sodium-dodecyl-sulfate and Dermatitis--Occupational

Skin protection creams (PC)s are used in the occupational setting to help prevent irritant hand dermatitis. The actual amounts of PC applied and the resulting dose per unit area on hands at work are lower than recommended.. To assess the influence of the applied dose on the efficacy of PCs in the prevention of irritant contact dermatitis.. Experimental cumulative irritant contact dermatitis was induced by twice daily application of 0.5% NaOH or sodium lauryl sulfate (SLS) for 4 days on the backs of 20 healthy volunteers. Test areas were left unprotected or were pretreated with three different PCs applied at a low dose (2 mg/cm(2) ) or a high dose (20 mg/cm(2) ) before irritation. Irritant responses were assessed by visual scoring and measurement of transepidermal water loss, chromametry, and corneometry.. Although cumulative irritant dermatitis developed in all unprotected test sites, irritation was significantly reduced in a dose-dependent manner on PC-protected sites. The higher doses of all PCs provided significant protection against irritation. However, the lower dose of one product did not significantly protect against SLS-induced irritation.. The protective efficacy of PCs depends on the amount of product applied per unit skin surface area. Some products may show no protective efficacy when used at doses close to those practically applied at workplaces. Future efficacy studies of PCs should be performed with doses not higher than 2 mg/cm(2) , to avoid overestimation of their protective efficacy.

Topics: Administration, Cutaneous; Adolescent; Adult; Dermatitis, Irritant; Dermatitis, Occupational; Dose-Response Relationship, Drug; Female; Healthy Volunteers; Humans; Irritants; Male; Middle Aged; Protective Agents; Single-Blind Method; Skin Cream; Sodium Dodecyl Sulfate; Sodium Hydroxide; Treatment Outcome; Young Adult

Irritant contact dermatitis (ICD) is one of the most frequent types of occupational dermatitis. Different factors are involved in the development of contact dermatitis. In the food-processing industry, the combined exposure to different irritants may be involved in the development of ICD. Few data have been published regarding the irritant potential of sodium lauryl sulphate (SLS) in combination with cold.. The present study was intended to analyse whether cold exposure and low skin temperature influence the development of ICD.. Twenty (part I) and 12 (part II) healthy volunteers were exposed twice daily for 4 days to SLS alone, different low temperatures alone (4 degrees C six times for 90 s with an interval of 20 s or 15 degrees C for 10 min) or a combination of cold and SLS (19.6 microL SLS 1% cm(-2), part I; or 52.6 microL SLS 0.5% cm(-2), part II) using the tandem repetitive irritation test. Irritant cutaneous reactions were measured by noninvasive biophysical methods with transepidermal water loss as a parameter for permeability barrier function and skin colour reflectance together with visual scoring as parameters for inflammatory reactions.. Cold alone caused no significant skin reaction compared with untreated control. Exposure to SLS alone and SLS together with cold (independent of the applied temperature of 4 or 15 degrees C) twice daily induced a clear irritant reaction and barrier disturbance. Reactions did not differ whether SLS was applied before or after cold. Furthermore, 'tandem application' of cold and SLS diminished the barrier disruption and irritant reaction compared with SLS alone.. We conclude that the application of cold may have a protective effect on the development of ICD, at least in our short-term model.

Topics: Adult; Cold Temperature; Dermatitis, Irritant; Dermatitis, Occupational; Female; Humans; Male; Middle Aged; Occupational Exposure; Single-Blind Method; Skin; Skin Pigmentation; Skin Temperature; Skin Tests; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

Combined exposure to dry climatic conditions and local heat sources together with detergents represents a common workplace situation. These conditions may support the induction of chronic barrier disruption leading subsequently to irritant contact dermatitis (ICD).. To test the irritant and barrier disrupting properties of air flow at different temperatures and velocities.. Using noninvasive biophysical measurements such as transepidermal water loss (TEWL) (TM 210; Courage & Khazaka, Cologne, Germany) we assessed the effects of short-term exposure to air flow at different temperatures (24 degrees C and 43 degrees C) in combination with sodium lauryl sulphate (SLS) 0.5% on the skin of 20 healthy volunteers in a tandem repeated irritation test. Chromametry was used to control the accuracy of the SLS irritation model.. In our study air flow alone did not lead to a significant increase in TEWL values. Sequential treatment with air flow and SLS led to an impairment of barrier function and irritation stronger than that produced by SLS alone. The two different air flow temperatures led to different skin temperatures but had no influence on permeability barrier function.. Warm air flow has an additional effect on the SLS-induced barrier disruption in a tandem irritation test with sequential exposure to SLS/air flow. This combination is suspected to promote ICD in workplace and household situations, especially in short-term applications as tested in our model.

