A review of non‐glove personal protective equipment‐related occupational dermatoses reported to EPIDERM between 1993 and 2013

Abstract

Background: Personal protective equipment (PPE) is defined as equipment that protects the wearer's body against health/safety risks at work. Gloves cause many dermatoses. Non-glove PPE constitutes a wide array of garments. Dermatoses resulting from these have hitherto not been documented.Objectives: To determine the incidence and types of non-glove PPE-related dermatoses.Patients/Methods: We analysed incident case reports from dermatologists of non-glove PPErelated dermatoses to a UK-wide surveillance scheme (EPIDERM) between 1993 and 2013.Results: The dermatoses associated with non-glove PPE accounted for 0.84% of all occupational skin disease. Of all PPE-related cases, 194 (9.2%) were attributable to non-glove PPE. Of these, 132 (68.0%) occurred in men, and the median age (both male and female) was 42 years (range 18-82 years). The non-glove PPE-related dermatoses were diagnosed as: allergic contact dermatitis (47.4%), irritant contact dermatitis (16.0%), friction (11.3%), occlusion (11.3%), unspecified dermatitis (8.8%), acne (3.1%), infections (1.5), and contact urticaria (0.52%). The industries most associated with non-glove PPE-related dermatoses were manufacturing (18.6%), public administration and defence (17.0%), health and social work (15.5%), and transport, storage, and communication (9.8%).Conclusions: Clothing, footwear, facemasks and headgear need to be recognized as causes of dermatoses occurring at body sites less commonly associated with occupational skin disease.

Safety equipment: When protection becomes a problem

“…Bhoyrul et al reported only five cases of facial mask-related and headwear-related dermatitis. 5 The high number of reactions to rubber accelerators and metals found in our study could be consistent with components in masks, respirators, and goggles. 6 In an outbreak of facial dermatitis during the severe acute respiratory syndrome epidemic, it was found that N95 respirators contained formaldehyde 7 ; similarly, surgical masks and shields have been shown to contain formaldehyde, methyldibromo glutraonitrile, and other preservatives.…”

“…A recent study by Bhoyrul et al of SE-related occupational dermatoses (including footwear and clothing, but excluding gloves) found that ACD was diagnosed in 47.4% of individuals, and ICD was diagnosed in 16.0% of individuals. 5 This differs from the frequencies in our study (ACD, 77.0%; ICD, 28.7%), probably because of differences in study design and definitions. Bhoyrul et al found a higher rate of dermatitis in healthcare occupations (15.5%), although the frequency of dermatitis in manufacturing occupations was similar to that in our study (18.6%).…”

Skin reactions to non‐glove personal protective equipment: an emerging issue in the COVID‐19 pandemic

“…Goggles, have been used routinely to protect HCWs against highly infectious diseases related to exposure to contaminated body fluids [6]. Heat and dehydration were major complications of both goggles and face shields application during the Ebola outbreak [7].…”

“…Skin reactions such as acne, ACD, and irritant contact dermatitis (ICD) were mentioned following the use of goggles in HCWs. Occlusion and friction were mentioned as the underlying mechanism [6].…”

Protecting medical staff from skin injury/disease caused by personal protective equipment during epidemic period of COVID‐19: experience from China

“…Skin injury can occur as a result of the continual pressure and frictions caused by goggles and masks 6 . Commonly affected parts include the cheeks, nose and ears.…”