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Patch Testing of Mercaptobenzothiazole and Mercapto Mix: The North American Contact Dermatitis Group Experience, 1994-2016. Dermatitis 2020; 32:232-244. [PMID: 33273233 DOI: 10.1097/der.0000000000000675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Mercapto compounds are a category of rubber accelerators that may cause allergic contact dermatitis. This study characterizes patch test reactions to mercaptobenzothiazole (MBT) and mercapto mix (MM) in a large North American population. METHODS The 1994-2016 North American Contact Dermatitis Group screening series data were analyzed. Patients with allergic reactions to either MBT or MM (mercapto+) were included. The following characteristics were analyzed: strength of reaction, clinical and occupational relevance, coreactivity with other rubber accelerators, and sources of exposure. RESULTS A total of 49,795 patients were tested to mercapto compounds from 1994 to 2016; 633 (1.3%) had positive reactions to MBT and/or MM. The frequency to both MBT and MM significantly decreased over time (P < 0.0001). Mercapto+ patients were significantly more likely to be male, have occupationally related skin disease, and report involvement of the hands and/or feet (P < 0.0001). They were significantly less likely to have face, scalp/ears/neck, or trunk involvement (P ≤ 0.0001). There was significant coreactivity with carba mix (23.4%) and thiuram mix (32.5%). Mercaptobenzothiazole and MM reactions were frequently clinically (81.7% and 83.5%, respectively) and occupationally relevant (29.8% and 33.4%, respectively). Gloves were the most common source (31.3% and 30.9%, respectively). CONCLUSIONS Patch test positivity to mercapto compounds significantly decreased from 1994 to 2016 but remains clinically and occupationally relevant.
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Positive Patch Test Reactions to Carba Mix and Thiuram Mix: The North American Contact Dermatitis Group Experience (1994-2016). Dermatitis 2020; 32:173-184. [PMID: 33273217 DOI: 10.1097/der.0000000000000648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/OBJECTIVE This study characterizes concomitant reactions to carba mix (CM) and thiuram mix (TM) in a large North American population. Because thiurams and dithiocarbamates have structural similarity, concomitant reactions are expected. METHODS The 1994-2016 North American Contact Dermatitis Group data were analyzed. Patients with a final reaction interpreted as "allergic" to either CM or TM were included. RESULTS A total of 49,758 patients were tested to both CM and TM. A total of 3437 (6.9%) had positive reactions to CM and/or TM including the following groups: CM+ only (n = 1403, 40.8%), TM+ only (n = 1068, 31.0%), or both (n = 966, 28.1%). A total of 47.5% of TM+ patients were positive to CM and 40.8% of CM+ patients were positive to TM. Male sex, occupationally related dermatitis, and hand involvement were significantly more common in individuals positive to CM and/or TM as compared with those who were negative (P < 0.0001). More than 80% of CM+/TM+ reactions were currently relevant. Gloves were the most common source of CM and TM; clothing and footwear were also frequent. CONCLUSIONS Carba mix and TM remain important, clinically relevant allergens. Although significant concomitant reaction frequency was demonstrated, more than half of the patients reacting to either CM or TM would have been missed if both had not been tested, underscoring the importance of testing to both.
