Sensitization potentials of methyl, ethyl, and n-butly methacrylates and mutual cross-sensitivity in guinea pigs

(Meth)Acrylate Occupational Contact Dermatitis in Nail Salon Workers: A Case Series

Background:

Recently, many cases of acrylate-associated allergic contact dermatitis have appeared among nail salon workers. Common acrylate-containing products in nail salons include traditional nail polish, ultraviolet-cured shellac nail polish, ultraviolet-cured gel nails, and press-on acrylic nails.

Methods:

Nail salon technicians seen in the occupational medicine clinic in 2015 and 2016 were identified, and their patch test results and clinical features were summarized. Patch testing was done with the Chemotechnique (Meth)Acrylate nail series, and either the North American Standard series or the North American Contact Dermatitis Group screening series.

Results:

Six patients were identified, all women, ages 38 to 58. Common presentations included erythematous dermatitis of the dorsa of the hands, palms, and forearms and fissures on the fingertips. Less common sites of eruptions included the periorbital region, cheeks, posterior ears, neck, sacral area, lateral thighs, and dorsa of the feet. All patients reacted to hydroxyethyl methacrylate, and 5 patients reacted to ethyl acrylate. Each patient also reacted to (meth)acrylates that are not found on either standard series, including ethyleneglycol dimethacrylate, 2-hydroxypropyl methacrylate, and 2-hydroxyethyl acrylate.

Conclusions:

The authors report 6 cases of allergic contact dermatitis to acrylates in nail technicians seen over the past year, representing a new trend in their clinic. These cases are reflective of a growing trend of nail technicians with allergic contact dermatitis associated with occupational (meth)acrylate exposure. Efforts to improve prevention are needed.

Final Report on Ethyl Methacrylate

Ethyl Methacrylate is the ester of ethyl alcohol and methacrylic acid used as the major structural monomer of artificial fingernail formulations that are cross-linked with one or more multifunctional methacrylates. Ethyl methacrylate monomer is polymerized rapidly and very little free monomer is available even during filing of the fingernails. The oral LD50 for rats ranged from 12.7 to 18.14 g/kg, with lesions in the respiratory system and hemoglobinuria observed in treated animals. Ocular, nasal, and respiratory tract irritation was observed in acute inhalation tests using rats. Very little toxicity was seen in subchronic studies using rabbits. Ethyl Methacrylate caused irritation and vehicle dependent sensitization in animals, but no photosensitization. Evidence of embryotoxic and teratogenic effects were observed in pregnant rats after intraperitoneal injection of Ethyl Methacrylate at a range of concentrations. Both positive and negative mutagenicity test data were found. Clinical testing showed little evidence of irritation, although case studies report allergic contact dermatitis as a result of exposure to Ethyl Methacrylate and related methacrylates with application of artificial fingernails. Occupational contact dermatitis from acrylates and methacrylates are also reported, with some evidence for cross-reactivity between the two chemical classes. Based on the sensitizing potential of this ingredient the CIR Expert Panel recommended that fingernail enhancement formulations with Ethyl Methacrylate be applied only by trained individuals and that the ingredient not be used in products intended for retail sale (currently, these products are believed to be sold only for application by a trained individual). Because of the low likelihood of significant exposure if such formulations are applied properly, the Expert Panel concluded that the ingredient is safe as used, with the caveat that skin contact should be avoided.

Assessment of the skin sensitising potency of the lower alkyl methacrylate esters