Topics: Adult; Air Conditioning; Air Movements; Analysis of Variance; Dermatitis, Irritant; Dermatitis, Occupational; Environment; Female; Humans; Male; Occupational Exposure; Skin Physiological Phenomena; Skin Temperature; Skin Tests; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

Combined exposure to different irritants in the workplace may lead to irritant contact dermatitis, which is the main type of occupational dermatitis among bakers and confectioners. Following previous work on "tandem irritation", a panel of healthy volunteers was exposed twice daily for 4 days to the organic fruit acids: citric, malic, and lactic acid, either alone or in tandem application with 0.5% sodium lauryl sulphate (SLS) in a repetitive irritation test. Irritant cutaneous reactions were quantified by visual scoring and non-invasive measurement of transepidermal water loss and skin colour reflectance. Twice daily application of either citric or malic acid alone did not induce a significant irritant reaction. Combined exposure to one of the fruit acids and SLS caused marked barrier disturbance, but the latter irritant effect was smaller than that obtained by combined exposure to SLS and water. Thus, combined exposure to the above-mentioned fruit acids and SLS did not enhance cumulative skin irritation.

Topics: Adult; Citric Acid; Citrus; Dermatitis, Allergic Contact; Dermatitis, Occupational; Drug Interactions; Female; Food Industry; Fruit; Humans; Irritants; Lactic Acid; Malates; Male; Predictive Value of Tests; Single-Blind Method; Skin Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

Chronic irritant contact dermatitis (ICD) is one of the most pressing problems in occupational medicine and is common in the food processing industry. To date, protective creams that fulfil the special requirements in the foodstuffs industry have not been available. Therefore, we studied the efficacy of pre-exposure application of natural vegetable fats in the prevention of experimentally induced ICD. A panel of 20 healthy volunteers was tested with a repetitive irritation test using sodium lauryl sulfate (SLS) as a standard irritant in a randomized study. Application sites were assessed clinically and by the use of bioengineering techniques (evaporimetry, chromametry, and corneometry). Rape seed and palm fats showed significant protective potential. Gas-chromatographic analysis revealed differences in the fatty acid composition of the vegetable. Higher content of linoleic acid and lower content of oleic acid was associated with beneficial effects. Our results are a new approach in the prevention of ICD and towards the development of new protective preparations for workplaces in the foodstuffs industry.

Topics: Adult; Dermatitis, Irritant; Dermatitis, Occupational; Fatty Acids; Female; Food Industry; Humans; Male; Plant Oils; Single-Blind Method; Sodium Dodecyl Sulfate

Eczematous skin disease is a serious work-related illness. Since 1995, reimbursement by insurance companies for treatment of skin diseases has become the largest cost source in some countries. This study was a randomized controlled trial (N = 20) of the efficacy of Pro-Q, a skin protectant product, in the prevention of contact dermatitis from sodium lauryl sulfate and urushiol, the resinous sap of poison ivy and poison oak. Pro-Q was significantly effective in reducing the irritation from sodium lauryl sulfate but did not prevent the allergic reaction to urushiol.

