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Rigali S, Cozzi C, Liszewski W. Identification of the pigments used in permanent makeup and their ability to elicit allergic contact dermatitis. J Am Acad Dermatol 2024; 91:474-479. [PMID: 38825076 DOI: 10.1016/j.jaad.2024.05.067] [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: 03/04/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Decorative tattoos are known to contain ingredients that may elicit allergic contact dermatitis; it is less well-known if permanent makeup pigments carry the same risk. OBJECTIVE Identify pigments used in permanent makeup inks sold in the United States and review cases of allergic contact dermatitis to these pigments. METHODS Using internet searches, permanent makeup inks sold in the United States were identified. Safety data sheets were used to catalog pigments used in permanent makeup. A subsequent literature search was performed to identify cases of allergic contact dermatitis to these pigments. RESULTS A total of 974 permanent makeup inks were reviewed, and 79 unique pigments were identified. The average product contained 4 pigments. Twenty of the pigments were inorganic metals, including carbon, iron, chromium, manganese, and molybdenum. Fifty-nine pigments were organic, of which most were azo, quinacridone, or anthraquinone dyes. A literature search revealed that 10 of the 79 pigments were associated with allergic contact dermatitis. CONCLUSION Permanent makeup primarily uses organic pigments, although some metallic pigments are still used. Physicians should also be aware that some of these pigments-both organic and inorganic-are known causes of allergic contact dermatitis. Of note, patch testing to these ingredients can be negative.
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Affiliation(s)
- Sarah Rigali
- Rosalind Franklin University, Chicago Medical School, North Chicago, Illinois.
| | - Cameron Cozzi
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, North Chicago, Illinois
| | - Walter Liszewski
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, North Chicago, Illinois
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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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Critchley E, Pemberton MN. The use of latex and non-latex gloves and dental equipment in UK and Irish dental hospitals. Br Dent J 2021:10.1038/s41415-021-3330-3. [PMID: 34489545 DOI: 10.1038/s41415-021-3330-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/09/2020] [Indexed: 11/08/2022]
Abstract
Aim To identify glove usage within UK and Ireland dental hospitals as well as the use of latex- and non-latex-containing dental equipment.Method A self-completed questionnaire was disseminated to 16 dental hospitals in the summer of 2017. The survey concerned their current use of latex and non-latex gloves and dental equipment. In addition, information was sought regarding any problems associated with non-latex and latex gloves.Results The questionnaire response rate was 13/16 (81%), of which 100% reported the use of non-latex examination gloves. The majority were using nitrile gloves. Twelve of the 13 dental hospitals would use examination gloves for simple extractions and 11 would use sterile gloves for minor oral surgery. In ten hospitals (77%), the sterile gloves were always non-latex, and again, the majority were nitrile. Latex-containing dental equipment including orthodontic bands, prophylactic polishing cups and dental dam was still being used within some dental hospitals, but to a much lesser extent than non-latex.Conclusion All dental hospitals were using latex-free examination gloves and were showing a move towards latex-free dental equipment. This usage is comparable to what has been seen in general dental practice and follows the trend towards latex-free dentistry.
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Affiliation(s)
- Emma Critchley
- Speciality Registrar Special Care Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M15 6FH, UK.
| | - Michael N Pemberton
- Consultant in Oral Medicine, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M15 6FH, UK
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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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Critchley E, Pemberton MN. Latex and synthetic rubber glove usage in UK general dental practice: changing trends. Heliyon 2020; 6:e03889. [PMID: 32405551 PMCID: PMC7210590 DOI: 10.1016/j.heliyon.2020.e03889] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/25/2019] [Accepted: 04/28/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives To evaluate the current routine use of latex gloves and latex containing dental dam in UK general dental practice. Methods A questionnaire was disseminated to 89 general dental practitioners (GDPs) in June 2017. The survey concerned their current, routine use of latex gloves and latex-containing dental dam in general dental practice. In addition, monthly sales figures of gloves classified by material, were obtained from a UK dental supply company, for 2015–2017. Results The questionnaire response rate was 84 (94%), of whom 90% reported using non-latex (non-sterile examination) gloves for their routine dentistry. The majority were using nitrile gloves. All GDPs surveyed would use examination gloves for routine extractions, and 76% would use examination gloves for surgical extractions. The majority (75%) reported using non-latex dental dam. Sales of nitrile gloves were significantly higher than for latex gloves, with a continuing trend in the reduction in volume of sales of latex gloves. Conclusion The majority of GDP's now routinely use non-latex containing gloves and dental dam in their clinical dentistry. Nitrile gloves are predominantly used. Examination gloves are used for straightforward extractions, with many practitioners also using them for minor oral surgery. Sales of latex containing gloves are continuing to decrease. Clinical significance The routine use of latex-containing products in UK dental practice is low and likely to reduce further, with on-going benefit for the dental practitioner, latex allergic patients and prevalence of latex allergy in the general population.
