Occupational allergic contact dermatitis from systemic drugs

Abstract

Background: Health-care workers (HCWs) and professionals working in the pharmaceutical industry are at risk of developing occupational allergic contact dermatitis (OACD) from systemic drugs (or drug intermediates).Objectives: To study demographic characteristics and identify systemic drugs responsible for OACD in patients investigated for contact allergy during the period 2001-2019.Methods: In the study period, 9780 patients were patch tested with the European baseline series, sometimes with additional series, and other relevant potential allergens. All patients with a positive patch-test reaction to systemic medication exposed to at work were included for further analysis.Results: Of 1248 HCWs examined in our clinic, 201 suffered from OACD. In 26 (13%) dermatitis was caused by skin contact with a systemic drug: 19 nurses, five chemists working in the pharmaceutical industry, one physician, and one veterinarian. In total, 45 positive patch-test reactions to 20 different systemic drugs were found, with tetrazepam (n = 11), ranitidine hydrochloride (n = 5), and zolpidem (n = 4) being the most frequent. Three pharmaceutical chemists were sensitized to a drug intermediate. The lesions were mostly localized on the hands, but often also on the face, as airborne dermatitis.

Using Fume Hood to Reduce Nurses’ Exposure to Particulate Matters Dispersed Into the Air During Pill Crushing

“…In this study, we did not examine the health effects of chronic exposures to PM from pill crushing, but studies have shown correlations between crushing benzodiazepine, beta-blockers, ACE inhibitors, trazodone, ranitidine, and zolpidem and the development of airborne occupational contact dermatitis in nurses (Gilissen et al, 2020; Hulst et al, 2010; Swinnen et al, 2014). It is critical to note that allergic reactions may result from exposure to inactive ingredients of oral medications (Abrantes et al, 2016; Kelso, 2014).…”

“…Her symptoms continued for several months but resolved when exposure to clozapine powder was stopped (Lewis et al, 2012). Multiple studies show the correlation between crushing benzodiazepine medications and nurse development of airborne occupational contact dermatitis (Gilissen et al, 2020; Hulst et al, 2010; Swinnen et al, 2014), but other drugs have also been correlated with contact dermatitis, such as beta-blockers, Angiotensin-converting enzyme (ACE) inhibitors, trazodone, ranitidine, and zolpidem (Gilissen et al, 2020; Swinnen et al, 2014). The allergic reactions might result from exposure to inactive ingredients of oral medications (Abrantes et al, 2016).…”

Dermatite de contato ocupacional e suas implicações

“…Perguntas como qual o cargo atual, tempo naquela atividade laboral, uso de roupas de proteção, se há melhora dos sintomas nos dias de folga e casos semelhantes em colegas de trabalho, podem ser úteis no diagnóstico precoce e controle de exposição (LAMPEL et al, 2018;GILISSEN et al, 2019).…”

Morbidity analysis of pharmacists during the COVID-19 pandemic (a literature review)

“…Вплив специфічних умов праці на фармацевтичних працівників підтверджується великою кількістю даних щодо алергічних та онкологічних захворювань у працівників фармацевтичного сектора охорони здоров'я [31][32][33][34]. Проаналізовані відомості про алергенну дію окремих активних фармацевтичних інгредієнтів, лікарських засобів, латексу, антисептичних, дезінфекційних засобів на фармацевтичних працівників не вичерпні.…”