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SummaryBackground The high risk of occupational skin disease among hairdressers, caused by skin exposure to irritants and sensitizers, such as hair dye substances, is of great concern. Objectives The aim of the present study was to assess how the various tasks involved in hair dyeing contribute to hairdressers' exposure to hair dye, in order to enable the formulation of well-founded recommendations on working routines that will reduce exposure and prevent occupational disease. Methods Skin exposure to hair dye was measured for 20 hairdressers applying highlights and all-over hair colour with the hand rinsing technique. Resorcinol was used as a proxy for hair dye exposure. Results Applying hair dye and cutting the newly dyed hair were the tasks that contributed most to exposure in treatments for highlights. After cutting all-over-coloured hair, all hairdressers had measurable amounts of hair dyes on both hands. Conclusions Hairdressers are exposed to hair dye ingredients during all steps of the hair dyeing procedure. Cutting newly dyed hair contributes significantly to exposure. As initial steps for the prevention of occupational disease resulting from hair dye exposure, we suggest cutting hair before dyeing it, and wearing gloves during all other work tasks.

The high risk of occupational skin disease among hairdressers, caused by skin exposure to irritants and sensitizers, such as hair dye substances, is of great concern.The aim of the present study was to assess how the various tasks involved in hair dyeing contribute to hairdressers' exposure to hair dye, in order to enable the formulation of well-founded recommendations on working routines that will reduce exposure and prevent occupational disease.Skin exposure to hair dye was measured for 20 hairdressers applying highlights and all-over hair colour with the hand rinsing technique. Resorcinol was used as a proxy for hair dye exposure.Applying hair dye and cutting the newly dyed hair were the tasks that contributed most to exposure in treatments for highlights. After cutting all-over-coloured hair, all hairdressers had measurable amounts of hair dyes on both hands.Hairdressers are exposed to hair dye ingredients during all steps of the hair dyeing procedure. Cutting newly dyed hair contributes significantly to exposure. For the prevention of occupational disease resulting from hair dye exposure, we suggest cutting hair before dyeing it, and wearing gloves during all other work tasks.

For those chemicals identified in point 2 above, to collect and critically analyse clinical and statistical evidence on the incidence and morbidity (clinical picture) of skin contact allergy (contact dermatitis) cases in the EU before (at least 3 years) and after the limits were set, so as to allow an assessment of the possible effect of the limits in the reduction/prevention of the incidence and morbidity of contact dermatitis.

Background. Preservatives and fragrances are important and frequent skin sensitizers, found in a wide range of products intended for personal and occupational use. Objectives. To examine the use of preservatives and fragrances in certain cosmetics and detergents on the market. The product types studied were shampoos, hair conditioners, liquid soaps, wet tissues, washing-up liquids, and multi-purpose cleaners. Materials/methods. Ingredient labels of 204 cosmetic products and ingredient data sheets of 97 detergents, available on company websites, were examined. Results. The preservatives most frequently identified were phenoxyethanol, methylparaben, sodium benzoate, propylparaben, and methylchloroisothiazolinone/methylisothiazolinone. Parabens were found in 44% of cosmetics and 9% of detergents; formaldehyde-releasers in 25% of cosmetics and 8% of detergents; and isothiazolinones in 23% of cosmetics and 28% of detergents. The fragrances most frequently identified were linalool, limonene, hexyl cinnamal, butylphenyl methylpropional, and citronellol. Eighty-eight per cent of the products contained fragrances, and any of the 26 fragrances requiring labelling were found in half of the cosmetics and one-third of the detergents. Conclusions. Several preservatives and fragrances with well-known skin-sensitizing potential were common in the examined product types. Such products may be used several times a day by consumers and workers.

Udgivelsesdato: 2005-Jan The Technical Committee of Classification and Labelling dealing with harmonized classification of substances and classification criteria under Directive 67/548/EEC on behalf of the European Commission nominated an expert group on skin sensitization in order to investigate further the possibility for potency consideration of skin sensitizers for future development of the classification criteria. All substances and preparations should be classified on the basis of their intrinsic properties and should be labelled accordingly with the rules set up in the Directive 67/548/EEC. The classification should be the same under their full life cycle and in the case that there is no harmonized classification the substance or preparation should be self-classified by the manufacturer in accordance with the same criteria. The Directive does not apply to certain preparations in the finished state, such as medical products, cosmetics, food and feeding stuffs, which are subject to specific community legislation. The main questions that are answered in this report are whether it would be possible to give detailed guidance on how to grade allergen potency based on the existing methods, whether such grading could be translated into practical thresholds and whether these could be set for both induction and elicitation. Examples are given for substances falling into various potency groups for skin sensitization relating to results from the local lymph node assay, the guinea pig maximization test, the Buehler method and human experience.

