Contact allergens and irritants in household washing and cleaning products

Prevalence, risk factors, and prevention of occupational contact dermatitis among professional cleaners: a systematic review

OBJECTIVE

The aim of this study was to investigate the prevalence, risk factors, and prevention of occupational contact dermatitis (OCD), as well as risk factors and consequences of OCD among professional cleaners.

METHODS

A systematic review following PRISMA guidelines was performed using Medline, EMBASE, and Cochrane Library.

RESULTS

Thirty-nine studies containing over 109.000 participants were included in the review. The prevalence of OCD varied between 2.2% and 30.1%. Main occupational risk factors for developing OCD among cleaners included wet work and irritants in cleaning products (bleach, chlorine, ammonia, multi-use-cleaning) and skin contact to metal. The most common contact allergies included rubber, biocides, nickel/cobalt, and perfumes. Other risk factors were inconsistent use of protective gloves and low educational level. Consequences associated with OCD included significant impairment in quality of life, tendency to have unscheduled absence from work, sick leave, increased rate of disability, and recognized degree of injury. Only one prevention study has been published investigating the effect of an educative course in skin-protective behavior in cleaners. The study reported a higher degree of knowledge of skin protection, a decrease in the severity of hand eczema, and a shift toward fewer daily hand washings at follow-up after 3 months.

CONCLUSION

Our study proves that OCD is common in cleaners, and the main risk factors included wet work, irritants, and contact allergies, as well as inconsistent use of protective gloves and low educational level. More focus and a greater number of studies are needed on skin protection in this population.

Changes in Latina Women's Exposure to Cleaning Chemicals Associated with Switching from Conventional to "Green" Household Cleaning Products: The LUCIR Intervention Study

BACKGROUND

Household cleaning products may be a significant source of chemical exposures, including carcinogens and suspected endocrine disruptors.

OBJECTIVES

We characterized exposures during routine household cleaning and tested an intervention to reduce exposures to cleaning product chemicals.

METHODS

The Lifting Up Communities with Interventions and Research (LUCIR) Study is a youth-led, community-based intervention project. Youth researchers conducted personal air monitoring with 50 Latina women while they cleaned their homes with their regular cleaning products (preintervention visit) and then 1 week later while they used "green" cleaning products provided by the study (postintervention visit). Air samples were analyzed for volatile and semivolatile organic compounds using gas chromatography-mass spectrometry and high-performance liquid chromatography. We compared pre- and postintervention air concentrations of 47 chemicals of concern, selected because they were on California's Proposition 65 list of carcinogens or reproductive/developmental toxicants or were suspected endocrine disruptors. Youth researchers were integrally involved in the study design, data collection, interpretation, and dissemination of findings.

RESULTS

We observed statistically significant decreases in air concentrations of 17 chemicals of concern when participants switched to green cleaning products, including decreases in geometric mean concentrations of 1,4-dioxane (-46.4%), chloroform (-86.7%), benzene (-24.8%), naphthalene (-40.3%), toluene (-24.2%), and hexane (-35.5%). We observed significant increases in air concentrations of three fragrance compounds: the plant-derived terpene, beta-myrcene (221.5%), and the synthetic musks celestolide (31.0%) and galaxolide (79.6%). Almost all participants (98%) said the replacement products worked as well as their original products, and 90% said that they would consider buying the replacement products in the future.

DISCUSSION

This study demonstrates that choosing cleaning products that are marketed as green may reduce exposure to several carcinogens and endocrine disruptors. Future studies should determine whether use of unscented green products would further reduce exposure to terpenes and musks. https://doi.org/10.1289/EHP8831.

