Occupational dermatoses in health care workers evaluated for suspected allergic contact dermatitis

Abstract

Our results underscore the importance of thoroughly evaluating HCWs for ACD and ACU with the use of expanded standard allergen series and prick or radioallergosorbent testing to latex.

Occupational Dermatitis in Health Care Workers Evaluated for Suspected Allergic Contact Dermatitis

“…Finally, despite the higher rate of thimerosal sensitization among HCWs, we encourage HCWs to be vaccinated as appropriate. As has been previously reported, allergic patch test reactions to thimerosal are rarely relevant, 5,30,31 and most individuals with a positive patch test reaction to thimerosal do not react when vaccinated to thimerosal. 32 …”

Benzalkonium Chloride

“…Nevertheless, BAK has been reported as a frequent sensitizer for those persons working in health care, 21,22,42 which is not surprising given that it is found in products used to disinfect the skin and surgical instruments. 1,3 In one study that sought to determine the most frequent allergens causing ACD among health care workers, those working in health care had a 7.5% rate of relevant reaction to BAK, whereas nonYhealth care workers had a rate of relevant reaction of 2.3%.…”

“…1,3 In one study that sought to determine the most frequent allergens causing ACD among health care workers, those working in health care had a 7.5% rate of relevant reaction to BAK, whereas nonYhealth care workers had a rate of relevant reaction of 2.3%. 22 Among the 31 health care workers identified as having occupationally related ACD, BAK was a relevant occupational allergen in 9.7%. 22,43 In a report that described sources of occupationally related dermatoses in nurses, sensitization to BAK 0.1% was present in 23.8% of 223 nurses studied.…”

“…6 Numerous reports have also associated BAK with allergic reactions, including contact dermatitis and conjunctivitis. 7Y20 Sensitization has been reported particularly among health care workers, 12,21,22 as BAK is used as a preoperative disinfectant and in the care of burns, cutaneous infections, ulcers, and wounds. 1 Benzalkonium chloride is also found in many products commonly encountered outside of health care, and a search of SkinSAFE (formerly known as CARD, the Contact Allergen Replacement Database) revealed that of 11,979 products listed, 2007 (17%) contain BAK or one of its crossreactors (eg, other quaternary ammonium compounds such as benzethonium chloride [BEC]).…”

The Role of Textiles in Dermatitis: An Update

“…The main culprits in the elicitation of textile-associated ACD are dyes and formaldehyde (FA) finishing resins. Common chemicals which result in primary sensitization and the corresponding occupations at highest risk for exposure include exposure to components of hair dye (pphenylenediamine (PPD), aminophenol, and diaminotoluene sulfate) in hair dressers and formaldehyde in health care workers [22], embalmers, cabinetmakers [23], and machinists. PPD exposure and sensitization can also occur through temporary black henna tattoos.…”