Automotive Industry - Springer

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The automotive industry of passenger vehicles and trucks includes industries associated with the production, retailing, and maintenance of (motor -) vehicles.
134 Automotive Industry Horst C. Broding1 . Manige´ Fartasch2 Head Exposure Laboratory, Consultant Dermatology - Allergology Occupational & Environmental Medicine, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance – Institute of the Ruhr-University Bochum (IPA), Bochum, NRW, Germany 2 Department for Clinical and Experimental Occupational Dermatology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University, Bochum (IPA), Bochum, NRW, Germany

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Core Messages ● The dermatological health care has to consider country-specific allocations between parts manufacturing and assembly facilities in vehicle production. ● The automotive industry of passenger vehicles and trucks includes industries associated with the production, retailing, and maintenance of (motor -) vehicles. ● Dermatological concerns and hazards differ between vehicle parts manufacturing, vehicle assembly, and vehicle repair and maintenance. ● Personal protective equipment (PPE) should involve appropriate gloves and skin covering. Substancespecific gloves or sleeves should be worn when using body filler and possible skin contact with paints and glues. Appropriate skin protection should also be worn for welding, grinding, and cutting.

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Introduction

The automotive industry is one of the global sources of employment, and its importance is largely derived from its linkages within the domestic and international economy and its complex value chain. The bulk of new vehicles come from moving assembly lines in refined and highly structured processes. Automotive industry employs more than two million people equivalent to about 5.5% of employment in the EU-27. Estimated 8.4 million employees (including manufacturers and suppliers) work in the worldwide car and truck production with major growth occurring in Asian-pacific countries (ILO 2009). A substantial change in vehicle production in the last decades, from selfassembling manufacturers of metal and plastic parts to spin off manufacturing companies producing in-house parts as independent companies, occurred. Country-specific allocations vary between parts manufacturing and assembly facilities in vehicle

production. The biggest share of employment is in assembly. At the one end of the range is Japan – with 29% of employees working in the assembly sector and 71% of employees work in the vehicle parts sector. At the other end of the range is Belgium, with 84% of employees in the assembly sector and only 16% in vehicle parts manufacturing. Contributing factors to these allocations are history, structure, and development of the automotive industry in different countries. The individual distribution between vehicle assembly and parts manufacturing is important from the health care provider’s perspective. One of the main differences between parts manufacture and assembly is that vehicle assembly plants are often larger: Six corporations produce 75% of the world’s vehicle production while, e.g., in the USA, there are 5,000–8,000 vehicle parts manufacturers. The corporate structure of larger assembly facilities has well-established implemented medical health care resources to address skin and safety issues than smaller vehicle parts manufacturers. Vehicle parts manufacturing and repair shops generate considerably more often dermatological hazards because it involves manifold processes like casting and machining of metal parts, manufacturing foam products, and extruding plastic. However, vehicle assembly requires extensive material handling as the various parts are assembled into the final vehicle.

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Dermatological Hazards and Diseases

This section highlights the dermatological hazards in vehicle assembly and parts manufacturing as well as in vehicle repair and maintenance. Since the last decades the investigation of developing occupational dermatitis and the determination of individual predictive risk factors is a burning issue. Preceding studies (Nilsson and Back

T. Rustemeyer, P. Elsner, S.M. John & H.I. Maibach (eds.), Kanerva’s Occupational Dermatology, DOI 10.1007/978-3-642-02035-3_134, # Springer-Verlag Berlin Heidelberg 2012

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1986; Rystedt 1985a, b) have already demonstrated that atopics are more susceptible to develop hand dermatitis especially in certain risk occupations, notably in the automotive industry (Attwa and el-Laithy 2009; Kristensen 1992; Meding et al. 1994). According to investigations of Funke et al. 1995, 2001 based on clinical and epidemiological observation, it was demonstrated that significant differences in the development of hand eczema already exist in different apprenticeships. However, allergic hand eczema plays a subsidiary role whereas irritant and eczema in the context of susceptible skin seems to be essential. Recent epidemiological studies about hand eczema in the car industry confirm the prediction of high prevalence of irritant hand eczema that was already found in earlier

investigations. The results of a study have shown that a majority (Johnson 2001) of car mechanics admitted daily use of soaps containing abrasives for cleaning the hands; 33% revealed a dermatitis resulting from contact allergy (Meding et al. 1994) to substances in the standard series. A population-based point prevalence, e.g., in Sweden, was calculated in 1996 with 9.7% (Meding and Jarvholm 2002). The incidence concerned 5.5–8.8 per 1,000 persons per year (Lerbaek et al. 2007). Current prospective studies (Apfelbacher et al. 2008) estimated that the incidence of hand eczema in the metalworking industry declines in the course of time. A summarized survey about prevalent and wellknown dermatological effects (allergic contact dermatitis

. Table 134.1 Work processes, exposures, and dermatological conditions in the automotive manufacturing industry Vehicle parts manufacturing

Work process

Exposure

Metal parts

Core/mold production

Isocyanates

Skin effects Contact dermatitis Skin irritation

Machining

Metal-working fluids

Contact dermatitis Skin irritation

Forging/stamping

Drawing compounds

Foam production for seats, arm rests, etc.