Enzymatic biofilm destabilisation to support mechanical cleansing of inserted dental implant surfaces: an in-vitro pilot study

Peri-implantitis is caused by microbial contamination and biofilm formation on the implant surface. To achieve re-osseointegration, the microbes must be completely removed from the surface. Adjunctive to mechanical cleaning, chemical treatment with enzymes or other substances could optimise the treatment outcome. Therefore, we investigated the efficacy of different enzymes, a surfactant, and a chelator in destabilising dental polymicrobial biofilm. The biofilm destabilising effect of the glycosidases α-amylase, dextranase, DispersinB^®, and lysozyme, as well as the proteinase subtilisin A, and the nuclease Benzonase^®, the chelator EDTA, and the surfactant cocamidopropyl betaine were investigated on biofilms, inoculated with plaque on rough titanium discs. The test and the control solutions were incubated for 15 min at 36 °C on biofilms, and loosened biofilm mass was removed by shear stress with a shaker. Fluorescence-stained biofilms were microscopically analysed. Acceptable cell tolerability concentrations of test substances were determined by the MTT (tetrazolium dye) assay on the MG-63 cell line. A statistically significant biofilm destabilising effect of 10% was shown with lysozyme (2500 µg/ml).

Persistence of Isothiazolinones in Clothes After Machine Washing

BACKGROUND

Sensitization to methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) is a worldwide problem. Washing machine detergents are suspected to cause cutaneous symptoms in highly sensitized patients. Little is known about the persistence of isothiazolinones in clothes that have been washed.

OBJECTIVE

The aim of the study was to analyze the possible persistence of MI, MCI, benzisothiazolinone, and octylisothiazolinone in common fabrics after machine washing.

METHODS

Different clothes (cotton, polyester, linen, and wool) were collected, and 4 types of wash were done (control, standard, standard + conditioner, and standard + double rinse). The samples were analyzed using ultrahigh-performance liquid chromatography.

RESULTS

The results showed that the concentrations of isothiazolinones were very low, independent of the type of material or wash. The highest levels were found in the control wash (hand wash), reaching a maximum of 0.4 ppm in the linen.

CONCLUSIONS

Our findings suggest that it is not necessary to recommend that patients sensitized to MI avoid isothiazolinones in machine detergents or fabric conditioners or to double rinse. However, after using the detergent for hand washing (the control in our study), there may remain sufficient concentrations of isothiazolinones in clothes to produce symptoms in highly sensitized patients.

Skin irritation potential of cosmetic preservatives: An exposure-relevant study

BACKGROUND

Preservatives represent one of the main causes of skin irritation and contact allergies.

AIMS

To comprehensively evaluate the skin irritation potential of phenoxyethanol, methylparaben, propylparaben, imidazolidinyl urea, and DMDM hydantoin under regulatory acceptable concentrations.

METHODS

A patch test and repeated open application test (ROAT) were applied to evaluate skin irritation in vivo. In vitro alternative methods consisting of the keratinocyte cytotoxicity assay, red blood cell (RBC) test, and hen's egg test-chorioallantoic membrane (HET-CAM) were performed to elucidate the mechanism of preservative-induced irritation responses.

RESULTS

The patch test showed that all test substances showed a weak erythema response. Propylparaben had the highest occlusive irritancy potential in the patch test, owing to damage to the cell membrane. The two formaldehyde releasers showed noticeable skin irritation potential in the ROAT through their cytotoxicity to keratinocytes, while a visible response was observed after applying phenoxyethanol and the two parabens. No filtration was noticed in the in vivo tests, which might be attributed to the failure of subcutaneous vessel alteration by the preservatives.

CONCLUSIONS

Commonly used cosmetic preservatives have minor skin irritation potential with mild erythema reaction under practical use, especially formaldehyde releasers and propylparaben.

Does the ubiquitous use of essential oil-based products promote indoor air quality? A critical literature review

Essential oils are frequently used as natural fragrances in housecleaning products and air fresheners marketed as green and healthy. However, these substances are volatile and reactive chemical species. This review focuses on the impact of essential oil-based household products on indoor air quality. First, housecleaning products containing essential oils are explored in terms of composition and existing regulations. Specific insight is provided regarding terpenes in fragranced housecleaning products, air fresheners, and pure essential oils. Second, experimental methodologies for terpene monitoring, from sampling to experimental chambers and analytical methods, are addressed, emphasizing the experimental issues in monitoring terpenes in indoor air. Third, the temporal dynamics of terpene emissions reported in the literature are discussed. Despite experimental discrepancies, essential oil-based products are significant sources of terpenes in indoor air, inducing a high exposure of occupants to terpenes. Finally, the fate of terpenes is explored from sorptive and reactive points of view. In addition to terpene deposition on surfaces, indoor oxidants may induce homogeneous and heterogeneous reactions, resulting in secondary pollutants, such as formaldehyde and secondary organic aerosols. Overall, essential oil-based products can negatively impact indoor air quality; therefore, standard protocols and real-scale approaches are needed to explore the indoor physics and chemistry of terpenes, from emissions to reactivity.