Topics: Administration, Cutaneous; Aerosols; Catechols; Dermatitis, Irritant; Dermatitis, Occupational; Dermatitis, Toxicodendron; Dermatologic Agents; Detergents; Dimethylpolysiloxanes; Double-Blind Method; Eczema; Glycerol; Humans; Irritants; Plants, Toxic; Protective Agents; Simethicone; Sodium Dodecyl Sulfate; Toxicodendron

Alcohol-based disinfectants and detergents are common workplace factors for irritant contact dermatitis (ICD). Though occlusion and water are relevant co-exposures, the tandem effects of occlusion and sequential exposure to alcohols and detergents have not been studied. We therefore investigated the combined effects of occlusion with water and repeated exposure to n-propanol and/or sodium lauryl sulphate (SLS) in an occlusion-modified tandem irritation test. The outcomes included visual scoring, measurement of erythema, transepidermal water loss, capacitance and natural moisturizing factor (NMF) levels. Occlusion abrogated the skin barrier function and significantly enhanced the irritant-induced barrier damaging effects. The NMF levels of all irritant-exposed fields decreased significantly compared with the non-exposed fields; occlusion enhanced the decrease in NMF. Although SLS exerted more pronounced effects on the measured parameters, the barrier function impairment and NMF decrease after exposure to n-propanol in workplace-relevant concentrations, found in the study, confirm the significance of short-chain aliphatic alcohols for occupational ICD.

Topics: 1-Propanol; Adult; Aged; Chromatography, High Pressure Liquid; Dermatitis, Irritant; Dermatitis, Occupational; Erythema; Female; Humans; Irritants; Male; Middle Aged; Skin Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin.. The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers.. The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels.. In the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups.. Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents.

Topics: Acetic Acid; Adult; Aged; Dermatitis, Allergic Contact; Dermatitis, Occupational; Detergents; Female; Food Industry; Fruit; Hand Dermatoses; Humans; Male; Middle Aged; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible; Young Adult

As previous observations have indicated an inter-relationship between irritant and allergic skin reactions we analysed data of synchronous allergen and sodium lauryl sulfate (SLS) patch tests in terms of a relationship between SLS responsiveness and allergic patch test reactions.. To analyse differences in terms of allergen-specific and overall reaction profiles between patients with vs. those without an irritant reaction to SLS.. Clinical data of 26 879 patients patch tested from 2008 to 2011 by members of the Information Network of Departments of Dermatology were analysed. After descriptive analyses, including the MOAHLFA index, the positivity ratio and the reaction index, a negative binomial hurdle model was adopted to investigate the correlation between SLS reactivity and positive patch test reactions.. Men, patients aged ≥ 40 years and patients with an occupational dermatitis background were over-represented in the SLS-reactive group. Patients with an irritant reaction to SLS showed a higher proportion of weak positive reactions, as well as more questionable and irritant reactions to contact allergens than patients not reactive to SLS. The risk of an additional positive patch test reaction increased by 22% for SLS-reactive patients compared with those who were SLS negative.. The marked association between SLS reactivity and the number of positive reactions in patch test patients may be due to nonspecific increased skin reactivity at the moment of patch testing only. However, increased SLS reactivity could also be due to longer-lasting enhanced skin irritability, which may have promoted (poly-)sensitization. Further studies, for example with longitudinal data on patients repeatedly patch tested with SLS and contact allergens, are necessary.

Topics: Adult; Aged; Allergens; Dermatitis, Irritant; Dermatitis, Occupational; Humans; Irritants; Male; Middle Aged; Retrospective Studies; Skin Irritancy Tests; Sodium Dodecyl Sulfate; Surface-Active Agents

Skin protective creams (PCs) are used widely in industrial work environments to prevent irritant contact dermatitis. However, workplace studies remain equivocal in terms of their effectiveness, which may be partly owing to whether the PC remains on the skin.. To assess the practicability of using skin occlusion testing in a workplace as a method to determine whether PCs applied under controlled conditions can reduce skin damage against known irritants. This study also compares two methods of skin evaluation: clinical dermatological assessment and bioengineering techniques.. Daily occlusion testing for 1 h (over two consecutive weeks) was conducted in an engineering company on the volar forearm of 21 healthy volunteer engineers with sodium lauryl sulfate (SLS) and a PC that was used on site. The engineers conducted their normal work activities during the occlusion testing period. The skin areas tested were assessed using transepidermal water loss (TEWL), Chroma Meter and by visual dermatological scoring.. Testing with PC and SLS together showed that PC does not prevent irritant contact dermatitis but significantly reduced skin damage compared with SLS alone (P < 0.01). The changes in skin were evident earlier with the biophysical measurements when compared with the dermatological assessment.. Occlusion testing is a useful method for assessing the potential effectiveness of protective creams and can be used in a workplace without affecting work practices. TEWL and the Chroma Meter provide useful objective information and should be used in combination with dermatological examinations.