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Affiliation(s)
- Emma Critchley
- University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK
| | - Michael N Pemberton
- University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK
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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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Dejonckheere G, Herman A, Baeck M. Allergic contact dermatitis caused by synthetic rubber gloves in healthcare workers: Sensitization to 1,3-diphenylguanidine is common. Contact Dermatitis 2019; 81:167-173. [PMID: 30891769 DOI: 10.1111/cod.13269] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The frequency of allergic contact dermatitis has significantly increased in healthcare workers since the transition from latex to synthetic rubber gloves, with 1,3-diphenylguanidine being identified as the most frequently implicated allergen. OBJECTIVES To highlight the role of 1,3-diphenylguanidine as the culprit allergen in contact allergies to synthetic rubber gloves, to propose recommendations for patch testing, and to discuss alternatives for sensitized subjects. MATERIALS AND METHODS Patch test data from healthcare workers who developed hand dermatitis after wearing rubber gloves and who reacted positively to glove samples and rubber additives were collected from September 2010 to December 2017 in a Belgian hospital. RESULTS A total of 44 caregivers were included in this study. Patch tests showed that: (a) 84% of the study population reacted positively to carba mix; (b) 86% reacted positively to 1,3-diphenylguanidine; and (c) 13 (30%) reacted positively to thiuram mix. Half of the subjects reacted positively to gloves containing 1,3-diphenylguanidine, whereas none reacted to accelerator-free gloves. CONCLUSION The most commonly identified allergen was 1,3-diphenylguanidine, far ahead of thiurams, which were previously described as the most sensitizing accelerators. The use of 1,3-diphenylguanidine-free gloves is recommended. No subject reacted to gloves without accelerators, thus confirming their efficiency among accelerator-sensitized patients. We recommend that 1,3-diphenylguanidine be added to the European baseline series.
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Affiliation(s)
- Guillaume Dejonckheere
- Department of Dermatology, Cliniques universitaires Saint-Luc, Brussels, Belgium and IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | - Anne Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Brussels, Belgium and IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Brussels, Belgium and IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, Dermatologie, Université Catholique de Louvain, Brussels, Belgium
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Pigments in American tattoo inks and their propensity to elicit allergic contact dermatitis. J Am Acad Dermatol 2019; 81:379-385. [DOI: 10.1016/j.jaad.2019.01.078] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 01/16/2019] [Accepted: 01/30/2019] [Indexed: 11/19/2022]
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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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Uter W, Werfel T, White IR, Johansen JD. Contact Allergy: A Review of Current Problems from a Clinical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061108. [PMID: 29844295 PMCID: PMC6025382 DOI: 10.3390/ijerph15061108] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/20/2018] [Accepted: 05/26/2018] [Indexed: 12/17/2022]
Abstract
Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054 Erlangen, Germany.
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, 30625 Hannover, Germany.
| | - Ian R White
- St John's Institute of Dermatology, Guy's Hospital, London SE1 9RT, UK.
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark.
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Wilke A, Skudlik C, Sonsmann FK. Individualprävention beruflicher Kontaktekzeme: Schutzhandschuhe und Hautschutzempfehlungen im berufsgenossenschaftlichen Heilverfahren. DER HAUTARZT 2018; 69:449-461. [DOI: 10.1007/s00105-018-4170-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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