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Havmose M, Thyssen JP, Zachariae C, Johansen JD. Use of protective gloves by hairdressers: A review of efficacy and potential adverse effects. Contact Dermatitis 2020; 83:75-82. [PMID: 32311093 DOI: 10.1111/cod.13561] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
Occupational hand eczema is common among hairdressers, and protective gloves are important in limiting exposure to irritants and allergens. Various glove types may differ in their protective ability, and their use may lead to hand eczema due to skin irritancy and allergy. MEDLINE was searched for studies investigating permeation of gloves to irritants and allergens used in the hairdressing trade, as well as adverse effects of glove use affecting hairdressers. Forty-four studies were identified; nine reported on permeation. Of those, two in vitro studies found nitrile rubber (NR) gloves to give the best protection when handling hair dyes. Polyethylene (PE) gloves had the lowest reported break-through time. The prevalence of sensitization to rubber materials in European hairdressers was as follows: thiuram mix, median 2.5% (range 0%-8.2%), weighted average 3.0% (95% confidence interval [CI] 3.0%-3.1%); mercapto mix, median 0.4% (range 0%-3.3%), weighted average 0.5% (95% CI 0.47%-0.50%), mercaptobenzothiazole, median 0.6% (range 0%-6.6%), weighted average 0.7% (95% CI 0.6%-0.7%), NRL-type I allergy, median 1.3% (range 1%-16.4%), weighted average 4.0% (95% CI 3.6%-4.5%). In conclusion, NR gloves provide the best skin protection for hairdressers, although natural rubber latex (NRL) and polyvinylchloride (PVC) gloves may be sufficient in most cases. PE gloves are not recommended. Synthetic rubber gloves with low or no levels of accelerators are preferred.
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Affiliation(s)
- Martin Havmose
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jeanne D Johansen
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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Oosterhaven JAF, Uter W, Aberer W, Armario-Hita JC, Ballmer-Weber BK, Bauer A, Czarnecka-Operacz M, Elsner P, García-Gavín J, Giménez-Arnau AM, John SM, Kręcisz B, Mahler V, Rustemeyer T, Sadowska-Przytocka A, Sánchez-Pérez J, Simon D, Valiukevičienė S, Weisshaar E, Schuttelaar MLA. European Surveillance System on Contact Allergies (ESSCA): Contact allergies in relation to body sites in patients with allergic contact dermatitis. Contact Dermatitis 2019; 80:263-272. [PMID: 30520058 PMCID: PMC6590142 DOI: 10.1111/cod.13192] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 11/08/2018] [Accepted: 12/02/2018] [Indexed: 12/30/2022]
Abstract
Background Analyses of the European Surveillance System on Contact Allergies (ESSCA) database have focused primarily on the prevalence of contact allergies to the European baseline series, both overall and in subgroups of patients. However, affected body sites have hitherto not been addressed. Objective To determine the prevalence of contact allergies for distinct body sites in patients with allergic contact dermatitis (ACD). Methods Analysis of data collected by the ESSCA (www.essca‐dc.org) in consecutively patch tested patients, from 2009 to 2014, in eight European countries was performed. Cases were selected on the basis of the presence of minimally one positive patch test reaction to the baseline series, and a final diagnosis of ACD attributed to only one body site. Results Six thousand two hundred and fifty‐five cases were analysed. The head and hand were the most common single sites that ACD was attributed to. Differences between countries were seen for several body sites. Nickel, fragrance mix I, cobalt and methylchloroisothiazolinone/methylisothiazolinone were the most frequent allergens reported for various body sites. Conclusions Distinct allergen patterns per body site were observed. However, contact allergies were probably not always relevant for the dermatitis that patients presented with. The possibility of linking positive patch test reactions to relevance, along with affected body sites, should be a useful addition to patch test documentation systems.