There is continued interest in, and imperatives for, the classification of contact allergens according to their relative skin sensitising potency. However, achieving that end can prove problematic, not least when there is an apparent lack of concordance between experimental assessments of potency and the prevalence allergic contact dermatitis as judged by clinical experience. For the purpose of exploring this issue, and illustrating the important considerations that are required to reach sound judgements about potency categorisation, the lower alkyl methacrylate esters (LAM) have been employed here as a case study. Although the sensitising potential of methyl methacrylate (MMA) has been reviewed previously, there is available new information that is relevant for assessment of skin sensitising potency. Moreover, for the purposes of this article, analyses have been extended to include also other LAM for which relevant data are available: ethyl methacrylate (EMA), n-butyl methacrylate (nBMA), isobutyl methacrylate (iBMA), and 2-ethylhexyl methacrylate (EHMA). In addressing the skin sensitising activity of these chemicals and in drawing conclusions regarding relative potency, a number of sources of information has been considered, including estimates of potency derived from local lymph node assay (LLNA) data, the results of guinea pig assays, and data derived from in silico methods and from recently developed in vitro approaches. Moreover, clinical experience of skin sensitisation of humans by LAM has also been evaluated. The conclusion drawn is that MMA and other LAM are contact allergens, but that none of these chemicals has any more than weak skin sensitising potency. We have also explored here the possible bases for this modest sensitising activity. Finally, the nature of exposure to LAM has been reviewed briefly and on the basis of that information, together with an understanding of skin sensitising potency, a risk assessment has been prepared.

Methyl methacrylate and respiratory sensitization: a critical review

Methyl methacrylate (MMA) is a respiratory irritant and dermal sensitizer that has been associated with occupational asthma in a small number of case reports. Those reports have raised concern that it might be a respiratory sensitizer. To better understand that possibility, we reviewed the in silico, in chemico, in vitro, and in vivo toxicology literature, and also epidemiologic and occupational medicine reports related to the respiratory effects of MMA. Numerous in silico and in chemico studies indicate that MMA is unlikely to be a respiratory sensitizer. The few in vitro studies suggest that MMA has generally weak effects. In vivo studies have documented contact skin sensitization, nonspecific cytotoxicity, and weakly positive responses on local lymph node assay; guinea pig and mouse inhalation sensitization tests have not been performed. Cohort and cross-sectional worker studies reported irritation of eyes, nose, and upper respiratory tract associated with short-term peaks exposures, but little evidence for respiratory sensitization or asthma. Nineteen case reports described asthma, laryngitis, or hypersensitivity pneumonitis in MMA-exposed workers; however, exposures were either not well described or involved mixtures containing more reactive respiratory sensitizers and irritants. The weight of evidence, both experimental and observational, argues that MMA is not a respiratory sensitizer.

Final report of the safety assessment of methacrylate ester monomers used in nail enhancement products

Methacrylate ester monomers are used in as artificial nail builders in nail enhancement products. They undergo rapid polymerization to form a hard material on the nail that is then shaped. While Ethyl Methacrylate is the primary monomer used in nail enhancement products, other methacrylate esters are also used. This safety assessment addresses 22 other methacrylate esters reported by industry to be present in small percentages as artificial nail builders in cosmetic products. They function to speed up polymerization and/or form cross-links. Only Tetrahydrofurfuryl Methacrylate was reported to the FDA to be in current use. The polymerization rates of these methacrylate esters are within the same range as Ethyl Methacrylate. While data are not available on all of these methacrylate esters, the available data demonstrated little acute oral, dermal, or i.p. toxicity. In a 28-day inhalation study on rats, Butyl Methacrylate caused upper airway irritation; the NOAEL was 1801 mg/m3. In a 28-day oral toxicity study on rats, t-Butyl Methacrylate had a NOAEL of 20 mg/kg/day. Beagle dogs dosed with 0.2 to 2.0 g/kg/day of C12 to C18 methacrylate monomers for 13 weeks exhibited effects only in the highest dose group: weight loss, emesis, diarrhea, mucoid feces, or salivation were observed. Butyl Methacrylate (0.1 M) and Isobutyl Methacrylate (0.1 M) are mildly irritating to the rabbit eye. HEMA is corrosive when instilled in the rabbit eye, while PEG-4 Dimethacrylate and Trimethylolpropane Trimethacrylate are minimally irritating to the eye. Dermal irritation caused by methacrylates is documented in guinea pigs and rabbits. In guinea pigs, HEMA, Isopropylidenediphenyl Bisglycidyl Methacrylate, Lauryl Methacrylate, and Trimethylolpropane Trimethacrylate are strong sensitizers; Butyl Methacrylate, Cyclohexyl Methacrylate, Hexyl Methacrylate, and Urethane Methacrylate are moderate sensitizers; Hydroxypropyl Methacrylate is a weak sensitizer; and PEG-4 Dimethacrylate and Triethylene Glycol Dimethacrylate are not sensitizers. Ethylene Glycol Dimethacrylate was not a sensitizer in one guinea pig study, but was a strong sensitizer in another. There is cross-reactivity between various methacrylate esters in some sensitization tests. Inhaled Butyl Methacrylate, HEMA, Hydroxypropyl Methacrylate, and Trimethylolpropane Trimethacrylate can be developmental toxicants at high exposure levels (1000 mg/kg/day). None of the methacrylate ester monomers that were tested were shown to have any endocrine disrupting activity. These methacrylate esters are mostly non-mutagenic in bacterial test systems, but weak mutagenic responses were seen in mammalian cell test systems. Chronic dermal exposure of mice to PEG-4 Dimethacrylate (25 mg, 2 x weekly for 80 weeks) or Trimethylolpropane Trimethacrylate (25 mg, 2 x weekly for 80 weeks) did not result in increased incidence of skin or visceral tumors. The carcinogenicity of Triethylene Glycol Dimethacrylate (5, 25, or 50%) was assessed in a mouse skin painting study (50 microl for 5 days/week for 78 weeks), but was not carcinogenic at any dose level tested. The Expert Panel was concerned about the strong sensitization and crossor co-reactivity potential of the methacrylate esters reviewed in this report. However, data demonstrated the rates of polymerization of these Methacrylates were similar to that of Ethyl Methacrylate and there would be little monomer available exposure to the skin. In consideration of the animal toxicity data, the CIR Expert Panel decided that these methacrylate esters should be restricted to the nail and must not be in contact with the skin. Accordingly, these methacrylate esters are safe as used in nail enhancement products when skin contact is avoided.

