Irritant contact dermatitis (also known as irritation, irritant dermatitis or dermatitis)
Irritant contact dermatitis is a non-allergic condition and may be caused by either non-glove related or glove-associated irritants. Indeed there are over 85,000 chemicals with the potential to cause irritation under the right conditions1)Drake L.A., Dorner W, Goltz R.W. (1995) “Guidelines of care for contact dermatitis” J Am Acad Dermatol 32:109-113.
When making an assessment of irritant dermatitis, it is helpful to remember that there are both non-glove-related and glove-related conditions.
Among the multitude of everyday products known to cause irritant dermatitis are detergents, chemicals in hand soaps, disinfectants, solvents, glues etc. Frequent washing and drying of hands have become part of the daily laboratory regime, but with it comes the potential to produce the right conditions for irritant contact dermatitis. In this context, scalding hot water helps to break down the natural skin barrier properties making it more vulnerable. With sudden changes in weather conditions, the skin may become chapped and more susceptible to developing irritant contact dermatitis. If you wear jewellery in the laboratory, then irritants can build up below or around rings particularly if there is inadequate rinsing.
Glove-associated irritant contact dermatitis
Glove-associated irritants are chemicals, powder, endotoxin, friction and air occlusion. Residual chemicals are a concern if they are not removed from the glove surface through extensive washing or processing. Powder is often used as a release agent on the ceramic moulds or to facilitate donning. It can have a drying and abrasive effect on the hands leaving the skin vulnerable to cracking. Endotoxin is fragments from the cell wall of dead gram- negative bacteria. It is an inflammatory substance and is typically associated with irritant contact dermatitis. It is ubiquitous in nature and is not eliminated by sterilization. Endotoxin has also been reported to accelerate the rate of sensitization to allergens. Friction and air occlusion are often overlooked when considering the causes of irritant contact dermatitis. Friction happens when the glove fits too tightly and rubs continuously against the skin. Compounding this condition is long-term wet work or excessive sweating that creates a soggy condition on the skin surface, leaving the cells more vulnerable to friction and abrasive irritation.
Symptoms of dermatitis
Typically the onset of symptoms is evident within minutes to hours after the gloves are donned. Initial symptoms often include redness, itching and a burning sensation. In its chronic stage irritant contact dermatitis can lead to the thick, dry crusty skin, papules (small, hard bumps), blisters and sores. The accumulation of sweat next to the skin is a feature of air occlusion and can lead to another form of irritant contact dermatitis known as dyshidrosis. Here vesicular skin eruptions on the hands can eventually burst causing considerable discomfort. It is important to note that if the irritation is associated solely with the gloves, the irritant symptoms are normally confined to the area of glove contact.
Proposed action for managing irritant contact dermatitis
- Consult your supervisor or occupational health professional.
- Select natural rubber latex or synthetic gloves that are low in residual chemicals and endotoxin (e.g. use gloves that have an undergone testing for irritation such as the Primary Skin Irritation Test).
- Wear a larger glove to increase air circulation until hands heal.
- Change gloves more frequently to allow air to get to the hands if gloves are worn for long periods.
- Wear powder-free gloves.
- Implement hand care regimen, using skin creams to restore natural barrier properties of skin. However, note that petroleum-based creams may degrade natural rubber latex.
- Wear glove liners, but be sure to replace them every time gloves are changed. Please note that glove liners do not replace hand washing.
Whilst irritant contact dermatitis may not be a serious occupational illness, it can lead to more serious conditions. As it is difficult to adequately scrub hands that have open cracks, irritant contact dermatitis can reduce the effectiveness of hand washing. In this way, micro-organism such as staphylococcus can colonize the open lesions, thereby increasing the risk of infection. Furthermore, the rupture of the skin’s natural skin barrier can facilitate the entry of allergens. In this context it has been demonstrated that latex protein penetration was 1% for those individuals without irritant contact dermatitis, but 23% for those with irritant contact dermatitis2)Hayes B.B., Afshari A, Millechial L, Willard P.A., Povoski S.P., Meade B.J. (2000) “Evaluation of percutaneous penetration of natural rubber latex proteins” Toxicol Sci Aug: 56(2).
References [ + ]
|1.||↑||Drake L.A., Dorner W, Goltz R.W. (1995) “Guidelines of care for contact dermatitis” J Am Acad Dermatol 32:109-113|
|2.||↑||Hayes B.B., Afshari A, Millechial L, Willard P.A., Povoski S.P., Meade B.J. (2000) “Evaluation of percutaneous penetration of natural rubber latex proteins” Toxicol Sci Aug: 56(2|