Contact allergy to antioxidants in industrial greases.
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Adult↗
Biomedical subjects
T Estlander
Publications and source records attributed to T Estlander.
Allergic contact dermatitis from dental composite resins due to aromatic epoxy acrylates and aliphatic acrylates.
7 patients were occupationally sensitized to dental composite resin products (DCR): 6 dental nurses and 1 dentist. All had a positive patch test to their DCR. 2 independent types of allergy were seen; (a) aromatic epoxy acrylate, and/or (b) aliphatic acrylates. 4 out of 5 patients reacted to BIS-GMA, the most widely used aromatic epoxy acrylate in DCR, but not the dentist. She and 2 dental nurses were allergic to aliphatic acrylates, including triethylene glycol dimethacrylate (TREGDMA) and triethylene diglycol diacrylate (TREGDA). 4 patients were allergic to epoxy resin (ER) (containing mainly MW 340), possibly an impurity in some DCR. 2 patients were also allergic to methyl methacrylate (MMA): the dentist, had been exposed to MMA, but the nurse's exposure was uncertain. 1 patient was also allergic to rubber gloves, 2 to rubber chemicals but not their gloves, and 5 to disinfectants used. diagnosis was delayed as long as 13 years in spite of previous patch testing. Dermatologists need to use the patients' own DCR and the (meth)acrylate series for patch testing. No dental nurses could continue their occupation, but the dentist could occasionally handle DCR if wearing PVC gloves. Dental personnel need to know about the risks of DCR, and use no-touch techniques and protective gloves.
Acrylic Resins↗
Occupational skin disease in Finland. An analysis of 10 years of statistics from an occupational dermatology clinic.
An analysis of 10 years (1974-1983) of statistics was carried out at the Institute of Occupational Health, Helsinki, Section of Dermatology, which is devoted to occupational dermatology. A total of 1,082 cases of occupational skin diseases were diagnosed during this period. Allergic (50.1%) and toxic eczema (47.1%) comprised the majority of occupational cases of dermatosis. The most frequent causes of allergic occupational eczemas were rubber chemicals (19.9%), chromates (18.8%), and epoxy resins (13.1%). If the metals (chromium, nickel and cobalt) were considered as a group, they formed the largest category (28.4%), followed by the plastic materials (27.7%). Detergents (37.8%), followed by organic solvents (16.1%), were responsible for most of the irritant (toxic) eczemas. Occupational skin diseases currently make up about 20% of all occupational diseases in Finland, but the percentage is decreasing.
Allergens↗
Occupational allergic rhinitis from guar gum.
Three cases of allergic rhinitis from a vegetable gum, guar gum, have been detected. Two subjects were exposed to fine guar gum powder (Emco Gum 563, Meyhall Chemical AG, Switzerland), an insulator in rubber cables, when opening cables in a power cable laboratory. After 1-2 years' exposure the patients developed rhinitis. Scratch-chamber tests, nasal provocation tests, nasal eosinophilia and a RAST test proved their allergy. A third subject developed allergic rhinitis from another guar gum product (Meyproid 5306, Meyhall Chemical AG) after 2 years' exposure in a paper factory. A positive skin test and nasal provocation test confirmed the diagnosis. A fourth case of possible allergy to guar gum after exposure to Meyproid 5306 in a paper factory is also presented. No final diagnosis was reached in this case (in 1974). The present subjects, only one of whom was atopic, developed allergy within 2 years, although their exposure to guar gum was not especially heavy. Therefore, when handling guar, adequate ventilation facilities should be provided and protective clothing, including a respiratory mask, should be worn.
Adult↗
Allergic dermatoses and respiratory diseases from reactive dyes.
5 cases of occupational eczema, urticaria and respiratory disease from reactive dyes, occurring during 1977-1987, are reported. The patients, 4 men and 1 woman, were 24-52 years old when examined. They had been working in dye houses or textile plants, and had been exposed to reactive dyes for 8 months to 4 years before symptoms developed. Only 1 of the patients has been able to continue in the same occupation. On patch testing, the 4 patients with eczema reacted positively to 9 commercial dye powders. 2 patients reacted to the same dye, Remazol Schwarz B. On scratch and/or prick testing, the 2 patients who also had respiratory symptoms and/or urticaria reacted positively to the same dyes as on patch testing. The 5th patient, who had urticaria and respiratory symptoms, reacted positively to a dye, Remazol Gold Gelb RNL, but the patch test with that dye was negative. None of the patients was patch-test-positive to para-phenylenediamine (PPD) or to textile dye allergens in a series of organic dyes. Thus, the series of organic dyes has little value in the screening of allergy to reactive dyes. A 1% pet. dilution of commercial dye powder for patch testing and the same concentration in distilled water for prick testing seem to be suitable for the screening of allergy to reactive dyes.
