Occupational Contact Dermatitis in North American Production Workers Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014

Warshaw, Erin M.; Hagen, Solveig L.; DeKoven, Joel G.; Zug, Kathryn A.; Sasseville, Denis; Belsito, D.; Zirwas, Matthew J.; Fowler, Joseph F.; Taylor, James S.; Fransway, Anthony F.; DeLeo, Vincent A.; Marks, James G.; Pratt, Melanie D.; Maibach, Howard I.; Mathias, C. G. Toby

doi:10.1097/der.0000000000000277

Cited by 27 publications

(39 citation statements)

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“…Other authors have also noted that HCWs have higher rates of hand dermatitis than NHCWs. 10,11 Male HCWs were more likely to have a history of AD than were male NHCWs. When compared to female NHCWs, female HCWs had similar rates of AD.…”

Section: Discussionmentioning

confidence: 96%

Occupational Dermatitis in Health Care Workers Evaluated for Suspected Allergic Contact Dermatitis

Kadivar

Belsito

2015

Dermatitis

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Section: Discussionmentioning

confidence: 96%

Occupational Dermatitis in Health Care Workers Evaluated for Suspected Allergic Contact Dermatitis

Kadivar

Belsito

2015

Dermatitis

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“…PT reactivity to topical medicaments with occupational relevance was also high, according to the previous findings in literature, 11 and it is justified by its frequent use in workplace particularly the antiseptics polivinylpirrolidone and chlorhexidine. Thimerosal, once used frequently as an antiseptic in most healthcare centres is still frequently responsible for positive PT, but relevance could not be traced, which justified its removal from the baseline series in 2014.…”

Section: Discussionmentioning

confidence: 54%

“…1,[11][12][13] Actually, more than 70% of the studied HCW had a positive PT, which is not significantly different from the whole population tested. Although, only about half of the reactive patients had an occupationally relevant positive PT, occupational ACD was documented in 38% of the HCW that searched a dermato-allergology testing, much higher than the percentage of occupational cases in the whole population tested (16%).…”

Section: Discussionmentioning

confidence: 98%

“…50 Rubber chemicals in gloves and/or shoes are still one of the most common allergens in HCW, 1,6,11,12,19,51,52 however the paradigm is changing in the last decade by the introduction of new allergens 53 and new types of gloves. Vinyl gloves do not usually contain these rubber addictive, so this is the usual alternative for HCW with ACD caused by vulcanization accelerators in rubber gloves material.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 Occupational allergic contact dermatitis (ACD) is particularly frequent among health care workers (HCW). 1,5,6,[11][12][13][14] In the healthcare setting ACD can occur due both to delayed-type hypersensitivity mediated by allergen specific T lymphocytes that recognize low molecular weight chemicals, and immediate-type hypersensitivity, with IgE recognizing larger chemicals, like latex proteins. 12,15,16 Clinical manifestations depend on the chemical properties of the allergens, local and form of exposure (acute or chronic) 17,18 and may also be influenced by individual factors (atopy) or concomitant risk factors, like intensive exposure to wet work and skin irritants, namely with frequent and cumulative hand washing at work and at home.…”

Section: Introductionmentioning

confidence: 99%

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Dermatite de Contacto Alérgica em Profissionais de Saúde

Pinheiro

Pestana

Marques

et al. 2017

SPDV

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RESUMO -Introdução: A dermatite de contacto alérgica (DCA) constitui patologia profissional particularmente frequente em profissionais de saúde. Os alergénios responsáveis podem variar ao longe do tempo, com a exposição ocupacional e com o tipo de trabalho. Objectivos e Métodos: Com o objetivo de avaliar a realidade local, foi feita uma análise retrospetiva dos profissionais de saúde que realizaram testes epicutâneos no Serviço de Dermatologia do Centro Hospitalar e Universitário de Coimbra (CHUC), num período de 6 anos (2010)(2011)(2012)(2013)(2014)(2015), por suspeita de dermatite de contacto alérgica. Os doentes foram todos testados com uma Série Básica e com séries complementares orientadas pela história clínica. Resultados: Dos 1858 doentes testados, 125 (6,7%) eram profissionais de saúde, 114 de género feminino/11 masculino, idade média de 39,26±12,5 anos, maioritariamente enfermeiras (56), assistentes técnicos (48) e médicos (21), 71 com dermatite das mãos (56.8%), 22 com dermatite atópica e/ou outros sinais de atopia (17,6%). Noventa (72%) revelaram pelo menos um patch test (PT) positivo, 47 dos quais (52,2%) com relevância profissional. Doentes com dermatite das mãos tiveram mais frequentemente PT positivo (76,1%). Os metais causaram maior número de PT positivos (total 51; Ni-41, maioritariamente com relevância passada, Co-8; Cr-2), seguidos das fragrâncias (total 30; mistura de fragrâncias (FM)-I-10; Myroxylon pereirae-8; lyral-5; FM-II-4; citronellol-3), conservantes (total 29, dos quais 20 à metilisotiazolinona (MI) e/ou clorometilisotiazolinona/MI (MCI/MI)), borrachas (24; P-fenilenodiamina (PPD)/Isopropil-PPD-9) e medicamentos tópicos (total 14; iodopovidona 5). As principais causas da DCA profissional foram os desinfetantes/sabonetes líquidos e produtos de higiene dos doentes (15), borracha das luvas/calçado (12) e medicamentos sistémicos ou tópicos (8 antissépticos e 3 antibióticos parentéricos). Os principais alergénios com relevância profissional foram a MI e/ou MCI/MI (15), lanolina (9), formaldeído e/ou libertadores (7), iodopovidona (5), carbamatos (4), FM-I (3), cefalosporinas (3) e acrilatos (3 dentistas e/ou assistentes dentários). Em 37 dos 42 casos avaliados, houve uma melhoria franca ou resolução da DCA, após evicção do alergénio causal, nomeadamente o conservante MCI/ MI contido num sabonete líquido sob a designação de "Acticide ® MV". Conclusões: A dermatite das mãos, a principal apresentação da DCA em profissionais de saúde, não mostrou relação com atopia e foi mais frequentemente associada a PT positivos. PT positivos a isotiazolinonas e libertadores de formaldeído foram mais frequentes entre profissionais de saúde do que na população geral estudada, muito provavelmente devido à exposição cumulativa, pessoal e profissional, a estes conservantes em sabonetes líquidos de uso pessoal e hospitalar. O PT foi crucial para orientar individualmente os doentes e para alertar a comunidade hospitalar para a presença de alergénios no local de trabalho e estabelecer medidas preventivas mais ade...

