The irritancy of metalworking fluids: a laser Doppler flowmetry study.

Irritant contact dermatitis is common in metalworkers exposed to metalworking fluids (MWF). The irritancy of 3 commercially available water-based cutting fluids in maximal user's concentration and 2 neat oils was investigated in 23 healthy volunteers. Additionally, the irritancy of some groups of components of the cutting fluids was studied. After Sellotape stripping, repeated patch tests were performed over 5 days and evaluated by a visual score (VS) and by laser Doppler flowmetry (LDF). In general, the MWF caused marginal skin irritation. In a comparison of the MWF and water, the cutting fluids were ranked higher in irritancy than the neat oils, but the effect of only one cutting fluid could be distinguished from that of water. The components of the cutting fluids also caused no strong reactions. The LDF response showed that one emulsifier was more irritant than water and according to the VS, one corrosion inhibitor was the most irritant. The correlation coefficient between the VS and the LDF response was probably diminished by a strong adverse reaction to the fixing tape in many volunteers. From this experiment, it was concluded that MWF are generally only mildly irritant when used in proper concentrations. However, orthoergic contact dermatitis often develops as a result of repeated and cumulative subclinical insults, in which MWF, especially water-based, play a crucial role because exposure at work is often extensive.

Sensitization to povidone-iodine.

Eight patients are described with adverse skin reactions to povidone-iodine-containing preparations (Betadine). Patch test reactions were positive to povidone-iodine 5 or 10 per cent in petrolatum or to Betadine Solution, Ointment, or Scrub. In five of eight patients, also tested with potassium iodide in concentrations ranging from 5 to 20 per cent in petrolatum, the reactions were negative. Open tests with iodine tincture performed in three patients were completely negative. Allergy to povidone-iodine seems not to be based on sensitization to iodine.

Dermatoses in metal workers. (II). Allergic contact dermatitis.

In an epidemiological study of 286 metalworkers exposed to metalworking fluids (MWF), the prevalence of contact sensitization was investigated. In part I, irritant contact dermatitis in metal workers has been discussed. In 40 employees with dermatitis, patch tests were performed with a routine series, a series of common components of MWF, and a series of preservatives the employees worked with. Contact sensitization was established in 8 persons (2.8% of all workers), of whom 4 were allergic to biocides and/or corrosion inhibitors. Difficulties in interpretation of the relevance of positive reactions are discussed. Attention is paid to the use of biocides in MWF, their various types and their sensitizing capacities. Measures to reduce the induction of contact sensitization to preservatives in water-based fluids are discussed.

Dermatoses in metal workers. (I). Irritant contact dermatitis.

In an epidemiological study of 286 metalworkers exposed to metalworking fluids (MWF), the prevalence of skin problems was investigated. Minor changes, such as a dry rough skin with slight erythema, were seen in 31%, and major changes, such as more serious and widespread dermatitis, were observed in 27% of all workers. By far the most cases were of irritant origin; in only 2.8% was a contact sensitization established. Exposure to water-based MWF caused irritant contact dermatitis more often than exposure to neat oils. No influence was found of the presence of atopy on the occurrence of dermatitis. Other factors that may result in irritation of the skin are discussed, as well as measures to be taken to minimize insult of the skin.

Dyshidrotic eczema as an occupational dermatitis in metal workers.

Metalworkers exposed to metalworking fluids often encounter dermatological problems. In an epidemiological study of 286 metalworkers, 14% had dermatitis. Of these, 21 (54%) presented with the clinical appearance of dyshidrotic eczema. 3 out of these 21 operators had positive patch test reactions, 1 to nickel and 2 to formaldehyde and formaldehyde releasers, while 1 other was diagnosed as atopic. According to the literature, dyshidrotic eczema is strongly related to an atopic constitution and to contact sensitization, especially to nickel. However, our findings suggest that dyshidrotic eczema in metalworkers is a predominantly irritant dermatitis, mainly induced by exposure to soluble oils and unrelated to atopy.

Irritant contact dermatitis and chrome-passivated metal.

An outbreak of hand dermatitis is reported amongst employees working on a new assembly line of an electronics factory. 24 out of 41 employees had signs of irritant contact dermatitis. The fingertips and the dorsal parts of the hands were especially affected. Mechanical factors in combination with zinc-chromium compounds from galvanised steel seemed to be responsible for the dermatitis and the dry skin. The use of an emollient solved the problem.

Systemic contact-type dermatitis by derivatives of adamantane?

The possibility of system skin reactions caused by amantadine in patients sensitized for tromantadine is discussed. The practical question arises how to handle patients allergic tromantadine patients which may be helped by therapy with amantadine.

Specific reactions and cross reactions of anti-penicilloyl antibodies.

In human sera the specific reactions and cross reactions of antibodies directed against the penicilloyl groups were determined using different penicilloyl derivatives as antigen. The penicilloyl group providing the highest titre in one Ig class was said to define the specific reaction for this Ig class. This criterium was justified by the fact that antibodies evoked by long-term treatment with benzylpenicillin showed specific reaction to the benzylpenicilloyl group. Moreover, specific reactions of antibodies of different Ig classes in one serum were the same. Both the side chain and the thiazolidine ring of the penicilloyl group can serve as antigenic determinants.