Download PDF
Aktuelle Dermatologie 2024; 50(10): 471-479
DOI: 10.1055/a-2331-4038
Übersicht

Kontaktallergien auf Inhaltsstoffe von Schutzhandschuhen: Aktuelle Erkenntnisse

Contact allergies to ingredients of protective gloves: An update
Richard Brans
1   Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Osnabrück, Deutschland
2   Abteilung Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland
,
Andreas Hansen
1   Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Osnabrück, Deutschland
2   Abteilung Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Handschuhe werden in vielen Berufen, aber auch im privaten Bereich zum Schutz der Hände eingesetzt. Abhängig vom Material und den Herstellungsprozessen können in Schutzhandschuhen verschiedene Allergene enthalten sein. Überwiegend handelt es sich hierbei um Kontaktallergene (z.B. Vulkanisationsbeschleuniger), die Spättypsensibilisierungen hervorrufen und beim Tragen der Handschuhe zu allergischen Kontaktekzemen führen können. Zur Abklärung von Handekzemen bei Personen, die Schutzhandschuhe verwenden, ist die Durchführung eines Epikutantests angezeigt. Nur so können Allergien auf Inhaltsstoffe von Handschuhen identifiziert und geeignete Handschuhalternativen ausgewählt werden. Da derartige Alternativen nicht immer zur Verfügung stehen, kann im ungünstigsten Fall eine Allergie gegenüber Handschuhinhaltsstoffen auch die Aufgabe einer beruflichen Tätigkeit zur Folge haben. Dieser Artikel befasst sich mit Allergenen in Schutzhandschuhen, der diagnostischen Abklärung sowie den sich hieraus ergebenden Herausforderungen und Lösungsansätzen für die Handschuhversorgung.

Abstract

Gloves are used in many occupations and at home to protect the hands. Depending on the material and the manufacturing process, protective gloves may contain various allergens, predominantly contact allergens (e.g. rubber accelerators) causing delayed-type sensitizations which may result in allergic contact dermatitis to protective gloves. In individuals with hand eczema who wear protective gloves, a thorough diagnostic work-up including a patch test is indicated to identify allergies against glove ingredients and subsequently select an appropriate alternative glove. As such alternatives are not always available, allergy to a glove ingredient may result in abandoning the profession. We here present allergens in protective gloves, the diagnostic work-up and related challenges and solutions for selecting appropriate gloves.



Publication History

Article published online:
03 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Hansen A, Brans R, Sonsmann F. Allergic contact dermatitis to rubber accelerators in protective gloves: Problems, challenges, and solutions for occupational skin protection. Allergol Select 2021; 5: 335-344
    CrossrefPubMedSearch in Google Scholar
  • 2 Rose RF, Lyons P, Horne H. et al. A review of the materials and allergens in protective gloves. Contact Dermatitis 2009; 61: 129-137
    CrossrefPubMedSearch in Google Scholar
  • 3 Mahler V. Allergic Reactions to Rubber Components. In: Johansen C, Mahler V, Lepoittevin JP. et al. Contact Dermatitis. Springer International Publishing; 2021: 891-911
    Search in Google Scholar
  • 4 Aalto-Korte K. Contact Allergy to Protective Gloves. In: Johansen JD, Mahler V, Lepoittevin JP. et al. Contact Dermatitis. 6th ed.. Cham: Springer; 2021
    CrossrefSearch in Google Scholar
  • 5 Geier J. Typ-IV-Diagnostik von Berufssubstanzen. In: Skudlik C, Schön MP, John SM. Berufsdermatologie. 1st ed.. Springer; 2023: 89-114
    Search in Google Scholar
  • 6 Bauer A, Geier J, Mahler V. et al. Contact allergies in the German workforce: Data of the IVDK network from 2003–2013. Hautarzt 2015; 66: 652-664
