Allergic contact dermatitis caused by polyester resin is considered to be rare. To describe 11 new patients diagnosed with occupational contact allergy to components of polyester resin systems in 1994-2009. Data on occupations, patch test... more
Allergic contact dermatitis caused by polyester resin is considered to be rare. To describe 11 new patients diagnosed with occupational contact allergy to components of polyester resin systems in 1994-2009. Data on occupations, patch test results, symptoms and exposure to polyester products were retrieved from patient files, covering 1994 to February 2015. Five patients reacted to unsaturated polyester resin putties. In 3 of these cases, putties were considered to be the main cause of the dermatitis. Four patients had cobalt allergy resulting from cobalt salts that were used as accelerators in polyester resins. Three patients were sensitized to triglycidyl isocyanurate (TGIC), a cross-linker in polyester powder paints. Two product types are of particular importance in contact allergy to polyester resin: powder paints cured by heat with TGIC as the cross-linker, and car putties. Car putties are used not only in repair car painting, but also in some industrial trades to smoothen surfaces before painting. As commercial patch test substances of polyester resin putties are lacking, patients' own products need to be tested. Cobalt salts are used in several types of polyester resin product as accelerators, and these must be considered as a possible cause of cobalt sensitization.
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Irritant-induced asthma is a rare disease, usually being caused by an accidental or other exceptionally strong exposure to substances irritating the respiratory passages. High-dose inhaled corticosteroid medication is immediately started... more
Irritant-induced asthma is a rare disease, usually being caused by an accidental or other exceptionally strong exposure to substances irritating the respiratory passages. High-dose inhaled corticosteroid medication is immediately started at the emergency call service. If severe exposure is suspected, it is important to monitor the patient at least for a couple of days in hospital. Immediately after the acute stage diagnostic investigations are carried out, including a metacholine or histamine challenge test, since demonstration of airway hyperreactivity is of diagnostic and prognostic significance. The asthma may remain permanent.
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One out of five working persons with asthma has work-related respiratory symptoms. When exploring the symptoms of a working-age patient it is essential to survey the job description and working conditions. Early intervention in the... more
One out of five working persons with asthma has work-related respiratory symptoms. When exploring the symptoms of a working-age patient it is essential to survey the job description and working conditions. Early intervention in the factors aggravating the respiratory symptoms will decrease morbidity, maintain working capacity and improve the quality of life. Occupational health service and the employer play a central role in identifying and decreasing the exposure factors in the working environment as well as in patient guidance for asthma therapy and protecting from the stimuli. The working capacity of an asthmatic person can be improved by applying vocational rehabilitation.
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Efficient, comfortable, yet affordable personal protective equipment (PPE) is needed to decrease the high incidence of allergic contact dermatitis arising from epoxy resin systems (ERSs) in industrial countries. The aim of this study was... more
Efficient, comfortable, yet affordable personal protective equipment (PPE) is needed to decrease the high incidence of allergic contact dermatitis arising from epoxy resin systems (ERSs) in industrial countries. The aim of this study was to find affordable, user-friendly glove and clothing materials that provide adequate skin protection against splashes and during the short contact with ERS that often occurs before full cure. We studied the penetration of epoxy resin and diamine hardeners through 12 glove or clothing materials using a newly developed test method. The tests were carried out with two ERS test mixtures that had a high content of epoxy resin and frequently used diamine hardeners of different molar masses. A drop (50 µl) of test mixture was placed on the outer surface of the glove/clothing material, which had a piece of Fixomull tape or Harmony protection sheet attached to the inner surface as the collection medium. The test times were 10 and 30min. The collecting materi...
