Combined exposure to carbon disulfide and sulfuric acid simultaneously increases the risk of hand dermatitis in rayon industry

Objective: To evaluate the association between hand dermatitis ( HD) and occupational exposure to CS2 and to determine whether combined exposure to CS2 and H2SO4 exhibits a higher risk of HD. Methods: In all, 110 subjects from a rayon factory were recruited and their exposure was classified into CS2 exclusively, H2SO4 exclusively, combined exposure, and nonexposure control based on workers' job characteristics. A dermatologist was designated in the diagnosis of HD on palm and dorsal sites for each subject. Other confounding factors including detergent, glove wearing, and participation in wet work were determined using a person-to-person questionnaire interview from 37 randomly selected subjects. Results: Significant elevated odds ratios ( ORs) for HD were found in CS2 exclusively ( 44.8, P<0.01) and combined exposure ( 49.0, P<0.001) compared with control. Dose-response trends of ORs for HD were found across control, single exposure, and combined exposure for both CS2 and H2SO4. Conclusions: HD could occur resulting from occupational exposure to CS2 alone. This study was unable to affirm that the exposure to H2SO4 alone is associated with HD due to limited H2SO4 exposure subjects. The combined exposure to both CS2 and H2SO4 simultaneously could increase the risk of HD. The control remedy in preventing dermal contact with either CS2 or H2SO4 among the rayon workers should be performed immediately.