To assess interlaboratory variability in the measurement of skin electrical impedance (IMP), we evaluated irritant reactions to sodium lauryl sulfate (SLS) (2%) and nonanoic acid (NAA) (40%) in 2 laboratories. We studied the patch test responses in 40 healthy male and female volunteers between 20 and 30 years of age (20 in each laboratory) with an instrument for measuring IMP. 2 other bioengineering methods and visual scoring were also used to facilitate further illumination of any findings. A strict protocol including all details of the measurement procedure was carefully implemented in both laboratories. The skin reactions were evaluated at 23 h and at 3, 7 and 14 days after exposure. Our findings show that both irritants caused distinct dynamic responses detectable with the bioengineering techniques. Interestingly, the IMP baseline values varied between the 2 laboratories. Moreover, at early stages in the development of irritation (day 1), the irritants induced changes in IMP indices in the opposite direction, which accords with the concept of various IMP patterns of contact dermatitis caused by different irritants. Although the absolute values of IMP differed in both laboratories, the dynamic response patterns were the same.

The fungicide chlorothalonil is used extensively under several tradenames for the protection of various horticultural and fruit crops and bananas against fungal infections. It is also used as fungicide in wood preservation and as a preservative in paints. Clinical experience has shown chlorothalonil to be a contact allergen and several cases of allergic contact dermatitis attributed to chlorothalonil have been described. 2 previous guinea pig maximization test studies have shown the sensitizing potential of chlorothalonil to be high. The sensitizing property of chlorothalonil was studied by us with the predictive test methods the local lymph node assay and the cumulative contact enhancement test. In the local lymph node assay, chlorothalonil induced a dose-dependent increase in proliferation with a maximal stimulation index of 19.2 and 27.2. In the cumulative contact enhancement test, a statistically significant dose-dependent high sensitization rate was seen with a maximal sensitization rate of 100%. In conclusion, it is evident that chlorothalonil is an extremely potent contact allergen, inducing sensitization using only topical exposure on intact skin.

The allergenicity of the preservative Euxyl K 400 and its principal allergen methyldibromo glutaronitrile (MDBGN) (1,2-dibromo-2,4-dicyanobutane) was investigated using 3 animal models; in mice, the local lymph node assay (LLNA) and in guinea pigs, the guinea pig maximization test (GPMT) and the cumulative contact enhancement test (CCET) with a dose-response protocol included. Previous attempts to define the sensitization capacity of these chemicals have given conflicting results. For comparison, the frequency and causes of positive patch test reactions to Euxyl K 400 and MDBGN were studied in patients referred to an occupational dermatology clinic. This investigation showed that Euxyl K 400 and MDBGN can give rise to contact allergy in man and that the relevant cases found mainly had similar exposure as non-occupational cases. A contact allergenic potential could be detected for MDBGN in 2 animal models, i.e., the CCET and the LLNA, and also for Euxyl K 400 in the LLNA. However, statistical analysis of the results from the GPMT with MDBGN failed to detect the sensitizing potential of this particular allergen. The results indicate that to be able to detect the allergenic potential of Euxyl K 400 and MDBGN, a predictive test method with multiple topical applications at induction is required. It is therefore important that an investigator is aware of the possibility of using various predictive test models for investigation of potential contact allergens.

IgE-mediated allergy to natural rubber latex was first noted from rubber gloves in 1979. The initial reports in dermatological journals described contact urticarial reactions; later, severe generalized allergic reactions and asthma were documented. A considerable proportion of the people involved in medical and dental care were found to be sensitized to latex. This article describes and surveys a broad range of primary prevention measures at the local and national levels. Examples are given from paediatrics, dental education, and medical care. National strategies and position papers on latex allergy are presented in which medical professionals, manufacturers and public authorities have cooperated. Special reference is paid to the European work to standardize medical gloves, which led to document EN 455:3.