Amended final report on the safety assessment of ethyl methacrylate

Ethyl Methacrylate is a methacrylate ester used as a chemical additive in artificial fingernail enhancement products. These products may be applied by trained professionals or be provided directly to consumers with instructions for use. Ethyl Methacrylate readily polymerizes and rapidly reacts with multifunction methacrylates to form a highly cross-linked polymer. The oral LD(50) of Ethyl Methacrylate for rats ranged from 12.7 to 18.14 g/kg. In acute studies with rats, hemoglobinuria and respiratory tract lesions were observed. Animal studies indicate that Ethyl Methacrylate is a skin irritant and sensitizer. In some cases the results were dependent on the vehicle. Evidence of embryotoxicity and teratogenicity were observed in rats injected intraperitoneally with 0.1223 to 0.4076 ml/kg Ethyl Methacrylate. Positive evidence of mutagenicity was observed in the L5178Y mouse lymphoma cell assay, but not in two Ames tests. Case reports cite examples of individuals suffering allergic contact dermatitis from exposure to Ethyl Methacrylate and related methacrylates, and some degree of cross-reactivity appears to exist between widely used acrylates and methacrylates. Information from several clinical registries of sensitization reactions to various agents reported that Ethyl Methacrylate is a sensitizer, but not a potent one. Because Ethyl Methacrylate monomer is short-lived in the normal course of using artificial fingernail-enhancement products, the primary hazard is expected to be inadvertant skin contact. In order to avoid sensitization, it is necessary to avoid skin contact. It is recommended that fingernail-enhancement products containing Ethyl Methacrylate include directions to avoid skin contact because of the sensitizing potential. Based on the available data on the formulation of nail products containing this ingredient, it is concluded that Ethyl Methacrylate is safe as used, when application is accompanied by directions for use as above.

Cross-reactions of multifunctional methacrylates and acrylates

Dental acrylic monomers (that is, acrylates and methacrylates) are important occupational sensitizers. Acrylic monomers may also cause allergic reactions in dental care. Unfortunately, acrylic monomers cross-react--that is, allergic sensitization induced by one acrylic compound extends to one or more other acrylic compounds. Therefore, sensitized individuals are often multiallergic and, accordingly, cannot be exposed to any of the compounds. In the present review aspects of cross-reactivity in general and data from animal studies of cross-reactivity of multifunctional methacrylates and acrylates are summarized. A multitude of acrylic monomers is used in dentistry, and when patients or dental personnel become sensitized, it is of great importance to identify the dental acrylic preparations to which the sensitized individual can be exposed. Sensitized dental workers are known to have ceased working in dentistry owing to occupational allergic contact dermatitis or asthma, caused by dental acrylic monomers. Unfortunately, cross-reactivity of acrylic monomers used in dentistry is not sufficiently mapped to enable selection of an appropriate compound for the sensitized person. Another important aspect is that product declarations of dental acrylic materials should show all acrylic compounds present in the products--even acrylic monomers/impurities with lower concentrations than 1%. This could help to select a product that the sensitized individual could use.

