Allergens in the Workplace

So-called universal precautions resulted in the marked increase in use of latex gloves as personal protective equipment. Since then, the rate of NRL allergy, especially type I allergy, has increased. While approximately 1% of the general population is sensitized to latex, it is now believed that 10-17% of healthcare workers have a type I allergy to NRL allergenic proteins [6, 7]. However, these numbers may be inflated by self-reported allergy assessments. In a study by Allmers [8], it was found that 63% of healthcare workers self-reporting sensitivity to NRL had negative results (hives, pruritus etc.) when exposed to NRL in an occupational use type of situation.

Many other professions use gloves on a daily basis for the perceived benefit of protection from irritant and allergy-provoking exposures. While protecting themselves to some degree, individuals using latex gloves may be exposed to other glove additive allergens (i.e. thiurams and carbamates) that result in delayed-type hypersensitivity.

The most common occupationally relevant causes of ACD in a 10-year study in Germany and recent data from the North American Contact Dermatitis Group reporting the top occupational allergens seen by their group are summarized in table 1 [9, 10]. Professions associated with exposure to these and other allergens and recommended gloves for protection are summarized in table 2. A comparison between the top occupations effected by occupational ACD is presented in table 3. Skoet et al. [11] examined the rates

Table 2. Glove penetration of allergens by profession

Profession

Allergen

Use

Protective

Not protective

Hairdresser

Glyceryl

Permanent wave

Neoprene

Butadiene

monothioglycolate/

solution

household

polymer,

ammonium

gloves, 4H

NRL, V

thioglycolate

Epoxy resin

Adhesive

N, SR, P, 4H

NRL

Acrylates

Adhesive/ plastic appliances

4H

NRL, N, V

S-Phenylenediamine

Hair dye

V

Tosylamide

Nail polishes

?

?

formaldehyde resin

Nickel

Metal finishes

P, polyethylene, neoprene

NRL

Cement/

Chromates

Cement additive/

Some BC

construction

leather tanning

industry

Epoxy resins

Adhesive

N, SR, P, 4H

NRL

Aliphatic isocyanates

Automobile paints

4H

NRL

Healthcare/

NRL

Glove material

BC

dentistry

Rubber accelerators (carba, thiuram, mercaptobenzothiazole)

Rubber production

P

NRL, N

Chlorhexidine

Antibacterial/surgical scrub

NRL, SR

Bacitracin/neomycin/

Antibacterial

?NRL (neomycin)

polymyxin

Formaldehyde

Preservative

SR, 4H

NRL

Acrylates

Adhesive/plastic appliances

4H

NRL, N

Epoxy resin

Adhesive

N, SR, P, 4H

NRL

Glutaraldehyde

Cold sterilization

N, P, SR, 4H

NRL

BC = Barrier cream; N = nitrile; P = plastic; SR = synthetic rubber; 4H = Silvershield/4H; ? = not known.

BC = Barrier cream; N = nitrile; P = plastic; SR = synthetic rubber; 4H = Silvershield/4H; ? = not known.

of occupational hand dermatitis both from irritant and allergic eczema in Denmark in 2004. Women were more likely to be allergic to rubber additives (from gloves) and biocides such as methylchloroisothiazolinone/ methylisothiazolinone, Euxyl K400 and quaternium-15 (from skin care products). Men reacted at significantly higher rates than women to chromates (from leather gloves), but at similar rates to rubber additives and nickel (from tools) [11].

Table 3. Risk of ACD by profession

Germany [9]

North America [10]

(1) Hairdressers/barbers

(2) Florists

(3) Tile setters/terrazzo workers

(4) Bakers

(5) Dental technicians

(6) Healthcare workers

(7) Machinists/metal surface processors

(1) Registered nurses

(2) Assemblers

(3) Nurses aides/orderlies

(4) Machinists

(5) Students

(6) Hairdressers

(7) Machine operators

(8) Auto mechanics

(9) Compressing/compacting (10) Cooks

Table 4. Methods of protection from occupational ACD [12, 13]

Identification of potential allergens

Elimination/replacement of harmful exposures

Personal protective equipment

Personal and environmental hygiene

Educational programs

Prevention of skin barrier breakdown (ICD)

Postexposure skin care

Regulatory controls

Preemployment screening

Allergy Relief

Allergy Relief

Have you ever wondered how to fight allergies? Here are some useful information on allergies and how to relief its effects. This is the most comprehensive report on allergy relief you will ever read.

Get My Free Ebook


Post a comment