Occupational dermatitis to 2,3-epoxypropyl trimethyl ammonium chloride

4 workers developed hand dermatitis in an automated starch modification process plant. 2,3-epoxypropyl trimethyl ammonium chloride (EPTMAC), a quaternary ammonium compound used as a cationizing chemical, produced allergic reactions in all 4 patients. They had only been in contact with EPTMAC for a shore time before developing dermatitis, which indicates that EPTMAC is a strong sensitizer.
Immunohistochemistry and electron microscopy showed the Features or an allergic patch test. An industrial hygiene project was initiated at the factory to prevent new eases. It revealed many risks of skin contact with the process chemicals. Thus an automated process does not guarantee protection.     

Occupational allergic contact dermatitis from 1,6-bis (2,3-epoxypropoxy) naphthalene in a one-component epoxy coating

Since heroin is delivered to a selected group of drug addicts under supervision of nurses in the Netherlands, we reported about several nurses who presented with work‐related eczema and positive patch tests to heroin. To investigate the prevalence of heroin contact allergy among all workers in this heroin delivery project, a study was started using questionnaires. Altogether 31 nurses reported work‐related complaints out of 100 who returned questionnaires. Besides reports of eczema, mainly of eyelids (probably airborne) and hands, there were mucosal and respiratory complaints. Patch tests were performed in 25 nurses with complaints; in 9 of them a heroin contact allergy could be confirmed. In 6 out of these 9 nurses this was combined with mucosal or respiratory complaints. There were also 6 nurses with mucosal or respiratory complaints without a contact allergy. Contact dermatitis from opioids, such as morphine and codeine, has been documented among opioid industry workers, nurses, doctors, pharmacists, and in patients. In conclusion heroin appears to be a potent contact allergen, causing contact dermatitis. Mucosal and respiratory complaints however, cannot be explained by this contact allergy; they might be caused by a type‐1‐allergy to heroin, or by a direct histamine liberating effect. Opioids are known histamine liberators causing urticaria, rhinitis and anaphylactoid reactions; therefore intracutaneous tests with heroin are unreliable. In an ongoing research project it will be attempted to detect specific IgE to heroin in the 12 workers with mucosal or respiratory complaints; within the next few months results will be available.     

Occupational airborne allergic contact dermatitis from methacrylates in a dental nurse

BACKGROUND: There are very few reports of airborne allergic contact dermatitis from methacrylates. OBJECTIVES: To report a dental nurse with facial eczema supposedly caused by airborne methacrylates present in the work environment. METHODS: Patch testing with serial dilutions of several methacrylates and work provocations in environments containing methacrylates was performed. RESULTS: Patch testing with serial dilutions of several methacrylates disclosed a high patch test reactivity. Repeated provocations when working with methacrylates resulted in facial eczema that resolved out of work. Attempts to collect the sensitizers using air pumps for the collection of vapors and filters for the collection of air-born aerosols failed. CONCLUSIONS: The clinical presentation was that of a facial dermatitis due to airborne exposure to methacrylates. It seems likely that 1 or several of these allergens caused the dermatitis.     

Allergic contact dermatitis from the preservative 1,2-benzisothiazolin-3-one (1,2-BIT; Proxel®): a case report, its prevalence in those occupationally at risk and in the general dermatological population, and its relationship to allergy to its analogue Kathon® CG

Occupational contact allergy to 1,2-benzisothiazolin-3-one (1,2-BIT, Proxel) is analysed. This compound is widely used in industry as a preservative in water-based solutions such as pastes, paints and cutting oils. The optimal concentration for patch testing proved to be 0.4 g/l (0.04%) in water. In 4 out of 17 patients (23%) at occupational risk (painters, paper-hangers), contact allergy to 1,2-BIT was found. Of 556 consecutive dermatological patients without clear occupational risk, 10 (1.8%) showed positive patch tests to 1,2-BIT; in 3 patients 1,2-BIT contact allergy was related to domestic paper-hanging. Although the chemical structure of 1,2-BIT shows some analogy with the preservative Kathon CG, true cross-sensitivity was found to be unlikely.