Allergic contact stomatitis caused by acrylic monomer in a denture

A 71-year-old edentulous man developed a severely painful red mouth at sites of contact with a new denture. Patch testing showed allergy to samples of the denture material and to 2-hydroxyethyl methacrylate. Patch testing to methyl methacrylate was negative. Prolonged boiling of the denture resulted in reversal of his symptoms and samples of this fully cured denture material produced negative patch tests. While allergy to acrylates is a rare cause of stomatitis, this possibility must be considered in patients presenting with oral symptoms. Material safety data sheets are unreliable in providing information regarding the type of acrylate present in the material. Hence, patch testing should be performed with a battery of acrylate allergens as well as with small samples of the denture material.

Biocompatibility of resin-modified filling materials

Increasing numbers of resin-based dental restorations have been placed over the past decade. During this same period, the public interest in the local and especially systemic adverse effects caused by dental materials has increased significantly. It has been found that each resin-based material releases several components into the oral environment. In particular, the comonomer, triethyleneglycol di-methacrylate (TEGDMA), and the 'hydrophilic' monomer, 2-hydroxy-ethyl-methacrylate (HEMA), are leached out from various composite resins and 'adhesive' materials (e.g., resin-modified glass-ionomer cements [GICs] and dentin adhesives) in considerable amounts during the first 24 hours after polymerization. Numerous unbound resin components may leach into saliva during the initial phase after polymerization, and later, due to degradation or erosion of the resinous restoration. Those substances may be systemically distributed and could potentially cause adverse systemic effects in patients. In addition, absorption of organic substances from unpolymerized material, through unprotected skin, due to manual contact may pose a special risk for dental personnel. This is borne out by the increasing numbers of dental nurses, technicians, and dentists who present with allergic reactions to one or more resin components, like HEMA, glutaraldehyde, ethyleneglycol di-methacrylate (EGDMA), and dibenzoyl peroxide (DPO). However, it must be emphasized that, except for conventional composite resins, data reported on the release of substances from resin-based materials are scarce. There is very little reliable information with respect to the biological interactions between resin components and various tissues. Those interactions may be either protective, like absorption to dentin, or detrimental, e.g., inflammatory reactions of soft tissues. Microbial effects have also been observed which may contribute indirectly to caries and irritation of the pulp. Therefore, it is critical, both for our patients and for the profession, that the biological effects of resin-based filling materials be clarified in the near future.

Cross-reactivity patterns of contact-sensitizing methacrylates

Methacrylates are well-known contact sensitizers with increasing frequency of contact leading to occupational skin disease. Here, we developed an animal model to facilitate studies on the sensitizing capacities and cross-reactivity patterns between four clinically most important allergens: methacrylate (MMA), 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxypropyl methacrylate (2-HPMA) and ethyleneglycol dimethacrylate (EGDMA). Inbred guinea pigs were immunized by ic injections of 300 microliters of 1.0 M methacrylate solutions in Freund's complete adjuvant into both flanks, both ears, and the neck. After 14 days open skin tests were performed with 50% MMA, 2-HEMA, or 2-HPMA or 10% EGDMA solutions in 40% DMSO in ethanol. Cross-reactivities were investigated 14 days later by skin testing with all four methacrylates. Using this newly developed protocol, strongly positive skin tests for methacrylates could be induced in almost all guinea pigs (MMA 26/26, 2-HEMA 16/18, 2-HPMA 15/16 and EGDMA 11/11). Whereas EGDMA induced only weak or infrequent cross-reactivities, 2-HEMA sensitization led to strong cross-reactions to all other methacrylates. Both MMA and 2-HPMA induced strong cross-reactivity to EGDMA but only weak to moderate reactivities to the other methacrylates. The absence of strong cross-reactions with monomethacrylates in EGDMA (dimethacrylate)-sensitized animals may be explained by the predominance of highly EGDMA-specific T-cells in these animals. In contrast, sensitization with MMA, 2-HEMA, and 2-HPMA would lead to recruitment of T-cells cross-reactive to the other monomethacrylates, according to their molecular similarities. The strong skin hypersensitivities observed for EGDMA in these latter groups are ascribed to enzymatic degradation into monomethacrylate compounds, notably 2-HEMA, at a rate sufficient to elicit cognate effector T-cells. The results of this study offer new insights in the development of methacrylate hypersensitivities and common cross-sensitization patterns in clinical practice.

