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Michaels BS, Ayers T, Brooks-McLaughlin J, McLaughlin RJ, Sandoval-Warren K, Schlenker C, Ronaldson L, Ardagh S. Potential for Glove Risk Amplification via Direct Physical, Chemical, and Microbiological Contamination. J Food Prot 2024; 87:100283. [PMID: 38679200 DOI: 10.1016/j.jfp.2024.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
This review focuses on the potential direct physical, chemical, and microbiological contamination from disposable gloves when utilized in food environments, inclusive of the risks posed to food products as well as worker safety. Unrecognized problems endemic to glove manufacturing were magnified during the COVID-19 pandemic due to high demand, increased focus on PPE performance, availability, supply chain instability, and labor shortages. Multiple evidence-based reports of contamination, toxicity, illness, deaths, and related regulatory action linked to contaminated gloves in food and healthcare have highlighted problems indicative of systemic glove industry shortcomings. The glove manufacturing process was diagramed with sources and pathways of contamination identified, indicating weak points with documented occurrences detailed. Numerous unsafe ingredients can introduce chemical contaminants, potentially posing risks to food and to glove users. Microbial hazards present significant challenges to overall glove safety as contaminants appear to be introduced via polluted water sources or flawed glove manufacturing processes, resulting in increased risks within food and healthcare environments. Frank and opportunistic pathogens along with food spoilage organisms can be introduced to foods and wearers. When the sources and pathways of glove-borne contamination were explored, it was found that physical failures play a pivotal role in the release of sweat build-up, liquefaction of chemical residues, and incubation of microbial contaminants from hands and gloves. Thus, with glove physical integrity issues, including punctures in new, unused gloves that can develop into significant rips and tears, not only can direct physical food contamination occur but also chemical and microbiological contamination can find their way into food. Enhanced regulatory requirements for Acceptable Quality Limits of food-grade gloves, and the establishment of appropriate bioburden standards would enhance safety in food applications. Based on the information provided, together with a false sense of security associated with glove use, the unconditional belief in glove chemical and microbiological purity may be unfounded.
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Affiliation(s)
- Barry S Michaels
- B. Michaels Group Inc., 487 West River Road, Palatka, FL 32177, USA.
| | - Troy Ayers
- Eurofins Microbiology Laboratories Inc., Des Moines, IA 50321, USA
| | | | | | | | | | - Lynda Ronaldson
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
| | - Steve Ardagh
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
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2
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Ljungberg Silic L, Persson C, Pesonen M, Suuronen K, Svedman C, Bergendorff O. 2-Cyanoethyl dimethyldithiocarbamate, a new contact allergen found in accelerator-free nitrile gloves. Contact Dermatitis 2024; 91:45-53. [PMID: 38602297 DOI: 10.1111/cod.14553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) from rubber glove usage is usually caused by rubber additives such as the accelerators. However, in analyses of the suspected gloves, ordinary rubber allergens are not always found. Accelerator-free rubber gloves are available, but some patients with accelerator allergy do not tolerate them and might also be patch test positive to them. OBJECTIVES To identify and chemically characterize a new allergen, 2-cyanoethyl dimethyldithiocarbamate (CEDMC), in rubber gloves. We describe two patient cases: patient 1 that led us to the identification of CEDMC and patient 2 with occupational ACD caused by CEDMC. METHODS The patients were examined with patch testing including baseline and rubber series, and their own rubber gloves. High-performance liquid chromatography (HPLC) was used for chemical analysis of rubber gloves. The allergen was synthesized and identified by nuclear magnetic resonance, mass spectrometry and infrared spectrometry, and tested on patient 2. RESULTS CEDMC was identified by HPLC in a nitrile glove associated with hand eczema in patient 1. Patient 2 whose nitrile gloves contained CEDMC was patch test positive to CEDMC. CONCLUSIONS CEDMC is a new contact allergen in nitrile gloves and probably forms during vulcanization from residual monomer acrylonitrile and rubber additives.
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Affiliation(s)
- Linda Ljungberg Silic
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Christina Persson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Katri Suuronen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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3
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Kursawe Larsen C, Schwensen JFB, Zachariae C, Johansen JD. Contact allergy to rubber accelerators in consecutively patch tested Danish eczema patients: A retrospective observational study from 1990 to 2019. Contact Dermatitis 2024; 90:116-125. [PMID: 37735996 DOI: 10.1111/cod.14421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Rubber accelerators are used in the production of rubber gloves and may cause contact allergy. OBJECTIVES To estimate long-term trend and prevalence of contact allergy to rubber accelerators for a 30-year period in Denmark, high-risk occupations, and exposures. METHODS Data from all patients with contact dermatitis consecutively patch tested at the department of Skin and Allergy Gentofte hospital with the rubber accelerators from the European baseline series (EBS) from 1990 to 2019, were analysed. Further, patients under suspicion of rubber accelerator contact allergy were additionally patch-tested with rubber accelerators from the specialised rubber series from 2005 to 2019 and these were additional extracted. RESULTS The overall prevalence of contact allergy to one or more of the rubber accelerators from the EBS series was 2.7% with a significant decline in the first 12-years, followed by a stable frequency in the past 18-years. Associations with occupational contact dermatitis, hand dermatitis, and leg/foot dermatitis were found. Wet-work occupations were most often affected and gloves the most frequent exposure. CONCLUSIONS Contact allergy to one or more of the rubber accelerators from the EBS is frequent and has been unchanged for several decades, which calls for prevention.