Association of use of cleaning products with respiratory health in a Canadian birth cohort

BACKGROUND

Comprehensive longitudinal studies are important for understanding the complex risk factors, pathways, exposures and interactions that lead to the development and persistence of asthma. We aimed to examine associations between use of household cleaning products in early life and childhood respiratory and allergic disease using data from the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study.

METHODS

We summed responses from parental questionnaires that indicated the frequency of use of 26 household cleaning products in the homes of 2022 children from this birth cohort when they were 3-4 months of age to create a cumulative Frequency of Use Score (FUS). We used multivariable logistic regression models to assess whether frequent compared with less frequent use was associated with recurrent wheeze, atopy or asthma diagnosis, as defined by the questionnaire and clinical assessments at age 3 years. Data were collected between 2008 and 2015.

RESULTS

Children in homes with a higher frequency of use of cleaning products in infancy, as determined by an interquartile range increase, had higher odds of recurrent wheeze (adjusted odds ratio [OR] 1.35, 95% confidence interval [CI] 1.11-1.64), recurrent wheeze with atopy (adjusted OR 1.49, 95% CI 1.02-2.16) and asthma diagnosis (adjusted OR 1.37, 95% CI 1.09-1.70), but no increase in the odds of atopy at age 3 years (adjusted OR 1.14, 95% CI 0.96-1.35). Compared with the lowest tertile of FUS exposure, infants in the highest tertile had higher odds of acquiring asthma. Stratification of the results showed that females had higher ORs than males for all outcomes, although the p values for this sex difference did not reach statistical significance.

INTERPRETATION

Frequent use of household cleaning products in early life was associated with an increased risk for childhood wheeze and asthma but not atopy at age 3 years. Our findings add to the understanding of how early life exposures to cleaning products may be associated with the development of allergic airway disease and help to identify household behaviours as a potential area for intervention.

Health impact assessment of a skin sensitizer: Analysis of potential policy measures aimed at reducing geraniol concentrations in personal care products and household cleaning products

A methodology to assess the health impact of skin sensitizers is introduced, which consists of the comparison of the probabilistic aggregated exposure with a probabilistic (individual) human sensitization or elicitation induction dose. The health impact of potential policy measures aimed at reducing the concentration of a fragrance allergen, geraniol, in consumer products is analysed in a simulated population derived from multiple product use surveys. Our analysis shows that current dermal exposure to geraniol from personal care and household cleaning products lead to new cases of contact allergy and induce clinical symptoms for those already sensitized. We estimate that this exposure results yearly in 34 new cases of geraniol contact allergy per million consumers in Western and Northern Europe, mainly due to exposure to household cleaning products. About twice as many consumers (60 per million) are projected to suffer from clinical symptoms due to re-exposure to geraniol. Policy measures restricting geraniol concentrations to <0.01% will noticeably reduce new cases of sensitization and decrease the number of people with clinical symptoms as well as the frequency of occurrence of these clinical symptoms. The estimated numbers should be interpreted with caution and provide only a rough indication of the health impact.

MI (2-methyl-4-isothiazolin-3-one) contained in detergents is not detectable in machine washed textiles

Background

European legislation has banned the preservative methylisothiazolinone (MI) from inclusion in leave-on cosmetics. However, the risk for allergic reactions depends on exposure. The aim of this study was to determine the risk of MI in laundry detergents for household machine washing.

Methods

Different formulations of laundry detergents with commercial MI levels, up to one thousand ppm were used and three different types of clothes were washed in a normal household machine setting one time and 10 times. The level of MI was measured by HPLC.