Isocyanates

Contact dermatitis Skin irritation

Polyurethane foam Plastic parts

Extrusion/injection molding

Contact dermatitis Irritation

Styrene

Contact dermatitis

Polyvinyl chloride

Skin irritation

Polyethylene Carpeting/liners

Flocking

Nylon flock

Skin irritation

Body shop

Welding, soldering

Hot metal, welding fumes, solderforming fluxes, UV-radiation

Burns, scars, actinic dermatoses

Paint line

Painting

Isocyanates

Vehicle assembly

Contact dermatitis Skin irritation

Assembly

Gluing

Epoxies

Vehicle repair and maintenance

Washing, polishing

Water, wet work, cleaning agents

Contact dermatitis Skin irritation Skin irritation Contact dermatitis

Dry sanding, grinding

Metal dusts

Skin irritation

Solvent wipedown

Solvents

Skin irritation

Paint mixing, (Hino et al. 2008), painting, spray gun cleaning

Paints, isocyanates, solvents

Engine and system overhaul

Oils, solvents, cooling and hydraulic fluids, antifreeze agents

Contact dermatitis Skin irritation Skin irritation

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and skin irritation) that are frequently associated with the different occupational exposures in the automotive industry is given in > Table 134.1.

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Vehicle Parts Manufacturing and Vehicle Assembly

Module suppliers of metal parts in the automotive industry often operate their own foundries and development divisions. In this milieu mold manufacturing represents a relevant area of production technology since it influences the feasibility and economics of producing a very large number of components. The traditional production of metal parts follows sand core manufacturing. A common binder used to manufacture sand cores is methylene diisocyanate (MDI). After the metal hardens, the mold and core must be removed and the metal smoothed. Operational procedures in casting houses include knocking off the hardened metal, shake-out, chipping, and grinding. Diisocyanates are a relevant group of chemically reactive agents, which are used in the production of coatings, adhesives, polyurethane foams, and parts for the automotive industry and as curing agents for cores in the foundry industry. Dermal (and inhalation) exposure to methylene bisphenyl isocyanate (MDI) is associated with respiratory sensitization and occupational asthma (Bello et al. 2005, 2008; Redlich 2010). Furthermore isocyanates are widely used in the manufacturing of rigid and flexible foams, fibers, and coatings such as paints, varnishes, and elastomers but are rarely reported as contact sensitizers. There is substantial opportunity for isocyanate skin exposure in many work settings, but such exposure is challenging to quantify and continues to be underappreciated. Isocyanate skin exposure can occur in the automotive industry, even with the use of personal protective equipment. In animals, isocyanate skin exposure is a possible route to induce sensitization with subsequent inhalation challenge resulting in asthma-like responses (Stingeni et al. 2008). Factors that impair skin barrier function, such as trauma, may promote sensitization to such agents. Animal studies demonstrate that skin exposure to isocyanates and protein allergens is highly effective, inducing sensitization (AltoKorte et al. 2007, 2010; Bello et al. 2005, 2008; Liu et al. 2007, 2009). Plastic resin systems have an increasingly diverse array of applications but also induce health hazards, the most common of which are allergic and irritant contact dermatitis. Contact urticaria, pigmentary changes, and photoallergic contact dermatitis may occur (Cahill et al. 2005). Resin