10 years of patch testing with the (meth)acrylate series

Statistics on 10 years of patch testing with 30 (meth)acrylates were compiled. Altogether 275 patients were patch tested and 48 patients (17.5%) had an allergic reaction to at least 1 (meth)acrylate. The (meth)acrylates most often provoking an allergic patch test reaction were 2-hydroxyethyl acrylate (2-HEA; 12.1%), 2-hydroxypropyl methacrylate (2-HPMA; 12.0%) and 2-hydroxyethyl methacrylate (2-HEMA; 11.4%). No allergic reactions were caused by 2-ethylhexyl acrylate (2-EHA), 2,2-bis[4-(methacryloxy)phenyl]propane (BIS-MA), trimethylolpropane triacrylate (TMPTA), oligotriacrylate 480 (OTA 480), N,N-methylenebisacrylamide (MBAA), or ethyl cyanoacrylate (ECA). The frequency of allergic patch test reactions presented cannot be considered as a "ranking" list of the most sensitizing (meth)acrylate compounds. In order to be able to judge the sensitization capacity of various (meth)acrylate compounds in humans, it would be necessary to have detailed information on the exposure history of the patients studied, including the purity of the (meth)acrylate compounds. Currently, this is not possible because (meth)acrylate-containing products regularly contain undeclared (meth)acrylate compounds.

A statistical assessment of orthodontic practices, product usage, and the development of skin lesions

Recently there has been great interest in skin lesions on the hands of orthodontic personnel who are exposed to a wide variety of metals, bonding agents, and other materials. Thus this 1985 national survey of 448 Canadian orthodontists (response rate 49%) was undertaken to examine orthodontic practice activities, bonding agent and wire product use, and prevalence of skin lesions on the hands and their possible association with these products. About 13% of the 213 responding orthodontists and at least one other staff member in 18% of the orthodontic practices reported the occurrence of hand lesions (reactions) over the preceding 3 years typical of exposure to dental materials. In nearly one fourth of the offices, at least one person was affected. Regarding product use. Concise, Mono-Lok, and Endur bonding agents and stainless steel, Nitinol, and Elgiloy wires were used most often. The orthodontists reported frequent involvement in bonding activities and infrequent use of gloves. Of all the individual and combined materials and practice characteristics and activities tested singly and multivariately for statistical association with hand lesions, only the orthodontists' use of Mono-Lok, gloves, and the activity of frequently cleaning excess bonding agent were statistically related to the lesions. Multiple logistic regression suggested that the statistical effects of Mono-Lok use and removal of excess bonding agent were independent; thus removal of excess agent may have consequences for lesion development separate from Mono-Lok use.

Laser-induced damage to transparent polymers: chemical effect of short-pulsed (Q-switched) Nd:YAG laser radiation on ophthalmic acrylic biomaterials. I. A review

The use of short-pulsed lasers in ophthalmic surgery inspired and called for research on the damage inflicted by the laser radiation upon the acrylic polymers from which artificial intraocular lenses are made. The possible release of toxic monomers by laser-induced depolymerization is of great concern but past investigations of this phenomenon have been very limited. The present knowledge of various types of laser-induced damage to transparent polymers is reviewed with particular emphasis on the acrylic materials and intraocular lenses.

