Debunking the Myth of Wool Allergy: Reviewing the Evidence for Immune and Non-immune Cutaneous Reactions.

Although wool is commonly believed to cause irritant (non-immune) and hypersensitivity (immune) cutaneous reactions, the evidence basis for this belief and its validity for modern garments have not been critically examined. Publications from the last 100 years, using MEDLINE and Google Scholar, were analysed for evidence that wool causes cutaneous reactions, both immune-mediated (atopic dermatitis exacerbation, contact urticaria, allergic contact dermatitis) and non-immune-mediated (irritant contact dermatitis, itch). Secondary aims of this paper were to examine evidence that lanolin and textile-processing additives (formaldehyde, chromium) cause cutaneous reactions in the context of modern wool-processing techniques. Current evidence does not suggest that wool-fibre is a cutaneous allergen. Furthermore, contact allergy from lanolin, chromium and formaldehyde is highly unlikely with modern wool garments. Cutaneous irritation from wool relates to high fibre diameters (≥ 30-32 µm). Superfine and ultrafine Merino wool do not activate sufficient c-fibres to cause itch, are well tolerated and may benefit eczema management.

Pulmonary function parameters in workers of woolen industry.

There is an increase in proportion of workers suffering from occupational diseases. In occupational respiratory diseases, pulmonary function tests are the most important and widely used diagnostic tool. Limited studies have been conducted to evaluate the effect of wool dust on pulmonary function parameters. Hence, the present study was undertaken to evaluate the pulmonary function parameters in workers of woolen industry. This study was done on 150 subjects of either gender who were divided into two groups of 75 each. Group I comprised of healthy subjects who served as controls and group II included workers of woolen industry. The values of lung function parameters i.e. volumes and flow rates in these workers were found to be lower than the healthy controls. The significant reduction in percentage predicted values of FEV1 (82 vs 59), FVC (79 vs 63) and MVV (77 vs 64) in workers as compared to healthy controls indicates obstructive pattern of respiratory abnormality. In male workers, percentage predicted FEV1% was significantly lower. The values of all other parameters were lower in female workers. There was a significant decrease in FEV and FVC with increase in age in group I and this negative correlation was statistically significant. The decrease in respiratory volumes and flow rates was more with increase in duration of exposure to wool dust. It can be concluded that wool dust present in environment of woolen industry affected the pulmonary function parameters of the workers leading to obstructive pattern of respiratory changes.

The effect of two sock fabrics on perception and physiological parameters associated with blister incidence: a field study.

The goal of the present study was to investigate differences in perception and skin hydration at the foot of two sock fabrics with distinct moisture properties in a realistic military setting. Thirty-seven military recruits wore two different socks (PP: 99.6% polypropylene and 0.4% elastane, and BLEND: 50% Merino-wool, 33% polypropylene, and 17% polyamide), one on each foot. Measurements were carried out after a daily 6.5-km march on 4 days. Each participant rated temperature, dampness, friction, and comfort for each foot. On a daily selection of participants, skin hydration was measured on three sites of both feet using a corneometer, and moisture content of the socks was determined. BLEND was rated to be cooler, less damp, and more comfortable (P < 0.05). Two out of three skin sites were drier for BLEND than PP (P < 0.05). Moreover, BLEND stored 2.9 ± 0.3 times more moisture compared to PP. Thus, under the present conditions, socks such as BLEND are to be preferred over polypropylene socks.

The effect of two sock fabrics on physiological parameters associated with blister incidence: a laboratory study.

The goal of the present study was to investigate physiological effects, mainly at the level of the foot, of two sock fabrics with distinct moisture properties. Twelve participants wore two different socks, one on each foot. The following two sock types were used: PP: 99.6% polypropylene and 0.4% elastane and BLEND: 50% Merino wool, 33% polypropylene, and 17% polyamide. The participants walked three times on a treadmill at 5 km h(-1), with no gradient for the first and third phase and a 10% upward inclination for the second walking phase. The microclimate temperature between the boot and foot was measured during walking. Preceding and following the walking phases, additional measurements were carried out at the level of the foot, i.e. skin temperature and skin hydration on three locations and skin friction between the posterior surface of the calcaneus and a glass plate. In addition, the moisture absorption of boots and socks was determined. Differences between the sock fabrics were found for weight gain and microclimate temperature: (i) PP tended to hold less water compared to BLEND, (ii) the boot's microclimate temperature resulted in larger values for BLEND measured at the dorsal surface at the level of the third metatarsal, and (iii) warmer microclimates of the boot were measured for PP compared to BLEND at the distal anterior end of the tibia. The established differences in moisture behavior of both socks did not result in detectable differences in parameters measured on the skin of the foot.

