Allergic contact hand dermatitis due to constituents of nitrile gloves

Purpose: This report of a case of allergic contact hand dermatitis due to constituents of nitrile gloves is to bring to the attention of practitioners four important practice points: 1) allergic contact dermatitis may occur due to exposure to chemicals in nitrile gloves; 2) skin patch testing is used to identify the causative allergens; 3) targeted allergens may be necessary in addition to the baseline European standard series if the standard series is unhelpful; and 4) there are potential interventions to manage nitrile glove dermatitis. Findings: A laboratory analyst had occupational exposure to several allergens and had worn latex gloves. She was exposed to laboratory chemicals and powdered ore dust, containing precious metals. She developed hand dermatitis and was relocated to administrative duties not requiring glove use. Her dermatitis cleared but recurred when she returned to the laboratory and started using nitrile gloves. On history, nitrile gloves and platinum group metal ore dust were consistently associated with her hand dermatitis, but laboratory chemicals were not. Latex-specific immunoglobulin E (IgE) was negative, as were skin patch tests for 13 allergens in the metal series, including salts of platinum group metals. She had positive allergic reactions to cobalt chloride, formaldehyde, nickel sulphate, and quaternium 15 in the European standard series patch tests. She did not react to the rubber chemicals in the European standard series, including thiuram mix. The patient was then tested with the rubber additives series because of the glove-relatedness of her hand dermatitis. She had positive reactions to three thiuram compounds used as accelerators in rubber gloves. The patient went on vacation during which time her dermatitis improved. She was relocated to a position without glove use or ore contact and her dermatitis did not recur. Conclusions: An analytic laboratory worker developed hand allergic contact dermatitis due to nitrile glove constituents. The diagnosis is supported by the improvement in her dermatitis after cessation of glove use, negative metal series patch tests, and positive patch tests to accelerators found in rubber gloves. Nevertheless, a contribution to the dermatitis by metals in the platinum group metal ore dust cannot be excluded. Recommendations: Nitrile glove constituents should be considered in wearers who develop hand dermatitis. Skin patch testing is recommended to investigate putative agents. Specific patch test series for more targeted testing may be required

Assessment of adverse reactions to latex gloves use among nurses at Mankweng Hospital, Limpopo Province, South Africa

Adverse reaction to latex is a common problem among nurses and other health care workers. The aim of the present study was to determine the prevalence of adverse reactions to latex amongst nurses at Mankweng Hospital. A cross sectional study was carried out amongst 235 nurses at Mankweng Hospital using a self-administered questionnaire to collect information about history of allergic reaction; family history; signs and symptoms of adverse reactions after using latex gloves. Among 155 nurses who responded to the questionnaire (66 response rate); 41 (26) had a family history of allergic reactions; with asthma as the commonest allergic condition reported. Fifty four respondents (n= 54; 35) reported having had signs and symptoms of adverse reaction after using latex gloves. The most common features associated with adverse reaction to latex gloves were sneezing (n=32; 21); itching nose (n=24; 16); itching eyes (n=21; 14); runny nose (n=18; 12); cough (n=16; 11); skin redness (n=13; 9); skin redness (n=13; 9); hives (n=12; 8); scratchy throat (n=9; 6); light headedness (n=10; 7) and swelling and rash in area(s) of contact (n=11; 7). There was significant association between family history and occurrence of adverse reaction to latex gloves (p=0.029). Accordingly; this study concludes that adverse reaction to latex gloves is prevalent among nurses at Mankweng Hospital; and poses the potential for harmful effects to nurses. These effects may vary in severity from skin problems to anaphylactic shock. It is therefore important to educate nurses about the prevalence; presentation and prevention of adverse reaction to latex