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Affiliation(s)
- Christoffer Kursawe Larsen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Institute of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Jakob F B Schwensen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Claus Zachariae
- Institute of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Institute of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
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4
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Clément A, Ferrier le Bouëdec MC, Crépy MN, Raison-Peyron N, Tétart F, Marcant P, Pralong P, Valois A, Pasteur J, Assier H, Bernier C, Le Cam MT, Hacard F, Nosbaum A, Giordano Labadie F, Morice C, Leleu C, Milpied B, Darrigade AS, Delaunay J, Barbaud A, Castelain F, Collet E, Amsler E. Hand eczema in glove-wearing patients. Contact Dermatitis 2023. [PMID: 37331721 DOI: 10.1111/cod.14357] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/28/2023] [Accepted: 05/25/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Allergic contact dermatitis to gloves is mostly induced by rubber accelerators. The European baseline series (EBS) appears insufficient to detect glove allergy. Since 2017, it is recommended to use the European rubber series (ERS) and to test the patients' own gloves. OBJECTIVES To investigate the clinical profile of glove-wearing patients with hand eczema (HE) and to evaluate their sensitisation profile to glove allergens and the value of testing the patients' own gloves. METHODS We conducted a French multicentre study of patients evaluated for HE between 2018 and 2020 and tested with the EBS, the ERS and their own gloves in patch tests and semi-open (SO) tests. RESULTS A total of 279 patients were included; 32.6% of patients had positive tests to their own gloves or to glove allergens. Almost 45% of the sensitisations to glove allergens were detected only by the ERS. Among the patients tested both in patch tests and SO tests with their own gloves with positive results, 28% had positive SO tests only. Polyvinylchloride (PVC) gloves were positive in four patients. CONCLUSION Our series confirms the need to test the ERS. All the patients' gloves must also be tested including PVC gloves. SO tests with gloves are useful as a complement to patch tests.
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Affiliation(s)
- Aude Clément
- Department of Dermatology, Hôpital Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Marie-Noëlle Crépy
- Department of Dermatology, Hôpital Cochin Port-Royal, APHP, Paris, France
| | - Nadia Raison-Peyron
- Department of Dermatology, Hôpital Saint Eloi, CHU Montpellier, Montpellier, France
| | - Florence Tétart
- Department of Allergology, Centre Erik Satie, CHU Rouen, Rouen, France
| | - Pierre Marcant
- Department of Dermatology, Hôpital Claude Huriez, CHU Lille, Lille, France
| | - Pauline Pralong
- Department of Dermatology, Hôpital Nord, CHU Grenoble, La Tronche, France
| | - Aude Valois
- Department of Dermatology, Hôpital d'instruction des armées Sainte Anne, Toulon, France
| | - Justine Pasteur
- Department of Dermatology, Hôpital Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Haudrey Assier
- Department of Dermatology, CHU Henri Mondor, Créteil, France
| | - Claire Bernier
- Department of Dermatology, Hôpital Hotel Dieu, CHU Nantes, Nantes, France
| | - Marie-Thérèse Le Cam
- Department of Professional Pathology, Centre hospitalier intercommunal, Créteil, France
| | - Florence Hacard
- Department of Allergology and Immunology, CHU Lyon sud, Lyon, France
| | - Audrey Nosbaum
- Department of Allergology and Immunology, CHU Lyon sud, Lyon, France
| | | | | | - Camille Leleu
- Department of Dermatology, CHU Dijon-Bourgogne, Dijon, France
| | - Brigitte Milpied
- Department of Dermatology, Hôpital Saint-André, CHU Bordeaux, Bordeaux, France
| | | | | | - Annick Barbaud
- Département de dermatologie et allergologie, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Tenon, Paris, France
| | - Florence Castelain
- Department of Dermatology, Hôpital Jean Minjoz, CHU Besançon, Besançon, France
| | - Evelyne Collet
- Department of Dermatology, CHU Dijon-Bourgogne, Dijon, France
| | - Emmanuelle Amsler
- Département de dermatologie et allergologie, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Tenon, Paris, France
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5
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Bauer A, Pesonen M, Brans R, Caroppo F, Dickel H, Dugonik A, Larese Filon F, Geier J, Gimenez-Arnau AM, Napolitano M, Patruno C, Rustemeyer T, Simon D, Schuttelaar MLA, Spiewak R, Stingeni L, Vok M, Weisshaar E, Wilkinson M, Valiukeviciene S, Uter W. Occupational contact allergy: The European perspective-Analysis of patch test data from ESSCA between 2011 and 2020. Contact Dermatitis 2023; 88:263-274. [PMID: 36694979 DOI: 10.1111/cod.14280] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Occupational skin diseases have led the occupational disease statistics in Europe for many years. Especially occupational allergic contact dermatitis is associated with a poor prognosis and low healing rates leading to an enormous burden for the affected individual and for society. OBJECTIVES To present the sensitization frequencies to the most relevant allergens of the European baseline series in patients with occupational contact dermatitis (OCD) and to compare sensitization profiles of different occupations. METHODS The data of 16 022 patients considered having OCD after patch testing within the European Surveillance System on Contact Allergies (ESSCA) network between January 2011 and December 2020 were evaluated. Patients (n = 46 652) in whom an occupational causation was refuted served as comparison group. RESULTS The highest percentages of OCD were found among patients working in agriculture, fishery and related workers, metal industry, chemical industry, followed by building and construction industry, health care, food and service industry. Sensitizations to rubber chemicals (thiurams, carbamates, benzothiazoles) and epoxy resins were associated with at least a doubled risk of OCD. After a decline from 2014 onwards, the risks to acquire an occupation-related sensitization to methyl(chloro)isothiazolinone (MCI/MI) and especially to methylisothiazolinone (MI) seem to increase again. Sensitization rates to formaldehyde were stable, and to methyldibromo glutaronitrile (MDBGN) slightly decreasing over time. CONCLUSIONS Among allergens in the European Baseline Series, occupational relevance is most frequently attributed to rubber accelerators, epoxy resins and preservatives.
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Affiliation(s)
- Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Germany and Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Francesca Caroppo
- Unit of Clinic Dermatology, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | | | - Francesca Larese Filon
- Department of Public Health, Occupational Medicine, University of Trieste, Trieste, Italy
| | - Johannes Geier
- Information Network of Department of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | | | - Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Thomas Rustemeyer
- Department of Dermatology and Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Marko Vok
- Dermatovenerološka ambulanta, Izola, Slovenia
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Skaidra Valiukeviciene
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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6
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Allergic contact dermatitis to rubber accelerators in protective gloves: Problems, challenges, and solutions for occupational skin protection. Allergol Select 2021; 5:335-344. [PMID: 34734158 PMCID: PMC8561832 DOI: 10.5414/alx02265e] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
Protective gloves are an elementary component of personal protective equipment in many occupations and are intended to protect the hands from various hazards (e.g., wetness, chemicals, mechanical forces, or thermal stress). This is particularly important when other occupational safety measures (e.g., technical-organizational measures) cannot be implemented or are insufficient. However, it is not uncommon for protective gloves themselves to become a problem, as some of their ingredients (e.g., rubber accelerators) can cause allergic reactions. Accelerators in rubber gloves include thiurams, dithiocarbamates, thiazoles, guanidines, and thioureas. If no alternative means of protection are available, this may even result in abandoning the profession. This article is about rubber accelerators, which are often contained in protective gloves made of different rubber materials (e.g., natural rubber (latex) and nitrile rubber) and may cause delayed-type allergies, as well as related challenges, problems, and solutions for occupational skin protection.