In working situations where there is a possibility of acquiring blood-borne infections, the use of disinfectants is important. It is also important to use protective gloves, both to protect the skin against disinfectants and to protect against infections. Changes in the structure of the glove material may, however, interfere with the protective capability of the gloves. The influence of 4 disinfectants on the material structure and protective effect of 6 different brands of protective gloves was studied. The proposed International Organization for Standardization (ISO) standard method for determining the liquid chemical resistance of air-impermeable materials was used for permeation testing. Pieces of latex and vinyl glove were also exposed to isopropanol and ethanol for 10, 30 and 60 min and then viewed in a scanning electron microscope. Isopropanol permeated through latex and vinyl gloves in less than 10 min. The polyethylene (PE) gloves were of quite variable quality, and the breakthrough time ranged from 4 to greater than 240 min. The latex and vinyl gloves were also permeated by ethanol, but at a much lower rate. The disinfectants Blifacid, based on p-chloro-m-cresol, and Cidex, based on glutaraldehyde, did not permeate any of the gloves tested within 60 min. Isopropanol had a destructive effect on the material, which became opaque, stiff and brittle. This change in structure was verified with the scanning electron microscope. The tested gloves of latex, vinyl and PE, gave acceptable protection from contact with Blifacid and Cidex for at least 60 min. The same gloves do not give any total protection from contact with isopropanol and ethanol.

Background: In recent years, the alarming increase in contact allergy to hair dyes has drawn much attention. It has been shown that many of the currently allowed hair dye substances are potent skin sensitizers. Objectives: To study the prevalence of hair dye substances, categorized as potent skin sensitizer, in oxidative hair dye products on the Swedish market. Materials and Methods: Ingredient labels of 122 oxidative hair dye products from 20 brands were examined. All ingredients were recorded, and the prevalence of hair dye substances categorized as potent skin sensitizers was assessed. Results: According to ingredient labelling, 120 out of 122 examined oxidative hair dye products contained hair dye substances categorized as potent skin sensitizers. More than 80% of the products contained at least four such substances; 37 hair dye substances categorized as potent skin sensitizers were identified, and 10 of these were more prevalent than p-phenylenediamine. Conclusions: Hair dye substances categorized as potent skin sensitizers are very common in oxidative hair dye products. A substantial number of potent skin sensitizers are more frequently used than p-phenylenediamine, while only a few are commercially available as patch test substances.

The fungicide chlorothalonil is used extensively under several tradenames for the protection of various horticultural and fruit crops and bananas against fungal infections. It is also used as fungicide in wood preservation and as a preservative in paints. Clinical experience has shown chlorothalonil to be a contact allergen and several cases of allergic contact dermatitis attributed to chlorothalonil have been described. 2 previous guinea pig maximization test studies have shown the sensitizing potential of chlorothalonil to be high. The sensitizing property of chlorothalonil was studied by us with the predictive test methods the local lymph node assay and the cumulative contact enhancement test. In the local lymph node assay, chlorothalonil induced a dose-dependent increase in proliferation with a maximal stimulation index of 19.2 and 27.2. In the cumulative contact enhancement test, a statistically significant dose-dependent high sensitization rate was seen with a maximal sensitization rate of 100%. In conclusion, it is evident that chlorothalonil is an extremely potent contact allergen, inducing sensitization using only topical exposure on intact skin.

A multi-dose-response induction protocol for the guinea pig maximization test (GPMT), including a statistical computer program, has earlier been developed to improve the power of predictive tests for identification of contact allergens. This dose-response protocol, with 2 modifications (i.e., increased number of animals in each group and increased number of challenge concentrations) was evaluated in the GPMT, the cumulative contact enhancement test (CCET) and the Freund's complete adjuvant test (FCAT), using potassium dichromate and hydroxycitronellal as model contact allergens. Application of the dose-response protocol on the CCET and the FCAT resulted in either monotone or non-monotone curves with significant dose-response. However, application of the dose-response protocol on the GPMT gave curves with no significant dose-response. The protocol makes it possible to obtain an EC50 value, thus improving the possibility of ranking contact allergens, which is of substantial use for risk assessments. The dose-response protocol could benefit from a few adjustments: a wider span in the induction doses; change to simultaneous increase in intradermal and topical induction doses to obtain a proper dose-response for the GPMT; the addition of further challenge concentrations. In addition the computer program should allow calculation of threshold concentration for sensitization and EC50 value for a non-monotone curve.

Baltic amber is a fossil resin deposited 36-7 million years ago and one source may be the extinct tree Pinites (Pinus) succinifer. Palaeobotanical studies of amber have an extensive literature, but the aspect of allergenicity has not been addressed before. The aim of our study was to present the results from sensitization studies with Baltic amber and to discuss these in view of possible cross-reactivity with contact allergens in colophony. It is concluded that allergens found in colophony can also be present in Baltic amber. The main resin acids were identified in an ether-soluble extract of amber. Amber suspended in petrolatum caused positive patch test reactions in patients with contact allergy to colophony. Furthermore, animals sensitized to colophony showed positive reactions to amber, but animals induced with amber did not react when challenged with amber. A use test with an amber necklace in patients with positive test reactions to amber and colophony was negative, which supports the view that amber in personal ornaments is not a clinical problem.

