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BACKGROUND: Assessment of fitness for employment represents the final phase of the risk evaluation and health surveillance carried out during pre-employment and periodical medical examination. Dermatoses are frequent diseases both in the general population and workers, therefore job fitness assessment for workers with skin problems will frequently fall within the occupational health area. The physician must verify whether or not the dermatosis is an occupational disease and must adopt preventive measures to avoid any worsening or relapse of the clinical situation due to occupational factors. OBJECTIVES: This article gives suggestions for correct management of occupational and non-occupational skin diseases in the workplace, with practical examples of job fitness assessment. METHODS: We first examined the role of the occupational physician in the evaluation of occupational risk factors that can induce work-related dermatoses or aggravate other dermatoses. We then discussed the factors that must be considered during assessment of fitness for employment when dermatoses are present. Finally, we examined practical examples of occupational or non-occupational dermatoses that can cause functional limitations, factors that can influence job fitness evaluation, and the possible role of allergological tests. RESULTS AND CONCLUSIONS: Several dermatoses can be aggravated or caused by occupational factors (e.g. atopic dermatitis, allergic contact dermatitis, irritant contact dermatitis, keratinization disorders, lichen planus, physical urticaria). Close cooperation between the dermatologist and the occupational physician is very important in order to make an etiological diagnosis that is necessary for the job fitness assessment. It is difficult to define definitive criteria for the assessment of fitness for employment; in this article only some suggestions are made and they can vary according to the different situations.
机译:背景:对职业适应性的评估代表了在职前和定期体检期间进行风险评估和健康监控的最后阶段。皮肤病在普通人群和工人中都是常见疾病,因此对皮肤问题工人的职业适应性评估通常会落在职业健康领域。医生必须核实皮肤病是否是职业病,并且必须采取预防措施,以避免由于职业因素而使临床情况恶化或复发。目的:本文提供一些建议,以正确管理工作场所的职业性和非职业性皮肤病,并提供职业适应性评估的实例。方法:我们首先检查了职业医师在评估可能诱发与工作有关的皮肤病或加重其他皮肤病的职业风险因素中的作用。然后,我们讨论了当存在皮肤病时,在评估是否适合就业时必须考虑的因素。最后,我们研究了可能引起功能限制的职业性或非职业性皮肤病的实例,可能影响工作适应性评估的因素以及变应性测试的可能作用。结果与结论:几种皮肤病可能会因职业因素而加重或引起(例如特应性皮炎,过敏性接触性皮炎,刺激性接触性皮炎,角化病,扁平苔藓,物理性荨麻疹)。皮肤科医生和职业医生之间的密切合作对于做出病因诊断是工作健康评估所必需的,这一点非常重要。很难为评估就业适合性确定明确的标准;在本文中,仅提出了一些建议,它们可能会根据不同情况而有所不同。

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