We did not undertake random sampling because of the paucity of occupational health information in this industry. In order to get an overview of the working conditions

in Indonesian tanneries, we selected one tannery that represented a highly mechanized and one that represented a medium mechanized plant according to the list provided by the Indonesian Centre for Leather (Centre for Leather 2004). All employees engaged in the production process and exposed to potentially hazardous chemicals were included Alectinib in vivo in the study. A summary of the research flow is shown in Fig. 1. Fig. 1 Research flow Observation of the workplace Preceding the cross-sectional study of skin symptoms and signs, the different work stations of the factories were observed with regard

to the nature of skin exposures to occupational hazards according to guidelines by Rycroft (2004). Workplace observation was done by an occupational dermatologist. This included the following: 1. Observing and making a detailed report on the working process in the factories. At each working stage, we interviewed responsible personnel and recorded the number of workers involved, job tasks, the duration and the frequency of exposure and indoor microclimates with a potential risk of causing occupational dermatoses.   2. Observing system of work, handling procedures, personal protective equipment (PPE) and skin care products.   3. Surveying the chemicals warehouse, chemicals being LY294002 purchase used in workplace and interviewing the workers and their supervisors. Chemical product lists and material safety data sheets (MSDS) were collected from the tannery and from Clomifene the manufacturers of the chemicals. Information was collected from the researchers

and the database at the Centre for Leather, Rubber and Plastic Agency for Research and Development, Ministry of Industry and Trade, Republic of Indonesia.   4. Listing of chemicals (including the CAS numbers of all ingredients), the workers are exposed to during the working process. The potential risk of all chemicals as a skin irritant or a skin sensitizer was assessed using the MSDS, the National Institute for Occupational Safety and Health Institute (NIOSH) website (NIOSH 2010), reference books (de Groot 2008) and a search using PubMed.   Questionnaire study and physical examination A trained interviewer interviewed each exposed employee. All subjects gave their informed consent prior to their inclusion in the study. The interviewers were anthropologists and medical students who were trained in interviewing skills by an occupational dermatologist. The interviews were guided by using the Nordic Occupational Skin Questionnaire 2002 long version (NOSQ-2002/LONG).