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Epoxy products are among the most common causes of occupational allergic contact dermatitis. Diglycidyl ether of bisphenol A resin (DGEBA-R) is the most important sensitizer in epoxy systems. To describe patients with occupational... more
Epoxy products are among the most common causes of occupational allergic contact dermatitis. Diglycidyl ether of bisphenol A resin (DGEBA-R) is the most important sensitizer in epoxy systems. To describe patients with occupational allergic contact dermatitis caused by epoxy products. Patients with allergic reactions to epoxy chemicals were chosen from test files (January 1991 to June 2014). Only patients with occupational contact allergy to some component of epoxy resin systems were included. We analysed patch test results, occupation, symptoms, and exposure data. We found a total of 209 cases with occupational contact allergy to epoxy chemicals. The largest occupational groups were painters (n = 41), floor layers (n = 19), electrical industry workers (n = 19), tile setters (n = 16), and aircraft industry workers (n = 15). A total of 82% of the patients reacted to DGEBA-R. Diagnosis of the DGEBA-R-negative patients required testing with m-xylylenediamine, N,N'-tetraglycidyl-4,4'-methylenedianiline, 1,4-butanediol diglycidyl ether, 2,4,6-tris-(dimethylaminomethyl)phenol, diglycidyl ether of bisphenol F resin, N,N'-diglycidyl-4-glycidyloxyaniline, isophoronediamine, 4,4'-diaminodiphenylmethane, diethylenetriamine, and cresyl glycidyl ether. The hands/upper extremities were most commonly affected (69%), but facial symptoms were also frequent (60%). Allergic contact dermatitis caused by to epoxy products cannot always be diagnosed by the use of commercial test substances. Workplace products need to be tested.
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One fifth of adult-onset asthma cases are associated with adverse effects occurring at work. In investigating occupational asthma an overall assessment is required of materials handled by the patient at work. This evaluation is based on... more
One fifth of adult-onset asthma cases are associated with adverse effects occurring at work. In investigating occupational asthma an overall assessment is required of materials handled by the patient at work. This evaluation is based on several sources: history of exposure from the patient, medical records in the occupational health service, process, material and chemical data obtained from the workplace, including safety data, and if necessary, workplace measurements and other documents. In suspected occupational asthma, the occupational health service has the primary responsibility to carry out assessment of exposure. In order to start investigations of occupational disease without delay, it is essential to recognize the role of work in the pathogenesis of the disease.
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Methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and MI are common preservatives in industrial and household products and in cosmetics. Occupational contact allergy to MCI/MI or MI has been reported among painters and paint... more
Methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and MI are common preservatives in industrial and household products and in cosmetics. Occupational contact allergy to MCI/MI or MI has been reported among painters and paint factory workers in particular. To retrospectively describe patients with occupational contact allergy to MCI/MI and MI at the Finnish Institute of Occupational Health (FIOH). Patch test files and clinical records of patients examined at the FIOH between January 2002 and February 2013 were reviewed to identify the patients. Seventy-two of 1745 patients showed positive reactions to MCI/MI and/or MI. Of these, 36 were occupational cases, and 31 were diagnosed during the second half of the study period. Hairdressers and beauticians, mechanics and repairmen, and machinists were the most significant occupational groups, followed by painters and paint factory workers, and café and restaurant workers. We observed a sixfold increase in the number of occupational cases in the second half of the study period as compared with the first half. Liquid soaps and industrial hand cleansers were common sources of exposure to MCI/MI or MI. A total of 33% of the patients used products without any mention of MCI/MI or MI in safety data sheets or product declarations.
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Diglycidyl ether of bisphenol A resin (DGEBA-R) is the most common sensitizer in epoxy systems, but a minority of patients also develop contact allergy to reactive diluents. To analyse the frequency and clinical relevance of allergic... more
Diglycidyl ether of bisphenol A resin (DGEBA-R) is the most common sensitizer in epoxy systems, but a minority of patients also develop contact allergy to reactive diluents. To analyse the frequency and clinical relevance of allergic reactions to different epoxy reactive diluents and related aliphatic epoxy resins. Test files (January 1991 to June 2014) were screened, and the clinical records of patients with allergic reactions were analysed for occupation, concomitant allergic reactions, and exposure. A total of 67 patients reacted to at least one of the compounds. The largest numbers of allergic reactions were to phenyl glycidyl ether (PGE; n = 41), 1,4-butanediol diglycidyl ether (BDDGE; n = 34), and p-tert-butylphenyl glycidyl ether (PTBPGE; n = 19). Ten of the patients did not have contact allergy to DGEBA-R. The reactions of 5 of these were related to the use of BDDGE-containing products. We found no significant exposure to PGE or PTBPGE in patients sensitized to them, but som...