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systems include epoxies, the most frequent synthetic resin systems to cause contact dermatitis, (meth)acrylics (Kawamura et al. 1996), polyurethanes, phenolformaldehydes, polyesters, amino resins (melamineformaldehydes, urea-formaldehydes), polyvinyls, polystyrenes, polyolefins, polyamides, and polycarbonates. Contact dermatitis usually occurs as a result of exposure to the monomers and additives in the vehicle assembly settings (Kanerva et al. 1999; Routledge 1971). Resin- and additive-induced direct contact dermatitis usually presents on the hands, fingers, and forearms, while facial, eyelid, and neck involvement may occur through indirect contact, e.g., via the hands, or from airborne exposure. Epoxy resins are a frequent cause of occupational allergic contact dermatitis (Rademaker 2000). Epoxy resins are in 75–90% diglycidyl ether of bisphenol A (DGEBA) and belong to the thermosetting type of plastic resins. The sensitization occurs not only to the resins, but also to hardeners and reactive diluents. Epoxy resins penetrate plastic and rubber gloves and seem to be a common cause of allergic contact dermatitis wherein the main sensitizer appears to be DGEBA-based epoxy resin oligomer. The sensitizing capacity of epoxy resins decreases as the molecular weight increases. Paints and coating systems are the most common occupational source of allergic dermatitis. The dermatitis is mostly localized at hands, forearms, and face. Allergy to epoxy resins is thought to occur early, often within a few months of initial contact (Bjorkner 1999; Kanerva et al. 1999). Patch testing with commercially available materials and in some cases the patient’s own resins is important for diagnosis. Industrial hygiene prevention techniques are essential to reduce contact dermatitis when handling these resin systems. Allergies caused from styrene, polyvinylchloride, or polyethylenes are doubtful and often described as case reports, but however rarely found in vehicle parts manufacturing industry. Soldering flux contains alcohols, rosins, organic acids and amines can cause both irritant and allergic contact dermatitis. Reported cases of contact allergy are often caused by rosin in flux resulting either from direct contact with the flux or from exposure to solder fumes (Mathias and Adams 1984; Yokota et al. 2004).

2.2

Metal Machining

Numerous metal parts in turneries of the vehicle manufacturing need to be cut, drilled, shaped, and rounded. Metal-working fluids (MWF) are essential therefore. In the vehicle parts industry, metal-working fluids, capable of

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causing irritant and allergic contact dermatitis, are still in use (Donovan et al. 2007; Suuronen et al. 2007a, b). Metal-working fluids are a complex mixture of oils and chemicals. Generally four types of metal-working fluids, straight (natural, mineral oil), emulsified, semisynthetic, and synthetic fluids, exist: The characteristics of chemicals for each mixture are related to cooling and lubrication requirements (Bartels et al. 2000; NIOSHInstitute 2001). Moreover a number of additives are added to metal-working fluids to enhance their operational lifespan or further requirements. Unfortunately, an unknown number and amount of contaminants also become part of the complex mixture during manufacturing processes (NIOSH-Institute 2001). Soluble and semisynthetic metal-working fluids have surpassed mineral oils as the most frequently used fluids. Four classes of MWFs, straight (natural, mineral oil), emulsified, semisynthetic, and synthetic fluids, are in use: Straight fluid, as the name implies, is 100% mineral oil and severely solvent-refined petroleum oils used before 1970s. Water-based oils are now more commonly used; emulsified oil is composed of mineral oil and water; semisynthetic contains smaller amounts of mineral oils than the emulsified oils; and synthetic oils contain no mineral oils. Since these are water-based products, corrosion inhibitors as well as dyes and biocides to inhibit microbiological growth are found in the three types of nonstraight MWFs. Typically these fluids are collected in sumps around the machining operations and repeatedly reused in the machining process after the metal particles are filtered out. Specific personnel are designated to check the pH, assess the biological content, and put in additives in response to the sampling results. Workers can be exposed to metal-working fluids through skin contact by (1) exposure to splashes and aerosols during immersion or flooding of the machine tool or work, and (2) handling parts, tools, and equipment covered with metal-working fluids (Godderis et al. 2008). Workers may also be exposed to metal-working fluids by inhalation of aerosols. Skin disorders (skin irritation, eczema, rashes, oil acne) are the most frequently reported health problems (Mirer 2010), followed by complaints of eye, nose, and throat irritation (mucous membrane irritation) and respiratory symptoms or disorders (breathing problems, cough, chest tightness, asthma). In a study (Suuronen et al. 2007a, b) the risk of hand dermatitis was about twofold higher than the risk of elsewhere located dermatitis. The most common causative agents of allergic contact dermatitis are antimicrobials and formaldehyde and