Results

While MI could be retrieved in the positive control of clothes drenched with washing powder but not washed afterwards, MI could not be detected in any specimen of clothes washed under household conditions. The detection limit was 0.5 ppm.

Conclusion

It is important to discuss the difference of risk and hazard. While MI clearly is a high hazard as a strong contact allergen, the risk depends on exposure. Regarding the risk of exposure levels for the consumer to MI in clothes it can be stated that the use of MI in laundry detergents is safe for the consumer if these products are used according to the instructions in the normal household setting machine wash.

Allergic Contact Dermatitis Due to Methylisothiazolinone in a Young Girl's Laundry Detergent

Methylisothiazolinone (MI) is an emerging and increasing cause of allergic contact dermatitis (ACD) in children. We present the case of a 7-year-old girl with an unusual dermatitis suspicious for contact allergy. Patch testing confirmed allergy to MI, found only in the patient's laundry detergent. This case highlights the importance of checking household product ingredients and the role of MI as an increasing cause of ACD in children.

Occurrence and concentrations of isothiazolinones in detergents and cosmetics in Switzerland

BACKGROUND

In recent years, the frequency of contact allergy to isothiazolinones has increased alarmingly in Europe, but only limited data are available on concentrations of isothiazolinones in consumer products.

OBJECTIVES

To examine the current frequency of isothiazolinones [methylisothiazolinone (MI), methylchloroisothiazolinone (MCI), benzisothiazolinone (BIT), and octylisothiazolinone (OIT)] in a wide array of detergents and cosmetics relevant for the Swiss population.

METHODS

By means of a market survey, the occurrence of isothiazolinones was investigated in 1948 consumer products. Of these, 88 products were analysed by liquid chromatography-high-resolution mass spectrometry after ultrasonic extraction.

RESULTS

Only 7.6% of all cosmetics contained isothiazolinones, but the prevalence in detergents was much higher (42.9%). The measured concentration ranges in detergents were 4.3–10, 3.5–279, 3.8–186 and 7.9 ppm (one product only) for MCI, MI, BIT, and OIT, respectively [corrected]. For cosmetics, these were 1.3-133 and 4.8 ppm (one product only) for MI and MCI, respectively.

CONCLUSIONS

Our study has shown that high concentrations of isothiazolinones (including MI) can be found in a large variety of products, in particular in detergents. Therefore, the safe use of these preservatives should be re-evaluated by including detergents in the exposure assessment.

Mechanism and kinetic properties for the gas-phase ozonolysis of β-ionone

The gas-phase degradation mechanisms of β-ionone with O₃are investigated using density functional theory (DFT).

Occupational contact dermatitis caused by D-limonene

BACKGROUND

Limonene is widely used as a fragrance substance and solvent in cleansing products. Oxidized limonene is a frequent contact allergen among consumers of cosmetics, personal care products, and scented household cleaning products. Less is known about the sources of occupational exposure and occupational contact dermatitis caused by limonene.

OBJECTIVE

To report 14 patients with occupational contact allergy to limonene.

METHODS

The patients were examined in 2008-2013. An in-house preparation of oxidized limonene was patch tested as 3% and 5% in petrolatum from 2008 to August 2010, and after this as 3%, 1% and 0.3% pet. From 2012 onwards, a commercial test substance of limonene hydroperoxides was also used. We assessed the patients' occupational and domestic exposure to limonene.

RESULTS

Occupational limonene allergy was observed in workers who used limonene-containing machine-cleaning detergents and hand cleansers, and in workers who used limonene-containing surface cleaners and dishwashing liquids similar to those used by consumers. In 3 cases, the occupational limonene allergy resulted from work-related use of limonene-containing, leave-on cosmetic products.

CONCLUSIONS

Limonene is a frequent occupational sensitizer in hand cleansers and cleaning products. Occupational limonene contact allergy may also be caused by exposure to cosmetic products scented with limonene.