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7
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Jamiolkowski D, Steveling-Klein E, Thomas ZRM, Bircher A, Hofmeier KS, Hartmann K. Strukturierte diagnostische Abklärung eines Handekzems bei Reinigungsfachkräften. J Dtsch Dermatol Ges 2021; 19:672-678. [PMID: 33979053 DOI: 10.1111/ddg.14452_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Dagmar Jamiolkowski
- Dermatologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Allergologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Departement Biomedizin, Universitätsspital Basel und Universität Basel, Basel, Schweiz
| | - Esther Steveling-Klein
- Dermatologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Allergologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Departement Biomedizin, Universitätsspital Basel und Universität Basel, Basel, Schweiz
| | - Zita-Rose Manjaly Thomas
- Dermatologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Allergologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Departement Biomedizin, Universitätsspital Basel und Universität Basel, Basel, Schweiz
| | - Andreas Bircher
- Dermatologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Allergologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz
| | - Kathrin Scherer Hofmeier
- Dermatologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Allergologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Departement Biomedizin, Universitätsspital Basel und Universität Basel, Basel, Schweiz
| | - Karin Hartmann
- Dermatologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Allergologie, Universitätsspital Basel und Universität Basel, Basel, Schweiz.,Departement Biomedizin, Universitätsspital Basel und Universität Basel, Basel, Schweiz
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8
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Jamiolkowski D, Steveling-Klein E, Thomas ZRM, Bircher A, Hofmeier KS, Hartmann K. Structured diagnostic assessment of hand eczema in cleaning workers. J Dtsch Dermatol Ges 2021; 19:672-676. [PMID: 33768711 DOI: 10.1111/ddg.14452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/03/2020] [Indexed: 11/29/2022]
Abstract
Hand dermatitis is a widespread problem among cleaners. In most cases, it is caused by a combination of wet work and contact with irritants, which can result in irritant (toxic) contact dermatitis. In some cases, the irritant contact eczema then evolves into allergic contact dermatitis, although not all cases of allergic contact dermatitis are preceded by irritant contact dermatitis. This mini-review proposes a two-step diagnostic algorithm based on patch testing, which can be used if allergic contact dermatitis is suspected in cleaning workers. As a first step, we recommend performing the DKG standard series (German Contact allergy research group, DKG), the DKG rubber series, both DKG "further fragrances" series as well as the DKG preservative and disinfectant series. If there are clear hints of an occupational contact dermatitis, the first step can also involve testing patients' own products alongside the standardized tests. In a second step (at the latest), if standardized tests do not suffice to identify the culprit allergen and there is well-founded suspicion, we recommend testing the patients' own products. If necessary, the second step can also include testing the individual contact allergens contained in the screening mixes that are part of the standard series.
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Affiliation(s)
- Dagmar Jamiolkowski
- Dermatology, Basel University Hospital and Basel University, Basel, Switzerland.,Allergology, Basel University Hospital and Basel University, Basel, Switzerland.,Department of Biomedicine, Basel University Hospital and Basel University, Basel, Switzerland
| | - Esther Steveling-Klein
- Dermatology, Basel University Hospital and Basel University, Basel, Switzerland.,Allergology, Basel University Hospital and Basel University, Basel, Switzerland.,Department of Biomedicine, Basel University Hospital and Basel University, Basel, Switzerland
| | - Zita-Rose Manjaly Thomas
- Dermatology, Basel University Hospital and Basel University, Basel, Switzerland.,Allergology, Basel University Hospital and Basel University, Basel, Switzerland.,Department of Biomedicine, Basel University Hospital and Basel University, Basel, Switzerland
| | - Andreas Bircher
- Dermatology, Basel University Hospital and Basel University, Basel, Switzerland.,Allergology, Basel University Hospital and Basel University, Basel, Switzerland
| | - Kathrin Scherer Hofmeier
- Dermatology, Basel University Hospital and Basel University, Basel, Switzerland.,Allergology, Basel University Hospital and Basel University, Basel, Switzerland.,Department of Biomedicine, Basel University Hospital and Basel University, Basel, Switzerland
| | - Karin Hartmann
- Dermatology, Basel University Hospital and Basel University, Basel, Switzerland.,Allergology, Basel University Hospital and Basel University, Basel, Switzerland.,Department of Biomedicine, Basel University Hospital and Basel University, Basel, Switzerland
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9
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DeKoven JG, DeKoven BM, Warshaw EM, Mathias CGT, Taylor JS, Sasseville D, Belsito DV, Fowler JF, Pratt MD, Zug KA, Maibach HI, DeLeo VA, Silverberg JI, Atwater AR, Reeder MJ, Holness DL. Occupational contact dermatitis: Retrospective analysis of North American Contact Dermatitis Group Data, 2001 to 2016. J Am Acad Dermatol 2021; 86:782-790. [PMID: 33753252 DOI: 10.1016/j.jaad.2021.03.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patch testing is an important diagnostic tool for suspected allergic contact dermatitis (ACD) in occupational settings. OBJECTIVE Provide an overview of occupational skin disease (OSD) and an analysis of occupational ACD in North American patients undergoing patch testing between 2001and 2016. METHODS Patients with OSD were analyzed for frequency of allergic reactions to a screening series of allergens, occupational relevance, location of skin disease, and exposure sources. Demographic, occupation, and industry information were recorded. RESULTS Of 38,614 patients evaluated, 4471 (11.6%) had OSD, of whom 3150 (70.5%) had ACD. The most common occupationally related allergens included rubber accelerators, preservatives, and bisphenol A epoxy resin. Hands (75.8%), arms (30.0%), and face (15.9%) were common sites of dermatitis. The occupations most affected were service workers and machine operators. LIMITATIONS Our cohort may not reflect the general working population. CONCLUSION This study identified common occupational allergens, exposure sources, and occupations/industries at risk. This information may help the clinician evaluate and manage patients with occupational contact dermatitis.