Most current data on the protective effect of gloves against chemicals are obtained in vitro, using permeation cells. In vivo testing would give additional information on efficiency but is both expensive and time-consuming. It would therefore be valuable to know whether any definitive relationship exists between results obtained in vivo and in vitro. Gloves of natural rubber, butyl rubber and polyvinyl chloride (vinyl) were tested against 3 organic solvents, toluene, 1,1,1-trichloroethane and butanol, in vivo in guinea pigs and in vitro in permeation cells. Breakthrough times, absorption rates and steady state permeation rates were determined and compared on a relative basis. Some of the gloves that had a low degree of resistance to the test solvent in vitro nevertheless showed a rather good reducing capacity on the percutaneous absorption in vivo. However, for 2 gloves where no breakthrough was noted for butanol in vitro, permeation occurred at a degree lower than the minimum detection level. At this low concentration, the solvent was not absorbed through intact skin but through damaged skin. The breakthrough times for the 3 solvents corresponded well for the 2 test systems. The relative absorption rates and relative steady-state permeation rates varied considerably and no definitive relationship between the 2 sets of test results could be seen.

Objective: To assess occupational dermal exposure to permanent hair dyes in hairdressers. Methods: Dermal exposure was assessed in 31 hairdressers using a previously evaluated method, hand wash sampling with bag rinsing. The measurements were performed in hairdressing saloons during working hours. Hand wash samples were collected from each hand before start of the hair dyeing process, after application of the hair dye and after cutting the newly dyed hair. 13 of the hairdressers did not use gloves during application of the hair dye, and during cutting of the dyed hair no one used gloves. The samples were analysed for aromatic amines and resorcinol using an HPLC-method. Results: After application of the hair dye PPD (p-phenylenediamine) was found in samples from 1 hairdressers (148–185 nmol/hand), TDA (toluenediamine) in samples from 12 hairdressers (range 10–735 nmol/hand) and resorcinol in 22 individuals (range 19–769 nmol/hand). In the samples taken after cutting the dyed hair PPD was found in 2 hairdressers (range 36–358 nmol/hand), TDA in 14 (range 8–361 nmol/hand) and resorcinol in 20 (range 10–725 nmol/hand. Conclusion: Skin exposure to aromatic amines and resorcinol was detected in more than half of the hairdressers after application of hair dye and also after cutting newly dyed hair. To reduce exposure improved skin protection is important.

Colour developing agents, derivatives of p-phenylenediamine, can cause contact allergy. Patch test reactions to more than one colour developer are sometimes seen in patients. To study whether this is due to simultaneous sensitization or cross-reactivity, guinea pig maximization tests (GPMT) with CD-2, CD-3 and CD-4 were carried out. 5 experiments were performed, using pet. or water as vehicles. When pet. was used, the challenge concentrations could be raised and cross-reactivity between the colour developers, but not with p-phenylenediamine-dihydrochloride, was revealed. When water was used as vehicle, the challenge concentrations were limited because of staining of the test sites and irritation. CD-2, CD-3 and CD-4 were found to be extreme sensitizers according to the classification by Magnusson and Kligman. The importance of using an appropriate vehicle to obtain optimal conditions for the GPMT is stressed. To study the purity and stability of the chemicals used, analysis by HPLC of the test substances at different stages of the GPMT procedure was performed. Aqueous solutions of the colour developers were found to be unstable, while pet. mixtures were stable.

Abietic acid is the main component of rosin. It is readily oxidized by air and its oxidation products are considered to be mainly responsible for the allergenic effect. Hydrogenation of the conjugated double bonds of abietic acid decreases its susceptibility to air oxidation and would thus reduce the allergenicity of rosin. Portuguese gum rosin was therefore hydrogenated and its allergenicity was compared with that of unmodified rosin in animal experiments and by patch testing in humans. Its sensitizing potential was determined in 2 studies. No response was found according to the FCAT method while the GPMT gave significant response in the animals challenged with the highest test concentration. Hydrogenated rosin showed no eliciting activity in animals induced with unmodified rosin according to the GPMT method. A marked decrease was found in the frequency of allergic reactions to hydrogenated rosin compared to the reactions to unmodified rosin in patients with known allergy to gum rosin. We conclude that elimination of the unsaturated non-aromatic compounds by hydrogenation considerably reduces the allergenicity of Portuguese gum rosin.