Knowledge of skin hazards and the use of gloves by Australian hairdressing students and practising hairdressers

Occupational contact dermatitis is common amongst hairdressers. In this population-based study, 193 trainee hairdressers and 184 practising hairdressers completed a questionnaire detailing their knowledge of skin hazards, the skills they practised and the frequency of glove use. Knowledge of skin hazards was poor in both groups. While up to 70% of participants correctly identified hairdressing chemicals as potential skin hazards, less than 15% correctly identified the role of wet work. Only a small proportion recognized that hairdressing chemicals could cause allergy. Contrary to findings elsewhere, less-experienced hairdressers often handled chemicals, particularly hair dyes containing p-phenylene diamine. The use of gloves was inadequate, particularly when performing work at the basin, which both junior and senior hairdressers did on a regular basis. Recommended strategies for the prevention of hand dermatitis in hairdressers include improved student education, appropriate glove use and the application of after-work moisturizing creams.     

Contact dermatitis in hairdressers'' clients

The aim of our study was to report the frequency of sensitization to hairdressing allergens in a group of patients with contact dermatitis, in whom previous treatments with hair dyes or permanent wave solutions were suspected to be the cause. 49 of 261 hairdressers' clients (18.7%), who were patch tested with the hairdressers' screening series in the years 1985-1990, showed one (27) or more (22) positive reactions to hairdressing chemicals. This study confirms hair dyeing to be the procedure associated with the highest risk of sensitization among hairdressers' clients. Among hair dye allergens, PPD is the most frequent sensitizer (7.3%). A low rate of sensitization to the PPD derivatives PAP, ONPPD and PTD was detected in these clients, there being no differences in the frequency of sensitization to the 3 substances (4.2%, 4.6% and 4.6%, respectively). Only 0.4% of clients were positive to resorcinol, while pyrogallol showed a 2.3% rate of sensitization. Sensitization to GMTG was found in 3.3% of patients. ATG was an infrequent sensitizer (1.1%). Allergic contact dermatitis due to APS is quite rare (2.7%), in view of the widespread use of this compound. A positive open patch test in 1 hairdressers' client, who complained of generalized urticaria after hair bleaching, confirmed the diagnosis of immediate contact reaction due to APS. Sensitization to hairdressing allergens among consumers (18.7%) is possibly more frequent than sensitization to other cosmetic ingredients. We previously detected a 14.3% rate of sensitization to cosmetic ingredients in patients with suspected allergic contact dermatitis caused by cosmetics. On the other hand, reactions to cosmetic ingredients were also common in our patients. This may indicate that hairdressers' clients make greater use of cosmetics than average.     

What do trainee hairdressers know about hand dermatitis?

Hand dermatitis is an important cause of morbidity in hairdressers. We conducted a questionnaire survey of 121 trainee hairdressers from 2 hairdressing colleges in Burnley (UK). The questionnaire concerned the number and types of hairdressing procedures performed, previous and current medical history, awareness of risks to the skin from hairdressing, and knowledge of hand dermatitis prevention. 17% of the trainees suffered currently from hand dermatitis. This is likely to be due to the large amount of wet work done by apprentice hairdressers, particularly those who worked in salons. 2/3 of trainees were not aware that atopic eczema predisposed to hand dermatitis. Formal pre-school and pre-employment counselling was limited. Knowledge on hand care among trainees was not often translated into practice, with gloves being worn by only 9% when shampooing and 58% when perming. Prevention of hand dermatitis by education and pre-employment counselling is of fundamental importance.     

Hairdressers with dermatitis should always be patch tested regardless of atopy status

Background: Allergic contact dermatitis is common in hairdressers because of their exposure to chemicals used in hair dyes and permanent wave solutions. Atopic individuals are known to have a higher prevalence of leaving the profession due to morbidity associated with hand eczema. Objectives: To assess which chemicals are responsible for allergic contact dermatitis in hairdressers and whether the prevalence is the same according to atopy status. Methods: A total of 729 hairdressers who had been patch tested were retrospectively identified. Allergic reactions to relevant allergens from the extended European baseline series and hairdressing series were analysed against history of atopic eczema. Results: Of the total, 29.9% of patients had a current or past history of atopic eczema. The most frequent positive allergens from the European baseline series were nickel sulfate (32.1%) and p‐phenylenediamine (19.0%) and from the hairdressing series were glyceryl monothioglycolate (21.4%) and ammonium persulfate (10.6%). There was no significant difference between people with or without a history of atopic eczema, except for fragrance mix I and nickel sulfate. Conclusions: We present findings from the largest cohort of hairdressers patch tested from a single centre. It is necessary to patch test hairdressers with dermatitis, regardless of a history of atopy. Strategies to reduce prevalence of allergic contact dermatitis are required.     