Occupational contact dermatitis in 2 dental technicians

2 dental technicians, both with chronic hand eczema, reported worsening from the use of 2 products containing methyl methacrylate, employed in manufacturing acrylic prostheses. Patch tests in both patients gave positive reactions to methyl methacrylate, ethylene glycol dimethacrylate and products employed in manufacturing acrylic prostheses (2% and 5% pet.). On the basis of results subsequently obtained from patch tests carried out with pieces of glove interposed between the skin and the allergens (methyl methacrylate and products employed), we advised our patients still to use latex gloves during work. Follow-up after 1 year showed complete regression of the dermatitis in 1 case and considerable improvement in the other.

Sensitizing potential of 2-hydroxyethylmethacrylate

Guinea pigs exhibited none or slight responses to sensitization with low concentrations of 2-hydroxyethylmethacrylate in the guinea pig maximization test, while 60-100% reacted to high concentrations regardless of the vehicle used for induction. Petrolatum, water, soybean oil and a mixture of oil and 2-butanone (sbomek) were used as vehicles for elicitation. The neat methacrylate was less effective than dilutions in any vehicle, petrolatum being the best. The major determinant of the frequency of response was the concentration used for intradermal induction. An increase in frequency and in duration of responsiveness after treatment with cyclophosphamide 3 days before challenge suggests that hydroxyethylmethacrylate preferentially stimulates the suppressor cell function.

Influence of the vehicle on elicitation of contact allergic reactions to acrylic compounds in the guinea pig

Many factors can influence the elicitation of hypersensitivity reactions in guinea pigs and humans. The effect which the vehicle might have on the test response in guinea pigs sensitized with various acrylic compounds, using the "guinea pig maximization test", has been investigated. A marked decrease in the number of positive animals was seen when acetone was used as test vehicle, compared to petrolatum. The same result was seen with alcohol as vehicle, when neopentyl glycol diacrylate (NPGDA) was used as an acrylic monomer model. The patch test locations on the guinea pig flank, also affected the test response. Half of the animals did not react when challenged near the abdomen, compared to a test site near the back. By means of HPLC-analysis, the possible adsorption of the acrylic monomer to the aluminium chamber or filter paper disc, was analysed. Our findings did not indicate that adsorption occurs. A decrease in the amount of acrylic monomer in the chamber with increasing time, was noted. There was a marked difference in the monomer residue between solutions with (darkness) and without (daylight) inhibitor. The monomer decrease was also more affected by an aluminium surface than a glass or filter paper surface. Aluminium oxide probably enhances the polymerization process. The discrepancy between the test results in this study, when petrolatum and acetone were used as test vehicles, is due to a polymerization process of the acrylic compounds. Thus, the petrolatum vehicle probably prevents polymerization of the acrylic monomer.

Hand dermatitis in dental technicians

The incidence of hand dermatitis and contact allergies was analyzed among dental technicians. A survey was carried out by postal questionnaire. It was returned by 106 technicians (88%); 30 had had skin problems, and 20 (19%) had present eruptions. All 20 were invited to a detailed dermatological investigation, but only seven participated. Epicutaneous tests to prosthetic materials were negative in these patients. The hand eruptions in 4 patients appeared to be irritant. 4 other patients (4%), who had had previous hand dermatitis, had a history of positive patch test reactions to methyl methacrylate, but they had become symptomless and refused to participate in further studies.

Contact sensitivity to acrylate compounds in guinea pigs

As reports of contact dermatitis in humans due to acrylate compounds have increased considerably in recent years, it was decided to investigate the ability of these chemicals to evoke contact sensitivity skin reactions in guinea pigs. 21 different acrylate and methacrylate compounds were scanned for their ability to induce contact sensitivity, using 5 different sensitization protocols. Contact reactions of varying intensities were produced to all the mono-, di- and triacrylates tested. However, it was not possible to sensitize guinea pigs to any methacrylates. It would appear that guinea pigs cannot be contact sensitized to acrylate chemicals that are substituted on carbon 2.

Hypersensitivity to Sta-Lok and Loctite anaerobic sealants

Three cases of allergic contact hypersensitivity to Sta-Lok and Loctite anaerobic sealants are reported. These two anaerobic sealants constitute a +100 million annual market in industrial sealants used to join metal surfaces together. To the best of my knowledge, these are the first reported cases of allergic contact hypersensitivity to these agents.