Investigation of terpinolene + ozone or terpinolene + nitrate radical reaction products using denuder/filter apparatus

Terpinolene's (1-methyl-4-(propan-2-ylidene)cyclohexene) reaction with ozone or the nitrate radical was investigated using a denuder/filter apparatus in order to characterize gas-phase and particulate reaction products. Identification of the reaction products (i.e., aldehydes, ketones, dicarbonyls and carboxylic acids) was made using two derivatization methods; O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine (PFBHA) to derivatize the carbonyl products or 3-Ethyl-1-[3-(dimethylamino)propyl]carbodiimide hydrochloride (EDC) and 2,2,2-trifluoroethylamine hydrochloride (TFEA) to derivatize the carboxylic acid products. Proposed carbonyl products for ozonolysis of terpinolene are: 4-methylcyclohex-3-en-1-one, 2-hydroxy-4-methylcyclohex-3-en-1-one, glyoxal, methyl glyoxal, 3-oxobutanal, and 6-oxo-3-(propan-2-ylidene)heptanal. Proposed carbonyl products for nitrate radical reaction of terpinolene are: 2-hydroxy-4-methylcyclohex-3-en-1-one, glyoxal, methyl glyoxal, and 4-oxopentanal. No carboxylic acid products were detected with either oxidizing reactant.

Impact of hand eczema severity on quality of life

Background:

Hand eczema is a common disease seen in dermatological practice comprising of a spectrum ranging from mild disease to a severe distressing and chronic course with a negative impact on the quality of life.

Aim:

To assess the impact of hand eczema severity on quality of life.

Materials and Methods:

Patients with hand eczema were enrolled in a prospective study. Disease severity was assessed by hand eczema severity index (HECSI) score and quality of life by dermatology life quality index (DLQI) questionnaire.

Results:

Forty-six patients participated of which 22 (47.8%) were males and 24 (52.2%) females. The commonest age group affected among men and women was 50-59 years (31.8%) and 40-49 years (41.7%) respectively. History of atopy was found in 23.9% and 63% had persistent disease. In 28 (60.9%), the trigger was washing soaps and detergents of which 21 (87.5%) were housewives. Of those employed, 27.7% reported loss of work days. The mean HECSI score was 14.46 (S.D = 20.98) and mean DLQI score was 9.54 (S.D = 5.62). Gender, age, occupation and duration of disease did not significantly affect the quality of life or disease severity. Increased episodes of eczema (>4 episodes/year) showed a statistically significant correlation with DLQI (P value = 0.021). There was no significant correlation between HECSI score and DLQI in this study.

Conclusion:

Majority of the patients with hand eczema had a significant impairment of their quality of life. The impairment of quality of life in this study was mainly dependent on increased frequency of the eruptions and not on hand eczema severity.

Isolation and screening of black fungi as degraders of volatile aromatic hydrocarbons

Black fungi reported as degraders of volatile aromatic compounds were isolated from hydrocarbon-polluted sites and indoor environments. Several of the species encountered are known opportunistic pathogens or are closely related to pathogenic species causing severe mycoses, among which are neurological infections in immunocompetent individuals. Given the scale of the problem of environmental pollution and the phylogenetic relation of aromate-degrading black fungi with pathogenic siblings, it is of great interest to select strains able to mineralize these substrates efficiently without any risk for public health. Fifty-six black strains were obtained from human-made environments rich in hydrocarbons (gasoline car tanks, washing machine soap dispensers) after enrichment with some phenolic intermediates of toluene and styrene fungal metabolism. Based on ITS sequencing identification, the majority of the obtained isolates were members of the genus Exophiala. Exophiala xenobiotica was found to be the dominant black yeast present in the car gasoline tanks. A higher biodiversity, with three Exophiala species, was found in soap dispensers of washing machines. Strains obtained were screened using a 2,6-dichlorophenol-indophenol (DCPIP) assay, optimized for black fungi, to assess their potential ability to degrade toluene. Seven out of twenty strains tested were able to use toluene as carbon source.

