Contact allergy is common in children, but no paediatric baseline series (pEBS) exists in Europe, despite recommendations in several countries.
To collect and compare patch testing data from European centres to propose a common pEBS, possibly adapted by age group.
Data from 13 centres in 12 European countries were aggregated, covering 1816 children (1099 girls, 60.5%), aged 0–16 years, tested with the adult EBS (aEBS) and other frequent allergens between 2018 and 2022. Allergen selection followed adult criteria, with a stricter cut-off for inclusion, requiring at least 1% positive reactions (lower 95% CI) in children.
A total of 17 allergens from the aEBS caused positive reactions in ≥ 1% of children (lower 95% CI). Common allergens included metals, fragrances, and preservatives. Tixocortol-21-pivalate was included despite its lower frequency due to its difficult-to-suspect nature. Additional frequent allergens were hydroperoxides of limonene and linalool, Amerchol L-101, and sorbitan sesquioleate. In total, 18 allergens were identified as potentially qualifying for a pEBS, with a further 7 as recommended additions.
Results from patch testing children across europe highlight a common set of frequent allergens, which should be considered for a pEBS.
Benzisothiazolinone is a preservative responsible for allergic contact dermatitis, with occupational exposure being a common source of sensitisation.
To investigate the prevalence of positive patch test reactions to benzisothiazolinone (BIT) in Belgium, between January 2010 and December 2022, and to assess co-sensitisations to other isothiazolinone derivatives in sensitised patients.
A retrospective monocentric study of patch test results with benzisothiazolinone (BIT) 0.1% petrolatum observed in patients attending a Belgian tertiary hospital. Prevalence, demographic data, concomitant patch test reactions, and clinical relevance were analysed.
Overall, 65 of 6128 patients (1.06%) had a positive patch test reaction to benzisothiazolinone, and its sensitisation rate increased from 0.39% in 2010 to 3.72% in 2019 (followed by a decline to 0.71% in 2022). Occupational exposure was relevant in 20% of cases, with painters and metalworkers being the most affected professions. Unexpectedly, 10.8% of BIT-sensitised patients underwent patch testing due to complications following orthopaedic prosthesis implantation.
This study confirms a significant rise in BIT sensitisation over time, followed by a recent unexplained decline. Occupational exposure remains a major risk factor, but other environmental sources, including consumer products, such as leather products, should not be overlooked. The BIT sensitisation in orthopaedic prosthesis-related complications requires further investigation.
Allergic contact dermatitis (ACD) caused by isothiazolinones is a growing concern, particularly in consumer products. Octylisothiazolinone (OIT) is a potent sensitiser and commonly used as a preservative in rubbers, plastics and coatings, including those found in headphones. Despite increasing regulations on isothiazolinones in cosmetics, their presence in wearable devices remains under-recognised.
This investigation aims to identify OIT as a possible sensitiser in patients with presumed ACD due to over-ear headphones.
Two patients with presumed ACD due to over-ear headphones were patch tested at the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö. Patch testing included Swedish baseline series, isothiazolinone compounds, and materials from headphones. To identify potential allergens, chemical analysis of components from headphones was conducted using high-performance liquid chromatography (HPLC).
Patch testing demonstrated strong positive reactions to OIT in both cases, with additional reactions to acetone extracts of artificial leather and blue plastic foam. OIT remained positive at dilutions as low as 0.00003%. Case 1 also showed positive reactions to MI/MCI. Chemical analysis confirmed OIT in both artificial leather (2.2 mg/g) and plastic foam (0.3 mg/g).
These findings contribute to the understanding of ACD by identifying OIT as a potential allergen in over-ear headphones. It calls for further research into the prevalence of OIT in consumer electronics and its role in sensitisation.
To assess the occurrence of carcinogenic, mutagenic, and reprotoxic substances (CMRs), endocrine disruptors, and skin sensitizers (i.e., polycyclic aromatic hydrocarbons (PAHs), phthalates, per- and polyfluoroalkyl substances (PFAS), bisphenols, isocyanates, isothiazolinones) in textiles, footwear, and clothing under in-force or proposed EU restrictions, and to evaluate exposure and risks for consumers related to bisphenols.
111 items from the Italian market or online were tested by gas or liquid chromatography mass spectrometry.
63% of the samples contained the investigated substances: 24% would exceed the proposed concentration limit for bisphenols under Regulation (EC) No. 1907/2006 (REACH); 19% could represent a significant source of exposure to phthalates and PAHs for consumers due to non-compliance with REACH; 7% contained octylisothiazolinone above the limit proposed to protect from skin sensitisation. Isocyanates and PFAS were quantified within concentration limits proposed or set by REACH and Regulation (EU) No. 2019/1021. No risks for consumers were related to the presence of bisphenols.
Safety of clothing articles, textiles, and footwear, especially from online market, would be significantly impacted by the presence of CMRs and environmental endocrine disruptors (i.e., phthalates, PAHs, bisphenols), highlighting the need for enforcement of EU controls and reduced use of harmful chemicals by manufacturers.
The objective of this review is to identify individual susceptibility factors and determine their role in the association between work-related exposures and contact dermatitis (CD). A scoping review was conducted using Medline, Embase, and CINAHL. Cohort and case-control studies were included for all types of CD, and cross-sectional studies for allergic contact dermatitis (ACD). In the absence of meta-analysis, we drew qualitative inferences summarising the findings. Twenty-one studies, primarily cross-sectional (n = 18), investigated how 44 individual susceptibility factors influenced associations between 53 work-related exposures (from six exposure categories) and CD. These factors were grouped into five categories: demographic, socioeconomic, host-related intrinsic factors, lifestyle, and exposures outside work. The factors variously mitigated, amplified, or had no effect on the exposure-CD association. The role of individual susceptibility factors in work-related exposure-CD associations remains underexplored and inconclusive. Determining their individual contributions is challenging, as studies often adjust for multiple factors, with inconsistent influence on the association. Age, sex, atopic history, hand eczema, smoking, and ethnicity may influence CD risk and should be considered in studies examining work-related exposure-CD associations. Further research is needed to clarify the role of individual susceptibility factors and guide effective prevention strategies for occupational CD.
Extended glove usage is crucial in various occupational settings to safeguard workers and maintain hygiene standards. However, prolonged wear creates an occlusive environment that disrupts normal skin evaporation, leading to temporary overhydration. This reversal of the diffusion gradient facilitates the penetration of residual soaps and alcohol from hand hygiene practices, which can deplete skin moisture and cause irritation. Moisturising agents have been integrated into gloves to address occupational dry skin, as conventional lotions often suffer from low compliance and incompatibility with latex. Their selection requires careful optimisation to ensure effective skin penetration without compromising glove integrity or introducing manufacturing complexities. Additionally, variations in activation stimuli among individuals must be taken into account to ensure consistent efficacy. This review discusses advancements in moisturising glove technologies, including interlayer coatings, direct surface applications, matrix integration, microencapsulation and hydrogel-based controlled-release systems. Despite these innovations, research gaps remain in standardising hydration assessment methods, evaluating real-world performance and comparing the efficacy of moisturising gloves with conventional skincare methods. Addressing these challenges through further clinical studies is crucial for refining the design and effectiveness of moisturising gloves in occupational applications.
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