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Affiliation(s)
- Joel G DeKoven
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada.
| | - Benjamin M DeKoven
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada
| | - Erin M Warshaw
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | | | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - D Linn Holness
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada
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10
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The European Baseline Series. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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12
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Aalto-Korte K. Contact Allergy to Protective Gloves. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Patch Testing of Mercaptobenzothiazole and Mercapto Mix: The North American Contact Dermatitis Group Experience, 1994-2016. Dermatitis 2020; 32:232-244. [PMID: 33273233 DOI: 10.1097/der.0000000000000675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Mercapto compounds are a category of rubber accelerators that may cause allergic contact dermatitis. This study characterizes patch test reactions to mercaptobenzothiazole (MBT) and mercapto mix (MM) in a large North American population. METHODS The 1994-2016 North American Contact Dermatitis Group screening series data were analyzed. Patients with allergic reactions to either MBT or MM (mercapto+) were included. The following characteristics were analyzed: strength of reaction, clinical and occupational relevance, coreactivity with other rubber accelerators, and sources of exposure. RESULTS A total of 49,795 patients were tested to mercapto compounds from 1994 to 2016; 633 (1.3%) had positive reactions to MBT and/or MM. The frequency to both MBT and MM significantly decreased over time (P < 0.0001). Mercapto+ patients were significantly more likely to be male, have occupationally related skin disease, and report involvement of the hands and/or feet (P < 0.0001). They were significantly less likely to have face, scalp/ears/neck, or trunk involvement (P ≤ 0.0001). There was significant coreactivity with carba mix (23.4%) and thiuram mix (32.5%). Mercaptobenzothiazole and MM reactions were frequently clinically (81.7% and 83.5%, respectively) and occupationally relevant (29.8% and 33.4%, respectively). Gloves were the most common source (31.3% and 30.9%, respectively). CONCLUSIONS Patch test positivity to mercapto compounds significantly decreased from 1994 to 2016 but remains clinically and occupationally relevant.
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Positive Patch Test Reactions to Carba Mix and Thiuram Mix: The North American Contact Dermatitis Group Experience (1994-2016). Dermatitis 2020; 32:173-184. [PMID: 33273217 DOI: 10.1097/der.0000000000000648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/OBJECTIVE This study characterizes concomitant reactions to carba mix (CM) and thiuram mix (TM) in a large North American population. Because thiurams and dithiocarbamates have structural similarity, concomitant reactions are expected. METHODS The 1994-2016 North American Contact Dermatitis Group data were analyzed. Patients with a final reaction interpreted as "allergic" to either CM or TM were included. RESULTS A total of 49,758 patients were tested to both CM and TM. A total of 3437 (6.9%) had positive reactions to CM and/or TM including the following groups: CM+ only (n = 1403, 40.8%), TM+ only (n = 1068, 31.0%), or both (n = 966, 28.1%). A total of 47.5% of TM+ patients were positive to CM and 40.8% of CM+ patients were positive to TM. Male sex, occupationally related dermatitis, and hand involvement were significantly more common in individuals positive to CM and/or TM as compared with those who were negative (P < 0.0001). More than 80% of CM+/TM+ reactions were currently relevant. Gloves were the most common source of CM and TM; clothing and footwear were also frequent. CONCLUSIONS Carba mix and TM remain important, clinically relevant allergens. Although significant concomitant reaction frequency was demonstrated, more than half of the patients reacting to either CM or TM would have been missed if both had not been tested, underscoring the importance of testing to both.
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Uter W, Gefeller O, Mahler V, Geier J. Trends and current spectrum of contact allergy in Central Europe: results of the Information Network of Departments of Dermatology (IVDK) 2007–2018*. Br J Dermatol 2020; 183:857-865. [DOI: 10.1111/bjd.18946] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2020] [Indexed: 12/30/2022]
Affiliation(s)
- W. Uter
- Department of Medical Informatics, Biometry and Epidemiology University of Erlangen/Nürnberg Erlangen Germany
| | - O. Gefeller
- Department of Medical Informatics, Biometry and Epidemiology University of Erlangen/Nürnberg Erlangen Germany
| | - V. Mahler
- Paul Ehrlich Institut Langen Germany
| | - J. Geier
- Information Network of Departments of Dermatology University Medical Center Göttingen Germany
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Are Rubber Gloves Marketed as Accelerator-Free Truly Free of Accelerators? [RETRACTED]. Dermatitis 2020; 31:128-133. [DOI: 10.1097/der.0000000000000508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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The European Baseline Series. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_64-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Allergic Reactions to Rubber Components. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_87-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Aalto-Korte K. Contact Allergy to Protective Gloves. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_74-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Lindberg T, Forreryd A, Bergendorff O, Lindstedt M, Zeller KS. In vitro assessment of mechanistic events induced by structurally related chemical rubber sensitizers. Toxicol In Vitro 2019; 60:144-153. [PMID: 31082492 DOI: 10.1016/j.tiv.2019.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/30/2019] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
Allergic contact dermatitis (ACD) is one of the most common forms of immunotoxicity, and increased understanding of how chemicals trigger these adverse reactions is needed in order to treat or design testing strategies to identify and subsequently avoid exposure to such substances. In this study, we investigated the cellular response induced by rubber chemicals in a dendritic cell (DC) model, focusing on the structurally similar chemicals diethylthiocarbamylbenzothiazole sulfide and dimethylthiocarbamylbenzothiazole sulfide, with regard to regulation of microRNA, and messenger RNA expression. Only a few miRNAs were found to be commonly regulated by both rubber chemicals, among them miR1973, while the overall miRNA expression profiles were diverse. Similarly, out of approximately 500 differentially regulated transcripts for each chemical, about 60% overlapped, while remaining were unique. The pathways predicted to be enriched in the cell model by stimulation with the rubber chemicals were linked to immunological events, relevant in the context of ACD. These results suggest that small structural differences can trigger specific activation of the immune system in response to chemicals. The here presented mechanistic data can be valuable in explaining the immunotoxicological events in DC activation after exposure to skin sensitizing chemicals, and can contribute to understanding, preventing and treating ACD.
