Triple relevant sensitization to didecyldimethylammonium chloride, benzalkonium chloride, and polyhexamethylene biguanide in a hospital cleaner

Ulicki, Michal; Dendooven, Ella; Aerts, Olivier

doi:10.1111/cod.14062

Cited by 4 publications

(3 citation statements)

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“…Airborne CD was also described in a cleaning woman due to a spreading on the floor of QUAT-10 ® containing BAC ( Mauleón et al, 2006 ). In a hospital cleaner, BAC and DDAC were also recently incriminated in severe dorsal and palmar hand dermatitis ( Ulicki et al, 2022 ). DDAC had already been described in other case reports of CD in hospital workers ( Dejobert et al, 1997 ; Dibo and Brasch, 2001 ; Geier et al, 2013 ).…”

Section: Quaternary Ammonium Compounds-associated Delayed Hypersensit...mentioning

confidence: 99%

“…QAC have been reported in immediate hypersensitivity reactions (asthma, contact urticaria) ( Bernstein et al, 1994 ; Burge and Richardson, 1994 ; Purohit et al, 2000 ; Houtappel et al, 2008 ; Oropeza et al, 2011 ) but also delayed reactions (CD, eczema) ( Klein et al, 1991 ; Cusano and Luciano, 1993 ; Dejobert et al, 1997 ; Mauleón et al, 2006 ; Ulicki et al, 2022 ) in the exposed populations. They also have been suggested to be the sensitizing molecules at the origin of NMBA anaphylaxis ( Florvaag et al, 2005 ; de Pater et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

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Quaternary ammonium compounds in hypersensitivity reactions

et al. 2022

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Quaternary ammonium compounds (QAC) are commonly used disinfectants, antiseptics, preservatives, and detergents due to their antibacterial property and represent the first used biocides before phenolic or nitrogen products. Their common structure consists of one or more quaternary ammonium bound with four lateral substituents. Their amphiphilic structure allows them to intercalate into microorganism surfaces which induces an unstable and porous membrane that explains their antimicrobial activity towards bacteria, fungi, and viruses. QAC are thus found in many areas, such as household products, medicines, hygiene products, cosmetics, agriculture, or industrial products but are also used in medical practice as disinfectants and antiseptics and in health care facilities where they are used for cleaning floors and walls. QAC exposure has already been involved in occupational asthma in healthcare workers or professional cleaners by many authors. They also have been suggested to play a role in contact dermatitis (CD) and urticaria in workers using cosmetics such as hairdressers or healthcare workers, inciting reglementary agencies to make recommendations regarding those products. However, distinguishing the irritant or sensitizing properties of chemicals is complex and as a result, the sensitizing property of QAC is still controverted. Moreover, the precise mechanisms underlying the possible sensitization effect are still under investigation, and to date, only a few studies have documented an immunological mechanism. Besides, QAC have been suggested to be responsible for neuromuscular blocking agents (NMBA) sensitization by cross-reactivity. This hypothesis is supported by a higher prevalence of quaternary ammonium (QA)-specific IgE in the professionally exposed populations, such as hairdressers, cleaners, or healthcare workers, suggesting that the sensitization happens with structurally similar compounds present in the environment. This review summarizes the newest knowledge about QAC and their role in hypersensitivities. After describing the different QAC, their structure and use, the most relevant studies about the effects of QAC on the immune system will be reviewed and discussed.

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Section: Quaternary Ammonium Compounds-associated Delayed Hypersensit...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quaternary ammonium compounds in hypersensitivity reactions

et al. 2022

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“…BAK ACD + Buttocks, upper part of the thighs [ 17 ] Oilatum™ Plus (antiseptic bath emollient) containing 6.0% BAK ICD N/A Scrotum, penis [ 18 ] Eyedrops persevered with 0.07% aq. BAK ACD + N/A [ 19 ] Hand Sanitizer containing BAK and DDAC ACD + Dorsal and palmar hands, arms, trunk [ 20 ] Eczema Cream containing BAK ACD + Trunk, legs [ 21 ] Disinfectant wipes ACD + Face [ 21 ] Didecyldimethylammonium Chloride (DDAC) 0.1% pet. DDAC ACD + Hand [ 22 ] Bath disinfectant and surface disinfectant containing DDAC 0.1% pet.…”

Section: Introductionmentioning

confidence: 99%

Quaternary Ammonium Compounds and Contact Dermatitis: A Review and Considerations During the COVID-19 Pandemic

Okeke¹,

Khanna²,

Ehrlich³

2023

CCID

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The recent global pandemic has resulted in increased use of quaternary ammonium compounds (QACs). Currently, QACs are active ingredients in 292 disinfectants recommended by the US EPA for use against SARS-CoV-2. Among QACs, benzalkonium chloride (BAK), cetrimonium bromide (CTAB), cetrimonium chloride (CTAC), didecyldimethylammonium chloride (DDAC), cetrimide, quaternium-15, cetylpyridinium chloride (CPC), and benzethonium chloride (BEC) were all identified as potential culprits of skin sensitivity. Given their widespread utilization, additional research is needed to better classify their dermal effects and identify other cross-reactors. In this review, we aimed to expand our knowledge about these QACs to further dissect its potential allergic and irritant dermal effects on healthcare workers during COVID-19.

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