Hence, all risk estimates are above 1. Largely, the ranking

according to adjusted PR estimates is in accordance with the ranking based on crude prevalence, with a few exceptions indicative of some confounding. After identifying three occupational subgroups with a relatively high risk of contact sensitisation to the thiurams, namely BMS202 research buy healthcare workers (physicians, nurses and related), food processors (cooks, meat and fish processors) and professional cleaners, the issue of a possible differential time trend was addressed. In view of (i) a distinct general risk gradient related to age (Table 2) and (ii) a weak, but significant association between age and year of patch test in the IVDK population (Uter et al. 2008), simple bivariate

Autophagy activator analyses of crude sensitisation prevalence across time were avoided. Instead, three separate Poisson regression models including age as confounder and the year of patch test as exposure of interest were used to identify a significant decline of sensitisation prevalence in case of healthcare workers (p for trend = 0.0008), but no significant trend for the other two subgroups. The time course of age-standardised sensitisation prevalences is shown in Fig. 1a for healthcare workers and in Fig. 1b for the two other occupational groups. Fig. 1 a Time trend of sensitisation to the thiuram mix in healthcare workers. Sensitisation prevalence is directly age standardised. Straight grey line Vadimezan order represents the fitted regression line to represent a linear subgroup-specific trend. b Time trend of sensitisation to the thiuram mix in food handlers and cleaners, respectively. Sensitisation prevalence is directly age standardised. Straight grey lines represent fitted regression lines to represent a linear subgroup-specific trend Discussion Thiurams and dithiocarbamates, which are also represented by the thiuram mix in patch testing (Andersen

et al. 2006), are important constituents of natural and synthetic rubber products. The vulcanisers (accelerators) may occur both in occupational and non-occupational context (e.g., in privately used “household gloves” (Proksch et al. 2009)). A considerable amount of unreacted accelerator—be it thiurams or other classes—remains PJ34 HCl in the cured rubber product, migrates to the surface and comes into contact with the skin. At least in thin products such as gloves or condoms, it is possible to reduce the residual amount, and, with it, dermal exposure, by washing with hot water to create a product, which is more or less “hypoallergenic” in this respect (Andersen et al. 2006). Although rubber products, in particular, rubber gloves, constitute the major part of dermal exposure, additional rather limited skin contact with thiurams may also be due (i) to pesticides (Saunders and Watkins 2001), (ii) fungicides, also in paints and (iii) to animal repellents (Andersen et al. 2006).