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Affiliation(s)
- Tim Lindberg
- Department of Immunotechnology, Medicon Village (406), 22381 Lund, Sweden.
| | - Andy Forreryd
- Department of Immunotechnology, Medicon Village (406), 22381 Lund, Sweden.
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, 20502 Malmö, Sweden.
| | - Malin Lindstedt
- Department of Immunotechnology, Medicon Village (406), 22381 Lund, Sweden.
| | - Kathrin S Zeller
- Department of Immunotechnology, Medicon Village (406), 22381 Lund, Sweden.
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21
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Gloves. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_74-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Hand dermatitis is a common condition with a lifetime prevalence of 20%. Glove allergic contact dermatitis (ACD) is a very important dermatitis affecting health care workers, hairdressers, cleaning personnel, kitchen workers, craftsmen, construction workers, laboratory workers, and homemakers. Occupationally related cases may be severe and can result in significant disability. Glove ACD is most commonly due to exposure to rubber accelerators, which are compounds that are added to rubber during production to increase strength and durability. Given the known allergic potential of these compounds, glove manufacturing companies have reformulated gloves leading to the introduction of new rubber allergens. In this review, we will discuss risk factors for glove ACD, both common and uncommon allergens in gloves, common contact allergens that permeate gloves, and patch testing to help uncover the inciting allergen(s).
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Hamnerius N, Svedman C, Bergendorff O, Björk J, Bruze M, Engfeldt M, Pontén A. Hand eczema and occupational contact allergies in healthcare workers with a focus on rubber additives. Contact Dermatitis 2018; 79:149-156. [PMID: 29923205 DOI: 10.1111/cod.13042] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hand eczema (HE) in healthcare workers (HCWs) is common. Besides wet work, healthcare work also implies exposure to contact allergens. OBJECTIVES To assess HE and contact allergy related to occupational exposures in HCWs. METHODS In a cross-sectional study, 311 HCWs with HE within the preceding 12 months and a control group of 114 HCWs without HE were investigated with the baseline series and a special patch test series based on substances found in the gloves, soaps, alcoholic hand disinfectants and hand creams provided at the hospitals. RESULTS Contact allergy to rubber additives was significantly more common in HCWs with HE (6%) than in HCWs without HE (1%, P = .02). The corresponding percentages for fragrances were 11% and 3%, respectively (P = .004). Occupational HE was found in 193 of 311 (62%) HCWs. Of these, 22 of 193 (11%) had occupational allergic contact dermatitis, including 17 with glove-related rubber contact allergy. Contact allergy to diphenylguanidine was as common as contact allergy to thiurams. Occupational contact allergy to rubber additives was significantly associated with sick-leave related to HE. CONCLUSION Contact allergy to rubber additives in medical gloves is the most common cause of occupational allergic contact dermatitis in HCWs. Aimed patch testing with relevant rubber additives is mandatory when HE in HCWs is investigated.
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Affiliation(s)
- Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jonas Björk
- Department of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ann Pontén
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Brans R, Schröder-Kraft C, Skudlik C, John SM, Geier J. Tertiary prevention of occupational skin diseases: Prevalence of allergic contact dermatitis and pattern of patch test results. Contact Dermatitis 2018; 80:35-44. [DOI: 10.1111/cod.13098] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/11/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Richard Brans
- Department of Dermatology; Environmental Medicine and Health Theory, University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Osnabrück Germany
- Lower-Saxonian Institute of Occupational Dermatology at the Georg-August University, Göttingen, Germany, and at the University of Osnabrück; Osnabrück Germany
| | - Claudia Schröder-Kraft
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), BG Hospital Hamburg; Hamburg Germany
| | - Christoph Skudlik
- Department of Dermatology; Environmental Medicine and Health Theory, University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Osnabrück Germany
- Lower-Saxonian Institute of Occupational Dermatology at the Georg-August University, Göttingen, Germany, and at the University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), BG Hospital Hamburg; Hamburg Germany
| | - Swen M. John
- Department of Dermatology; Environmental Medicine and Health Theory, University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Osnabrück Germany
- Lower-Saxonian Institute of Occupational Dermatology at the Georg-August University, Göttingen, Germany, and at the University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), BG Hospital Hamburg; Hamburg Germany
| | - Johannes Geier
- Lower-Saxonian Institute of Occupational Dermatology at the Georg-August University, Göttingen, Germany, and at the University of Osnabrück; Osnabrück Germany
- Information Network of Departments of Dermatology (IVDK), Georg-August University; Göttingen Germany
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Dittmar D, Uter W, Bauer A, Fortina AB, Bircher AJ, Czarnecka‐Operacz M, Dugonik A, Elsner P, Gallo R, Ghaffar SA, Giménez‐Arnau A, Johnston GA, Kręcisz B, Filon FL, Rustemeyer T, Sadowska‐Przytocka A, Sánchez‐Pérez J, Schnuch A, Simon D, Spiewak R, Spring P, Corradin MT, Valiukevičienė S, Vok M, Weisshaar E, Wilkinson M, Schuttelaar ML, Aberer W, Ballmer‐Weber B, Grabbe J, Beiteke U, Brasch J, Fuchs T, John SM, Mahler V, Pesonen M, Jolanki R, Rantanen T, Armario‐Hita JC, Fernández‐Redondo V, García‐Gavín J, Mercader P, Ruiz I, Silvestre JF, Balato A, Ayala F, Peserico A, Sliuziaviciene G, Kieć‐Świerczyńska M, Kmecl T, Pandurovic MK, Kecelj N, Lunder T, Simončič Godnič M, Chowdhury MMU, Cooper SM, English JSC, Cousen P, Horne HL, Gawkrodger DJ, Holden C, Sabroe R, Green CM, King CM, Ormerod AD, Samson JE, Statham B, Stone N, White I. European Surveillance System on Contact Allergies (ESSCA): polysensitization, 2009–2014. Contact Dermatitis 2018; 78:373-385. [DOI: 10.1111/cod.12966] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/14/2017] [Accepted: 12/18/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Daan Dittmar
