Allergic Contact Dermatitis

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

75%

Irritant Contact Dermatitis

25%

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

	Cr	Ni	Epx	Acr	FmR	Rub	Frm	Glu	Col	pPD	GTG	KCG
	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
Cement Workers	x		x			x
Electricians			x						x
House Painters					x				x			x
Shoemakers					x	x
Aircraft Assemblers			x		x
Medical Workers				x		x	x	x
Dental Workers			x	x	x	x		x
Textile Workers	x	x	x		x	x	x			x
Electronics Workers		x	x	x	x				x
Mechanics	x	x	x			x			x	x
Printers	x		x	x	x					x		x
Hairdressers		x				x				x	x	x
Housekeeping		x				x	x	x				x
Machinists		x					x		x			x

Source of Information in Tables

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

Workers at Increased Risk for Allergic Contact Dermatitis: Table 2

	BP	Cin	Urt	Gar	Ses	Tul	Car	Fun	Ivy	Pin	Cre
	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
Bakers	x	x	x
Food Workers			x	x
Florists					x	x
Farm workers			x				x	x	x
Roofers											x
Carpenters										x	x

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)