Topics: Administration, Cutaneous; Adult; Anti-Inflammatory Agents; Dermatitis, Irritant; Dermatitis, Occupational; Dermatologic Agents; Drug Combinations; Drug Interactions; Erythema; Humans; Humidity; Kaolin; Male; Middle Aged; Oils; Patch Tests; Skin Cream; Sodium Dodecyl Sulfate; Surface-Active Agents; Temperature; Water Loss, Insensible; Waxes; Workplace

Topics: Allergens; Dermatitis, Irritant; Dermatitis, Occupational; Humans; Irritants; Male; Sodium Dodecyl Sulfate; Surface-Active Agents

A total of 56 departments of dermatology from Germany, Austria, and Switzerland collaborate to study the clinical epidemiology of contact allergies (CA). Data generated in the course of the diagnostic work-up of CA (e.g., patch test data) have been stored since 1989 in the data center in Göttingen, Germany, including data for more than 200,000 patients (March 2011). These data can be used as a register and as a surveillance system. Analysis of the register may identify and quantify risk factors of sensitization to an allergen, which is exemplified with the case of the allergen para-phenylenediamine. It turned out that-in addition to the risk factor hair dyeing-other important risk factors must be considered. In contrast, data collected every 6 months (from approximately 6,000 patients) allow for time-trend analyses of allergens, thus, identifying allergens of concern, which is of utmost importance for early preventive intervention. Here, the epidemiology of allergies to epoxy resins serves as an example. Continuous monitoring of contact allergens will also be mandatory in the future, as the CA premarketing screening systems will have imperfect predictive values with regard to human CA risk. Unfortunately, the (current) national regulatory framework severely hampers clinical surveillance/epidemiology of contact sensitization and, thus, prevention of contact allergy.

Topics: Adult; Austria; Coloring Agents; Comorbidity; Cross Reactions; Cross-Sectional Studies; Dermatitis, Allergic Contact; Dermatitis, Occupational; Epoxy Resins; Female; Fungicides, Industrial; Germany; Health Surveys; Humans; Male; Phenylenediamines; Population Surveillance; Public Health; Registries; Risk Factors; Sodium Dodecyl Sulfate; Surface-Active Agents; Switzerland; Thiram

Exposure to humid environments/water and prolonged glove occlusion are both believed to cause irritant contact dermatitis.. To study the effects of different forms of wet work, especially the differences between water exposure and occlusion, by using an experimental model simulating occupational wet work.. The responses to water exposure and occlusion over multiple daily exposure periods for 7 days were compared in 73 volunteers. After the 1 week exposure, the sites were irritated with sodium lauryl sulfate (SLS). Comparison was performed via visual inspection and bioengineering methods.. Whereas occlusion did not induce measurable alterations in skin physiology, water exposure for more than 3 hr daily caused a significant increase in transepidermal water loss (TEWL) as compared with the control areas. SLS irritation of the previously occluded and the water-exposed sites induced higher TEWL and clinical scores in a time-dependent fashion as compared with the control areas, with more pronounced reactions in the water-exposed sites than in the occluded sites.. Both previous occlusion and water exposure were capable of inducing higher susceptibility to SLS irritation. Skin hydration by occlusion had a different biological effect than water exposure. Short occlusions seem to harm the skin less than water exposure for the same duration.

Topics: Adult; Dermatitis, Irritant; Dermatitis, Occupational; Eczema; Female; Gloves, Protective; Humans; Male; Skin; Sodium Dodecyl Sulfate; Time Factors; Water; Water Loss, Insensible

