Allergic Contact Dermatitis Is a Common Problem in Nursing Personnel

Summary and Comment |
February 2, 2015

Allergic Contact Dermatitis Is a Common Problem in Nursing Personnel

  1. Craig A. Elmets, MD

Occupational contact dermatitis is a particular problem for healthcare workers who regularly use protective gloves and disinfecting agents.

  1. Craig A. Elmets, MD

Allergic contact dermatitis affects approximately 20% of the population but especially nursing and healthcare staff. These investigators reviewed occupational contact allergy in nurses, physician assistants, ambulance crews, and midwives using data from 56 European dermatology departments. They compared patch tests from 2248 nursing personnel with and without suspected occupational contact dermatitis (OD).

Hand dermatitis was the most common OD; it was more common in the OD group than the non-OD group (79% vs. 19%, respectively). OD subjects were younger, with a higher incidence of atopic dermatitis, while the non-OD group was more likely to have generalized eczema. The most important contact allergens were protective gloves and disinfectants. Although positive reactions to nickel sulfate, fragrances, cobalt chloride, and thimerosal were particularly common in both groups, positive reactions to thiuram mix, potassium dichromate, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), colophony, bronopol, zinc diethyldithiocarbamate, and methyldibromo glutaronitrile were all more likely to occur in those with OD than in those without. Interestingly, the rubber accelerator mercaptobenzothiazole, often a common cause of glove dermatitis, was not among the 40 most frequent allergens in the OD group. A few OD subjects reacted to their own gloves or to the disinfectants that they were using but did not react to individual components of those agents present in the patch test series.

Comment

Occupational dermatitis is common and a particular problem for nursing personnel, who must wear protective gloves and use disinfectant frequently. Although hand dermatitis is most frequently produced by irritation, this study highlights the importance of allergic reactions as a cause and emphasizes the utility of performing patch tests in these patients. The study also underscores the value of patch testing to the gloves themselves and to disinfectants and other agents, rather than relying solely on chemicals in the patch test series.

Editor Disclosures at Time of Publication

  • Disclosures for Craig A. Elmets, MD at time of publication Consultant / Advisory board Astellas Pharmaceuticals Grant / Research support NIH; NIH/NCI; Veteran’s Administration; Ferndale Laboratories; Abbvie Editorial boards Cancer Prevention Research; Photodermatology, Photoimmunology, & Photomedicine; UpToDate; eMedicine; Journal of Dermatological Sciences Leadership positions in professional societies American Academy of Dermatology (Chair, Clinical Guidelines and Research Committee); Photomedicine Society (Board of Directors)

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