formaldehyde liberators shown by studies of de Boer et al. 1989a, b; Geier et al. 2004, 2006. Concomitant patch test reactions to formaldehyde and formaldehyde liberators are common in machinists (Camarasa et al. 1993; Geier et al. 2004). In most cases, the primary allergen is formaldehyde released from the formaldehydeliberating antimicrobial agent (Alto-Korte et al. 2008). Alkanolamines or ethanolamines (triethanolamine (TEA), diethanolamine (DEA), and monoethanolamine (MEA)) are used in metal-working fluids to stabilize pH or inhibit corrosion. DEA has a considerable possible carcinogenic potential (Henriks-Eckerman et al. 2007). Especially, monoethanolamine was reported as causative agents for allergic contact dermatitis while triethanolamine had none or only a low sensitization potential (Geier et al. 2004, 2006; Breuer and Fartasch 2007; Lessmann et al. 2009). Occasional cases of allergic contact dermatitis are more often caused by rubber or plastic chemicals in machinists. Rubber and plastic chemicals are common occupational contact allergens, but they are not often reported in machinists (HalkierSorensen 1996; Riihimaki et al. 2010; Skoet et al. 2004). Based on reports of Suuronen et al. 2007a, b, in addition to MWFs themselves, coconut fatty acid derivatives in liquid hand soaps seem to be noteworthy causes of allergic contact dermatitis in machinists. Non-formaldehyde-releasing antimicrobial agents are effective against fungi than formaldehyde releasers but are also effective against bacteria. The phenolic compounds are oil soluble, and the antimicrobial agent derivatives are partially soluble in oil and water. The biocide 4-chloro-3-methylphenol (CMP) is a common additive to metal-working fluids (MWF). National Institute for Occupational Safety and Health (NIOSH-Institute 2001) previously identified and quantified CMP in a commercial water-soluble MWF and demonstrated irritancy and sensitization potential as well as in vitro human epidermal permeability (Frasch et al. 2010). MWFs can contain skinsensitizing substances, but the specific substances and their concentrations vary. The relevance of positive patch test results in connection with MWF ingredients may be difficult to determine due to deficiencies in safety data sheets, especially if the patch test result to MWF itself is negative. Iodopropynyl butylcarbamate, IPBC, a relatively new allergen, seems to be a common additive in present MWFs. Isothiazolinones may be relevant allergens for machinists (Henriks-Eckerman et al. 2007). Contact allergies to chromium represent mainly exposure to chromium released from chromium tanned leather gloves (Hansen et al. 2006) while contact allergy to nickel may be due to, e.g., direct skin contact with tools

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containing nickel (Liden et al. 1998). However, nickel is a frequent allergen in the general population, and its occupational relevance is often controversial (Liden 1994; Shah et al. 1998; Skoet et al. 2004). Nickel, chromium, and cobalt may also dissolve into MWFs from tooling edges and machined pieces, but the concentrations reported thus far have been low, suggesting that induction of contact allergy is possible only in rare cases (Alomar et al. 1985; Einarsson et al. 1975; Papa et al. 2000; Skoet et al. 2004). However, it is possible that the concentration of dissolved cobalt in MWF is high enough to induce contact allergy when hard metal alloys containing cobalt are machined (Linnainmaa et al. 1996; Sjogren et al. 1980). Furthermore, resin acids of colophonium (colophony) which mainly originated from distilled tall oil (contains 10–30% colophonium) were also detected in MWFs and may cause contact allergy in its oxidized form. In a German multicenter study colophony with its main component abietic acid was shown to be patch test positive in 7% of metal workers with contact dermatitis (Geier et al. 2006) and seems to be a relevant allergen in machinists (Henriks-Eckerman et al. 2008).

2.3

Vehicle Repair and Maintenance

Vehicle repair and maintenance is extensive domain of the automotive industry. Unlike vehicle production, repair and maintenance usually occurs in small workshop or repair workshops. Epidemiologic studies investigating the risk of occupational skin disease have been performed in car factories (Kristensen 1992; Newhouse 1964; Sinitsyn et al. 1988) but fewer studies have been performed on the workforce of mechanics doing repair jobs at garages (Meding et al. 1994). The annual incidence rates of contact dermatitis in a cohort of automobile workers of an occupational skin disease register with locksmiths and automobile mechanics yielded 1.7 for irritant contact dermatitis and 0.7 subjects with allergic contact dermatitis per 10,000 workers. The predominant exposure included cutting fluids, mineral oils and lubricants, and solvents (e.g., turpentine, petrol, acetone) (Dickel et al. 2002). Workers in the larger workshops are usually more specialized, and these larger premises are more likely to have industrial hygiene controls and protective equipment. A different spectrum of exposures is seen in the automobile maintenance and repair industry compared with the primary manufacturing of vehicles (Hebisch and Auffarth 2001). Maintenance repair workshops may cover general engine repairs or specialize in certain repair work, such as radiators or transmissions. It is important to

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differentiate maintenance workshops from collision repair workshops or auto body workshops, which have additional unique exposures. Worker titles may assist in this distinction: A mechanic or service technician generally works on engines and mechanical repairs; auto body technicians may perform much of the same engine/mechanical work, but usually also do structural repairs and some paintings. Painters are responsible for spray painting in body workshops. Trucks and buses are usually maintained and repaired in separate facilities given differences in types of engines (diesel and biodiesel vs. gasoline) and large scale. The types of dermal hazards are similar, although spray painting, if an appropriate sized spray booth is not available, can involve greater exposures.

