| 11. |
- Bruze, M., et al.
(author)
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Validation of questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix II : the EDEN Fragrance Study
- 2021
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In: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 35:8, s. 1692-1701
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Journal article (peer-reviewed)abstract
- Background: In a European study on contact allergy in the general population, it has been hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure and thereafter subsequent avoidance of scented products implied a diagnosis of allergic contact dermatitis. Objectives: The primary aim of this study was to validate this hypothesis/algorithm. The secondary aim was to investigate whether there was any association between the outcome of the recent repeated open application test (ROAT) and the patch test reactivity. Methods: One hundred nine subjects with and without contact allergy to fragrance mix II (FM II) were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. Results: Twenty-four positive ROAT reactions were noted in total including 20 of those 32 with contact allergy to FM II. None of the volunteers reacted to the vehicle (P < 0.001). More individuals with a positive algorithm had positive ROATs when compared with those with a negative algorithm. However, the difference was not statistically significant (P = 0.12). The lower the patch test concentration eliciting a positive test reaction, the more likely was a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. Conclusions: The algorithm used in this study was not validated but it was indicated in this ROAT setup. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period.
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| 12. |
- Frosch, PJ, et al.
(author)
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Patch testing with a new fragrance mix detects additional patients sensitive to perfumes and missed by the current fragrance mix
- 2005
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In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 52:4, s. 207-215
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Journal article (peer-reviewed)abstract
- The currently used 8% fragrance mix (FM I) does not identify all patients with a positive history of adverse reactions to fragrances. A new FM II with 6 frequently used chemicals was evaluated in 1701 consecutive patients patch tested in 6 dermatological centres in Europe. FM II was tested in 3 concentrations - 28% FM II contained 5% hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral((R))), 2% citral, 5% farnesol, 5% coumarin, 1% citronellol and 10%alpha-hexyl-cinnamic aldehyde; in 14% FM II, the single constituents' concentration was lowered to 50% and in 2.8% FM II to 10%. Each patient was classified regarding a history of adverse reactions to fragrances: certain, probable, questionable, none. Positive reactions to FM I occurred in 6.5% of the patients. Positive reactions to FM II were dose-dependent and increased from 1.3% (2.8% FM II), through 2.9% (14% FM II) to 4.1% (28% FM II). Reactions classified as doubtful or irritant varied considerably between the 6 centres, with a mean value of 7.2% for FM I and means ranging from 1.8% to 10.6% for FM II. 8.7% of the tested patients had a certain fragrance history. Of these, 25.2% were positive to FM I; reactivity to FM II was again dose-dependent and ranged from 8.1% to 17.6% in this subgroup. Comparing 2 groups of history - certain and none - values for sensitivity and specificity were calculated: sensitivity: FM I, 25.2%; 2.8% FM II, 8.1%; 14% FM II, 13.5%; 28% FM II, 17.6%; specificity: FM I, 96.5%; 2.8% FM II, 99.5%; 14% FM II, 98.8%; 28% FM II, 98.1%. 31/70 patients (44.3%) positive to 28% FM II were negative to FM I, with 14% FM II this proportion being 16/50 (32%). In the group of patients with a certain history, a total of 7 patients were found reacting to FM II only. Conversely, in the group of patients without any fragrance history, there were significantly more positive reactions to FM I than to any concentration of FM II. In conclusion, the new FM II detects additional patients sensitive to fragrances missed by FM I; the number of false-positive reactions is lower with FM II than with FM I. Considering sensitivity, specificity and the frequency of doubtful reactions, the medium concentration, 14% FM II, seems to be the most appropriate diagnostic screening tool.
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| 13. |
- Frosch, PJ, et al.