Occupational irritant and allergic contact dermatitis among healthcare workers

Contact dermatitis is the most frequent occupational dermatosis and non-specific irritants in addition to specific Type IV sensitization are involved. We reviewed our database for data from 1994 to 1998 and selected 360 consecutive patients working in healthcare environments and experiencing contact dermatitis at their hands, wrists and forearms. We found that allergic contact dermatitis and irritant contact dermatitis were considered to be work-related in 16.5% (72/436) and 44.4% (194/436) of diagnoses, respectively. Occupational irritant contact dermatitis is due to exposure to a wide range of irritants in the workplace, such as soaps, solvents, cleansers and protective gloves, which conspire to remove the surface lipid layer and/or produce cellular damage. In this study the major relevant aetiological agents that induced occupational allergic contact dermatitis were: nickel sulphate (41 patch positivities), components of disinfectants [glutaraldehyde (5) and benzalkonium chloride (7)] and rubber chemicals [thiuram mix (15), carba mix (9) and tetramethylthiuram monosulphide (6)]. The best treatment for allergic contact dermatitis is to avoid those allergens causing the rash. Whenever this is not possible, contact with them needs to be reduced using properly selected protective gloves. Finally, subjects with atopic dermatitis should avoid 'wet work' and contact with irritants, because atopic dermatitis is significantly associated with irritant contact dermatitis.     

Dermatitis in hairdressers

Contact dermatitis among hairdressers is common. In The Netherlands, registered sick leave for hand dermatitis among hairdressers rose from 21,050 days in 1986 to 54,293 in 1991. In a survey among 45 hairdressers in 5 different salons, 12 had a history of hand dermatitis and 16 showed moderate to severe hand dermatitis. After extensive investigations, 13 were classified as having allergic contact dermatitis and 3 cumulative irritant contact dermatitis, fn the past 4 years, 103 hairdressers were extensively patch tested and glyceryl thioglycolate (GTG), ammonium persulfate and nickel sulfate were responsible for the majority of positive reactions. Hair dyes and preservatives were responsible for a moderate % of the positive reactions. Positive reactions were also found to cocamidopropyl betaine and sodium coco hydrolyzed animal protein. These 2 allergens show a rather capricious patch test reaction pattern and irritant reactions may easily be confused with allergic. The relevance of positive patch test reactions to these chemicals should always be questioned. Atopy was not a frequent cause of hand dermatitis in this study. Chemicals with a thiol group can be demonstrated with a chemical spot test. With this test, contamination of the hairdressing salon with thioglycolates was demonstrated. It is emphasized that contamination of hairdressing salons with GTG is probably a significant factor in explaining the severe flare-ups in GTG-sensitized hairdressers who no longer use GTG permanent-waving solutions.     

OCCUPATIONAL CONTACT DERMATITIS IN NEW SOUTH WALES

Five hundred and seventy patients with occupational contact dermatitis (OCD) were seen between 1984 and 1990 at the Skin and Cancer Foundation in Sydney. Data derived from these patients demonstrated that hairdressing, food, construction and the medical industries were the most at risk of OCD. The hairdressing and food industries had a high percentage of apprentices suffering OCD whilst the 35 to 44 year age bracket was most at risk in the construction industry. Allergic contact dermatitis was responsible for 38.2% of cases. The main allergens were chromate, thiuram, epoxy resin, nickel and cobalt. A third (33.9%) of patients were atopic. The average time lost from work was 16 days each year and the calculated yearly cost of OCD in New South Wales was approximately $12 million.     

Occupational allergic contact dermatitis from bisphenol A in vinyl gloves

Allergic contact dermatitis caused by polyvinyl chloride gloves is rarely reported, and in only 2 cases was bisphenol A considered to be the responsible sensitizer. We report a patient with occupational hand dermatitis after the use of a new type of high-density vinyl (HDV) gloves. Patch tests showed positive (++) reactions to both used and new HDV gloves and to bisphenol A. Chemical analysis by gas chromatography-mass spectrometry demonstrated the presence of bisphenol A in the HDV gloves. Replacement by nitrile rubber gloves resulted in complete clearance of the hand dermatitis.     

Skin diseases in workers at a perfume factory

The aim of this study is to find out the causes of skin diseases in one-third of the staff of a perfume factory, in which 10 different perfume sprays were being manufactured. Site inspection, dermatological examination and patch testing of all 26 persons at risk with 4 perfume oils and 30 ingredients of them. The results showed 6 bottlers were found suffering from allergic contact dermatitis, 2 from irritant contact dermatitis, 12 workers showed different strong reactions to various fragrances. The main causes of allergic contact dermatitis were 2 perfume oils (12 cases) and their ingredients geraniol (12 cases), benzaldehyde(9), cinnamic aldehyde (6), linalool, neroli oil, terpenes of lemon oil and orange oil (4 each). Nobody was tested positive to balsam of Peru. Job changes for office workers, packers or printers to other rooms, where they had no longer contact with fragrances, led to a settling. To conclude, automation and replacement of glass bottles by cartridges from non-fragile materials and using gloves may minimize the risk.     

