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

Final Report on the Safety Assessment of Sodium p -Chloro- m -Cresol, p -Chloro- m -Cresol, Chlorothymol, Mixed Cresols, m -Cresol, o -Cresol, p -Cresol, Isopropyl Cresols, Thymol, o -Cymen-5-ol, and Carvacrol1

Sodium p -Chloro- m -Cresol, p -Chloro- m -Cresol (PCMC), Mixed Cresols, m -Cresol, o -Cresol, p -Cresol, Isopropyl Cresols, Thymol, Chlorothymol, o -Cymen-5-ol, and Carvacrol are substituted phenols used as cosmetic biocides/preservatives and/or fragrance ingredients. Only PCMC, Thymol, and o -Cymen-5-ol are reported to be in current use, with the highest concentration of use at 0.5% for o -Cymen-5-ol in perfumes. The use of PCMC in cosmetics is restricted in Europe and Japan. Cresols can be absorbed through skin, the respiratory tract, and the digestive tract; metabolized by the liver; and excreted by the kidney as glucuronide and sulfate metabolites. Several of these cresols increase the dermal penetration of other agents, including azidothymidine. In acute oral toxicity studies, LD50 values were in the 200 to 5000 mg/kg day-1 range across several species. In short-term studies in rats and mice, an o -Cresol, m -Cresol, p -Cresol or m -Cresol/ p -Cresol mixture at 30,000 ppm in the diet produced increases in liver and kidney weights, deficits in liver function, bone marrow hypocellularity, irritation to the gastrointestinal tract and nasal epithelia, and atrophy of female reproductive organs. The no observed effect levels (NOEL) of o -Cresol was 240 mg/kg in mink and 778 mg/kg in ferrets in short-term feeding studies, with no significant dose-related toxicity (excluding body weight parameters). In mice, 0.5% p -Cresol, but neither m -Cresol nor o -Cresol, caused loss of pigmentation. Short-term and subchronic oral toxicity tests performed with various cresols using mice, rats, hamsters, and rabbits resulted in no observed adverse effect levels (NOAELs) for mice of 625 ppm and rats of 50 mg/kg day -1, although the NOEL was 2000 ppm ina chronic study using rats. In rabbits, 160 mg/kg PCMC was found to produce irritation and erythema, but no systemic effects. Hamsters dosed with 1.5% p -Cresol in diet for 20 weeks had a greater incidence of mild and moderate forestomach hyperplasia as compared to the control. Acute inhalation toxicity studies using rats yielded LC50 values ranging from > 20 mg/m3 for o -Cresol to > 583 mg/m3 for PCMC. No deaths were recorded in mice given o -Cresol at 50 mg/m3. Cats exposed (short-term) to 9 to 50 mg/m3 of o -Cresol developed inflammation and irritation of the upper respiratory tract, pulmonary edema, and hemorrhage and perivascular sclerosis in the lungs. Rats exposed (subchronic) to o -Cresol at 9 mg/m3 had changes in leukocytes, spinal cord smears, nervous activity, liver function, blood effects, clinical signs, and neurological effects. In guinea pigs, exposure to 9 mg/m3 produced changes in hemoglobin concentrations and electrocardiograms (EKGs). Rats exposed (subchronic) to 0.05 mg/m3 Mixed Cresols by inhalation exhibited central nervous system (CNS) excitation, denaturation of lung protein, and decreased weight gain. All cresols appear to be ocular irritants. Numerous sensitization studies have been reported and most positive reactions were seen with higher concentrations of Cresol ingredients. Developmental toxicity is seen in studies of m -Cresol, o -Cresol, and p -Cresol, but only at maternally toxic levels. In a reproductive toxicity study of a mixture of m -Cresol and p -Cresol using mice under a continuous breeding protocol, 1.0% caused minimal adult reproductive and significant postnatal toxicity in the presence of systemic maternal toxicity. The o -Cresol NOAEL was 0.2% for both reproductive and general toxicity in both generations. Cresol ingredients were generally nongenotoxic in bacterial, fruit fly, and mammalian cell assays. Thymol did not induce primary lung tumors in mice. No skin tumors were found in mice exposed dermally to m -Cresol, o -Cresol, or p -Cresol for 12 weeks. In the tryphan blue exclusion assay, antitumor effects were observed for Thymol and Carvacrol. Clinical patch testing with 2% PCMC may produce irritant reactions, particularly in people with multiple patch test reactions, that are misinterpreted as allergic responses. o -Cresol, p -Cresol, Thymol, Carvacrol, and o -Cymen-5-ol caused no dermal irritation at or above use concentrations. In two predictive patch tests, PCMC did not produce a sensitization reaction. Overall, these ingredients are not significant sensitizing or photosensitizing agents. The Cosmetic Ingredient Review (CIR) Expert Panel noted some of these ingredients may increase the penetration of other cosmetic ingredients and advised cosmetic formulators to take this into consideration. The CIR Expert Panel concluded that the toxic effects of these ingredients are observed at doses higher than would be available from cosmetics. A concentration limitation of 0.5% was chosen to ensure the absence of a chemical leukoderma effect. For p -Cresol and Mixed Cresols (which contain p -Cresol), the Panel considered that the available data are insufficient to support the safety of these two ingredients in cosmetics. Studies that would demonstrate no chemical leukoderma at concentrations of use of p -Cresol and Mixed Cresols, or would demonstrate a dose response from which a safe concentration could be derived, are needed.

