Allergic Contact Dermatitis

Allergens are responsible for only about 25% of occupational contact dermatitis.

75%
Irritant Contact Dermatitis
 25%
Allergic Contact Dermatitis

Recognizing allergic causes is important because it makes possible effective treatment and prevention.

Allergic contact dermatitis (ACD) is a delayed type IV or cell-mediated hypersensitivity. The diagnosis of ACD is confirmed with patch testing. [LaDou, p. 283-5]

The following two tables illustrate some of the more common occupational contact allergens and the occupations most commonly affected by them. The occupations listed generally have the highest incidence rates of both allergic and irritant contact dermatitis.

Workers at Increased Risk for Allergic Contact Dermatitis: Table 1
Chromium:
Cr

Nickel:
Ni

Epoxy Resins:
Epx

Acrylate Resins:
Acr
Formaldehyde Resins:
FmR

Rubber Chemicals:
Rub

Formaldehyde:
Frm

Glutaraldehyde:
Glu
Colophony:
Col

p-Phenylenediamine:
pPD

Glycerol Thioglycolate:
GTG

Kathon CG:
KCG
CrNiEpxAcrFmRRubFrmGluColpPDGTGKCG
Cement Workersxxx
Electriciansxx
House Paintersxxx
Shoemakersxx
Aircraft Assemblersxx
Medical Workersxxxx
Dental Workersxxxxx
Textile Workersxxxxxxx
Electronics Workersxxxxx
Mechanicsxxxxxx
Printersxxxxxx
Hairdressersxxxxx
Housekeepingxxxxx
Machinistsxxxx

Source of Information in Tables

The two tables are based on Chapter 15, "Occupations Commonly Associated with Contact Dermatitis" inĀ Marks & DeLeo, plus additions based on recent published reports indexed in Medline.

Workers at Increased Risk for Allergic Contact Dermatitis: Table 2
Benzoyl Peroxide:
BP

Cinnamic Aldehyde:
Cin

1Contact Urticaria:
Urt
Garlic & Onions:
Gar

Sesquiterpenes:
Ses

Tuliposide A:
Tul

Carbamates:
Car
Fungicides:
Fun

Poison Ivy:
Ivy

Pine Dust & Tar:
Pin

2Creosote:
Cre
BPCinUrtGarSesTulCarFunIvyPinCre
Bakersxxx
Food Workersxx
Floristsxx
Farm workersxxxx
Roofersx
Carpentersxx

1 Contact urticaria is an immediate, type 1, antibody-mediated hypersensitivity. It appears within minutes of contact and disappears within a few hours.
2 Creosote is different from the other chemicals listed in that it causes a photoirritant contact dermatitis. There are also several foods that can cause this type of reaction, including lime, celery, parsnip and fig.

Other occupations with exposures to skin sensitizers: Morticians and embalmers (formaldehyde, glutaraldehyde and rubber chemicals); Foundry workers (formaldehyde, isocyanates and amines); Welders (colophony flux, chromium and nickel); Photo processors (Metol, thiourea, CD-2,CD-3, CD-4, formaldehyde, phenidone, phenols and amines)