2.4

Exposures from Automobile Maintenance and Repair

Hand eczema in automobile mechanics may be caused by exposure to irritants such as organic solvents, hydraulic oils, engine fuels, working fluids, fiberglass, and skin cleansers (Maibach and Mathias 2001; Moen et al. 1995; Zsigmond 1985). Repair of clutches and brake linings can exposure solvents. Working on batteries may expose a worker to lead from the lead battery plates and acids. Welding, grinding, and cutting metal engine parts can produce metal fumes, aerosols, and particulates. Other maintenances and repair work includes exposures to benzene from fuels, or glycols from cooling liquids absorbed by skin contact (Javelaud et al. 1998).

2.5

Exposures in Auto Body Workshops

Collision repair shops generally repair vehicles that have been damaged in accidents by restoring their exteriors (and interiors). In addition to the exposures in car maintenance workshops, auto body workers are also exposed to a number of hazards like grinding, sanding, cutting, and, occasionally, sandblasting of metal parts that occurs in auto body repair work, resulting in dust that can contain heavy metals and various particulates. Occurrence of white fingers and paresthesia is known to be related to work with vibrating tools such as wrenches, drills, cutters, and polishes. These tools are used by car mechanics (Moen et al. 1995). Resin or putty typically contains polyester resin, styrene, and talc that are commonly used as plastic body part filler. Workers, who apply it to the damaged car body parts, sand it after it hardens, which can generate substantial irritant dust exposures to skin.

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Workers in the collision repair industry are potentially exposed to a wide range of chemical hazards, including metals, organic solvents, and isocyanates. After cars are structurally repaired, the last step is to apply a new durable finish, comprising several layers of sprayed-on two-part polyurethane coating. These paints typically contain aliphatic diisocyanates, primarily polymeric hexamethylene diisocyanate (Alto-Korte et al. 2010) or isophorone diisocyanate (IPDI) dissolved in solvents such as acetone, toluene, xylene, and methyl ethyl ketone (Bello et al. 2005; Pisaniello and Muriale 1989). Solvents are also used to wipe down a car prior to re-painting, usually hand-applied with a cloth or sprayed, and during clean-up. Several coats of primer and sealer are typically applied, followed by the color coat and the protective top coat is applied in several layers. The color coat usually does not contain isocyanate; the clear coat almost always contains isocyanate, which imparts the hard finish that is impervious to ultraviolet rays. Spray painting entails the risk of respiratory and skin exposure to isocyanates. Skin exposure is particularly of concern with isocyanates, since such exposure probably is an effective route of sensitization. Skin exposure can occur from deposition of airborne exposures on skin, and also in settings where airborne exposures are generally well controlled, such as paint mixing. Skin exposure to isocyanate typically does not cause rashes or other warning symptoms that might reduce exposure.

2.6

Prevention in Automobile Workers

Car repair workers have a high risk of occupational contact dermatitis due to the exposure to various chemicals. In this context atopic background and long duration of work are found to be the highest risk factor of contact dermatitis (Attwa and el-Laithy 2009). Atopic skin diathesis is according to the result of present studies one of the most important determinant for the induction of irritant contact dermatitis (Apfelbacher et al. 2010). The use of gloves can reduce the occurrence of injuries to the hands, especially cuts (Moen et al. 1995). The results of epidemiological studies depict that a large proportion of irritant contact dermatitis could be prevented if milder detergents are used and proper skin care measures are established. In epidemiological surveys where workers are not seen by a dermatologist, skin screening lists seem to be more appropriate to detect cases of dermatitis, as its higher specificity results in less false positives. Alternatively, it would be preferable applying the symptom-based questionnaire; workers

with symptoms should be seen by a dermatologist to identify false positives (de Joode et al. 2007). Gloves should be worn when using body filler, for sanding, and dermal contact with paints. Appropriate skin protection should also be worn for welding, grinding, and cutting. To avoid hand eczema risk groups for hand eczema should be identified and personal protective equipment (PPE) whenever spraying paint should include appropriate gloves and skin covering – suit or sleeves. For paint jobs, workers may be less inclined to wear PPE. In the case of suspected occupational dermatoses in the automotive industry, the detailed investigation should include: ● Job title, employment duration, and tasks (e.g., painting, welding, sanding, filling) the employee performs and how often. ● Type of skin protective equipment (glove, clothing) that is worn and how frequently. ● Safety data sheets should be obtained and reviewed to identify potential causative chemicals, in particular sensitizing agents.

