Skin problems related to Indonesian leather & shoe production and the use of footwear in Indonesia

This thesis describes a series of studies into skin exposure and the occurrence of occupational skin disease (OSD), primarily occupational contact dermatitis (OCD), among leather and shoe factory workers, and shoe dermatitis patients in Indonesia. Although leather and shoe industries have existed in Indonesia for several decades  and more than thousands of workers are employed in the medium and large factories, occupational skin diseases in these factories have not been fully studied. An investigation into the hazardous chemicals and physical agents encountered by workers in this industry, and the related occupational skin diseases is thus highly relevant. Also, shoe dermatitis, a troublesome disease among consumers, needs further elucidation, as well as the allergens that have been unravelled as important causes of these diseases. We performed a cross-sectional study on the observation of the working process and an inventory and risk assessment of the chemicals used. Classification of chemicals as potential sensitizers/irritants and qualitative assessment of exposure to these chemicals are presented. Workers were examined and interviewed using the Nordic Occupational Skin Questionnaire (NOSQ-2002/LONG.

Shoe dermatitis is a form of contact dermatitis resulting from exposure to shoes. We performed a study that focuses primarily on as yet unexplored shoe dermatitis cases in Indonesia. Our study was a prospective study, following actual patients with skin problem of the feet. The most frequent relevant sensitizers were rubber allergens followed by preservatives, shoe adhesives and leather materials.

We further report two shoe dermatitis patients who showed no positive reactions to shoe allergens but gave positive reactions to an extract from the shoe materials. We performed chemical analyses with Thin Layer Chromatography (TLC) and Gas Chromatography-Mass Spectrometry (GCMS) to find substances causing the problems.

Dissertation: http://irs.ub.rug.nl/ppn/387282947