Chronic irritant hand dermatitis is an issue for healthcare workers and may negatively impact infection control.. We examined the effects of a G to A transition at position -308 on the tumour necrosis factor-α (TNF-α) gene on chronically damaged skin of healthcare workers during exposure and recovery from repetitive hand hygiene, after intensive treatment, and on the irritant response in normal skin.. In 68 healthcare workers with irritant hand dermatitis, we genotyped TNF-α-308 and measured the epidermal response via quantitative digital imaging, erythema, dryness, and barrier integrity.. Excess hand erythema decreased with hand hygiene exposure and increased during time off for AA/GA genotypes, but had opposite effects for GG. AA/GA had smaller reductions in dryness with lotion treatment and larger reductions in excess erythema than GG. The atopic diathesis and heightened neurosensory irritation resulting from water and lactic acid significantly influenced the responses. Repeated exposure to water and sodium lauryl sulfate (0.05, 0.1%) produced higher erythema in normal skin for AA/GA than for GG.. This study provides evidence that the TNF-α polymorphism at -308 and an atopic history impact the severity of irritation and recovery from exposure and response to treatment for common hand skin products in both chronic irritant hand dermatitis and normal skin.

Topics: Adult; Dermatitis, Atopic; Dermatitis, Irritant; Dermatitis, Occupational; Epidermis; Erythema; Female; Hand Disinfection; Health Personnel; Humans; Male; Middle Aged; Occupational Exposure; Polymorphism, Genetic; Severity of Illness Index; Sodium Dodecyl Sulfate; Tumor Necrosis Factor-alpha; Young Adult

We investigated the biological response of regular human skin to alcohol-based disinfectants and detergents in a repetitive test design. Using non-invasive diagnostic tools such as transepidermal water loss, laser-Doppler flowmetry and corneometry, we quantified the irritative effects of a propanol-based hand disinfectant (Sterillium), its propanol mixture (2-propanol 45% w/w and 1-propanol 30% w/w), sodium lauryl sulfate (SLS) 0.5% and distilled water. The substances were applied in a 2-D patch test in a repetitive occlusive test design to the back. Additionally, we performed a wash test on the forearms that was supposed to mimic the skin affection in the normal daily routine of health care workers. In this controlled half-side test design, we included the single application of the hand rub, SLS 0.5% and water as well as a tandem application of the same substances. Patch test and wash test showed similar results. The alcohol-based test preparations showed minimal irritation rather comparable to the application of water. However, the detergent SLS produced stronger barrier disruption, erythema and dryness than the alcohol-based preparations. There was no additional irritation at the combined use of SLS and disinfectants. By contrary, there was even a decrease in barrier disruption and erythema induced by the tandem application of SLS followed by alcohol-based disinfection compared with the use of SLS alone. These findings show a less irritant effect of alcohol-based disinfectants on the skin than detergents. Our study shows that there is no summation of irritating effects of a common detergent and propanol and that the combination of washing and disinfection has a rather protective aspect compared with washing alone.

Topics: Adolescent; Adult; Dermatitis, Irritant; Dermatitis, Occupational; Detergents; Disinfectants; Erythema; Female; Hand Dermatoses; Hand Disinfection; Health Personnel; Humans; Laser-Doppler Flowmetry; Male; Middle Aged; Patch Tests; Quaternary Ammonium Compounds; Regional Blood Flow; Skin; Sodium Dodecyl Sulfate; Water; Water Loss, Insensible

There is evidence that a higher skin susceptibility may induce nonspecific erythematous or weak positive reactions to contact allergens in patch testing.. To evaluate whether simultaneous application of sodium lauryl sulphate (SLS) along with diagnostic patch tests with contact allergens can provide information regarding skin irritability which may help to discriminate allergic from nonspecific irritant reactions to contact allergens.. Between July 2001 and June 2003, this prospective study collected patch test data of 5971 patients from 19 centres in Germany and Austria in the Information Network of Departments of Dermatology (IVDK). In addition to contact allergens (standard series and eight known 'problematic' allergens with a low reaction index and a high positivity ratio: 1,3-diphenylguanidine, amerchol L-101, benzalkonium chloride, benzoyl peroxide, cocamidopropyl betaine, octyl gallate, phenyl mercuric acetate and propylene glycol), patches with SLS 0.5% and 0.25% aq. were applied. Reactions to the allergens and to SLS were analysed at the IVDK data centre. The association between an erythematous or positive reaction to a certain allergen and an irritant reaction to SLS was assessed with logistic regression analysis, at the same time controlling for the influence of age and sex.. Of the 29 allergens of the standard series, 23 and 21 gave a higher percentage of nonspecific erythematous reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, in comparison with SLS-negative patients. All eight 'problematic' allergens gave an increased percentage of nonspecific erythematous reactions. Similarly, 22 and 21 allergens of the standard series gave a higher percentage of positive allergic reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, and seven of the eight 'problematic' allergens gave a higher percentage of positive allergic reactions (exception: octyl gallate). For most allergens, the markers of skin reaction (reaction index and positivity ratio) were worse in SLS-positive patients. Differences were more pronounced when testing with SLS 0.25% than with SLS 0.5%.. Because there is a convincing association between skin irritability (evaluated by SLS test) and the degree of skin reaction to contact allergens, the SLS test may help in deciding whether a doubtful erythematous or weakly 'positive' skin reaction should be interpreted as allergic or irritant.