References Alomar A, Conde-Salazar L, Romaguera C (1985) Occupational dermatoses from cutting oils. Contact Dermatitis 12:129–138 Alto-Korte K, Alanko K, Henriks-Eckerman ML, Kuuliala O, Jolanki R (2007) Occupational allergic contact dermatitis from 2-N-octyl-4isothiazolin-3-one. Contact Dermatitis 56:160–163 Alto-Korte K, Kuuliala O, Suuronen K, Alanko K (2008) Occupational contact allergy to formaldehyde and formaldehyde releasers. Contact Dermatitis 59:280–289 Alto-Korte K, Pesonen M, Kuuliala O, Alanko K, Jolanki R (2010) Contact allergy to aliphatic polyisocyanates based on hexamethylene-1,6diisocyanate (HDI). Contact Dermatitis 63:357–363 Apfelbacher CJ, Radulescu M, Diepgen TL, Funke U (2008) Occurrence and prognosis of hand dermatitis in the car industry: results from the PACO follow up study (PACO II). Contact Dermatitis 58:322–329 Apfelbacher CJ, Funke U, Radulescu M, Diepgen TL (2010) Determinants of current hand eczema: results from case-control studies nested in the PACO follow-up study (PACO II). Contact Dermatitis 62: 363–370 Attwa E, el-Laithy N (2009) Contact dermatitis in car repair workers. J Eur Acad Dermatol Venereol 23:138–145 Bartels T, Bock W, Braun J, Busch C, Buss W, Dresel W, Freiler C, Harperscheid M, Heckler RP, Haerner D, Kubicki F, Lingg G, Losch A, Luther R, Mang T, Noll S, Omeis J (2003) Lubricants and lubrication. In: Ullmann’s encyclopedia of industrial chemistry. Wiley-VCH, Weinheim, Germany Bello D, Woskie SR, Streicher RP, Stowe MH, Sparer J, Redlich CA, Cullen MR, Liu Y (2005) A laboratory investigation of the effectiveness of various skin and surface decontaminants for aliphatic polyisocyanates. J Environ Monit 7:716–721

Automotive Industry Bello D, Redlich CA, Stowe MH, Sparer J, Woskie SR, Streicher RP, Hosgood HD, Liu Y (2008) Skin exposure to aliphatic polyisocyanates in the auto body repair and refinishing industry: II. A quantitative assessment. Ann Occup Hyg 52:117–124 Bjorkner B (1999) Plastic materials. In: Adams RM (ed) Occupational skin disease. WB Saunders Company, Philadelphia, pp 434–462 Breuer D, Fartasch M (2007) Pitfalls in interpretation of positive patch test reaction in metal workers to triethanolamine (TEA). Air Quality Control 67(1/2):12–16 Cahill J, Keegel T, Dharmage S, Nugriaty D, Nixon R (2005) Prognosis of contact dermatitis in epoxy resin workers. Contact Dermatitis 52:147–153 Camarasa JG, Romaguera C, Serra-Baldrich E, Vilaplana J (1993) Allergic contact dermatitis from Biobans in Spanish metalworkers. Contact Dermatitis 29:98 de Boer EM, van Ketel WG, Bruynzeel DP (1989a) Dermatoses in metal workers. (I). Irritant contact dermatitis. Contact Dermatitis 20: 212–218 de Boer EM, van Ketel WG, Bruynzeel DP (1989b) Dermatoses in metal workers. (II). Allergic contact dermatitis. Contact Dermatitis 20:280–286 de Joode BW, Vermeulen R, Heederik D, van Ginkel K, Kromhout H (2007) Evaluation of 2 self-administered questionnaires to ascertain dermatitis among metal workers and its relation with exposure to metalworking fluids. Contact Dermatitis 56(6):311–317 Dickel H, Kuss O, Schmidt A, Kretz J, Diepgen TL (2002) Importance of irritant contact dermatitis in occupational skin disease. Am J Clin Dermatol 3:283–289 Donovan JC, Kudla I, Holness DL (2007) Hand dermatitis in auto mechanics and machinists. Dermatitis 18:143–149 Einarsson O, Kylin B, Lindstedt G, Wahlberg JE (1975) Chromium, cobalt and nickel in used cutting fluids. Contact Dermatitis 1:182–183 Frasch HF, Zang LY, Barbero AM, Anderson SE (2010) In vitro dermal penetration of 4-chloro-3-methylphenol from commercial metal working fluid and aqueous vehicles. J Toxicol Environ Health A 73:1394–1405 Funke U, Diepgen TL, Fartasch M (1995) Identification of high-risk groups for irritant contact dermatitis by occupational physicians. Curr Probl Dermatol 23:64–72 Funke U, Fartasch M, Diepgen TL (2001) Incidence of work-related hand eczema during apprenticeship: first results of a prospective cohort study in the car industry. Contact Dermatitis 44:166–172 Geier J, Lessmann H, Dickel H, Frosch PJ, Koch P, Becker D, Jappe U, Aberer W, Schnuch A, Uter W (2004) Patch test results with the metalworking fluid series of the German Contact Dermatitis Research Group (DKG). Contact Dermatitis 51:118–130 Geier J, Lessmann H, Becker D, Bruze M, Frosch PJ, Fuchs T, Jappe U, Koch P, Pfohler C, Skudlik C (2006) Patch testing with components of water-based metalworking fluids: results of a multicentre study with a second series. Contact Dermatitis 55:322–329 Godderis L, Deschuyffeleer T, Roelandt H, Veulemans H, Moens G (2008) Exposure to metalworking fluids and respiratory and dermatological complaints in a secondary aluminium plant. Int Arch Occup Environ Health 81:845–853 Halkier-Sorensen L (1996) Occupational skin diseases. Contact Dermatitis 35:1–120 Hansen MB, Menne T, Johansen JD (2006) Cr(III) and Cr(VI) in leather and elicitation of eczema. Contact Dermatitis 54:278–282 Hebisch R, Auffarth J (2001) Dermal exposure: how to get information. Appl Occup Environ Hyg 16:169–173

