Allergic contact dermatitis from nonoxynol-12 in a polish

Multicentre patch test study of air-oxidized ethoxylated surfactants

Frequent exposure to water and surfactants is considered to be the main cause of hand eczema from wet work. Ethoxylated surfactants are susceptible to oxidation and some of the oxidation products formed have proved to be contact sensitizers in guinea pigs. The question of human sensitization to oxidized surfactants was addressed in a multicentre study in the Stockholm region. 528 consecutive dermatitis patients were patch tested with widely used ethoxylated surfactants in oxidized and non-oxidized form as well as certain identified oxidation compounds. 61 patients presented with mild, clearly irritant reactions to some of the surfactants tested. 18 patients showed not only erythema but also oedema and/or papules and vesicles, using a morphologic descriptive system for reading the patch test reactions. These reactions occurred mostly to oxidized surfactants and oxidation products. When retesting 9 of these 18 patients only an allergic reaction to acetaldehyde was confirmed. We conclude that oxidized ethoxylated surfactants have increased irritant potential compared to non-oxidized material. Our working hypothesis is that oxidized surfactants of technical quality exert a lower risk of sensitization than do oxidized homologous pure surfactants. Among the potential allergens formed during autoxidation, formaldehyde and acetaldehyde must be considered as a source of unexpected exposure.

Allergenic activity of an air-oxidized ethoxylated surfactant

Ethoxylated surfactants are used in household and industrial cleaners, topical pharmaceuticals, cosmetics and laundry products. Polyethers, e.g. ethoxylated surfactants and polyethylene glycols, are oxidized by atmospheric oxygen (autoxidized) when stored and handled. We have previously shown that a chemically well-defined non-ionic surfactant, the ethoxylated alcohol penta-ethylene glycol mono-n-dodecyl ether (C12E5), forms a complex mixture of autoxidation products when exposed to air. Predictive testing in guinea pigs showed that the surfactant itself is a non-sensitizer, but that oxidation products formed are skin sensitizers. The aim of this study was to investigate the sensitizing capacity of a total oxidation mixture of C12E5 obtained after autoxidation. The allergenic activity of different oxidation products is discussed as well as the clinical importance of the findings. This study shows that the non-ionic surfactant C12E5 containing 20% oxidation products is a sensitizing mixture. The result accords with what is observed for other compounds that are unstable when in contact with air, e.g. limonene and linalool, major fragrance terpenes. Studies regarding the clinical relevance of our findings should be performed. However, it is already clear from this study that precautions must be taken in handling and storage of ethoxylated surfactants to avoid formation of allergenic mixtures.

Contact allergenic activity of Tween 80 before and after air exposure

Tween 80 is an ethoxylated hydrophilic non-ionic surfactant, which is used for the preparation of oil-in-water emulsions in pharmaceutical products, cosmetics, and industrial detergents. Ethoxylated surfactants are polyethers and are thus easily oxidized by atmospheric oxygen to a variety of hydroperoxides, peroxides and carbonyl compounds. The aim was to investigate the formation of oxidation products and the allergenic potential of Tween 80 before and after air exposure. The formation of peroxides and formaldehyde was followed with chemical analyses during air and pure oxygen exposure of water solutions of Tween 80 of technical quality. A complex mixture of compounds was formed when Tween 80 was oxidized. Formaldehyde was detected in amounts that may be eliciting in allergic individuals. Acetaldehyde was identified in Tween 80 before oxygen exposure, whereafter the amount gradually decreased. The contact allergenic activity was determined in experimental sensitization studies in guinea pigs. Non-oxidized as well as oxidized Tween 80 of technical quality showed allergenic activity. The results indicate that allergens are present in Tween 80 before oxidation and that new allergens are formed in the oxidation process. No obvious dose-response relationship was found in the sensitization studies. The possibility that allergenic compounds can be formed during storage and handling of products containing ethoxylated surfactants should be taken into consideration.