Topics: Adult; Allergens; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Contact; Dermatitis, Occupational; Diagnosis, Differential; Diagnostic Errors; Erythema; Female; Humans; Male; Patch Tests; Predictive Value of Tests; Prospective Studies; Sodium Dodecyl Sulfate

The interaction between potential irritants in the workplace might be important because workers are not usually exposed to a single irritant, but to multiple potentially harmful substances. Physical irritant contact dermatitis caused by friction or mechanical abrasion is a common occupational dermatosis. Prolonged water exposure by occlusion is also common in the workplace. Several studies have revealed the negative effect of the common anionic detergent sodium lauryl sulphate (SLS) on permeability barrier function.. To study the additive impairment of permeability barrier function by mechanical irritation combined with 0.5% SLS or prolonged water exposure by occlusion, as models of mild irritation.. The volar forearms of 20 healthy volunteers were exposed to mechanical irritation and occlusion with water or 0.5% SLS for four consecutive days in a combined tandem repeated irritation test (TRIT). Permeability barrier function was measured with a Tewameter TM 210. Irritation was assessed with a Chromameter CR 300 and a visual score.. Barrier disruption in our model was rated as follows: occlusion with SLS and mechanical irritation > occlusion with SLS > occlusion with water and mechanical irritation > mechanical irritation and occlusion with water > occlusion with a glove and mechanical irritation > mechanical irritation > occlusion with water. Barrier disruption caused by occlusion or mechanical irritation was enhanced by the tandem application. The choice of irritant under occlusion, time of occlusion and order of tandem application all affected the degree of barrier disruption. Evaporimetry was able to detect early stages in the development of an irritant reaction before it became visible. Chromametry was not able to detect this early response.. Physical irritants (friction, abrasive grains, occlusion) and detergents such as SLS represent a significant irritation risk and should be minimized, especially when acting together, as shown in our TRIT model.

Topics: Adult; Dermatitis, Irritant; Dermatitis, Occupational; Electric Capacitance; Epidermis; Erythema; Female; Humans; Irritants; Male; Physical Stimulation; Severity of Illness Index; Sodium Dodecyl Sulfate; Stress, Mechanical; Water Loss, Insensible

The benefit of alcohol-based disinfectant used on normal skin has been debated.. The objective of the present study was to compare the effects of repeated exposure to an alcohol-based disinfectant, a detergent and an alcohol-based disinfectant/detergent alternately for 10 days, including noninvasive measurements in the evaluation. Skin reactivity in irritated skin after a 4-week interval was also evaluated.. Detergent, disinfectant and alternate disinfectant and detergent were applied twice daily every 10 min for 1 h to the ventral upper arms and forearms of 17 healthy volunteers. A control area was included. After 4 weeks an SLS patch was applied to each area. Irritant reactions were quantified with a visual score recording and measurements of transepidermal water loss (TEWL) and skin colour were performed on days 1, 5, 11, 38 and 40.. On day 5 the detergent caused a higher visual score than either disinfectant applied alone or alternate disinfectant and detergent, P < 0.05. On day 11 detergent and alternate disinfectant and detergent caused a higher score than disinfectant, P < 0.05. An increased irritant response for detergent compared with disinfectant alone and alternate disinfectant and detergent was confirmed by TEWL evaluations on days 5 and 11, P < 0.001, while no significant difference was found by colour measurement. After 4 weeks, when evaluated by colour measurement, significantly less response to the SLS patch was found on the disinfectant-treated area compared with the control area and detergent area, and a similar trend was found for TEWL, although it was not statistically significant.. Alcohol-based disinfectant caused less visible skin irritation and less skin barrier disruption than the use of detergent. The alternate use of detergent and disinfectant caused less irritation than the use of detergent, and a possible interaction between the two irritants was not indicated. After 4 weeks there was a tendency for decreased skin reactivity in the skin areas which had 4 weeks previously been exposed to disinfectant.

