An uncommon outbreak of irritant contact dermatitis caused by rubber accelerators: a historical cohort study
- 26 Downloads
Our aim was to study the association between the rubber accelerators and predisposing factors of irritant contact dermatitis (ICD) among the semiconductor factory workers. The research design was a historical cohort study. The study population was divided into two groups: (1) the rubber accelerator exposure group, including workers who wore natural rubber finger cots containing 2,2 dibenzthiazyl disulfide (MBTS), zinc diethyldithiocarbamate (ZDEC), and zinc dibutyldithiocarbamate (ZDBC); and (2) the non-rubber accelerator exposure group, including the workers who wore finger cots with less accelerators and without ZDBC (i.e., the non-exposed group). The samples were calculated, and each group comprised 99 workers. The content of rubber accelerators in the finger cots was determined using high-performance liquid chromatography technique. Cases of ICD and the respective associated factors were collected from the medical records as well as information derived from the questionnaire. Inferential statistics using multiple regression analysis were applied and the results presented as relative risk (RR), adjusted relative risk (adjusted RR), and the 95% confidence interval (CI). The demographics of the exposed and non-exposed group were statistically different in age, duration of employment, duration of contact to rubber accelerators, underlying atopic diseases, underlying allergic rhinitis, family history of atopic diseases, and family history of allergic rhinitis. The results showed that the ICD occurred in 27 (27.3%) of workers in the exposed group compared to 4 (4.0%) of workers in the non-exposed group. The adjusted RR of rubber accelerators containing MBTS, ZDEC, and ZDBC was 9.84 (95% CI 3.70, 26.15) and the predisposing factors which associated with ICD were finger cot contact duration more than 4 years, underlying allergic rhinitis, and family history of atopic diseases [1.78 (95% CI 1.03, 3.08), 1.50 (95% CI 0.85, 2.64) and 1.97 (95% CI 1.12, 3.46), respectively], while having underlying atopic dermatitis was found to be a protective factor adjusted RR 0.62 (95% CI 0.10, 4.13). Rubber accelerators MBTS, ZDEC, and ZDBC were the causes of ICD. The possible agent was ZDBC. Other predisposing factors play less important role in this epidemic.
KeywordsIrritant contact dermatitis Occupational Natural rubber latex Rubber accelerators
This study was granted by Faculty of Medicine, Khon Kaen University, Thailand (Grant No. IN61114). In addition, we would like to acknowledge Mr. Bryan Roderick Hamman, for editing the MS via Publication Clinic KKU, Thailand.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Salako KB, Chowdhury MMU (2007) Occupational skin disorder. In: Ladou J, Harrison RJ (eds) Current occupational and environmental medicine, 5th edn. McGraw-Hill, New York, pp 324–345Google Scholar
- 11.Coman G, Zinsmeister C, Norris P (2015) Occupational contact dermatitis: workers’ compensation patch test results of Portland, Oregon, 2005–2014. Dermat Contact Atopic Occup Drug 26:276–283Google Scholar
- 18.Truscott WM (2009) Latex glove use: essentials in modern hospital safety. In: Charney W (ed) Handbook of modern hospital safety, 2nd edn. Taylor & Francis Group, Boca RatonGoogle Scholar
- 19.Pattanakul V (2011) Natural rubber and synthetic rubber. Faculty of Science Mahidol University, NakhonpathomGoogle Scholar
- 21.Callahan A, Baron E, Fekedulegn D, Kashon M, Yucesoy B, Johnson VJ et al (2013) Winter season, frequent hand washing, and irritant patch test reactions to detergents are associated with hand dermatitis in health care workers. Dermat Contact Atopic Occup Drug 24:170–175Google Scholar
- 26.Human and Environmental Risk Assessment on Ingredients of Household Cleaning Products (HERA) (2013) Linear alkylbenzene sulphonate (revised HERA report 2013). HERA, Brussels. https://bit.ly/2SuAVfO. Accessed 27 Feb 2019
- 27.Leibert MA (1983) Final report on the safety assessment of sodium laureth sulfate and ammonium laureth sulfate. J Am Coll Toxicol 2:1–34Google Scholar
- 28.Chumnankarn S (2013) Factors which affected the migration of tetramethylthiuram disulfide and dithiocarbamates from food contact rubber gloves. Prince of Songkhla University, SongkhlaGoogle Scholar
- 30.Amado A, Sood A, Taylor JS (2012) Irritant contact dermatitis. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K (eds) Fitzpatrick’s dermatology in general medicine, 8th edn. McGraw-Hill, New YorkGoogle Scholar
- 31.National Statistical Office Thailand. Cigarette smoking and alcohol drinking survey in 2017. NSO Thailand, Bangkok. https://bit.ly/2BFFb6w. Accessed 27 Feb 2019