4: Final Report on the Safety Assessment of Hydroquinone and Pyrocatechol

Hydroquinone and Pyrocatechol, two benzenediol isomers, are used as couplers in oxidative hair dyes at concentrations of less than 1.0%. Both compounds are absorbed from the gastrointestinal tract; Pyrocatechol is also readily absorbed through the skin. Both compounds are excreted in the urine, mainly as the ethereal sulfate. In acute oral studies Hydroquinone is practically nontoxic to moderately toxic; the data from subchronic feeding studies of Hydroquinone indicated that it was not toxic at 1% but was at higher concentrations. Pyrocatechol was moderately toxic in acute studies. Subchronic oral studies of Pyrocatechol at 0.25% produced hepatic cell hyperplasia in rats. Hydroquinone was a weak depigmenter but not an irritant when tested at 1.0%. Theingredient was a sensitizer when injected at 2.0%. The acute dermal LD50 of Pyrocatechol was 0.8 g/kg. Pyrocatechol did not depigment rabbit skin at 1.0% but did at 3.0%; skin irritation was observed at 5.0%. Guinea pigs were sensitized when Pyrocatechol was injected at concentrations above 0.2 μM. Undiluted product formulation containing 2.0% Hydroquinone produced mild conjunctivitis in 3 of 6 animals; undiluted Pyrocatechol is an extreme ocular irritant.

Hydroquinone was not teratogenic in three separate studies. The results of mutagenesis assays of Hydroquinone varies with the assay system used. In four Salmonella typhimurium strains, both with and without activation, the mutagenesis assay was negative. Hydroquinone produced positive results both with and without activation in the HeLa DNA synthesis test but was not considered mutagenic in assays using Chinese hamster cells. Hydroquinone induced SCE and delayed cell-turnover time in human lymphocyte studies. Oral doses of Hydroquinone did not inhibit testicular DNA synthesis in male mice, and was nonmutagenic in the mouse sperm-head abnormality test. In multigeneration studies with rats, topically applied hair dyes containing 0.2% Hydroquinone had no effect on reproduction; the dye was neither embryotoxic or teratogenic. Dermally applied hair dyes containing Hydroquinone were not carcinogenic. Hydroquinone when applied topically was neither a tumor promoter nor a cocarcinogen in mice. The mutagenicity of Pyrocatechol also varies with the test system used. In most studies, Pyrocatechol was nonmutagenic, both with and without metabolic activation, in the Ames' assay. The compound was negative in the Escherichia coli DNA polymerase assay, but was positive in the yeast, Saccharomyces cerevisiae. Pyrocatechol was negative in the HeLa DNA synthesis test and with Chinese Hamster V79 cells. The compound increased the numbers of chromatid breaks and exchanges in Chinese hamster ovary cells and induced SCE and delayed cell turnover time in human lymphocyte cultures. The compound given by intraperitoneal injection to mice was negative in the sperm-head abnormality test but was positive in the bone marrow assay.