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Affiliation(s)
- Jart A F Oosterhaven
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen/Nürnberg, Erlangen, Germany
| | - Werner Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - José C Armario-Hita
- Department of Dermatology, University Hospital of Puerto Real, University of Cádiz, Cádiz, Spain
| | - Barbara K Ballmer-Weber
- Department of Dermatology, University Hospital Zürich and Clinic of Dermatology and Allergology, Kantonsspital St Gallen, Zürich, Switzerland
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, University Allergy Centre, Technical University Dresden, Dresden, Germany
| | | | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Juan García-Gavín
- Department of Dermatology, University Hospital Complex, Faculty of Medicine, A Coruña, Santiago de Compostela; also: Dermatological Office, Vigo, Spain
| | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, IMIM Universitat Autònoma, Barcelona, Spain
| | - Swen M John
- Department of Dermatology and Environmental Medicine, Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), Lower Saxony Institute for Occupational Dermatology (NIB), University of Osnabrück, Osnabrück, Germany
| | - Beata Kręcisz
- Faculty of Medicine and Health Science, The Jan Kochanowski University, Kielce, Poland
| | - Vera Mahler
- Department of Dermatology, University of Erlangen/Nürnberg, Erlangen, Bavaria.,Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Thomas Rustemeyer
- Department of Dermatology and Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | | | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Environmental and Occupational Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
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Powers C, Lampel HP. The rubber manufacturing industry: a case report and review of cutaneous exposure and sequelae. J Occup Med Toxicol 2015; 10:33. [PMID: 26339279 PMCID: PMC4558935 DOI: 10.1186/s12995-015-0075-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 08/31/2015] [Indexed: 11/10/2022] Open
Abstract
Exposure to chemical carcinogens in rubber manufacturing remains a serious occupational health concern. Workers are exposed to these carcinogens via skin or inhalation. Rubber manufacturing work is associated with a high prevalence of dermatologic diseases such as eczema, allergic contact dermatitis and atopic dermatitis. The role that epidermal exposure plays in the development of malignancies historically associated with the rubber industry is less certain. We present a case relevant to this discussion and review the role of skin exposure in the rubber industry, providing an overview of the cutaneous and systemic manifestations of occupational exposures in modern day rubber workers.
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Affiliation(s)
- Claire Powers
- School of Medicine, Duke University, Durham, North Carolina USA
| | - Heather P Lampel
- Department of Dermatology, Duke University, Durham, North Carolina USA
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Warburton KL, Bauer A, Chowdhury MMU, Cooper S, Kręcisz B, Chomiczewska-Skóra D, Kieć-Świerczyńska M, Filon FL, Mahler V, Sánchez-Pérez J, Schnuch A, Uter W, Wilkinson M. ESSCA results with the baseline series, 2009-2012: rubber allergens. Contact Dermatitis 2015; 73:305-12. [DOI: 10.1111/cod.12454] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/10/2015] [Accepted: 06/13/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | - Andrea Bauer
- Department of Dermatology; University Allergy Centre, University Hospital Carl Gustav Carus, Technical University Dresden; Dresden D-01307 Germany
| | | | - Susan Cooper
- Department of Dermatology; Churchill Hospital; Oxford OX3 7LJ UK
| | - Beata Kręcisz
- Nofer Institute of Occupational Medicine; Lodz 91-348 Poland
| | | | | | - Francesca L. Filon
- Department of Public Health, Occupational Medicine; University of Trieste; IT-34129 Trieste Italy
| | - Vera Mahler
- Allergy Unit, Department of Dermatology; University Hospital Erlangen; 91054 Erlangen Germany
| | - Javier Sánchez-Pérez
- Department of Dermatology; Hospital Universitario de la Princesa; 28006 Madrid Spain
| | - Axel Schnuch
- Information Network of Departments of Dermatology; University Medicine Göttingen; 37075 Göttingen Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen/Nurnberg; 91054 Erlangen Germany
| | - Mark Wilkinson
- Department of Dermatology; The Leeds Teaching Hospitals NHS Trust; Leeds LS7 4SA UK
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Frosch PJ, Mahler V, Uter W. Dihydroxydiphenyl - a historical rubber contact allergen? Contact Dermatitis 2015; 73:377-80. [PMID: 26234388 DOI: 10.1111/cod.12459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Peter J Frosch
- Department of Dermatology, University of Witten/Herdecke and Klinikum Dortmund (formerly), 44137, Dortmund, Germany
| | - Vera Mahler
- Allergy Unit, Department of Dermatology, University Hospital Erlangen, 91054, Erlangen, Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nürnberg, 91054, Erlangen, Germany
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Warshaw EM, Schram SE, Belsito DV, DeLeo VA, Fowler JF, Maibach HI, Marks JG, Mathias TC, Pratt MD, Rietschel RL, Sasseville D, Storrs FJ, Taylor JS, Zug KA. Shoe Allergens: Retrospective Analysis of Cross-Sectional Data from the North American Contact Dermatitis Group, 2001-2004. Dermatitis 2007; 18:191-202. [DOI: 10.2310/6620.2007.06047] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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