- University of Groningen, University Medical Centre GroningenDepartment of Dermatology 9700 RB Groningen The Netherlands
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and EpidemiologyUniversity of Erlangen/Nürnberg 91054 Erlangen Germany
| | - Andrea Bauer
- Department of DermatologyUniversity Allergy Centre, University Hospital Carl Gustav Carus, Technical University of Dresden 01307 Dresden Germany
| | - Ana B. Fortina
- Dermatology Unit, Department of PaediatricsUniversity of Padova 35137 Padova Italy
| | - Andreas J. Bircher
- Allergy Unit, Department of DermatologyUniversity Hospital 4031 Basel Switzerland
| | | | - Aleksandra Dugonik
- Department of DermatologyUniversity Medical Centre Maribor 2000 Maribor Slovenia
| | - Peter Elsner
- Department of DermatologyUniversity Hospital Jena 07743 Jena Germany
| | - Rosella Gallo
- Section of Dermatology, DISSAL – Department of Health SciencesUniversity of Genoa 16132 Genoa Italy
| | - Sharizan A. Ghaffar
- Department of DermatologyNinewells Hospital and Medical School Dundee DD1 9SY UK
| | - Anna Giménez‐Arnau
- Department of DermatologyHospital del Mar. Universitat Autònoma and Pompeu Fabra 08003 Barcelona Spain
| | - Graham A. Johnston
- Department of DermatologyLeicester Royal Infirmary Leicester, LE1 5WW, UK
| | - Beata Kręcisz
- Faculty of Medicine and Health ScienceThe Jan Kochanowski University 25‐317 Kielce Poland
| | | | - Thomas Rustemeyer
- Department of DermatologyFree University of Amsterdam 1081 HV Amsterdam The Netherlands
| | | | - Javier Sánchez‐Pérez
- Dermatology DepartmentHospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS‐IP) 28006 Madrid Spain
| | - Axel Schnuch
- Information Network of Departments of Dermatology at the University of Göttingen 37075 Göttingen Germany
| | - Dagmar Simon
- Department of DermatologyInselspital, Bern University Hospital, University of Bern 3010 Bern Switzerland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and CosmetologyJagiellonian University Medical College 30‐688 Krakow Poland
| | - Philipp Spring
- Department of DermatologyCentre Hospitalier Universitaire Vaudois 1011 Lausanne Switzerland
| | - Maria T. Corradin
- Department of DermatologyHospital of Pordenone 33170 Pordenone Italy
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal DiseasesLithuanian University of Health Sciences 44307 Kaunas Lithuania
- Lithuanian University of Health Sciences Hospital 50009 Kaunas Lithuania
| | - Marko Vok
- Dermatovenerološka ambulanta 6310 Izola Slovenia
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental DermatologyUniversity Hospital Heidelberg 69117 Germany
| | - Mark Wilkinson
- Dermatology, Leeds Teaching Hospitals NHS Trust Leeds LS7 4SA UK
| | - Marie L. Schuttelaar
- University of Groningen, University Medical Centre GroningenDepartment of Dermatology 9700 RB Groningen The Netherlands
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Crepy MN, Lecuen J, Ratour-Bigot C, Stocks J, Bensefa-Colas L. Accelerator-free gloves as alternatives in cases of glove allergy in healthcare workers. Contact Dermatitis 2018; 78:28-32. [PMID: 28748553 DOI: 10.1111/cod.12860] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/15/2017] [Accepted: 06/18/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Accelerators in rubber gloves constitute an important group of contact allergens, particularly in healthcare workers. OBJECTIVES To assess the efficacy of accelerator-free medical gloves in the secondary prevention of allergic contact dermatitis caused by rubber accelerators in healthcare workers. METHODS Nine healthcare workers with hand eczema were advised to use accelerator-free rubber gloves after a diagnosis of allergic contact dermatitis caused by rubber accelerators. RESULTS Switching from conventional medical single-use gloves containing accelerators to accelerator-free medical gloves led to improvement in all cases, and more than two-thirds of the patients were completely free of symptoms. CONCLUSION The use of accelerator-free medical gloves can be an effective alternative in healthcare workers who are allergic to rubber accelerators.
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Affiliation(s)
- Marie-Noëlle Crepy
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, 75004 Paris, France
| | - Jérome Lecuen
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, 75004 Paris, France
| | - Carole Ratour-Bigot
- Department of Dermatology, University Hospital of Centre of Paris, Cochin Hospital, AP-HP, 75014 Paris, France
| | - Jill Stocks
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Lynda Bensefa-Colas
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, 75004 Paris, France.,Paris Descartes University, Sorbonne Paris Cité, EA 4064, Laboratoire Santé Publique et Environnement, 75006 Paris, France
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28
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Wilkinson M, Gallo R, Goossens A, Johansen JD, Rustemeyer T, Sánchez-Pérez J, Schuttelaar ML, Uter W. A proposal to create an extension to the European baseline series. Contact Dermatitis 2017; 78:101-108. [PMID: 29194657 DOI: 10.1111/cod.12918] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/04/2017] [Accepted: 09/29/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND The current European baseline series consists of 30 allergens, and was last updated in 2015. OBJECTIVES To use data from the European Surveillance System on Contact Allergies (ESSCA) to propose an extension to the European baseline series in response to changes in environmental exposures. METHODS Data from departmental and national extensions to the baseline series, together with some temporary additions from departments contributing to the ESSCA, were collated during 2013-2014. RESULTS In total, 31689 patients were patch tested in 46 European departments. Many departments and national groups already consider the current European baseline series to be a suboptimal screen, and use their own extensions to it. The haptens tested are heterogeneous, although there are some consistent themes. Potential haptens to include in an extension to the European baseline series comprise sodium metabisulfite, formaldehyde-releasing preservatives, additional markers of fragrance allergy, propolis, Compositae mix, and 2-hydroxyethyl methacrylate. CONCLUSION In combination with other published work from the ESSCA, changes to the current European baseline series are proposed for discussion. As well as addition of the allergens listed above, it is suggested that primin and clioquinol should be deleted from the series, owing to reduced environmental exposure.