2-Butoxyethanol and Benzyl Alcohol Reactions with the Nitrate Radical: Rate Coefficients and Gas-Phase Products

The bimolecular rate coefficients [Formula: see text] and [Formula: see text] were measured using the relative rate technique at (297 ± 3) K and 1 atmosphere total pressure. Values of (2.7 ± 0.7) and (4.0 ± 1.0) × 10^-15 cm³ molecule^-1 s^-1 were observed for [Formula: see text] and [Formula: see text], respectively. In addition, the products of [Formula: see text] and [Formula: see text] gas-phase reactions were investigated. Derivatizing agents O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine and N, O-bis (trimethylsilyl)trifluoroacetamide and gas chromatography mass spectrometry (GC/MS) were used to identify the reaction products. For [Formula: see text] reaction: hydroxyacetaldehyde, 3-hydroxypropanal, 4-hydroxybutanal, butoxyacetaldehyde, and 4-(2-oxoethoxy)butan-2-yl nitrate were the derivatized products observed. For the [Formula: see text] reaction: benzaldehyde ((C₆H₅)C(=O)H) was the only derivatized product observed. Negative chemical ionization was used to identify the following nitrate products: [(2-butoxyethoxy)(oxido)amino]oxidanide and benzyl nitrate, for [Formula: see text] and [Formula: see text], respectively. The elucidation of these products was facilitated by mass spectrometry of the derivatized reaction products coupled with a plausible 2-butoxyethanol or [Formula: see text] reaction mechanisms based on previously published [Formula: see text] gas-phase mechanisms.

Occupational risk factors for hand dermatitis among professional cleaners in Spain

BACKGROUND

Dermatitis is an important health outcome for workers whose jobs put them in contact with irritants or sensitizing agents.

OBJECTIVES

We conducted an analysis of data from the Epidemiological Study on the Risk of Asthma in Cleaning Workers 2 (EPIASLI2) to assess worksites and cleaning products as risk factors for hand dermatitis among professional cleaning workers.

MATERIALS/METHODS

We distributed 4993 questionnaires to employees of 37 cleaning companies, and used data from 818 (16%) respondents who provided information about skin symptoms and cleaning-related exposures. We assessed associations between the frequencies of worksite and cleaning product exposures and a symptom-based definition of hand dermatitis among current cleaning workers (n = 693) and a comparison population (n = 125).

RESULTS

Hand dermatitis was reported by 28% of current cleaning workers, versus 18% of the comparison population, and was associated with cleaning outdoor areas and schools, and the use of hydrochloric acid [prevalence ratio (PR) 1.92, 95% confidence interval (CI) 1.22-3.02] and dust mop products (PR 1.75, 95% CI 1.11-2.75).

CONCLUSIONS

Professional cleaning workers may not be sufficiently protected from cutaneous disease at work. Future research should further investigate the roles of multiple product exposures and personal protective equipment.

Safety and Feasibility of Topical Application of Limonene as a Massage Oil to the Breast

BACKGROUND

Limonene, a major component in citrus oil, has demonstrated anti-cancer effects in preclinical mammary cancer models. However, the effective oral dose translates to a human dose that may not be feasible for chronic dosing. We proposed to evaluate topical application of limonene to the breast as an alternative dosing strategy.

MATERIALS AND METHODS

We conducted a mouse disposition study to determine whether limonene would be bio available in the mammary tissue after topical application. SKH-1 mice received topical or oral administration of limonene in the form of orange oil every day for 4 weeks. Plasma and mammary pads were collected 4 hrs after the final dosing. We also conducted an exploratory clinical study to evaluate the safety and feasibility of topically applied limonene in the form of orange oil to the breast. Healthy women were recruited to apply orange oil containing massage oil to their breasts daily for four weeks. Safety and feasibility were assessed by reported adverse events, clinical labs, and usage compliance. Pre and post-intervention nipple aspirate fluid (NAF) and plasma were collected for limonene concentration determination.

RESULTS

The mouse disposition study showed that topical and oral orange oil administration resulted in similar mammary tissue disposition of limonene with no clinical signs of toxicity. In the clinical study, the topical application of limonene containing massage oil to the breast was found to be safe with high levels of usage compliance for daily application, although NAF and plasma limonene concentrations were not significantly changed after the massage oil application.

CONCLUSIONS

Our studies showed that limonene is bio available in mammary tissue after topical orange oil application in mice and this novel route of administration to the breast is safe and feasible in healthy women.