(author)
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Patch testing with a new fragrance mix - reactivity to the individual constituents and chemical detection in relevant cosmetic products
- 2005
-
In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 52:4, s. 216-225
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Journal article (peer-reviewed)abstract
- A new fragrance mix (FM II), with 6 frequently used chemicals not present in the currently used fragrance mix (FM I), was evaluated in 6 dermatological centres in Europe, as previously reported. In this publication, test results with the individual constituents and after repeated open application test (ROAT) of FM II are described. Furthermore, cosmetic products which had caused a contact dermatitis in patients were analysed for the presence of the individual constituents. In 1701 patients, the individual constituents of the medium (14%) and the highest (28%) concentration of FM II were simultaneously applied with the new mix at 3 concentrations (break-down testing for the lowest concentration of FM II (2.8%) was performed only if the mix was positive). ROAT was performed with the concentration of the FM II which had produced a positive or doubtful (+ or ?+) patch test reaction. Patients' products were analysed for the 6 target compounds by gas chromatography-mass spectrometry (GC-MS). Results: 50 patients (2.9%) showed a positive reaction to 14% FM II and 70 patients (4.1%) to 28% FM II. 24/50 (48%) produced a positive reaction to 1 or more of the individual constituents of 14% FM II and 38/70 (54.3%) to 28% FM II, respectively. If doubtful reactions to individual constituents are included, the break-down testing was positive in 74% and 70%, respectively. Patients with a positive reaction to 14% FM II showed a higher rate of reactions to the individual constituent of the 28% FM II: 36/50 (72%). Positive reactions to individual constituents in patients negative to FM II were exceedingly rare. If doubtful reactions are regarded as negative, the sensitivity, specificity, positive predictive value and negative predictive value for the medium concentration of FM II towards at least 1 individual constituent was 92.3% (exact 95% confidence interval 74.9-99.1%), 98.4% (97.7-99.0%), 48% (33.7-62.6%) and 99.9% (99.6-"100.0%), respectively. For the high concentration, the figures were very similar. The frequency of positive reactions to the individual constituents in descending order was the same for both FM II concentrations: hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral((R))) > citral > farnesol > citronellol > alpha-hexyl-cinnamic aldehyde (AHCA). No unequivocally positive reaction to coumarin was observed. Lyral((R)) was the dominant individual constituent, with positive reactions in 36% of patients reacting to 14% FM II and 37.1% to 28% FM II. 5/11 patients developed a positive ROAT after a median of 7 days (range 2-10). The 5 patients with a doubtful or negative reaction to 28% FM II were all ROAT negative except 1. There were 7 patients with a certain fragrance history and a positive reaction to either 28% or 14% FM II but a negative reaction to FM I. Analysis with GC-MS in a total of 24 products obtained from 12 patients showed at least 1-5 individual constituents per product: Lyral((R)) (79.2%), citronellol (87.5%), AHCA (58.3%), citral (50%) and coumarin (50%). The patients were patch test positive to Lyral((R)), citral and AHCA. In conclusion, patients with a certain fragrance history and a negative reaction to FM I can be identified by FM II. Testing with individual constituents is positive in about 50% of cases reacting to either 14% or 28% FM II.
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| 14. |
- Hamnerius, N., et al.
(author)
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Hand eczema in healthcare workers : a questionnaire survey of risk factors and work-related exposures
- 2016
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In: Contact Dermatitis. - : Wiley. - 0105-1873. ; 75:S1
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Conference paper (other academic/artistic)abstract
- Recent data on the prevalence and causes of hand eczema among healthcare workers in Sweden are lacking. Multidrug-resistant bacteria have necessitated improved hand hygiene and preventive measures. This has led to an increase in the use of disposable rubber gloves and hand disinfectants, which might influence the risk of hand eczema. Our aims were to identify healthcare workers with hand eczema; to estimate quantitative and qualitative exposure to rubber gloves, hand disinfectants and other exposures; and to survey constitutional factors. An electronic questionnaire was distributed to all employees at the hospitals in southern Sweden. The results were statistically analysed using χ2-tests and binary logistic regression. The 1-year prevalence of self-reported hand eczema was 20% among the responding 9051 nurses and physicians. On a daily basis, 30% reported hand washing >20 times at work, 45% reported using hand disinfectants >50 times, and 28% used >20 pairs of nonsterile rubber gloves. The prevalence of hand eczema was significantly higher among the employees reporting a higher exposure to hand washing, hand disinfectants and rubber gloves than in those reporting a lower exposure. The prevalence of hand eczema was also significantly higher among respondents with a history of childhood eczema, who were smokers, who had a body mass index >30 kgm-2, who spent >30 min per day working in the kitchen or who had children aged
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| 15. |
- Hamnerius, N., et al.
(author)
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In Vivo Testing of the Protective Effect of Gloves
- 2022. - 3rd
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In: Protective Gloves for Occupational Use. - Boca Raton : CRC Press. - 9781003126874 - 9780367649050 ; , s. 171-181
-
Book chapter (peer-reviewed)abstract
- The use of protective gloves is of importance in workplaces where hazardous chemicals are handled, including the chemical industry, the plastic industry, as well as in environments such as dental practices, hairdressing, and beauty salons. Occupational dermatology can provide crucial advice regarding how to avoid or protect the patient against allergens found in the work environment and provide the patient with important information and advice regarding the correct use of gloves. This chapter provides a review of in vitro and in vivo testing of gloves, with a focus on an in vivo model developed for testing different glove materials against hazardous materials while also mimicking workplace conditions. The in vitro methods for testing can be adapted to simulate the strain from glove movement. However, in vitro methods have their limitations with regards to the interaction between the glove and the skin, the effect of occlusion, or possible chemical interaction. Thus, in vivo evaluation is needed to supplement the in vitro testing of available protective materials.
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| 16. |
- Hamnerius, N, et al.