    CrossrefPubMedSearch in Google Scholar
  • 7 Bauer A, Pesonen M, Brans R. et al. Occupational contact allergy: The European perspective-Analysis of patch test data from ESSCA between 2011 and 2020. Contact Dermatitis 2023; 88: 263-274
    CrossrefPubMedSearch in Google Scholar
  • 8 Hansson C, Ponten A, Svedman C. et al. Reaction profile in patch testing with allergens formed during vulcanization of rubber. Contact Dermatitis 2014; 70: 300-308
    CrossrefPubMedSearch in Google Scholar
  • 9 Brans R, Bauer A, Becker D. et al. Auswirkung einer arbeitsbedingten Kontaktallergie gegen Thiurame/Dithiocarbamate bei der BK 5101. Dermatol Beruf Umwelt 2023; 71: 67-75
    CrossrefPubMedSearch in Google Scholar
  • 10 Geier J, Lessmann H, Mahler V. et al. Occupational contact allergy caused by rubber gloves – nothing has changed. Contact Dermatitis 2012; 67: 149-156
    CrossrefPubMedSearch in Google Scholar
  • 11 Uter W, Aberer W, Armario-Hita JC. et al. Current patch test results with the European baseline series and extensions to it from the ‘European Surveillance System on Contact Allergy’ network, 2007–2008. Contact Dermatitis 2012; 67: 9-19
    CrossrefPubMedSearch in Google Scholar
  • 12 Bergendorff O, Persson C, Hansson C. High-performance liquid chromatography analysis of rubber allergens in protective gloves used in health care. Contact Dermatitis 2006; 55: 210-215
    CrossrefPubMedSearch in Google Scholar
  • 13 Knudsen BB, Hametner C, Seycek O. et al. Allergologically relevant rubber accelerators in single-use medical gloves. Contact Dermatitis 2000; 43: 9-15
    CrossrefPubMedSearch in Google Scholar
  • 14 Depree GJ, Bledsoe TA, Siegel PD. Survey of sulfur-containing rubber accelerator levels in latex and nitrile exam gloves. Contact Dermatitis 2005; 53: 107-113
    CrossrefPubMedSearch in Google Scholar
  • 15 Goodier MC, Ronkainen SD, Hylwa SA. Rubber Accelerators in Medical Examination and Surgical Gloves. Dermatitis 2018; 29: 66-76
    CrossrefPubMedSearch in Google Scholar
  • 16 Geier J, Gefeller O. Sensitivity of patch tests with rubber mixes: results of the Information Network of Departments of Dermatology from 1990 to 1993. Am J Contact Dermat 1995; 6: 143-149
    CrossrefPubMedSearch in Google Scholar
  • 17 Aalto-Korte K, Pesonen M. Patterns of simultaneous patch test reactions to thiurams and dithiocarbamates in 164 patients. Contact Dermatitis 2016; 75: 353-357
    CrossrefPubMedSearch in Google Scholar
  • 18 Uter W, Warburton K, Weisshaar E. et al. Patch test results with rubber series in the European Surveillance System on Contact Allergies (ESSCA), 2013/14. Contact Dermatitis 2016; 75: 345-352
    CrossrefPubMedSearch in Google Scholar
  • 19 Uter W, Wilkinson SM, Aerts O. et al. Patch test results with the European baseline series, 2019/20-Joint European results of the ESSCA and the EBS working groups of the ESCD, and the GEIDAC. Contact Dermatitis 2022; 87: 343-355
    CrossrefPubMedSearch in Google Scholar
  • 20 Uter W, Gefeller O, Mahler V. et al. Trends and current spectrum of contact allergy in Central Europe: results of the Information Network of Departments of Dermatology (IVDK) 2007–2018. Br J Dermatol 2020; 183: 857-865
    CrossrefPubMedSearch in Google Scholar
  • 21 Knudsen BB, Menne T. Contact allergy and exposure patterns to thiurams and carbamates in consecutive patients. Contact Dermatitis 1996; 35: 97-99
    CrossrefPubMedSearch in Google Scholar
  • 22 Pesonen M, Jolanki R, Larese Filon F. et al. Patch test results of the European baseline series among patients with occupational contact dermatitis across Europe – analyses of the European Surveillance System on Contact Allergy network, 2002–2010. Contact Dermatitis 2015; 72: 154-163