In three studies in mice, topically applied Pyrocatechol was not a tumor promotor. However, topically applied Pyrocatechol was a cocarcinogen for mouse skin in two other studies. Positive sensitization reactions to Hydroquinone were reported in 8.9% of 536 dermatologic patients. Two of 38 patients treated with an ointment containing 5.4% Hydroquinone became sensitized. A cosmetic formulation containing 2% Hydroquinone produced one or more mild irritation reactions in 69 of 90 subjects in the induction phase of a sensitization test; 22 of the 69 subjects were mildly sensitized when challenged. The use of ointments containing 2, 3, and 5% Hydroquinone produced at least minimal depigmentation in white but not black subjects. It is concluded that Hydroquinone and Pyrocatechol are safe for cosmetic use at concentrations of ≤ 1.0% in formulations that are designed for discontinuous, brief use followed by rinsing from the skin and hair.

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.

Upper airway symptoms and function in wood surface coating industry workers

Respiratory and ocular effects from exposure to airborne contaminants in workers employed in the manufacture of wood products using ultraviolet radiation curing (UV) or acid curing (AC) of surface coating were investigated. Surface coating line or finishing workers exclusively employed in one or both processes were compared to a control group. Symptoms of exposure were investigated by questionnaire and medical examination. Nasal, pharyngeal, and ocular symptoms of discomfort, but not lower airway, were common among all exposed groups. These symptoms were most frequent in UV line workers and finishers of UV surface-coated wood products. Mucociliary clearance was significantly slower in UV line workers. Significantly higher olfaction thresholds were observed in UV line and AC line workers and finishers of UV/AC surface-coated wood products. Low levels of organic solvents and coating dusts (composed in part of wood dust, chemical composition unknown) were measured in the workers' breathing zones. Although remarkable improvements have been made in both AC and UV surface coating, additional control measures to eliminate airborne contaminants and improved work practices are required.

Cytotoxic effects of residual chemicals from polymeric biomaterials for artificial soft intraocular lenses

Development of improved hydrogels for soft intraocular lenses, based on 2-hydroxyethyl methacrylate monomer, requires the use of various other monomers and polymerization additives which have potential ocular toxicity. Three monomers, 2-hydroxyethyl methacrylate, methyl methacrylate, and 2-ethoxyethyl methacrylate, as well as two common inhibitors, hydroquinone and 4-methoxyphenol, were subjected to in vitro cytotoxicity assays as aqueous solutions at different concentrations. A new polymerization initiator, 2,2'-azo-bis-(2,4-dimethyl valeronitrile), was thermally decomposed in water at different concentrations and the products were also assayed for cytotoxicity. Assays were based on incubation with human choroidal fibroblasts. Cell death was evaluated by trypan blue dye exclusion, DNA synthesis inhibition, and lactate dehydrogenase tests. While methyl methacrylate and 2-ethoxyethyl methacrylate were found nontoxic, the other chemicals displayed high cytotoxicity. However, when extracts of synthesized poly(2-hydroxyethyl methacrylate) specimens, differentially treated after polymerization, were subjected to the same assays it was found that toxicity from residual 2-hydroxyethyl methacrylate monomer was lost during steam sterilization and storage in water because of the removal of the monomer through aqueous washing. The lack of toxicity in these specimens suggests that residual contents of inhibitor and initiator are too low to cause toxic effects on choroidal fibroblasts. It is concluded that hydrogels have low cytotoxic effects in vitro.