(author)
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Wet work exposure and hand eczema among healthcare workers - a cross-sectional study
- 2018
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In: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 178:2, s. 452-461
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Hand eczema is more common in healthcare workers compared to the general population. The hands are subject to changing occupational exposures due to mandatory hygiene regulations for health care workers.OBJECTIVES: To describe the exposure due to hygiene procedures and investigate the associations between occupational hand washing, use of non-sterile gloves, and hand disinfectant and self-reported hand eczema.METHODS: Cross-sectional study with an electronic questionnaire distributed to 28 762 hospital employees in southern Sweden. Respondents working as nurses, assistant nurses or physicians constituted the group of healthcare workers analysed. Adjustments were made for gender, age, wet work at home, life-style factors and atopic dermatitis.RESULTS: 12 288 (43%) responded including 9051 healthcare workers. In this group the 1-year prevalence of self-reported hand eczema was 21%. On a daily basis, 30% reported hand washing with soap >20 times at work, 45% used hand disinfectants >50 times, and 54% used non-sterile gloves > 2 hours. After adjustment for confounding factors, a dose-dependent association with self-reported hand eczema was found for the daily number of hand washes with soap at work and time working with disposable gloves, but not for alcoholic disinfectant use. Hand washing outside work was not associated with self-reported hand eczema in the adjusted multivariate analysis.CONCLUSIONS: In this study, we found a higher 1-year prevalence of self-reported hand eczema among Swedish healthcare workers than reported in the general population. Hand washing with soap and use of disposable gloves were associated with the occurrence of self-reported hand eczema in a dose-dependent way. Use of hand disinfectant was not associated with self-reported hand eczema. This article is protected by copyright. All rights reserved.
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| 17. |
- Isaksson, Marléne, et al.
(author)
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Suitable test concentration of cobalt and concomitant reactivity to nickel and chromium. A multicentre study from the Swedish Contact Dermatitis Research Group
- 2021
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In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 84:3, s. 153-158
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Journal article (peer-reviewed)abstract
- Background In Sweden, cobalt chloride 0.5% has been included in the baseline series since the mid-1980s. A recent study from Stockholm showed that cobalt chloride 1% petrolatum (pet.) was more suitable than 0.5%. Cobalt chloride at 1.0% has been patch tested for decades in many European countries and around the world. Objectives To study the suitability of patch testing to cobalt 1.0% vs 0.5% and to analyze the co-occurrence of allergy to cobalt, chromium, and nickel. Results Contact allergy to cobalt was shown in 90 patients (6.6%). Eighty (5.9%) patients tested positive to cobalt 1.0%. Thirty-seven of the 90 patients (41.1%) with cobalt allergy were missed by cobalt 0.5% and 10 (0.7%) were missed by cobalt 1.0% (P < .001). No case of patch test sensitization was reported. Allergy to chromium was seen in 2.6% and allergy to nickel in 13.3%. Solitary allergy to cobalt without nickel allergy was shown in 61.1% of cobalt-positive individuals. Female patients had larger proportions of positive reactions to cobalt (P = .036) and nickel (P < .001) than males. Conclusion The results speak in favor of replacing cobalt chloride 0.5% with cobalt chloride 1.0% pet. in the Swedish baseline series, which will be done 2021.
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| 18. |
- Johansen, JD, et al.
(author)
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Hydroxyisohexyl 3-cyclohexene carboxaldehyde-known as Lyral (R): quantitative aspects and risk assessment of an important fragrance allergen
- 2003
-
In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 48:6, s. 310-316
-
Journal article (peer-reviewed)abstract
- Hydroxyisohexyl 3-cyclohexene carboxaldehyde, also known as Lyral(R), is a fragrance ingredient identified as the cause of contact allergic reactions in 2-3% of eczema patients undergoing patch testing. Lyral(R) has been included in the standard patch test series in many clinics due to its importance as an allergen. It has been used without restrictions in cosmetic products, until now. In the present study, the dose-response relationship of Lyral(R) contact allergy was studied with doses relevant for normal exposure in cosmetic products. 18 eczema patients, who previously had given a positive patch test to Lyral(R) 5% petrolatum, were included along with 7 control subjects. All cases were tested with a serial dilution of Lyral(R) in ethanol 6% to 6 p.p.m and subjected to a 2-week, repeated open application test with a low dose of Lyral(R) in ethanol. In the case of no reaction, this was followed by another 2 weeks of testing with a higher dose. The test was performed at the volar aspect of the forearm. In 16 of 18 cases (89%), a positive use test developed, 11 reacting to the low and 5 to the high concentration. None reacted to the vehicle control of ethanol applied to the contralateral arm. All controls were negative to both the test solutions of Lyral(R) and the ethanol control. The difference between the test and the control group was statistically significant (Fisher's test, P < 0.001). It is concluded that Lyral(R) at the current usage levels is inducing sensitization in the community. The same levels were shown to elicit allergic contact dermatitis in almost all sensitized individuals. A significant reduction in usage concentrations is recommended to prevent contact allergic reactions.
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| 19. |
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| 20. |
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