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Facial Dermatitis in Male Patients Referred for Patch Testing

et al. 2020

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IMPORTANCEFacial dermatitis in women is well characterized. However, recent shifts in the men's grooming industry may have important implications for male facial dermatitis. OBJECTIVE To characterize male patients with facial dermatitis. DESIGN, SETTING, AND PARTICIPANTSA 22-year retrospective cross-sectional analysis of North American Contact Dermatitis Group (NACDG) data, including 50 507 patients who underwent patch testing by a group of dermatology board-certified patch test experts at multiple centers was carried out. Facial dermatitis was defined as involvement of the eyes, eyelids, lips, nose, or face (not otherwise specified). MAIN OUTCOMES AND MEASURESThe main outcome was to compare characteristics (including demographics and allergens) between male patients with facial dermatitis (MFD) and those without facial dermatitis (MNoFD) using statistical analysis (relative risk, CIs). Secondary outcomes included sources of allergic and irritant contact dermatitis and, for occupationally related cases, specific occupations and industries in MFD.RESULTS Overall, 1332 male patients (8.0%) were included in the MFD group and 13 732 male patients (82.0%) were included in MNoFD. The mean (SD) age of participants was 47 (17.2) years in the MFD group and 50 (17.6) years in the MNoFD group. The most common facial sites were face (not otherwise specified, 817 [48.9%]), eyelids (392 [23.5%]), and lips (210 [12.6%]). Participants in the MFD group were significantly younger than MNoFD (mean age, 47 vs 50 years; P < .001). Those in the MFD group were less likely to be white (relative risk [RR], 0.92; 95% CI, -0.90 to 0.95) or have occupationally related skin disease (RR, 0.49; 95% CI, -0.42 to 0.58; P < .001) than MNoFD. The most common allergens that were associated with clinically relevant reactions among MFD included methylisothiazolinone (n = 113; 9.9%), fragrance mix I (n = 27; 8.5%), and balsam of Peru (n = 90; 6.8%). Compared with MNoFD, MFD were more likely to react to use of dimethylaminopropylamine (RR, 2.49; 95% CI, -1.42 to 4.37]) and paraphenylenediamine (RR, 1.43; 95% CI, -1.00 to 2.04; P < .001). Overall, 60.5% of NACDG allergen sources were personal care products.CONCLUSIONS AND RELEVANCE Although many allergens were similar in both groups, MFD were more likely to react to use of dimethylaminopropylamine and paraphenylenediamine, presumably owing to their higher prevalence in hair products. Most sources of allergic and irritant contact dermatitis in MFD were personal care products. This study provides insight into the risks and exposures of the increasing number of grooming products used by male dermatology patients. This will enable clinicians to better identify male patients who would benefit from patch testing and treat those with facial dermatitis.

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Occupational Contact Dermatitis in North American Production Workers Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014

Abstract: Production workers had a high rate of occupationally related skin disease, as well as irritant and allergic contact dermatitis. Involvement of exposed body areas was common. Frequently identified allergens included adhesives/glues, rubber accelerators, metals, and preservatives.

Cited by 27 publications

References 20 publications

Occupational Dermatitis in Health Care Workers Evaluated for Suspected Allergic Contact Dermatitis

Occupational Dermatitis in Health Care Workers Evaluated for Suspected Allergic Contact Dermatitis

Dermatite de Contacto Alérgica em Profissionais de Saúde

Facial Dermatitis in Male Patients Referred for Patch Testing

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