    CrossrefPubMedSearch in Google Scholar
  • 23 Uter W, Hegewald J, Pfahlberg A. et al. Contact allergy to thiurams: multifactorial analysis of clinical surveillance data collected by the IVDK network. Int Arch Occup Environ Health 2010; 83: 675-681
    CrossrefPubMedSearch in Google Scholar
  • 24 Warburton KL, Bauer A, Chowdhury MM. et al. ESSCA results with the baseline series, 2009–2012: rubber allergens. Contact Dermatitis 2015; 73: 305-312
    CrossrefPubMedSearch in Google Scholar
  • 25 Schwensen JF, Menne T, Johansen JD. et al. Contact allergy to rubber accelerators remains prevalent: retrospective results from a tertiary clinic suggesting an association with facial dermatitis. J Eur Acad Dermatol Venereol 2016; 30: 1768-1773
    CrossrefPubMedSearch in Google Scholar
  • 26 Hansson C, Agrup G. Stability of the mercaptobenzothiazole compounds. Contact Dermatitis 1993; 28: 29-34
    CrossrefPubMedSearch in Google Scholar
  • 27 Chipinda I, Hettick JM, Simoyi RH. et al. Oxidation of 2-mercaptobenzothiazole in latex gloves and its possible haptenation pathway. Chem Res Toxicol 2007; 20: 1084-1092
    CrossrefPubMedSearch in Google Scholar
  • 28 Schuttelaar ML, Meijer JM, Engfeldt M. et al. Allergic contact dermatitis caused by dimethylthiocarbamylbenzothiazole sulfide (DMTBS) in canvas shoes: in search of the culprit allergen. Contact Dermatitis 2018; 78: 7-11
    CrossrefPubMedSearch in Google Scholar
  • 29 Hulstaert E, Bergendorff O, Persson C. et al. Contact dermatitis caused by a new rubber compound detected in canvas shoes. Contact Dermatitis 2018; 78: 12-17
    CrossrefPubMedSearch in Google Scholar
  • 30 Andersen KE, Burrows D, Cronin E. et al. Recommended changes to standard series. Contact Dermatitis 1988; 19: 389-390
    CrossrefPubMedSearch in Google Scholar
  • 31 Geier J, Uter W, Schnuch A. et al. Both mercaptobenzothiazole and mercapto mix should be part of the standard series. Contact Dermatitis 2006; 55: 314-316
    CrossrefPubMedSearch in Google Scholar
  • 32 Warshaw EM, Gupta R, DeKoven JG. et al. Patch Testing of Mercaptobenzothiazole and Mercapto Mix: The North American Contact Dermatitis Group Experience, 1994–2016. Dermatitis 2021; 32: 232-244
    CrossrefPubMedSearch in Google Scholar
  • 33 Brans R, Bauer A, Becker D. et al. Auswirkung einer arbeitsbedingten Kontaktallergie gegen Benzothiazole bei der BK 5101. Derm Beruf Umwelt 2023; 71: 76-81
    CrossrefPubMedSearch in Google Scholar
  • 34 Brans R, Bauer A, Becker D. et al. Auswirkung einer arbeitsbedingten Kontaktallergie gegen 1,3-Diphenylguanidin (1,3-DPG) bei der BK 5101. Derm Beruf Umwelt 2023; 71: 82-86
    CrossrefPubMedSearch in Google Scholar
  • 35 Dejonckheere G, Herman A, Baeck M. Allergic contact dermatitis caused by synthetic rubber gloves in healthcare workers: Sensitization to 1,3-diphenylguanidine is common. Contact Dermatitis 2019; 81: 167-173
    CrossrefPubMedSearch in Google Scholar
  • 36 Ponten A, Hamnerius N, Bruze M. et al. Occupational allergic contact dermatitis caused by sterile non-latex protective gloves: clinical investigation and chemical analyses. Contact Dermatitis 2013; 68: 103-110
    CrossrefPubMedSearch in Google Scholar
  • 37 Hansen A, Buse AS, Wilke A. et al. Sensitization to 1,3-diphenylguanidine: An underestimated problem in physicians and nurses using surgical gloves?. Contact Dermatitis 2021; 84: 207-208
    CrossrefPubMedSearch in Google Scholar
  • 38 Hamnerius N, Ponten A, Bjork J. et al. Skin exposure to the rubber accelerator diphenylguanidine in medical gloves-An experimental study. Contact Dermatitis 2019; 81: 9-16
    CrossrefPubMedSearch in Google Scholar
