Occupationally induced allergic contact dermatitis to methylchloroisothiazolinone/methylisothiazolinone among machinists

Occupational contact dermatitis: Retrospective analysis of North American Contact Dermatitis Group Data, 2001 to 2016

BACKGROUND

Patch testing is an important diagnostic tool for suspected allergic contact dermatitis (ACD) in occupational settings.

OBJECTIVE

Provide an overview of occupational skin disease (OSD) and an analysis of occupational ACD in North American patients undergoing patch testing between 2001and 2016.

METHODS

Patients with OSD were analyzed for frequency of allergic reactions to a screening series of allergens, occupational relevance, location of skin disease, and exposure sources. Demographic, occupation, and industry information were recorded.

RESULTS

Of 38,614 patients evaluated, 4471 (11.6%) had OSD, of whom 3150 (70.5%) had ACD. The most common occupationally related allergens included rubber accelerators, preservatives, and bisphenol A epoxy resin. Hands (75.8%), arms (30.0%), and face (15.9%) were common sites of dermatitis. The occupations most affected were service workers and machine operators.

LIMITATIONS

Our cohort may not reflect the general working population.

CONCLUSION

This study identified common occupational allergens, exposure sources, and occupations/industries at risk. This information may help the clinician evaluate and manage patients with occupational contact dermatitis.

Hand dermatitis: a focus on allergic contact dermatitis to biocides

Hand dermatitis is a common disease of the skin resulting in significantly decreased quality of life. Allergic contact dermatitis is a frequent cause of hand dermatitis. Recent studies have revealed that biocides used as preservatives are frequent allergens affecting the hands. This article reviews common biocides implicated in hand dermatitis.

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.

Prognosis of occupational hand dermatitis in metalworkers

Hand dermatitis is common in workers employed in the cutting and grinding of metals. Previous studies have given conflicting results on the prognosis of this common occupational disease. This study was designed to determine the prognosis of hand dermatitis in metalworkers and the responsible allergens. A questionnaire survey was conducted on 64 patients seen between 1 and 5 years previously in the contact dermatitis clinic. Of the 51 patients responding, 82% still had hand dermatitis. There was no difference in outcome between those who continued to work with metals and oils, and those who had changed their occupation. Hand dermatitis in metalworkers carries a poor prognosis, with most workers remaining symptomatic even if they no longer had occupational exposure to metals or oils. This study also demonstrates that biocides are the most important allergen group in the aetiology of hand dermatitis in metalworkers.