Adult↗
Sensitization to patch test acrylates.
Data on allergic contact dermatitis from acrylates and 4 patients sensitized during routine patch testing are reported. During 1982-1985, we used 7 different acrylates for tests. 1 patient out of 22 (= 4.5%) was sensitized to ethyl acrylate and butyl acrylate (1% pet.). Since September 1985, we have used a commercial (meth)acrylate series containing 28 substances. 3 of 24 patients tested became sensitized to ethyl acrylate, 2-hydroxyethyl acrylate and 2-hydroxypropyl acrylate (0.5% pet.). Because active sensitization with acrylates can be very harmful, it may be necessary to use lower concentrations than recommended. Currently, we test ethyl acrylate, 2-hydroxyethyl acrylate and 2-hydroxypropyl acrylate at 0.167% pet.
Acrylates↗
Immunohistochemistry of lymphocytes and Langerhans' cells in long-lasting allergic patch tests.
A long-lasting allergic patch test is a "normal" allergic patch test that remains positive for weeks or months. An immunohistochemical study of immunocompetent cells in the skin in this rare type of patch tests was performed. Most inflammatory cells were T11 positive T-lymphocytes. The majority of these cells were of the helper/inducer phenotype (T4+), but a relative increase of T8+ cells as compared to the initial (1-2d) stages of allergic patch tests was observed. T6+ Langerhans' cells (LCs) were normal or increased in number in the epidermis, while very few dendritic cells displayed Ial antigen in the epidermis, indicating loss of Ial-staining of LCs. High to very high numbers of T6+ cells were found in the dermis. An inflammatory reaction of hair follicles with moderate numbers of T6+ cells in the peribulbar infiltrate was observed indicating that hair follicles might act as shunt pathways for allergens. A defect in down regulation of the contact hypersensitivity reaction and/or a constant antigen stimulation could be responsible for the long-lasting allergic patch tests.
Allergens↗
How to protect the hands.
Hand protection entails many problems. There is a wide variety of individual differences in the types of skin among human beings, and an even wider variety of chemicals to be handled and working methods to be learned in various workplaces. There are great differences in the degree of experience and education among job applicants and thus in their ability to understand the importance of instructions on safe working methods and the use of personal protective equipment. Therefore, proper employee selection is an important and demanding task for occupational health care personnel and dermatologists. Despite these complexities, an appropriate means of hand protection is essential in the prevention of many skin disorders and injuries.
Absorption↗
Contact allergy to an epoxy reactive diluent: 1,4-butanediol diglycidyl ether.
3 female workers in a brush factory developed contact allergy from a 2-component epoxy glue containing epoxy resin (37% w/w), reactive diluents: i.e., 1,4-butanediol diglycidyl ether (BDDGE) 3%, glycidyl ethers of aliphatic alcohols (Epoxide 8) 0.03% and phenyl glycidyl ether (PGE) 0.01%; and inert fillers. All 3 patients were positive to the resin component of the glue and to BDDGE, indicating that BDDGE was the main allergen. 2 of the patients reacted to PGE, but none to the 3rd reactive diluent (Epoxide 8) in the glue. 2 of the patients did not react to epoxy resin, indicating that BDDGE may be an even stronger sensitizer in humans than epoxy resin, and that it does not cross-react with epoxy resins. Permeation studies revealed that BDDGE penetrates disposable PVC and rubber gloves in less than 30 min; thus, contaminated gloves should be replaced immediately. Reactive diluents should be included in patch test series if contact allergy to epoxy products is suspected.
Adult↗
[Occupational dermatoses from exposure to rubber and plastic gloves].
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Dermatitis, Occupational↗
Hair bulb accumulation of Langerhans cells in allergic patch tests.
The occurrence of occupational allergic contact dermatitis due to 2,3-epoxypropyl trimethyl ammonium chloride (EPTMAC) is reported and supplemented with immunohistochemical and electron microscopic observations. Four young workers developed hand dermatitis at a factory in which modified, cationic starch is manufactured. EPTMAC, a quaternary ammonium compound used as a cationizing chemical in the process, produced allergic reactions in all four patients in epicutaneous testing. The patients had only been in contact with EPTMAC for a short time (one to three months) before developing allergic eczema, which indicates that EPTMAC is a strong sensitizer. Immunohistochemistry showed that dendritic OKT6+ cells (Langerhans cells) increase in the hair follicles and the peribulbar infiltrate during the allergic patch test indicating that hair follicles might actively be involved in delayed type allergic reactions, possibly as a shunt way for allergens. Using electron microscopy, mitotic immunocompetent cells were found in the epidermis during the allergic patch test.