  • 39 Dahlin J, Bergendorff O, Vindenes HK. et al. Triphenylguanidine, a new (old?) rubber accelerator detected in surgical gloves that may cause allergic contact dermatitis. Contact Dermatitis 2014; 71: 242-246
    CrossrefPubMedSearch in Google Scholar
  • 40 Friis UF, Johansen JD, Krongaard T. et al. Quantitative assessment of diethylthiourea exposure in two cases of occupational allergic contact dermatitis. Contact Dermatitis 2011; 64: 116-118
    CrossrefPubMedSearch in Google Scholar
  • 41 Sommer S, Wilkinson SM, Beck MH. et al. Type IV hypersensitivity reactions to natural rubber latex: results of a multicentre study. Br J Dermatol 2002; 146: 114-117
    CrossrefPubMedSearch in Google Scholar
  • 42 Wilkinson SM, Burd R. Latex: a cause of allergic contact eczema in users of natural rubber gloves. J Am Acad Dermatol 1998; 39: 36-42
    CrossrefPubMedSearch in Google Scholar
  • 43 Allmers H, Schmengler J, John SM. Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German health care workers. J Allergy Clin Immunol 2004; 114: 347-351
    CrossrefPubMedSearch in Google Scholar
  • 44 Zachariae CO, Agner T, Menne T. Chromium allergy in consecutive patients in a country where ferrous sulfate has been added to cement since 1981. Contact Dermatitis 1996; 35: 83-85
    CrossrefPubMedSearch in Google Scholar
  • 45 Thyssen JP, Jensen P, Carlsen BC. et al. The prevalence of chromium allergy in Denmark is currently increasing as a result of leather exposure. Br J Dermatol 2009; 161: 1288-1293
    CrossrefPubMedSearch in Google Scholar
  • 46 Thyssen JP, Strandesen M, Poulsen PB. et al. Chromium in leather footwear – risk assessment of chromium allergy and dermatitis. Contact Dermatitis 2012; 66: 279-285
    CrossrefPubMedSearch in Google Scholar
  • 47 Bregnbak D, Thyssen JP, Zachariae C. et al. Characteristics of chromium-allergic dermatitis patients prior to regulatory intervention for chromium in leather: a questionnaire study. Contact Dermatitis 2014; 71: 338-347
    CrossrefPubMedSearch in Google Scholar
  • 48 Hedberg YS, Liden C, Lindberg M. Chromium Dermatitis in a Metal Worker Due to Leather Gloves and Alkaline Coolant. Acta Derm Venereol 2016; 96: 104-105
    CrossrefPubMedSearch in Google Scholar
  • 49 Lim JH, Kim HS, Park YM. et al. A Case of Chromium Contact Dermatitis due to Exposure from a Golf Glove. Ann Dermatol 2010; 22: 63-65
    CrossrefPubMedSearch in Google Scholar
  • 50 Thyssen JP, Menne T, Johansen JD. Hexavalent chromium in leather is now regulated in European Union member states to limit chromium allergy and dermatitis. Contact Dermatitis 2014; 70: 1-2
    CrossrefPubMedSearch in Google Scholar
  • 51 Aalto-Korte K, Ackermann L, Henriks-Eckerman ML. et al. 1,2-benzisothiazolin-3-one in disposable polyvinyl chloride gloves for medical use. Contact Dermatitis 2007; 57: 365-370
    CrossrefPubMedSearch in Google Scholar
  • 52 Norman T, Guenther J, Asante I. et al. Analysis of Contact Allergens in Polyvinyl Chloride Examination Gloves in the United States. Dermatitis 2024; 35: 160-166
    CrossrefPubMedSearch in Google Scholar
  • 53 Andre R, Alipour Tehrany Y, Bugey A. et al. Hand dermatitis aggravated by contact allergy to methylisothiazolinone in protective nitrile gloves. Contact Dermatitis 2022; 87: 383-384
    CrossrefPubMedSearch in Google Scholar
  • 54 Ponten A. Formaldehyde in reusable protective gloves. Contact Dermatitis 2006; 54: 268-271
    CrossrefPubMedSearch in Google Scholar
  • 55 Castelain M, Castelain PY. Allergic contact dermatitis from cetyl pyridinium chloride in latex gloves. Contact Dermatitis 1993; 28: 118
    CrossrefPubMedSearch in Google Scholar
  • 56 Steinkjer B. Contact dermatitis from cetyl pyridinium chloride in latex surgical gloves. Contact Dermatitis 1998; 39: 29-30
