A case of occupational allergic contact dermatitis

Posted on: August 8, 2016 by in Uncategorized
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A case of occupational allergic contact dermatitis

in a plumber performing pipeline repair Jussi Liippo and Kaija Lammintausta Department of Dermatology, Turku University Hospital, 20521 Turku, Finland doi:10.1111/j.1600-0536.2011.01956.x Key words: (meth)acrylates; occupational sensitization. The frequency of fresh-water and sewage pipeline renovations and coating has been increasing in old apartment houses in recent years. We describe a case of occupational allergic contact dermatitis in a plumber performing pipeline renovations. Case Report A 30-year-old female plumber had a history of hay fever since childhood, but no history of previous skin problems. She had been working as a plumber for 2 years before she started working for a company undertaking pipeline renovations in apartment houses. In the renovation process, the pipelines were coated with Baltoflake Ecolife® (Jotun Paints Ltd, Fixborough, England) (BFE) mass mixed with Norpol Peroxide® (Reichhold, Inc, USA) hardener. The plumber made a mixture of BFE and the hardener before spraying it into the pipeline. After a 1- year apprenticeship, the patient continued to perform the pipeline coating work on a daily basis. One year later, she developed erythematous itchy and scaling dermatitis on the arms. The dermatitis disappeared when the patient worked in the office, and reappeared when she returned to the pipeline coating work. Patch test results are shown in Table 1. When queried, the company stated that BFE contained 2,2 – ethylenedioxydiethyl dimethacrylate [triethylene glycol Correspondence: Jussi Liippo, Department of Dermatology, Allergy Unit, Turku University Hospital, P.O. Box 52, 20521 Turku, Finland. Tel: +358 2 3131644; Fax: +358 2 313 1047. E-mail: jussi.liippo@utu.fi Conflicts of interest: The authors have declared no conflicts. Table 1. Patch test reactions to tested (meth)acrylates in the series of glues and plastics and in the baseline series D2 D4 Test reactions to (meth)acrylates tested in the series of plastics and glues 1,4-Butanediol dimethacrylate − − 2,2-Bis(4-2-hydroxy-3- methacryloxypropoxy) phenylpropane − − Methyl methacrylate − − Epoxy acrylate − − 2-Hydroxy ethylmethacrylate − ++ Ethyl acrylate − − Ethylene glycol dimethacrylate ++ ++ Triethylene glycol diacrylate ++ ++ Ethylcyanoacrylate − − Test reactions to other allergens in the series of plastics and glues Mono-methylol phenol − + Test reactions to allergens in the baseline series Formaldehyde − + Nickel sulfate + + Test reactions to own materials Baltoflake Ecolifea + + Baltoflake Ecolife combined with 2.5% Norpol Peroxideb + ++ aThe material safety data sheet (MSDS) gave the constituents as follows: vinyl toluene, dibutyl maleate, fumaric acid, oxy bisethanol, and a cobalt salt of hexanoic acid. bFor the hardener Norpol Peroxide, the constituents were 2-butanone peroxide and dimethyl phthalate according to the MSDS. dimethacrylate (TEGDMA)], which was not declared to be unsafe. BFE contained no formaldehyde or mono-methylol phenol. © 2011 John Wiley & Sons A/S • Contact Dermatitis, 65, 239–248 247 Contact Dermatitis • Contact Points CONTACT ALLERGY IN PIPELINE REPAIR • LIIPPO & LAMMINTAUSTA Discussion In plumbers, (meth)acrylate sensitization resulting from sealants has been described(1), but notfrom coatingmaterials. Instead, epoxy systems have been reported to cause allergic contact sensitization in people performing water pipe renovation work (2). The coating material that our patient used inside the old pipelines often splashed onto the arms. The material safety data sheet was incomplete, as TEGDMA was missing. Triethylene glycol diacrylate and ethylene glycol dimethacrylate showed positive reactions in the patch test, and cross-reactivity between them and TEGDMA was evident. Dental workers and those making artificial nails are at risk of developing methacrylate contact sensitization (3, 4). This young female plumber had tried using artificial nails once, many years ago. At that time she had no skin problems. She had not had dental problems, and shehadnot beenworkingin dentistry. Thus,methacrylate sensitization caused by artificial nails or dental materials was unlikely in her case. Previous occupational sensitization to formaldehyde and to 2-methylol phenol was possible. Besides epoxy system allergens, the increasingly used pipeline renovation and coating systems seem to carry a clinically