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Affiliation(s)
- Mark Wilkinson
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, LS7 4SA, UK
| | - Rosella Gallo
- Clinica Dermatologica, Department of Health Sciences (DiSSAL), Università di Genova, Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - An Goossens
- Contact Allergy Unit, Department of Dermatology, University Hospital KU Leuven, 3000, Leuven, Belgium
| | - Jeanne D Johansen
- Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark
| | - Thomas Rustemeyer
- Department of Dermatology, Free University of Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | | | - Marie L Schuttelaar
- Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9713 GZ, Groningen, The Netherlands
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054, Erlangen, Germany
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Hulstaert E, Bergendorff O, Persson C, Goossens A, Gilissen L, Engfeldt M, Bruze M, Schuttelaar ML, Meijer JM, Lapeere H. Contact dermatitis caused by a new rubber compound detected in canvas shoes. Contact Dermatitis 2017; 78:12-17. [DOI: 10.1111/cod.12886] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 08/12/2017] [Accepted: 08/15/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Eva Hulstaert
- Department of Dermatology; University Hospital Gent; 9000, Ghent Belgium
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology; Lund University, Skåne University Hospital; 205 02, Malmö Sweden
| | - Christina Persson
- Department of Occupational and Environmental Dermatology; Lund University, Skåne University Hospital; 205 02, Malmö Sweden
| | - An Goossens
- Department of Dermatology; University Hospital KU Leuven; 3000, Leuven Belgium
| | - Liesbeth Gilissen
- Department of Dermatology; University Hospital KU Leuven; 3000, Leuven Belgium
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology; Lund University, Skåne University Hospital; 205 02, Malmö Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology; Lund University, Skåne University Hospital; 205 02, Malmö Sweden
| | - Marie L. Schuttelaar
- Department of Dermatology; University of Groningen, University Medical Centre Groningen; 9700 RB, Groningen The Netherlands
| | - Joost M. Meijer
- Department of Dermatology; University of Groningen, University Medical Centre Groningen; 9700 RB, Groningen The Netherlands
| | - Hilde Lapeere
- Department of Dermatology; University Hospital Gent; 9000, Ghent Belgium
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Schuttelaar ML, Meijer JM, Engfeldt M, Lapeere H, Goossens A, Bruze M, Persson C, Bergendorff O. Allergic contact dermatitis caused by dimethylthiocarbamylbenzothiazole sulfide (DMTBS) in canvas shoes: in search of the culprit allergen. Contact Dermatitis 2017; 78:7-11. [DOI: 10.1111/cod.12857] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/05/2017] [Accepted: 06/07/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Marie L. Schuttelaar
- Department of Dermatology; University of Groningen, University Medical Centre Groningen; 9700 RB Groningen The Netherlands
| | - Joost M. Meijer
- Department of Dermatology; University of Groningen, University Medical Centre Groningen; 9700 RB Groningen The Netherlands
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology; Lund University, Skåne University Hospital; 205 02 Malmö Sweden
| | - Hilde Lapeere
- Department of Dermatology; Ghent University Hospital; 9000 Ghent Belgium
| | - An Goossens
- Department of Dermatology; University Hospital KU Leuven; 3000 Leuven Belgium
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology; Lund University, Skåne University Hospital; 205 02 Malmö Sweden
| | - Christina Persson
- Department of Occupational and Environmental Dermatology; Lund University, Skåne University Hospital; 205 02 Malmö Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology; Lund University, Skåne University Hospital; 205 02 Malmö Sweden
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Warburton KL, Uter W, Geier J, Spiewak R, Mahler V, Crépy MN, Schuttelaar ML, Bauer A, Wilkinson M. Patch testing with rubber series in Europe: a critical review and recommendation. Contact Dermatitis 2016; 76:195-203. [DOI: 10.1111/cod.12736] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/26/2016] [Accepted: 10/27/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen/Nürnberg; 91054 Erlangen Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK); University Medical Centre; 37075 Goettingen Germany
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology; Jagiellonian University Medical College; 30-688 Krakow Poland
| | - Vera Mahler
- Department of Dermatology; University Hospital of Erlangen; 91054 Erlangen Germany
| | - Marie-Noëlle Crépy
- Department of Occupational Diseases, Centre Hôtel-Dieu, AP-HP; Paris University Hospital; 75004 Paris France
| | - Marie Louise Schuttelaar
- Department of Dermatology; University Medical Centre Groningen, University of Groningen; 9713 GZ Groningen The Netherlands
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, University Hospital Carl Gustav Carus; Technical University Dresden; 01307 Dresden Germany
| | - Mark Wilkinson
- Department of Dermatology; Chapel Allerton Hospital; Leeds LS7 4SA UK
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Forreryd A, Zeller KS, Lindberg T, Johansson H, Lindstedt M. From genome-wide arrays to tailor-made biomarker readout – Progress towards routine analysis of skin sensitizing chemicals with GARD. Toxicol In Vitro 2016; 37:178-188. [DOI: 10.1016/j.tiv.2016.09.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 09/09/2016] [Indexed: 11/28/2022]
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Aalto-Korte K, Pesonen M. Patterns of simultaneous patch test reactions to thiurams and dithiocarbamates in 164 patients. Contact Dermatitis 2016; 75:353-357. [DOI: 10.1111/cod.12687] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/03/2016] [Accepted: 08/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Kristiina Aalto-Korte
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); 00250 Helsinki Finland
| | - Maria Pesonen
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); 00250 Helsinki Finland
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Sensitization to Rubber Accelerators in Northeastern Italy: The Triveneto Patch Test Database. Dermatitis 2016; 27:222-6. [DOI: 10.1097/der.0000000000000205] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bauer A, Geier J, Mahler V, Uter W. [Contact allergies in the German workforce : Data of the IVDK network from 2003-2013]. Hautarzt 2016; 66:652-64. [PMID: 26228172 DOI: 10.1007/s00105-015-3660-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND In Germany, occupational skin diseases rank first in the occupational skin disease statistics for many years. Especially, occupationally acquired contact allergies as well as multi-sensitization are the most important predictors for a poor prognosis and persistent eczema. OBJECTIVES To update the spectrum and sensitization frequencies of most frequent allergens from the standard series in Germany in patients with occupationally acquired type IV sensitizations in general and within different occupational groups. METHODS Data of all employed patients (age range: 16-68 years, n = 14234) patch tested between 2003 and 2013 in the German Departments of the Information Network of Departments of Dermatology (IVDK) and diagnosed occupationally acquired contact dermatitis after patch testing were analyzed. The control group was composed of all other patients (n = 31706) within the same time frame, in which occupationally acquired allergic contact dermatitis was negated explicitly. RESULTS The prevalence Ratio (PR; indicating risk) was significantly increased for: Thiuram-mix (PR 5.63 95 %CI 4.97-6.4), zinkdiethyldithiocarbamate (PR 6.22 95 %CI 4.76-8.22), mercaptobenzothiazole (MBT) (PR 3.88 95 %CI 3.09-4.89), mercapto-mix without MBT (PR 3.23 95 %CI 2.59-4.03), N-isopropyl-N'-phenyl-p-phenylene diamine (IPPD) (PR 2.3195 %CI 1.87-2.86), epoxy resin (PR 2.82 95 %CI 2.45-3.25), chloromethylisothiazolinone/methylisothiazolinone (MCI/MI) (PR 2.19 95 %CI 1.97-2.42) and compositae mix II (PR 2.05 95 %CI 1.45-2.89). They were the predominant occupational allergens and were at least associated with a doubled risk (PR ≥ 2.0) for acquiring occupationally allergic contact dermatitis. The highest risk increase was identified in employees in the health services, in agriculture, metal industry, food and service industry as well as building trades CONCLUSIONS A limited number of occupationally relevant allergens cause the majority of sensitizations in the workforce, if standard series allergens are concerned. Data analysis of national and international contact allergy data bases provide valuable information on sensitization rates and profiles in skin risk occupations to implement targeted prevention strategies. To diagnose occupational allergic contact dermatitis in individual cases additional testing of occupation related patch test series as well as patients' own products is commonly inevitable.
