The great majority of allergic patch test reactions to bis-GMA, bis-GA, GMA and bis-EMA were not associated with specific exposure, and cross-allergy to DGEBA epoxy resin remained a probable explanation. However, independent reactions to bis-GA indicated specific exposure. Anaerobic sealants may induce sensitization not only to aliphatic (meth)acrylates but also to aromatic bis-GA.
Background
Epoxy resin systems (ERSs) are among the leading causes of occupational allergic contact dermatitis.
Objectives
To identify riskful exposures and sources of skin exposure, and to quantify skin exposure to diglycidyl ether of bisphenol A (DGEBA) epoxy monomer, in construction coating work.
Methods
Skin exposure to epoxy chemicals was studied in 5 coating companies through (a) interviews and visual observation, (b) quantifying DGEBA on 12 workers’ skin by tape‐stripping, (c) measuring DGEBA on 23 surfaces by wipe‐sampling, and (d) quantifying DGEBA in new sewage pipe. Acetone extracts of the tapes, wipes and sawdust from a newly hardened sewage pipe were analysed by gas chromatography/mass spectrometry.
Results
Identified riskful exposures were, for example, mixing ERSs, handling coating pots, and working above shoulder level. Epoxy stains on, for example, tools, equipment and clothing were seen in all workplaces. Protective gloves were of varying quality, and were not always suitable for chemicals. The amount of DGEBA on the workers’ skin varied considerably. All screened tool handles were contaminated. Two‐day‐old epoxy sewage pipe contained 3.2% DGEBA.
Conclusions
Construction coating entails skin contact with ERSs directly and via contaminated surfaces, personal protective equipment, and recently hardened epoxy materials. Observation is a useful method for assessing skin exposure in coating work.
Orthopedic plaster casts contain methylene diphenyl diisocyanate (MDI). A few case reports have suggested occupational asthma to MDI in casting work. However, the knowledge of the exposure levels related to the occupational asthma cases is lacking. We report on two occupational asthma cases due to MDI in nurses irregularly applying orthopedic plaster casts, verified with placebo controlled specific inhalation challenge. The levels of MDI in the air were measured in the exposure chamber during the specific inhalation challenges with a quantitative method including filter collection and subsequent liquid chromatography-mass spectrometry (LC-MS) analysis of the isocyanate groups. In order to estimate the level of airborne MDI in casting work, measurements were conducted also in two hospitals during the application and removal of synthetic plaster casts using the same method. The concentrations were well below the occupational exposure limit in both specific inhalation challenge and hospital measurements. Based on our findings, even minor exposure to airborne MDI in casting work can cause an asthmatic reaction in some patients.
Buckwheat is a known, though uncommon, allergen in occupational settings. It has recently gained popularity as healthy food and as an ingredient in gluten-free diets. We describe a series of six patient cases with occupational immediate allergy to buckwheat. Three cooks, two bakers, and a worker in a grocery store were occupationally exposed to buckwheat flour and developed immediate allergy to buckwheat, which was confirmed by skin prick testing and measurement of specific immunoglobulin E antibodies. Four of the patients were diagnosed with occupational asthma, four with occupational rhinitis, and two with occupational contact urticaria caused by buckwheat. Three of the six patients suffered anaphylaxis as consequence of their occupational buckwheat allergy after ingestion of food that contained buckwheat. The high rate of life-threatening reactions, together with a short exposure time to buckwheat before sensitization occurred in these cases, highlights the importance of a detailed occupational history and a high index of suspicion for occupational food allergens.
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