Hand dermatitis in a prospectively-followed cohort of hairdressing apprentices:nal results of the POSH study

The incidence of hand dermatitis is high in the hairdressing trade; the individual disease burden is substantial, as are the costs of treatment, workers compensation and retraining programs. To evaluate the risk of developing occupational irritant hand dermatitis associated with several potential risk factors, namely constitution (atopy) and occupational exposure, an observational prospective population-based cohort study set in vocational training schools in northwest Germany, recruiting 2352 hairdressing apprentices, was performed. Unprotected wet work of more than 2 h per day is the major significant risk factor; low ambient absolute humidity is equally associated with a significantly increased risk. Compared to the youngest age group, risk diminishes with increasing age. Constitutional risk factors are difficult to evaluate because of selective dropout of atopic participants. For primary prevention, a population approach, improving working conditions and skin protection for all exposed, appears to be the most beneficial.     

Prevalence of atopy in a population of hairdressing students and practising hairdressers in Melbourne, Australia

Hairdressers are one of the largest groups affected by occupational contact dermatitis. In this population-based study, 193 trainee hairdressers and 184 practising hairdressers each completed a questionnaire and had their hands examined. Participants were asked about past or present atopy including eczema, asthma or hayfever, which occurred in 59.2%, and were individually correlated with a history of occupational skin problems. Almost 60% of hairdressers and trainees had experienced changes on their hands since commencing hairdressing, while 29% had evidence of abnormal skin on examination on the day of participation. Atopic individuals, who plan to work in a career such as hairdressing with known high rates of occupational contact dermatitis, should be advised to care for and protect their skin from the outset to prevent the development of this condition. There has been little awareness of this issue in Australia, despite longstanding knowledge of the association of hairdressing and contact dermatitis.     

Allergic contact dermatitis due to rubber chemicals in haemodialysis equipment

6 of 80 haemodialysed patients developed a sub-acute eczematous dermatitis of the area surrounding the arteriovenous shunt in the forearm. Patch tests were positive to rubber chemicals: 6 patients reacted to the thiuram group, 4 of them also to carba compounds. Since the equipment contained only small pieces of rubber, the cause of the allergy remains obscure. It is possible that allergy was caused by short and intermittent contact of the skin with the rubber gloves used by the nursing personnel.     

Purpuric contact dermatitis from black rubber chemicals

Black rubber chemicals are capable of causing an allergic contact dermatitis, in some cases associated with a purpuric capillaritis. A typical case of such a purpuric reaction is described in a man sensitive to black rubber chemicals.     

Trend of contact allergy to cosmetic ingredients in Thais over a period of 10 years

Background. Contact allergy to cosmetic ingredients is common. However, there are no recent comprehensive studies on contact allergy to cosmetic ingredients in Asia. Objectives. To identify positive patch test reactions in patients tested at Siriraj Hospital, Bangkok, Thailand to allergens present in cosmetics. Methods. A retrospective review of medical records from the outpatient contact dermatitis clinic was conducted from January 1999 to December 2008. Patients with at least one positive patch test reaction to allergens associated with cosmetic ingredients were studied. The results were evaluated using Pearson's χ²‐test with Yates' continuity correction or Fisher's exact test where appropriate,and a p‐value <0.002 was considered to be statistically significant by Bonferroni correction. Results. There were 1247 cases (239 males and 1008 females; mean age 38.5 years). Fragrance chemicals and preservatives were the most commonly recognized cosmetic allergens. Ammoniated mercury was the only allergen that showed a significantly increased frequency over the 10‐year period (p = 0.0008). Conclusions. Our study showed that ammoniated mercury is an emerging cosmetic allergen, showing an increased prevalence in recent years in Thailand. A focus is required on emerging cosmetic allergens and what may account for the upward trend of cosmetic contact dermatitis.     

631例化妆品皮肤病回顾性分析

目的:探讨化妆品皮肤病发生的规律和特点,为监管化妆品皮肤病和开展健康教育活动提供数据支持.方法:收集我院2015年1月至2020年12月化妆品皮肤病患者一般资料、使用化妆品来源、化妆品不良反应等信息,汇总数据并进行统计分析.结果:化妆品皮肤病患者占皮肤科门诊患者总数的0.08％.631份报告中:发病以女性为主,占97....     