Topics: Adult; Alcohols; Colorimetry; Dermatitis, Irritant; Dermatitis, Occupational; Detergents; Disinfectants; Female; Hand Disinfection; Humans; Male; Patch Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

Little is known of the predictive value of methods to test an individual's susceptibility to acquiring occupational contact dermatitis. Recently, the recovery rate after induced irritation was suggested for this purpose. Although it is likely that repeated exposure to sodium lauryl sulphate (SLS) is preferable to a single application, there is little evidence to support this idea. Similarly, little is known about whether the outcome of a repeated SLS test can be predicted by a brief test.. We studied the relationship between the skin reaction after a repeated SLS test and two brief tests, devoting special attention to the recovery rate.. In 29 healthy volunteers, we measured transepidermal water loss (TEWL) and erythema after applying 0.03, 0.1 and 0.3% SLS for 6 h, 3 days per week, over a course of 3 weeks. The data were compared with the effects after applying 0.1, 0.3 and 1.0% SLS for 24 h and with 10 and 15 repetitions of tape stripping.. A poor correlation was found between the repeated test and the brief SLS test, or tape stripping, when using an increase in TEWL (r = 0.04 and 0.26, respectively) or its recovery rate (r = - 0.01 and 0.42, respectively).. We presume that in a repeated test of sufficient duration, additional mechanisms come into play that are absent in a brief test, e.g. an alteration in the thickness of the epidermis, with a resulting change in the permeability of SLS. When such an effect differs between subjects it could explain the lack of agreement between the acute and the repeated tests. At present, a brief irritation test will, in all likelihood, be unable to assess an individual's susceptibility to occupational contact dermatitis.

Topics: Adult; Dermatitis, Allergic Contact; Dermatitis, Occupational; Erythema; Female; Humans; Hypersensitivity, Immediate; Male; Patch Tests; Permeability; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible

Skin hyperirritability to irritants as well as atopy are considered to be predisposing factors for contact dermatitis. The aim of the study was to evaluate whether these predictive factors are independent or whether they are so closely related that one could possibly replace the other 205 metalworker trainees underwent skin examination for skin atopy, including standardized questionnaire, clinical examination of the skin and a series of skin irritability tests. These tests included measurements of transepidermal water loss (TEWL) before and after irritation with 3 different irritants: sodium lauryl sulfate (SLS), dimethylsulfoxide (DMSO) and sodium hydroxide (NaOH). The results of the linear regression analysis demonstrate that skin atopy is not associated with increased skin irritability, as assessed by the irritability testing methods presented.

Topics: Adolescent; Adult; Dermatitis, Atopic; Dermatitis, Contact; Dermatitis, Irritant; Dermatitis, Occupational; Dimethyl Sulfoxide; Drug Hypersensitivity; Evaluation Studies as Topic; Humans; Male; Metallurgy; Multivariate Analysis; Regression Analysis; Skin Tests; Sodium Dodecyl Sulfate; Sodium Hydroxide; Switzerland; Water Loss, Insensible

Topics: Adult; Dermatitis, Irritant; Dermatitis, Occupational; Female; Hand Dermatoses; Hand Disinfection; Humans; Male; Soaps; Sodium Dodecyl Sulfate