    CrossrefPubMedSearch in Google Scholar
  • 57 Dendooven E, Darrigade AS, Foubert K. et al. The presence of sulfites in ‘natural rubber latex’ and ‘synthetic’ rubber gloves: an experimental pilot study. Br J Dermatol 2020; 182: 1054-1055
    CrossrefPubMedSearch in Google Scholar
  • 58 Aalto-Korte K, Alanko K, Henriks-Eckerman ML. et al. Allergic contact dermatitis from bisphenol A in PVC gloves. Contact Dermatitis 2003; 49: 202-205
    CrossrefPubMedSearch in Google Scholar
  • 59 Matthieu L, Godoi AF, Lambert J. et al. Occupational allergic contact dermatitis from bisphenol A in vinyl gloves. Contact Dermatitis 2003; 49: 281-283
    CrossrefPubMedSearch in Google Scholar
  • 60 Vandevenne A, Ghys K, Dahlin J. et al. Allergic contact dermatitis caused by triphenyl phosphite in poly(vinyl chloride) gloves. Contact Dermatitis 2013; 68: 181-182
    CrossrefPubMedSearch in Google Scholar
  • 61 Suuronen K, Pesonen M, Henriks-Eckerman ML. et al. Triphenyl phosphite, a new allergen in polyvinylchloride gloves. Contact Dermatitis 2013; 68: 42-49
    CrossrefPubMedSearch in Google Scholar
  • 62 Crepy MN, Langlois E, Melin S. et al. Tricresyl phosphate in polyvinylchloride gloves: a new allergen. Contact Dermatitis 2014; 70: 325-328
    CrossrefPubMedSearch in Google Scholar
  • 63 Sowa J, Kobayashi H, Tsuruta D. et al. Allergic contact dermatitis due to adipic polyester in vinyl chloride gloves. Contact Dermatitis 2005; 53: 243-244
    CrossrefPubMedSearch in Google Scholar
  • 64 Nishioka K, Koizumi A, Takita Y. et al. Contact dermatitis due to 2,2,4-trimethyl 1,3-pentanediol diisobutyrate contained in latex-free, accelerator-free nitrile rubber gloves. Contact Dermatitis 2020; 82: 255-2557
    CrossrefPubMedSearch in Google Scholar
  • 65 Kanerva L, Jolanki R, Estlander T. Organic pigment as a cause of plastic glove dermatitis. Contact Dermatitis 1985; 13: 41-43
    CrossrefPubMedSearch in Google Scholar
  • 66 Weimann S, Skudlik C, John SM. Allergic contact dermatitis caused by the blue pigment VINAMON(R) Blue BX FW – a phthalocyanine blue in a vinyl glove. J Dtsch Dermatol Ges 2010; 8: 820-822
    CrossrefPubMedSearch in Google Scholar
  • 67 Reckling C, Engfeldt M, Bruze M. Occupational nitrile glove allergy caused by Pigment Blue 15. Contact Dermatitis 2016; 75: 189-190
    CrossrefPubMedSearch in Google Scholar
  • 68 Pesonen M, Suuronen K. Occupational allergic contact dermatitis caused by Solvent Orange 60 in protective gloves. Contact Dermatitis 2020; 83: 55-57
    CrossrefPubMedSearch in Google Scholar
  • 69 Geier J, Lessmann H, Frosch PJ. et al. Contact sensitization to N-(cyclohexylthio)phthalimide. Contact Dermatitis 2003; 48: 1-6
    PubMedSearch in Google Scholar
  • 70 Brans R, Bauer A, Becker D. et al. Auswirkung einer arbeitsbedingten Kontaktallergie auf N-Isopropyl-N’-phenyl-p-phenylendiamin (IPPD) bei der BK 5101. Derm Beruf Umwelt 2023; 71: 90-95
    CrossrefPubMedSearch in Google Scholar
  • 71 Clement A, Ferrier le Bouedec MC, Crepy MN. et al. Hand eczema in glove-wearing patients. Contact Dermatitis 2023; 89: 143-152
    CrossrefPubMedSearch in Google Scholar
  • 72 Aalto-Korte K, Suuronen K, Frosch P. Patch Testing with the Patients’ Own Products. Contact Dermatitis. 6th ed. Cham: Springer; 2021
    Search in Google Scholar
  • 73 Ludewig M, Hansen A, Bartling S. et al. Length matters: Use of polyethylene glove liners to prevent allergic contact dermatitis to rubber accelerators. Contact Dermatitis 2022; 86: 321-322
    CrossrefPubMedSearch in Google Scholar
  • 74 Brans R, Werner S, Obermeyer L. et al. Allergic contact dermatitis to accelerators in rubber gloves marketed as accelerator-free. Contact Dermatitis 2023; 89: 65-68
    CrossrefPubMedSearch in Google Scholar