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Affiliation(s)
- A Bauer
- Klinik und Poliklinik für Dermatologie, UniversitätsAllergieZentrum, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - J Geier
- Informationsverbund Dermatologischer Kliniken (IVDK), Universitätsmedizin Göttingen, Georg-August Universität Göttingen, Göttingen, Deutschland
| | - V Mahler
- Hautklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen/Nürnberg, Erlangen, Deutschland
| | - W Uter
- Institut für Medizininformatik, Biometrie und Epidemiologie, Friedrich-Alexander Universität Erlangen/Nürnberg, Erlangen, Deutschland
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Schwensen JF, Bregnbak D, Johansen JD. Recent trends in epidemiology, sensitization and legal requirements of selected relevant contact allergens. Expert Rev Clin Immunol 2015; 12:289-300. [DOI: 10.1586/1744666x.2016.1120159] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jakob F. Schwensen
- National Allergy Research Centre, Department of Dermato-Allergology, Gentofte University Hospital, Hellerup, Denmark
| | - David Bregnbak
- National Allergy Research Centre, Department of Dermato-Allergology, Gentofte University Hospital, Hellerup, Denmark
| | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermato-Allergology, Gentofte University Hospital, Hellerup, Denmark
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Frosch PJ, Mahler V, Uter W. Dihydroxydiphenyl - a historical rubber contact allergen? Contact Dermatitis 2015; 73:377-80. [PMID: 26234388 DOI: 10.1111/cod.12459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Peter J Frosch
- Department of Dermatology, University of Witten/Herdecke and Klinikum Dortmund (formerly), 44137, Dortmund, Germany
| | - Vera Mahler
- Allergy Unit, Department of Dermatology, University Hospital Erlangen, 91054, Erlangen, Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nürnberg, 91054, Erlangen, Germany
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Pesonen M, Jolanki R, Larese Filon F, Wilkinson M, Kręcisz B, Kieć-Świerczyńska M, Bauer A, Mahler V, John SM, Schnuch A, Uter W. Patch test results of the European baseline series among patients with occupational contact dermatitis across Europe - analyses of the European Surveillance System on Contact Allergy network, 2002-2010. Contact Dermatitis 2015; 72:154-63. [DOI: 10.1111/cod.12333] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 11/17/2014] [Accepted: 11/17/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Pesonen
- Occupational Medicine; Finnish Institute of Occupational Health; Topeliuksenkatu 41 a A, 00250 Helsinki Finland
| | - Riitta Jolanki
- Occupational Medicine; Finnish Institute of Occupational Health; Topeliuksenkatu 41 a A, 00250 Helsinki Finland
| | - Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medicine and Public Health; University of Trieste; Via della Pietà 19, 34129 Trieste Italy
| | - Mark Wilkinson
- Department of Dermatology; The Leeds Teaching Hospitals NHS Trust; Harehills Lane, Leeds LS7 4SA UK
| | - Beata Kręcisz
- Department of Allergology and Environmental Health; Nofer Institute of Occupational Medicine; 8 Teresy Street, 91-348 Lodz Poland
| | - Marta Kieć-Świerczyńska
- Department of Allergology and Environmental Health; Nofer Institute of Occupational Medicine; 8 Teresy Street, 91-348 Lodz Poland
| | - Andrea Bauer
- Department of Dermatology; University Allergy Centre, University Hospital Carl Gustav Carus, Technical University Dresden; Fetscherstraße 74, D-01307 Dresden Germany
| | - Vera Mahler
- Department of Dermatology; University Hospital Erlangen; Ulmenweg 18, D-91054 Erlangen Germany
| | - Swen M. John
- Department of Dermatology; Environmental Medicine and Health Theory, University of Osnabrueck; Sedanstrasse 115, 49069 Osnabrueck Germany
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK); University of Göttingen; von-Sieboldstr. 3, D-37075 Göttingen Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen/Nürnberg; Waldstr. 6, D-91054 Erlangen Germany
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Molin S, Bauer A, Schnuch A, Geier J. Occupational contact allergy in nurses: results from the Information Network of Departments of Dermatology 2003-2012. Contact Dermatitis 2014; 72:164-71. [DOI: 10.1111/cod.12330] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 10/28/2014] [Accepted: 11/16/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Sonja Molin
- Department of Dermatology and Allergy; Ludwig Maximilian University; Frauenlobstr. 9-11 80337 Munich Germany
| | - Andrea Bauer
- Department of Dermatology; University Hospital Carl Gustav Carus, Technical University Dresden; Fetscherstraße 74 01307 Dresden Germany
| | - Axel Schnuch
- Information Network of Departments of Dermatology; Georg-August University; von-Sieboldstr. 3 37075 Göttingen Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology; Georg-August University; von-Sieboldstr. 3 37075 Göttingen Germany
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