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Henriks-Eckerman ML, Suuronen K, Jolanki R, Riala R, Tuomi T (2007) Determination of occupational exposure to alkanolamines in metalworking fluids. Ann Occup Hyg 51:153–160 Henriks-Eckerman ML, Suuronen K, Jolanki R (2008) Analysis of allergens in metalworking fluids. Contact Dermatitis 5:261–267 Hino R, Nishio D, Kabashima K, Tokura Y (2008) Percutaneous penetration via hand eczema is the major accelerating factor for systemic absorption of toluene and xylene during car spray painting. Contact Dermatitis 58:76–79 ILO (2009). ILO database of labour statistics Javelaud B, Vian L, Molle R, Allain P, Allemand B, Andre´ B, Barbier F, Churet AM, Dupuis J, Galand M, Millet F, Talmon J, Touron C, Vaissie`re M, Vechambre D, Vieules M, Viver D (1998) Benzene exposure in car mechanics and road tanker drivers. Int Arch Occup Environ Health 71(4):277–283 Johnson W Jr (2001) Final report on the safety assessment of PEG-25 propylene glycol stearate, PEG-75 propylene glycol stearate, PEG-120 propylene glycol stearate, PEG-10 propylene glycol, PEG-8 propylene glycol cocoate, and PEG-55 propylene glycol oleate. Int J Toxicol 20(Suppl 4):13–26 Kanerva L, Estlander T, Alanko K, Pfaffli P, Jolanki R (1999) Occupational allergic contact dermatitis from unsaturated polyester resin in a car repair putty. Int J Dermatol 38:447–452 Kawamura T, Fukuda S, Ohtake N, Furue M, Tamaki K (1996) Lichen planus-like contact dermatitis due to methacrylic acid esters. Br J Dermatol 134:358–360 Kristensen O (1992) A prospective study of the development of hand eczema in an automobile manufacturing industry. Contact Dermatitis 26:341–345 Lerbaek A, Kyvik KO, Ravn H, Menne T, Agner T (2007) Incidence of hand eczema in a population-based twin cohort: genetic and environmental risk factors. Br J Dermatol 157:552–557 Lessmann H, Uter W, Schnuch A, Geier J (2009) Skin sensitizing properties of the ethanolamines mono-, di-, and triethanolamine. Data analysis of a multicentre surveillance network (IVDK∗) and review of the literature. Contact Dermatitis 5:243–255 Liden C (1994) Occupational contact dermatitis due to nickel allergy. Sci Total Environ 148:283–285 Liden C, Rondell E, Skare L, Nalbanti A (1998) Nickel release from tools on the Swedish market. Contact Dermatitis 39:127–131 Linnainmaa M, Kangas J, Kalliokoski P (1996) Exposure to airborne metals in the manufacture and maintenance of hard metal satellite blades. Am Ind Hyg Assoc J 57(2):196–201 Liu Y, Bello D, Sparer JA, Stowe MH, Gore RJ, Woskie SR, Cullen MR, Redlich CA (2007) Skin exposure to aliphatic polyisocyanates in the auto body repair and refinishing industry: a qualitative assessment. Ann Occup Hyg 51:429–439 Liu Y, Stowe MH, Bello D, Sparer J, Gore RJ, Cullen MR, Redlich CA, Woskie SR (2009) Skin exposure to aliphatic polyisocyanates in the auto body repair and refinishing industry: III. A personal exposure algorithm. Ann Occup Hyg 53:33–40 Maibach HI, Mathias CT (2001) Allergic contact dermatitis from cycloaliphatic epoxide in jet aviation hydraulic fluid. Contact Dermatitis 45:56 Mathias CG, Adams RM (1984) Allergic contact dermatitis from rosin used as soldering flux. J Am Acad Dermatol 10:454–456 Meding B, Jarvholm B (2002) Hand eczema in Swedish adults – changes in prevalence between 1983 and 1996. J Invest Dermatol 118:719–723 Meding B, Barregard L, Marcus K (1994) Hand eczema in car mechanics. Contact Dermatitis 30:129–134