Since irritants are the major cause of contact dermatitis, it is important to identify those chemicals that possess significant ability to cause skin irritation. This process must then be followed by risk assessment and risk management. Historically, animal tests have played a major rôle in this process, but human volunteer studies are of increasing importance in this field. Where the appropriate safety and ethical controls are in place, human testing can give data that identifies skin irritation hazard. To be of widest value, these human studies must not be flawed due to inter-individual, inter-ethnic or seasonal variation. We conducted a large dose-response study and studied the impact of summer and winter weather on a predictive human assay. Sodium dodecyl sulphate (SDS) was tested at 0.1%-20% in 3 national groups of approximately 100 volunteers, using 25 mm Hill Top chambers loaded with 0.2 ml, solution and applied to the upper outer arm for 4 h. Reactions were scored at 24, 48 and/or 72 h after patch application. The German and Chinese studies were completed in a few weeks under similar winter conditions, whereas the UK work was spread fairly evenly over about a 15-month period. Some relatively minor differences were observed in the dose-response curves obtained, probably due to weather conditions. The effect of the weather on the intensity, but not the pattern, of irritant reactivity was also evident in the smaller specific study that assessed reactions to SDS in summer and in winter. Whereas 45% of the panel reacted to 20% SDS in summer, 91% reacted in the winter. However, in both studies, substantial inter-individual variations in response to SDS dominated the pattern of response. When designing a human patch test to discriminate skin irritant substances from those that are of minimal effect, it is this inter-individual variability, rather than any small inter-ethnic or seasonal variation, which must be taken into account. This can be achieved by the routine inclusion of a suitable positive irritant control, which then calibrates each human volunteer panel.

Topics: Adult; Aged; China; Dermatitis, Irritant; Dermatitis, Occupational; Dose-Response Relationship, Drug; Ethnicity; Female; Germany; Humans; Male; Middle Aged; Patch Tests; Predictive Value of Tests; Seasons; Sodium Dodecyl Sulfate; Surface-Active Agents; United Kingdom

To reduce the incidence of irritant contact dermatitis, the development of screening methods to identify subjects with increased susceptibility to irritants is essential. In a pilot study on the comparison between two quick, non-invasive irritancy tests (dimethyl sulfoxide (DMSO) and sodium hydroxide (NaOH) with the time-consuming patch testing with sodium lauryl sulphate (SLS), no correlation between the "quick tests" and SLS patch testing was observed. In the present paper the results of irritancy testing in 181 metal worker trainees are presented. Experimental irritant contact dermatitis reactions were induced on the medial third of the volar forearm using SLS 0.5%, applied for 23 h and as "quick tests" DMSO 90% and 95% and a solution of 0.2% mol/l NaOH applied for 5 min. Assessment of skin irritability was made by visual scoring and measurement of transepidermal water loss. Except for a statistically significant relationship between the irritations by DMSO 90% and 95%, correlations between the different techniques were weak or non-existent. This is most probably due to different pathophysiological pathways for the irritant reactions. We therefore propose to use a spectrum of different tests in occupational dermatology for predicting the individual's risk of irritant contact dermatitis.

Topics: Adolescent; Adult; Dermatitis, Occupational; Dimethyl Sulfoxide; Female; Humans; Irritants; Male; Patch Tests; Pilot Projects; Sodium Dodecyl Sulfate

853 individuals who are still working or had previously worked in hard metal manufacture were examined and selected for patch tests with materials from their working environment including metal allergens. The majority of the individuals with positive test reactions to cobalt chloride were retested with serial dilutions of cobalt chloride and with the same serial dilutions after preparation of the skin with a layer of barrier or emollient cream used for hand care in this factory. The irritant effect of sodium lauryl sulphate (SLS) was similarly investigated. The barrier and emollient creams did not give any protection against cobalt chloride or sodium lauryl sulphate. In fact they seemed to enhance the penetration of cobalt ions. Their use in protection against metal allergens and cutting fluids is questionable.

Topics: Cobalt; Dermatitis, Occupational; Dermatologic Agents; Humans; Irritants; Ointments; Sodium Dodecyl Sulfate

Topics: Dermatitis, Contact; Dermatitis, Occupational; Drug Evaluation; Humans; Patch Tests; Sodium Dodecyl Sulfate

Topics: Acetone; Dermatitis, Contact; Dermatitis, Occupational; Dermatitis, Toxicodendron; Drug Eruptions; Eczema; Humans; Hydrochloric Acid; Hydrogen-Ion Concentration; Hydroxides; Irritants; Lipids; Nitrates; Permeability; Potassium; Skin; Skin Absorption; Skin Diseases; Skin Tests; Sodium Dodecyl Sulfate; Sodium Hydroxide; Solubility; Sweating; Turpentine