Pulpitis of the fingers from a shoe glue containing 1,2-benzisothiazolin-3-one (BIT)

Contact sensitization to benzisothiazolinone: IVDK-data of the years 2002 to 2021

BACKGROUND

Benzisothiazolinone (BIT; CAS no. 2634-33-5) is used as a biocide in various products, including water-based paints, metalworking fluids, and household products. In recent years, increasing sensitization rates have been observed in Europe.

OBJECTIVE

To describe a time trend of sensitization to BIT, analyse concomitant reactions, and identify patients with increased risk of BIT sensitization.

METHODS

Retrospective analysis of data from 26 739 patients patch tested with BIT, sodium salt, 0.1% petrolatum as part of several special test series within the Information Network of Departments of Dermatology (IVDK), 2002 to 2021.

RESULTS

Positive reactions to BIT were noted in 771 patients (2.9%). Sensitization frequency varied over time and increased in recent years, peaking at 6.5% in 2020. Painters and metalworkers handling metalworking fluids, but not cleaners, had a significantly increased risk of BIT sensitization. From our data, there is no evidence of immunological cross-reactivity between BIT and other isothiazolinones.

CONCLUSION

The increasing frequency of sensitization justifies adding BIT to the baseline series. More research on the clinical relevance of positive patch test reactions to BIT and the cause for the rising numbers of BIT sensitization is needed.

HIGHLIGHTS

Frequency of sensitization to BIT has increased in recent years. The increasing frequency of sensitization justifies adding BIT to the baseline series. Painters and metalworkers handling metalworking fluids, but not cleaners, has a significantly increased risk of BIT sensitization. We found no evidence of immunological cross-reactivity between BIT and other isothiazolinones.

Allergic contact dermatitis to isothiazolinones in a rubber factory: A case report

Isothiazolinones, used as preservative, are known to be skin sensitizers. Although cosmetics represent their main source, occupational exposure may be a significant origin of eczema. While allergic eczema related to these derivates have been reported in a number of professional sectors, their presence in the same workplace was not common.

Outbreak of Occupational Allergic Contact Dermatitis from a Smartphone Screen Protector Glue

Background

Sensitization to acrylates is a concern in the occupational/environmental dermatology field.

Objective

To describe an occupational allergic contact dermatitis (ACD) outbreak from a smartphone screen protector glue.

Methods

Thirteen affected workers of a chain store selling phone screen protectors were investigated in five Spanish dermatology departments. The glue datasheet and label were assessed. A chemical analysis of the glue was performed. Based on this, some patients underwent additional testing.

Results

All patients (all female, mean age: 25) had severe fingertip dermatitis.

The datasheet/label indicated that the glue contained isobornyl acrylate (IBOA), a “photoinitiator” and polyurethane oligomer. The company informed us that the ingredients were polyurethane acrylate, “methacrylate” (unspecified), acrylic acid, hydroxyethyl methacrylate, propylmethoxy siloxane, and photoinitiator 184. Isobornyl acrylate (or IBOA) and N,N‐dimethylacrylamide (DMAA) were patch tested in eight and two cases, respectively, with negative results.

A chemical analysis revealed 4‐acryloylmorpholine (ACMO); isobornyl methacrylate (IBMA), and lauryl acrylate in one glue sample. Seven patients were patch tested with dilutions of the identified substances and six of seven were positive for ACMO 0.5% pet.

Conclusion

An outbreak of occupational ACD, likely from ACMO in a glue is described. Further investigations are needed to corroborate the role played by each compound identified in the chemical analyses.

Isothiazolinone Content of US Consumer Adhesives: Ultrahigh-Performance Liquid Chromatographic Mass Spectrometry Analysis

BACKGROUND

There are limited data regarding the prevalence and concentration of isothiazolinone preservatives in consumer adhesives.

OBJECTIVES

The aim of this study was to determine the prevalence and concentration of 5 specific isothiazolinones (methylisothiazolinone [MI], methylchloroisothiazolinone [MCI], benzisothiazolinone [BIT], butyl BIT, and octylisothiazolinone) in US adhesives.

METHODS

Thirty-eight consumer adhesives were analyzed using ultrahigh-performance liquid chromatographic-mass spectrometry. Fisher exact tests were used to test for isothiazolinone content and: 1) glue format (2) application purpose and 3) extraction method.

RESULTS

Nineteen adhesives (50%) had at least 1 isothiazolinone, and 15 contained 2 isothiazolinones. Frequencies and concentrations were as follows: MI (44.7%; 4-133 ppm), MCI (31.6%; 7-27 ppm), BIT (15.8%; 10-86 ppm), and octylisothiazolinone (2.6%; 1 ppm). Butyl BIT was not detected in any of the adhesives. Format (stick vs liquid) was not statistically associated with isothiazolinone presence. At least half of adhesives in the following application purposes had at least 1 isothiazolinone: shoe, craft, fabric, and school. All-purpose glues had a statistically significant lower concentration of MI and MCI, whereas craft glues were associated with higher concentrations of MI and MCI. Compared with other glues, fabric adhesives were associated with a higher risk of containing BIT.

CONCLUSIONS

Half of the tested adhesives contained at least 1 isothiazolinone. Methylisothiazolinone and MCI were the most common. Consumers and dermatologists should be aware of adhesives as a source of isothiazolinones.

Isothiazolinone derivatives and allergic contact dermatitis: a review and update

Allergic contact dermatitis (ACD) from isothiazolinones has frequently been described in the literature. Following an epidemic of sensitization to methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) in the 1980s, and more recently to MI, the Scientific Committee on Consumer Safety of the European Commission banned their use in leave-on products, while restricting that in rinse-off cosmetics. Despite a decreasing prevalence of ACD from MCI/MI and MI, cases caused by occupational exposure and non-cosmetic isothiazolinone sources are on the rise. Moreover, sensitization to newer and lesser known isothiazolinones has been reported. This paper reviews the epidemiology of contact allergy to different isothiazolinones, clinical presentation of isothiazolinone-induced ACD, most relevant sensitization sources and potential cross-reactions between isothiazolinone derivatives. It also provides an update on recent legislative measures.

Hypersensitivity to preservatives

Preservatives are biocidal chemicals added to cosmetics, topical medicaments, consumer goods, foods, and industrial products to protect them against microbial spoilage and to protect the consumer against infection. The ideal preservative, both effective and devoid of irritant or sensitizing potential, is still to be discovered. The present paper reviews the most important classes of preservatives, namely parabens, formaldehyde-releasers, and isothiazolinones. The author also discusses newer agents such as Euxyl K 400 and isopropynyl butylcarbamate. Each preservative is described in terms of chemical and physical characteristics, antimicrobial efficacy, exposure, cutaneous adverse reactions, patch testing concentrations, patterns of cross-reactions, and reported rates of sensitization. The history of preservatives goes back to the 1930s, and ironically, the parabens, which the industry has sought to replace with "safer" alternatives, are still the most frequently used biocides in cosmetics and appear to be far less sensitizing than most of the newer agents.