1351

1352

134

Automotive Industry

Mirer FE (2010) New evidence on the health hazards and control of metalworking fluids since completion of the OSHA advisory committee report. Am J Ind Med 53:792–801 Moen BE, Hollund BE, Torp S (1995) A descriptive study of health problems on car mechanics’ hands. Occup Med (Lond) 45:318–322 Newhouse ML (1964) Epidemiology of skin disease in an automobile factory. Br J Ind Med 21:287–293 Nilsson E, Back O (1986) The importance of anamnestic information of atopy, metal dermatitis and earlier hand eczema for the development of hand dermatitis in women in wet hospital work. Acta Derm Venereol 66:45–50 Niosh-Institute (2001) Metal working fluids, potentially hazardous components. National Institute for Occupational Safety and Health, Cincinnati Papa G, Romano A, Quaratino D, Di FM, Viola M, Sernia S, Boccia I, Di GM, Venuti A, Calvieri S (2000) Contact dermatoses in metal workers. Int J Immunopathol Pharmacol 13:43–47 Pisaniello DL, Muriale L (1989) The use of isocyanate paints in auto refinishing-a survey of isocyanate exposures and related work practices in South Australia. Ann Occup Hyg 33:563–572 Rademaker M (2000) Occupational epoxy resin allergic contact dermatitis. Australas J Dermatol 41:222–224 Redlich CA (2010) Skin exposure and asthma: is there a connection? Proc Am Thorac Soc 7:134–137 Riihimaki H, Kurppa K, Karjalainen A, Palo L, Jolanki R, Keskinen H, Makinen I, Saalo A, Kauppinen T (2010) Occupational diseases in Finland in 2002. Finnish Institute of Occupational Health, Helsinki Routledge R (1971) Contact dermatitis and bronchial irritation due to ammonium acrylate in the motor industry. Trans Soc Occup Med 21:59–60

Rystedt I (1985a) Atopic background in patients with occupational hand eczema. Contact Dermatitis 12:247–254 Rystedt I (1985b) Work-related hand eczema in atopics. Contact Dermatitis 12:164–171 Shah M, Lewis FM, Gawkrodger DJ (1998) Nickel as an occupational allergen. A survey of 368 nickel-sensitive subjects. Arch Dermatol 134:1231–1236 Sinitsyn BI, Logunov VP, Fedotov VP (1988) Epidemiology and pathogenesis of occupational skin diseases in automobile factory workers. Vestn Dermatol Venerol 1:56–59 Sjogren I, Hillerdal G, Andersson A, Zetterstrom O (1980) Hard metal lung disease: importance of cobalt in coolants. Thorax 35:653–659 Skoet R, Olsen J, Mathiesen B, Iversen L, Johansen JD, Agner T (2004) A survey of occupational hand eczema in Denmark. Contact Dermatitis 51:159–166 Stingeni L, Bellini V, Lisi P (2008) Occupational airborne contact urticaria and asthma: simultaneous immediate and delayed allergy to diphenylmethane-4,40 -diisocyanate. Contact Dermatitis 58: 112–113 Suuronen K, Alto-Korte K, Piipari R, Tuomi T, Jolanki R (2007a) Occupational dermatitis and allergic respiratory diseases in finnish metalworking machinists. Occup Med (Lond) 57:277–283 Suuronen K, Jolanki R, Luukkonen R, Alanko K, Susitaival P (2007b) Selfreported skin symptoms in metal workers. Contact Dermatitis 57:259–264 Yokota K, Minami T, Michitsuji H, Fujio T, Yamada S (2004) Occupational dermatitis from soldering flux. Ind Health 42:383–384 Zsigmond A (1985) Sudden onset irritant dermatitis in a car component factory. J Soc Occup Med 35:62–64