Immediate-type latex hypersensitivity in a hairdresser

Hairdressers commonly develop contact dermatitis caused by either skin irritants or allergens to which they are exposed. Those using latex gloves are also at risk of developing immediate hypersensitivity reactions to latex. We present a hairdresser with hand dermatitis, primarily as a result of immediate-type hypersensitivity to latex causing contact urticaria, diagnosed with radioallergosorbent testing. Only three previous studies have reported latex allergy in hairdressers. This condition needs to be considered as a differential diagnosis in hairdressers presenting with hand dermatitis and a history of wearing either rubber or disposable latex gloves.     

Occupational contact dermatitis in nurses with hand eczema

Occupationally related dermatitis is a common problem in nurses, who are exposed to a wide variety of allergenic and irritant substances. In a group of 44 nurses with hand dermatitis (40 female, 4 male), 18 were thought to have a predominantly allergic contact dermatitis, 15 an irritant dermatitis, 7 other form of eczema, 3 atopic dermatitis and one pompholyx. 10 of the 15 irritant cases were diagnosed as occupational. Of the 18 patients with allergic contact dermatitis, the allergens were thought to be occupationally relevant in 8 cases. In 6 of these 8 the dermatitis was due to natural rubber latex (3) or other rubber chemicals (3). 2 had additional evidence of immediate-type hypersensitivity to natural rubber latex (one was patch test allergic to latex, the other to thiuram mix). Natural rubber latex allergy, both delayed and immediate, is a significant problem, and nurses at risk should be tested for both types of hypersensitivity, as well as being patch tested to standard, rubber and medicaments series.     

Exposure, skin protection and occupational skin diseases in the glass-fibre-reinforced plastics industry

A total of 100 workers, 86 from the glass-fibre-reinforced plastics (GRP) industry, 11 from polystyrene production and 3 from polyester resin coating manufacture, were examined for occupational skin hazards and for evaluation of skin protection. The workers had been exposed to many chemicals. Those working in the GRP industry had also been exposed to glass fibre and to dust produced by finishing work. 94% used protective gloves. 22 workers, all employed in the GRP industry, had contracted occupational skin disorders. 6 had allergic and 12 irritant contact dermatitis. 4 workers had an accidental injury caused by a peroxide catalyst, fire, hot air and Constant mechanical friction. Allergic dermatoses were due to natural rubber (latex) (4 cases) in protective gloves, phenol-formaldehyde resin (1 case) and cobalt naphthenate (1 case). Irritant hand dermatoses (5 cases) were caused by the combined hazardous effect of unsaturated polyester or vinyl ester resins, organic solvents, glass fibre and dust from finishing work on the skin. Other cases of irritant dermatoses (7 cases) were due to the dust, promoted by mechanical Friction of clothes. Skin disorders in the GRP industry were common (26%) but the symptoms were mild and only 3 patients had been on sick leave because of occupational skin disease.     

Contact dermatitis in hairdressers: the Italian experience

A multicenter study was performed in 9 Italian centers by members of the GIRDCA, to evaluate the frequency and source of contact sensitization in a group of 302 hairdressers with dermatitis. Occupational habits and use of preventive measures were specifically investigated both in these 302 hairdressers and in a further group of 240 hairdressers who answered a questionnaire. The results showed the presence of an occupationally relevant sensitization in 60.9% of the 302 hairdressers. This proportion included 52 hairdressers who had negative patch tests to the hairdressers' series but showed positive reactions to other allergens, such as nickel, rubber additives, preservatives and fragrances, which were judged relevant to their occupation. Among hair dyes, PPD caused 73 reactions (24.2%), PAP 32 reactions (10.6%), ONPPD 24 reactions (7.9%), and PTD 40 reactions (13.2%). A low incidence of sensitization was detected in our hairdressers to resorcinol and pyrogallol (1.3% for each substance). Among permanent wave allergens, positive reactions to GMTG were found in 11.3% of patients, while ATG gave a lower rate of positive reactions (5.0%). Allergic contact dermatitis due to APS was also relatively common (11.3%). 4 hairdressers in this study gave a positive reaction 30 min after a provocative test with latex gloves, patch testing to the rubber series being negative. Enquiry regarding preventive measures revealed that the majority of hairdressers use gloves when doing hair dyeing, but rarely use them for washing dyed hair or for doing permanent waving. The infrequent use of preventive measures by Italian hairdressers was confirmed by the results of the questionnaire, and possibly explains the high frequency of skin problems (12.5%) in the hairdressing population that was specifically interviewed.     

Contact dermatitis from an ostomy deodorant

Two patients with contact dermatitis from an ostomy agent are described. Detailed patch testing revealed contact allergic dermatitis to one of the twelve groups of ingredients which largely comprised citronella oil. The problem of dermatitis is discussed in relation to the perfume ingredients of the ostomy agent.