Article

Allergic contact dermatitis from a condensate of boric acid, monoethanolamine and fatty acids in a metalworking fluid.

Department of Dermatology, Odense University Hospital, University of Southern Denmark and National Allergy Research Centre, Gentofte, Denmark.
Contact Dermatitis (Impact Factor: 2.93). 08/2003; 49(1):45-6. DOI: 10.1111/j.0105-1873.2003.0120e.x
Source: PubMed
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    ABSTRACT: In view of the wide variety of components currently used in metalworking fluids (MWF), relevant contact sensitizations may be overlooked, because commercially available MWF test series cannot cover the full spectrum. Hence, patch testing with MWF from the patient's workplace is an important additional diagnostic tool. However, recommendations on how to perform such patch tests vary. We retrospectively analyzed patch test data of the Department of Dermatology in Dortmund, 1992-2003. In 141 metalworkers tested because of suspected occupational contact dermatitis due to MWF, 829 patch tests with 306 samples of MWF were performed. Water-based MWF (wb MWF) were mainly tested in 2 dilution series, i.e. pure (workplace concentration), 10% aq. and 1% aq., and pure, 50% aq. and 10% aq. Positive reactions to wb MWF occurred in 27 patients. Patch testing with wb MWF at workplace concentration resulted in 16.1% (39/242) positive reactions, with a positivity ratio of 69% and a reaction index of 0. From the analysis of reaction patterns and concomitant reactions, we conclude that most of these positive reactions indicated true contact allergy. With lower concentrations, relevant allergic reactions may be missed. Neat oils were tested as is or diluted from 1 to 50% in olive oil, but no reactions at all were observed. For optimum benefit of patch testing with MWF from the patient's workplace, breakdown testing is recommended. To overcome the time-consuming difficulties associated with this procedure, we propose a centre for information and documentation of contact allergies due to occupational exposure. Furthermore, full declaration of MWF ingredients is desirable.
    Contact Dermatitis 11/2004; 51(4):172-9. · 2.93 Impact Factor
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    ABSTRACT: The composition of water-based metalworking fluids (wb MWF) is complex, and various admixtures may be added before or during usage. Wb MWF may cause irritant as well as allergic contact dermatitis. While several current case reports point towards allergens particularly related to wb MWF, systematic studies have not been performed for several years. From 1999 to 2001, a study on contact allergies among patients with occupational dermatitis (OD) called "Fruhzeitige Erkennung allergener Stoffe bei beruflicher und nicht-beruflicher Exposition" (German acronym: FaSt) was conducted by the Information Network of Departments of Dermatology (IVDK), funded by the employers' liability insurances in Germany (HVBG). The objective of FaSt was to detect sensitization patterns related to particular occupational exposures. Anamnestic and clinical data were gathered using a standardised questionnaire. Patch test results were recorded by computer within the IVDK routine procedure. In addition to descriptive statistical analyses, logistic regression analysis was performed to control the effect of potential confounders. Among the 1842 OD patients in the FaSt study, there were 160 metalworkers exposed to wb MWF, whose data is presented in this paper. A specific allergen pattern of these patients can be described: most frequently, sensitizations to monoethanolamine (MEA), colophony/abietic acid, and fragrance mix were observed. Additionally, cobalt, formaldehyde, formaldehyde releasers and other biocides are important allergens in these patients. Preventive measures and aimed in-depth research may be based on these results. The special MWF test series have to be kept up to date based on exposure information from the MWF industry and on continuous surveillance of the target group.
    International Archives of Occupational and Environmental Health 11/2004; 77(8):543-51. · 2.10 Impact Factor
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    ABSTRACT: Metalworking fluids (MWF) are complex mixtures potentially containing various irritants and allergens. Occupational contact dermatitis is common in metal workers exposed to MWF. Important MWF allergens are monoethanolamine, oxidations products of resin acids, formaldehyde and formaldehyde releasers and so on. Contact allergy due to MWF may be under-diagnosed because many allergens are not commercially available for patch testing, in spite of recent improvements of allergy diagnostics in this field. Therefore, patch testing with MWF from the patients’ workplace is crucial. In this chapter, MWF allergens are presented in detail, a MWF patch test series is recommended, rare MWF allergens are described and a guideline for patch testing with MWF from the workplace is given.
    12/2010: pages 681-694;

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