Cross reaction pattern of 26 acrylic monomers on guinea pig skin

The cross reaction pattern of acrylic monomers was investigated in 20 groups of animals sensitized to a different acrylic monomer. Animals sensitized to one monoacrylate tend to react to other monoacrylates. Reactions to corresponding monomethacrylates (same alcohol group in the ester) or other monomethacrylates did not occur. Some reactions to di(meth)acrylates were observed. A number of animals sensitized to one monomethacrylate reacted to some other monomethacrylates and to monoacrylates. Reactions to di(meth)acrylates were observed. Animals sensitized to di(meth)acrylates showed hardly any positive cross reaction. A universal screening allergen to detect acrylic monomer sensitizations does not exist. The composition of (industrial) products should be made accessible to the occupational dermatologist in order to prevent the undesirable situation in which a patient suspected of having an acrylic monomer sensitization must be tested with a large series of potent allergens in order to detect the real origin of the sensitization.

Sensitizing potential of 14 mono (meth) acrylates in the guinea pig

The aim of this study was to investigate differences in the sensitizing potential of 14 mono(meth)acrylates, when tested by the guinea pig maximization test (GPMT) and Freund's complete adjuvant test (FCAT) with an identical, intradermal induction concentration. A new grading classification of the sensitization potential is proposed. Mono(meth)acrylates show a wide range of sensitizing potential. Compared with other (meth)acrylates, methyl methacrylate is a moderate sensitizer. Attention was paid to concomitant sensitization of additives. In 9 of 16 FCATs, concomitant sensitization occurred to the inhibitors hydroquinone and p-methoxyphenol.

Secondary acrylamides in Nyloprint printing plate as a source of contact dermatitis

Several chemically pure fractions have been isolated from Nyloprint printing plates. 5 of the fractions elicited positive patch test reactions in 7 Nylonprint allergic printers. 4 of the 5 components were analysed by means of nuclear magnetic resonance, infrared spectrophotometry, mass spectrometry and elemental analysis. The fractions were identified as N,N'-methylene-bis-acrylamide. N,N'-[oxybis(methylene)]bis-2-propenamide, N,N'-[1,2-ethanediylbis(oxymethylene)]-2-propenamide, and a new compound N-[(2-hydroxyethoxy)-methyl]-2-propenamide. All of the analysed fractions have the common feature of being secondary acrylamides.

Concomitant sensitization to hydroquinone and P-methyoxyphenol in the guinea pig; inhibitors in acrylic monomers

Concomitant sensitization to hydroquinone and p-methoxyphenol occurred in sensitization experiments with acrylic monomers in guinea pigs. No relation between the concentration of the inhibitor in the monomers and the incidence of these concomitant sensitizations could be detected. Concomitant sensitization did not influence the cross reaction pattern of the acrylic monomers. The sensitizing potential of acrylic monomers is not influenced by the inhibitors, but some acrylic monomers seem to interfere with the sensitizing potential of the inhibitors.

2-Hydroxy- ethyl-methacrylate and di- and tetraethylene glycol dimethacrylate: contact sensitizers in a photoprepolymer printing plate procedure

In a platemaking procedure differing from Nyloprint and Letterflex, contact sensitizations to 2-hydroxy-ethyl-methacrylate, di- and tetraethylene glycol dimethacrylate and nicotinic acid were found. Preoperational testing of the complete mixture gave a false impression of safety. Preventive measures and enumeration of acrylic substances so far recognized as sensitizers or cross-sensitizers are discussed.

Skin problems associated with multifunctional acrylic monomers in ultraviolet curing inks

Fifteen cases of contact dermatitis and three of irritant contact conjunctivitis due to multifunctional acrylic monomers in printing inks are described. Seven with dermatitis were sensitized to pentaerythritol triacrylate but evidenced no cross-reactivity to methyl methacrylate. The other eight cases of dermatitis were irritant. Pentaerythritol triacrylate has been shown experimentally to be a cutaneous sensitizer for guinea-pigs and man. Multi-functional acrylates should be handled with minimal skin contact, to avoid cutaneous problems.