure, personal protective equipment, skin management, and ongoing skin monitoring. Principles associated with successful RTW included good communication and the availability of modified work and a worker adherence to the plan. Barriers included lack of modified work, unresponsive employers, and ongoing skin problems.

Conclusions: Specific approaches are important to identify if RTW is to be successful for workers with occupational contact dermatitis.
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http://dx.doi.org/10.1111/cod.13945DOI Listing
July 2021

Occupational Dermatitis and Urticaria.

Immunol Allergy Clin North Am 2021 Aug 5;41(3):439-453. Epub 2021 Jun 5.

Department of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. Electronic address:

Occupational contact dermatitis is the most common occupational skin disease (OSD), and most of them are irritant in nature. There is less information available about contact urticaria than contact dermatitis. There are several strategies to prevent OSD, although workplace studies suggest there are gaps in their use in the workplace. Because early detection leads to improved outcomes, screening for dermatitis in industries such as health care would be useful. Both diagnosis and management involve 2 components: the actual disease diagnosis and medical treatment and the work-relatedness and management of the workplace to reduce exposures.
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http://dx.doi.org/10.1016/j.iac.2021.04.006DOI Listing
August 2021

Exploratory study to determine if risk factors for occupational skin disease vary by type of food processing operation.

Work 2021 ;68(4):1113-1119

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Background: Occupational skin disease (OSD) is a common health issue in the food processing sector. However, risk factors for OSD are suspected to differ according to the nature of the operation.

Objective: To ascertain if the risk factors for OSD vary depending on the type of food processing operation, namely meat processing vs. a commercial bakery.

Methods: Participants were asked to answer questions regarding workplace exposures and the current skin condition of their hands. Bivariate analyses were conducted to identify differences between the two participating operations.

Results: The meat processing workers were more likely to have wet work exposure, used hand sanitizer more often and changed their gloves more frequently. These findings from meat processing represented a statistically significant difference compared to the commercial bakery workers. Also, workers from meat processing reported more severe skin symptoms.

Conclusions: Risk factors for OSD apparently differ between types of food processing operations. Differences in the nature of skin symptoms were also found between the two participating operations. It is therefore suggested that future studies examining OSD within the food processing sector should evaluate this health effect based on the nature of operations rather than the sector as a whole.
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http://dx.doi.org/10.3233/WOR-213441DOI Listing
June 2021

Occupational contact dermatitis: Retrospective analysis of North American Contact Dermatitis Group Data, 2001 to 2016.

J Am Acad Dermatol 2021 Mar 19. Epub 2021 Mar 19.

Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada.

Background: Patch testing is an important diagnostic tool for suspected allergic contact dermatitis (ACD) in occupational settings.

Objective: Provide an overview of occupational skin disease (OSD) and an analysis of occupational ACD in North American patients undergoing patch testing between 2001and 2016.

Methods: Patients with OSD were analyzed for frequency of allergic reactions to a screening series of allergens, occupational relevance, location of skin disease, and exposure sources. Demographic, occupation, and industry information were recorded.

Results: Of 38,614 patients evaluated, 4471 (11.6%) had OSD, of whom 3150 (70.5%) had ACD. The most common occupationally related allergens included rubber accelerators, preservatives, and bisphenol A epoxy resin. Hands (75.8%), arms (30.0%), and face (15.9%) were common sites of dermatitis. The occupations most affected were service workers and machine operators.

Limitations: Our cohort may not reflect the general working population.

Conclusion: This study identified common occupational allergens, exposure sources, and occupations/industries at risk. This information may help the clinician evaluate and manage patients with occupational contact dermatitis.
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http://dx.doi.org/10.1016/j.jaad.2021.03.042DOI Listing
March 2021
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