Evaluation of the effects of allergies on the reduction in earning capacity in the context of BK 5101 : Thiurams, mercaptobenzothiazoles, dithiocarbamates, N-isopropyl-N′-phenyl-p-phenylenediamine

Abstract

The following evidence-based recommendations help to evaluate the "effects of allergies" with regard to the excluded job possibilities as necessary for the evaluation of the reduction in earning capacity in occupational skin diseases according to BK No. 5101, German regulation for occupational diseases. According to this, the prevalence of an allergy to thiurams is scored as mild to moderate, depending on the sensitization intensity. The same is true for an allergy to dithiocarbamates. An occupationally relevant allergy to N-isopropyl-N′-phenyl-p- phenylenediamine is generally scored as mild. In justified individual cases it is scored as moderate. The effects of a simultaneous occupation-related allergy to thiurams and dithiocarbamates is generally evaluated as moderate, in justified individual cases as severe. A simultaneous sensitization against thiurams and MBT derivates normally accounts for moderate to severe allergy effects. If a pronounced contact sensitization to thiurams is present, an additional pronounced contact sensitization to MBT derivates can justify the evaluation "severe". In contrast, for the case of the combination of a contact allergy to thiurams and IPPD, the addition of the excluded occupational areas normally results in moderate allergy effects. Similarly, based on the excluded occupational areas, the simultaneous sensitization against MBT derivates and IPPD normally justifies to score the effects as moderate. Combined sensitizations against three or all four of the four contents of rubber lead to the exclusion of further occupational areas as compared to the combination of two of the substances. As the additionally excluded occupational areas normally do not significantly increase the number of excluded occupational possibilities in the job market, it is justified to score the effects of a combination of three substances as moderate to severe. If the sensitization is extremly pronounced, i.e. if skin reactions occur even at slight or slightest contact (e.g. aerogenic exposure to rubber abrasion or only short-term intermittent direct skin contact), the allergy effects are to be considered as severe. However, the combined sensitization against thiurams, dithiocarbamates and MBT derivates has to be considered as severe, because it results in an extremely limited choice of appropriate protective gloves. In cases of a simultaneous sensitization against all four substances - thiurams, dithiocarbamates, MBT derivates and IPPD - the contact with rubber in almost every form has to be avoided. This rather suggests to score the effects as severe.