Post hurricane skin disorders in clean up workers

Four distinct skin disorders were found in construction workers who helped repair buildings after Hurricane Katrina and Hurricane Rita, according to a report in the November issue of Archives of Dermatology.

Outbreaks of skin diseases frequently occur following hurricanes and flooding, but few of these outbreaks have been thoroughly investigated, according to background information in the article. “Hurricane Katrina made landfall on Aug. 29, 2005, and Hurricane Rita on Sept. 24, 2005. Syndromic surveillance in New Orleans, Louisiana, following these hurricanes indicated that 22 percent of diseases treated were dermatologic conditions (i.e., skin or wound infections and rashes).”

Rebecca Noe, M.P.H., at the Centers for Disease Control and Prevention, Atlanta, and colleagues analyzed the results of surveys, skin biopsy specimens and the environmental exposures of 136 civilian construction workers working and living at a New Orleans military base between August 2005 and October 2005. Many of these workers lived in wooden huts and tents with limited sanitation facilities.

“Of 136 workers, 58 reported rash, yielding an attack rate of 42.6 percent,” the authors write. Forty-one (70.7 percent) of those who reported a rash were examined for diagnosis. Twenty-seven (65.9 percent) were found to have papular urticaria, a sensitivity reaction to insect bites resulting in solid raised bumps on the skin; eight (19.5 percent) had bacterial folliculitis, an infection causing inflammation around the hair follicles; six (14.6 percent) had fiberglass dermatitis, an irritation and inflammation of the skin from contact with fiberglass; and two (4.9 percent) had brachioradial photodermatitis, an abnormal skin reaction to sunlight causing irritation and burning in the arms.

Workers who were Native American, worked as roofers or slept in huts that had sustained flooding during Hurricane Katrina were more likely to suffer from papular urticaria than other workers. Native American workers were also more likely to develop fiberglass dermatitis than workers of another race.

“A suspected mite infestation of flooded housing units is the most plausible hypothesis, although we were unable to identify the arthropod [such as insects, spiders and scorpions] source,” the authors conclude. “People working and living in post-hurricane environments where flooding has occurred may be at an increased risk of exposure to arthropods. To reduce dermatologic morbidity, we suggest avoiding flooded areas, fumigating with an acaricide [pesticide], wearing protective clothing and using arthropod repellant.”

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