Contact dermatitis to methyl methacrylate

Abstract

2 cases of contact dermatitis to methyl methacrylate monomer are presented. The patients are nurses who mixed bone cement at orthopedic operations. During the procedure, they used 2 pairs of gloves (latex). Butyl rubber gloves are recommended for methyl methacrylate monomer to avoid sensitization and/or cumulative irritant contact dermatitis on the hands.

Skin protection against methylmethacrylate

“…Consequently, the orthopedic staff does not know if they are already on the way to develop a contact allergy. Because the MMA has been shown to be the cause of all reported skin problems caused by bone cement (Fisher 1956, Pegum & Medhurst 1971, Fries et al 1975, Fisher 1979, Kassis et al 1984, concentrated MMA was used to detect the protective properties of the gloves tested. As the partial pressure of MMA in mixed bone cement is much less than in concentrated MMA, a glove able to withstand the concentrated MMA will provide a splendid protection.…”

“…Correspondence: Dr. Darre, Frcidings All6 27, DK-2860 Soborg, Denmark Contact sensitization and toxic dermatitis to bone cement have been reported in dentists and dental laboratory technicians (Fisher 1956) and in orthopedic surgeous and nurses (Pegum and Medhurst 1971, Fries et al 1975, Fisher 1979, Kassis et al 1984. Surgical rubber gloves are not impervious to methylmethacrylate monomer (MMA) (Pegum & Medhurst 1971, Fries et al 1975, Waegemaekers et al 1983, Darre I % Vedell984).…”

“…A butyl rubber glove, 0.48 mm thick, proved to be impervious to MMA in vitro and prevented skin eruptions in 1 orthopedic nurse with known contact allergy to MMA , Kassis et al 1984. However, because the glove thickness was inconvenient and the rather expensive butyl glove had to be sterilized after each use, we studied the permeability of MMA through alternative glove materials.…”

Evaluation of a Nontoxic Rigid Polymer as Connecting Bar in External Skeletal Fixators

“…Mutagenicity of MMA has also been demonstrated by in vitro assay 24 . Furthermore, MMA is a sensitizer producing allergic contact eczema, 25,26 delayed hypersensitivity, 27 finger paresthesia, 28 and asthma 29 after contact with PMMA bone cement in surgeons and theater personnel. Besides limiting exposure, current recommendations for handling PMMA bone cement include the following: double gloving (and/or use of special gloves) as well as change of gloves immediately after the end of PMMA handling 30 and use of special air conditioned or vacuum mixing systems with a closed application device 31 .…”

The Use and Handling of Acrylic Bone Cement in Danish Orthopaedic Departments

“…Toxic encephalopathy and organic dementia have been reported in two Danish papers describing dental technicians with several years of heavy exposure to MMA (Christiansen et al 1986;Steendahl et al 1992). Additionally MMA is a modest sensitizer which may cause contact allergy and contact dermatitis (Fischer 1979;Fregert 1983;Fries et al 1975;Kassis et al 1984;Pegum & Medhurst 1971;Van der Walle et a/. 1982).…”