The sensitizing potential of di-(meth)acrylates based on bisphenol A or epoxy resin in the guinea pig

Most composite materials in dentistry used today, contain resins based on dimethacrylates. BIS-GMA [2,2-bis-(4-(2-hydroxy-3-methacryloxypropoxy)phenyl)propane], the addition reaction product of bisphenol A and glycidyl methacrylate or an epoxy resin and methacrylic acid, is used most extensively. More recently, dimethacrylates based on bisphenol A, with various chain lengths have appeared on the market as a substitute for or in addition to BIS-GMA. Such compounds are BIS-MA [2,2-bis-(4-(methacryloxy)phenyl)propane], BIS-EMA [2,2-bis-(4-(2-methacryloxyethoxy)phenyl)propane] and BIS-PMA [2,2-bis-(4-(3-methacryloxypropoxy)phenyl)propane]. Increasing interest in the radiaton cure of coatings and printing inks have focused attention on these substances and on epoxy diacrylates as radiation-curable resins. The sensitizing capacity of the different acrylates based on bisphenol A or epoxy resin have been investigated with the guinea pig maximization test. The pattern of simultaneous reactivity of the compounds was also studied. Epoxy diacrylate [2,2-bis-(4-(2-hydroxy-3-acryloxy-propoxy)phenyl)propane], BIS-EMA and BIS-MA are shown to be strong sensitizers, while the linear fraction of BIS-GMA and its isomers and BIS-PMA have none or a low sensitizing capacity. The impurities in the BIS-GMA and BIS-MA batches seem to have high allergenic potential. These results stress the importance of a pure substance when discussing allergenicity and cross reactions.

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.

Role of medical materials, both in implant and surface applications, in immune response and in resistance to infection

The term biocompatibility encompasses many aspects of the behaviour of a material in the body including its effects on the host and the host's effects on it. Two aspects of biocompatibility which are difficult to predict are sensitivity reactions and infections. These reactions are very dependent on the host and other factors beyond the control of the testing laboratory. Much of the information on the problems of sensitivity reactions and infection rates in the actual use of the biomaterials and devices comes from case reports in the literature. This article will focus on review papers and a synthesis of reports and does not contain a thorough citation of the literature.

Permeability of surgeons' gloves to methyl methacrylate

The quick passage of methyl methacrylate at 21 degrees C and 35 degrees C through seven surgeon's glove materials in a diffusion chamber was quantified by gas-chromatographic analysis. Polystyrene-butadiene dissolved in methyl methacrylate, latex and polychlorobutadiene showed reversible expansion, during which material from the samples dissolved. In order to prevent these phenomena from interfering with the analyses, experiments were performed with 4.7 M methyl methacrylate in ethanol. Even then, the time in which methyl methacrylate permeated the membrane was too short for sufficient protection. When using these gloves, the orthopaedic surgeon who is fixing endoprostheses is no doubt occlusively exposed to methyl and other methacrylates, benzoyl peroxide, rubber additives, etc. Of glove materials which are not surgically used, vinyl was inferior to latex, whereas a very thin polyethylene copolymer did not change in methyl methacrylate, showed better resistance to diffusion, but was insufficiently elastic and easily perforated. A better protective material is urgently needed.

The sensitizing potential of 2-ethylhexyl acrylate in the guinea pig

The sensitizing potential of 2-ethylhexyl acrylate in the guinea pig could be demonstrated by Freund's Complete Adjuvant Test. This acrylate ester is a common constituent of adhesive tape. Allergic reactions to several brands of adhesive tape were not observed in 2-ethylhexyl acrylate sensitized animals. Cross reactions with other acrylic monomers were observed.

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.