ABSTRACT
Aim: Occupational contact dermatitis (OCD) is common amongst healthcare workers (HCW). This retrospective study describes the causes of allergic contact dermatitis in HCW in New Zealand and reviews the current literature review on OCD in HCW during the COVID-19 pandemic. Material and Methods: All HCW undergoing patch testing between July 2008 and January 2020 at a public hospital patch-test clinic, and between June 2019 and January 2020 at a private dermatology clinic were included. Data collected included patient demographics, occupation, results of patch testing and pre and post-patch test diagnoses. Literature search was performed on Pubmed with keywords: healthcare workers, occupational, allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), COVID-19. Results: Out of 837 patients patch tested during the study period, 67 were HCW. The mean age of HCW was 41 years (standard deviation 14) and 58 (87%) were female. The most common occupations were nurses (40%), allied health (22%) and doctors (18%). Forty-six (69%) patients had a background of atopic dermatitis. Hand dermatitis was the most common presentation (49%), followed by facial/neck dermatitis (25%). The most common relevant positive reactions were to rubber accelerators (24%), fragrances (16%), perservatives (15%) and topical steroids (9%). Literature review reflects that the incidence of ICD increased significantly due to increased frequency of hand washing and use of personal protective equipment during the COVID-19 pandemic. Contemporary data regarding ACD is limited. Conclusion: The most common allergens in HCW are rubber chemicals, fragrances and preservatives. The COVID- 19 pandemic has highlighted the incidence of OCD amongst HCWs. While rates of ICD have risen, data does not yet suggest increased rates of ACD.
ABSTRACT
PURPOSE OF REVIEW: This article aims to summarize some recent trends in occupational allergic contact dermatitis (ACD), including dermatitis related to pandemic-level personal protective equipment in healthcare workers, hazards patients may experience when working from home, and occupational perspectives on the recent American Contact Dermatitis Society (ACDS) allergens of the year and ACDS Core Allergen Series updates. RECENT FINDINGS: Recent ACDS Allergens of the Year may be particularly relevant to healthcare workers, including isobornyl acrylate, which is present in glucose sensors and propylene glycol present in hand cleansers and disinfectants. Lavender, limonene, and linalool, all of which are new additions to the ACDS Core Allergen Series, have been reported as causes for occupational ACD in massage therapists and aromatherapists. Isothiazolinone allergy continues to rise in both consumer and occupational settings. Finally, the COVID-19 pandemic has resulted in a wave of occupational ACD in healthcare workers to personal protective equipment, and revealed new potential allergens for individuals working from home. Occupational allergic contact dermatitis continues to exert a significant occupational disease burden. Remaining aware of the current trends in allergens may allow for earlier recognition, diagnosis, and treatment, subsequently helping our patients to work in healthier and safer environments.