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Diglycidylether of bisphenol A resin is the most important sensitizer in epoxy systems, but a minority of patients develop concomitant or solitary contact allergy to epoxy hardeners. At the Finnish Institute of Occupational Health,... more
Diglycidylether of bisphenol A resin is the most important sensitizer in epoxy systems, but a minority of patients develop concomitant or solitary contact allergy to epoxy hardeners. At the Finnish Institute of Occupational Health, several in-house test substances of epoxy hardeners have been tested in a special epoxy compound patch test series. To analyse the frequency and clinical relevance of allergic reactions to different epoxy hardeners. Test files (January 1991 to March 2013) were screened for contact allergy to different epoxy hardeners, and the clinical records of patients with allergic reactions were analysed for occupation, concomitant allergic reactions, and exposure. The most commonly positive epoxy hardeners were m-xylylenediamine (n = 24), 2,4,6-tris-(dimethylaminomethyl)phenol (tris-DMP; n = 14), isophorone-diamine (n = 12), and diethylenetriamine (n = 9). Trimethylhexamethylenediamine (n = 7), tetraethylenepentamine (n = 4), and triethylenetetramine (n = 2) elicited...
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Diphenylmethane diisocyanate (MDI) is a sensitizing chemical that can cause allergic contact dermatitis and asthma. Protective gloves and clothing are necessary to prevent skin exposure. Breakthrough times are used for the selection of... more
Diphenylmethane diisocyanate (MDI) is a sensitizing chemical that can cause allergic contact dermatitis and asthma. Protective gloves and clothing are necessary to prevent skin exposure. Breakthrough times are used for the selection of chemical protective gloves and clothing. In the EN 374-3:2003 European standard, breakthrough time is defined as the time in which the permeation reaches the rate of 1.0 µg min(-1) cm(-2) through the material. Such breakthrough times do not necessarily represent safe limits for sensitizing chemicals. We studied the permeation of 4,4'-MDI through eight glove materials and one clothing material. The test method was derived from the EN 374-3 and ASTM F 739 standards. All measured permeation rates were below 0.1 µg min(-1) cm(-2), and thus, the breakthrough times for all the tested materials were over 480min, when the definitions of EN 374-3 and ASTM F 739 for the breakthrough time were used. Based on the sensitizing capacity of MDI, we concluded that...
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One fifth of adult-onset asthma cases are associated with adverse effects occurring at work. In investigating occupational asthma an overall assessment is required of materials handled by the patient at work. This evaluation is based on... more
One fifth of adult-onset asthma cases are associated with adverse effects occurring at work. In investigating occupational asthma an overall assessment is required of materials handled by the patient at work. This evaluation is based on several sources: history of exposure from the patient, medical records in the occupational health service, process, material and chemical data obtained from the workplace, including safety data, and if necessary, workplace measurements and other documents. In suspected occupational asthma, the occupational health service has the primary responsibility to carry out assessment of exposure. In order to start investigations of occupational disease without delay, it is essential to recognize the role of work in the pathogenesis of the disease.
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Research Interests: Occupational Health, Metallurgy, Asthma, Adolescent, Occupational Medicine, and 17 moreFinland, Humans, Occupational Asthma, Respiratory Disease, Female, Male, Incidence, Middle Aged, Contact Dermatitis, Adult, Occupational Exposure, Public health systems and services research, Chemical Industry, Skin Disease, Epoxy Resin, Occupational Diseases, and Occupational Disease
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Epoxy products are among the most common causes of occupational allergic contact dermatitis. Diglycidyl ether of bisphenol A resin (DGEBA-R) is the most important sensitizer in epoxy systems. To describe patients with occupational... more
Epoxy products are among the most common causes of occupational allergic contact dermatitis. Diglycidyl ether of bisphenol A resin (DGEBA-R) is the most important sensitizer in epoxy systems. To describe patients with occupational allergic contact dermatitis caused by epoxy products. Patients with allergic reactions to epoxy chemicals were chosen from test files (January 1991 to June 2014). Only patients with occupational contact allergy to some component of epoxy resin systems were included. We analysed patch test results, occupation, symptoms, and exposure data. We found a total of 209 cases with occupational contact allergy to epoxy chemicals. The largest occupational groups were painters (n = 41), floor layers (n = 19), electrical industry workers (n = 19), tile setters (n = 16), and aircraft industry workers (n = 15). A total of 82% of the patients reacted to DGEBA-R. Diagnosis of the DGEBA-R-negative patients required testing with m-xylylenediamine, N,N'-tetraglycidyl-4,4'-methylenedianiline, 1,4-butanediol diglycidyl ether, 2,4,6-tris-(dimethylaminomethyl)phenol, diglycidyl ether of bisphenol F resin, N,N'-diglycidyl-4-glycidyloxyaniline, isophoronediamine, 4,4'-diaminodiphenylmethane, diethylenetriamine, and cresyl glycidyl ether. The hands/upper extremities were most commonly affected (69%), but facial symptoms were also frequent (60%). Allergic contact dermatitis caused by to epoxy products cannot always be diagnosed by the use of commercial test substances. Workplace products need to be tested.