Azo Compounds↗
Occupational contact dermatitis and contact urticaria caused by epoxy resins.
Over a ten-year period (1974-1983) 542 cases of allergic occupational contact dermatitis were diagnosed in our clinic. Epoxy resins caused 71 cases (13.1%) of occupational allergic contact dermatitis (CD), and three cases (0.6%) of irritant CD. One contact urticaria was caused by an epoxy resin hardener, methyl hexahydrophthalic anhydride. Epicutaneous testing with standard epoxy resin 1% in pet. (mainly oligomer of molecular weight 340) produced allergic reactions in all the patients with allergic CD with the exception of three. These three patients had allergic reactions only to their own resins. Testing the 71 patients of allergic CD with epoxy hardeners produced allergic reactions in 19 (26.8%). None of the patients had separate delayed contact allergy to epoxy hardeners without simultaneous contact allergy to standard epoxy resin.
Dermatitis, Occupational↗
Contact urticaria from rubber gloves: a detailed description of four cases.
Four cases of contact urticaria from rubber gloves are presented in detail. Three of the four patients, including two atopics had present or previous hand dermatitis. The causative gloves were made of natural rubber. Interestingly, one patient also reacted to her synthetic nitrile rubber gloves which the distributor had sold her as plastic gloves, and explanation for this case is discussed. Contact urticaria should be taken into consideration when there is recalcitrant hand dermatitis in spite of regular use of polymeric protective gloves. Manufacturers should give more accurate and reliable information on the composition of the glove materials to distributors and consumers.
Dermatitis, Occupational↗
Organic pigments in plastics can cause allergic contact dermatitis.
A short review on organic pigments in plastics as a cause of allergic contact dermatitis is presented. Previously, organic pigments have been reported as provoking allergic pigmented contact dermatitis when used in cosmetics. Here we present the case of a patient who developed allergic contact dermatitis from an organic pigment (Irgalite Orange F2G) in a plastic glove. This shows that organic pigments in plastics can also cause allergic contact dermatitis. The potential sensitizing capacity of organic pigments should be noted.
Coloring Agents↗
Dermatitis and urticaria from rubber and plastic gloves.
The number and nature of allergic occupational glove dermatoses were analysed. 542 cases of allergic contact dermatosis were diagnosed during 1974-1983. Amongst these, 68 (12.5%) were caused by rubber or plastic gloves. 2 patients had contact urticaria due to rubber gloves. Gloves were the main cause of occupational allergic rubber eczema, inducing 63 (58.3%) of 108 rubber eczema cases. 38 of them had positive reactions to rubber chemicals and glove material, 14 to glove material only, and 11 to rubber chemicals. 5 cases of allergic eczema from plastic gloves were diagnosed, all due to polyvinyl chloride (PVC). 2 cases of contact urticaria from natural rubber gloves were diagnosed by a provocation test. Epicutaneous testing with material of natural rubber gloves and rubber chemicals was negative. The present study shows that allergy to rubber gloves is usual, while allergy to plastic gloves is rare. Thus, plastic gloves should be used, when possible. Patch testing with protective gloves should always be used when patients develop prolonged hand dermatitis and where the possibility of glove eczema exists.
Clothing↗
Occupational dermatitis to 2,3-epoxypropyl trimethyl ammonium chloride.
4 workers developed hand dermatitis in an automated starch modification process plant. 2,3-epoxypropyl trimethyl ammonium chloride (EPTMAC), a quaternary ammonium compound used as a cationizing chemical, produced allergic reactions in all 4 patients. They had only been in contact with EPTMAC for a short time before developing dermatitis, which indicates that EPTMAC is a strong sensitizer. Immunohistochemistry and electron microscopy showed the features of an allergic patch test. An industrial hygiene project was initiated at the factory to prevent new cases. It revealed many risks of skin contact with the process chemicals. Thus an automated process does not guarantee protection.
Allergens↗
Occupational dermatitis due to an epoxy acrylate.
A dental assistant developed sensitivity to dental restorative materials within 3 months of starting to use them. They contained the epoxy acrylate BIS-GMA, which is the most commonly used dimethacrylate monomer in dental composite restorations. She was positive to a patch test with BIS-GMA, which was the probable allergen, and epoxy resin, but this substance was not present in the materials used, as shown by high performance liquid chromatography. The patient was also allergic to the disinfectant Desimex i containing dodecyl diaminoethyl glycine.
Adult↗
Organic pigment as a cause of plastic glove dermatitis.
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Coloring Agents↗