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Epoxy resins based on diglycidyl ether of bisphenol F (DGEBF) are widely used as such in applications requiring chemical resistance, and also together with diglycidyl ether of bisphenol A resin (DGEBA-R). Concomitant patch test reactions... more
Epoxy resins based on diglycidyl ether of bisphenol F (DGEBF) are widely used as such in applications requiring chemical resistance, and also together with diglycidyl ether of bisphenol A resin (DGEBA-R). Concomitant patch test reactions to DGEBA-R and DGEBF resin (DGEBF-R) are common. Previous studies have yielded conflicting results on the frequency of independent DGEBF-R contact allergies. To report the results of over 11 years of screening with DGEBF-R. An in-house test substance of DGEBF-R (Epikote 862) was tested in the baseline patch test series, first at 1% and later at 0.25%. Test files were screened for allergic reactions to DGEBF-R and DGEBA-R, and the clinical records of positively reacting patients were analysed for occupation and exposure. Among 1972 patients, 66 (3.3%) reacted to DGEBF-R and 96 (4.9%) to DGEBA-R. Independent DGEBF-R allergies were seen in 5 patients only, and independent DGEBA-R allergies in 35. Specific exposure to DGEBF-R was found in 26 patients. The main occupational fields were the aircraft industry, the electrical and sports equipment industry, boat building, painting/floor coating, tile setting, and pipe relining. Independent contact allergies to DGEBF-R were rare, and screening with it was not found to be useful.
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Research Interests: Immunology, Humans, Female, Allergens, Clinical Sciences, and 3 moreContact Dermatitis, Adult, and Patch Tests
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The monomeric isocyanates diphenylmethane diisocyanate (MDI), 2,4-toluene diisocyanate (TDI), isophorone diisocyanate (IPDI) and 1,6-hexamethylene diisocyanate (HDI) are used in polyurethane products and sometimes cause contact allergy.... more
The monomeric isocyanates diphenylmethane diisocyanate (MDI), 2,4-toluene diisocyanate (TDI), isophorone diisocyanate (IPDI) and 1,6-hexamethylene diisocyanate (HDI) are used in polyurethane products and sometimes cause contact allergy. To describe patients with isocyanate contact allergy in an occupational dermatology clinic. Test files were screened for allergic reactions to isocyanates and 4,4'-diaminodiphenylmethane (MDA). Patients with allergic reactions to some of the allergens were analysed for occupation, exposure, concomitant reactions to other allergens, and diagnosis. Over a period of almost 13 years, 54 patients reacted to isocyanates (9 to IPDI, 12 to MDI, 6 to TDI, and 1 to HDI) or MDA (44 patients). The motor vehicle, electronics and paint industries, and painting and construction work, were among the most significant occupational fields. An in-house polymeric MDI (PMDI) test substance was superior to commercial MDI preparations. About half of the occupational cases related to MDI products were diagnosed by testing MDA. The most prominent cause of IPDI allergy comprised polyurethane paint hardeners. Some of the IPDI reactions could be explained by cross-allergy to isophoronediamine in epoxy products. Specific exposure to MDA was difficult to trace. MDA and PMDI test substances were significant in the diagnosis of MDI contact allergy.
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... PCS.06 Establishment of safe exposure limits for the elicitation of allergy – fragrancesJeanne Duus Johansen National Allergy Research Centre, Department of Dermatology, Gentofte Hospital, University of Copenhagen, Denmark ...