Toxicological responses in SW mice exposed to inhaled pyrolysates of polymer/tobacco mixtures and blended tobacco.

Modern cigarette manufacturing is highly automated and produces millions of cigarettes per day. The potential for small inclusions of non-cigarette materials such as wood, cardboard packaging, plastic, and other materials exists as a result of bulk handling and high-speed processing of tobacco. Many non-tobacco inclusions such as wood, paper, and cardboard would be expected to yield similar pyrolysis products as a burning cigarette. The aircraft industry has developed an extensive literature on the pyrolysis products of plastics, however, that have been reported to yield toxic by-products upon burning, by-products that have been lethal in animals and humans upon acute exposure under some exposure conditions. Some of these smoke constituents have also been reported in cigarette smoke. Five synthetic polymers, nylon 6, acrylonitrile-butadiene-styrene (ABS), nylon 12, nylon 6,6, and acrylonitrile-butadiene (AB), and the natural polymer wool were evaluated by adding them to tobacco at a 3, 10, and 30% inclusion level and then pyrolyzing the mixture. The validated smoke generation and exposure system have been described previously. We used the DIN 53-436 tube furnace and nose-only exposure chamber in combination to conduct exposures in Swiss-Webster mice. Potentially useful biological endpoints for predicting hazards in humans included sensory irritation and pulmonary irritation, respiratory function, clinical signs, body weights, bronchoalveolar lavage (BAL) fluid analysis, carboxyhemoglogin, blood cyanide concentrations, and histopathology of the respiratory tract. Chemical analysis of selected smoke constituents in the test atmosphere was also performed in order to compare the toxicological responses with exposure to the test atmospheres. Under the conditions of these studies, biological responses considered relevant and useful for prediction of effects in humans were found for sensory irritation, body weights, BAL fluid analysis, and histopathology of the nose. There was a marked sensory irritation response that recovered slowly for some polymers. Sustained body weight depression, lesions of the respiratory epithelium of the nose, and morphological changes in pulmonary alveolar macrophages (PAM) were observed after exposure to some polymer/tobacco pyrolysates. These responses were increased compared to exposure to tobacco pyrolysate alone. No moribundity or mortality occurred during the study. The data suggest that polymeric inclusions pose a minimal additional toxicologic hazard in humans.

Detection, pathogenesis, and prevention of damage to human granulocytes caused by interaction with nylon wool fiber. Implications for filtration leukapheresis.

Granulocytes collected by reversible adhesion to nylon wool fiber (NWF) function relatively well in standard in vitro tests; however, they have an abnormally shortened survival time in the circulation. Assuming that this rapid disappearance represents clearance and that recognition by phagocytes is important for such clearance, we used an autologous in vitro cell:cell recognition assay to determine whether phagocytes can detect cellular changes induced by exposure of normal granulocytes to NWF. Human granulocytes incubated with NWF 1 h at 37 degrees C, eluted with 20% acid citrate dextrose plasma, and washed stimulated the hexose monophosphate shunt activity of normal granulocytes an average of twofold (193+/-40% of controls), indicating a recognition response. NWF-induced granulocyte recognition was not dependent on plasma factors or activated complement components but was dependent on the time that the granulocyte was on the NWF and was maximal by 60 min of exposure. After elution from NWF, granulocytes demonstrated resting glucose oxidation rates only slightly higher than normal; however, during the first 20 min of exposure to NWF, granulocytes increased their rate of (14)CO(2) production from [1-(14)C]glucose three- to five-fold. Therefore, experiments were performed to determine whether toxic oxygen metabolites produced by NWF-adherent cells might contribute to recognition. The results showed that (a) normal granulocytes exposed to NWF in the presence of scavengers of superoxide anion (superoxide dismutase) or free radicals (ascorbate, mannitol, or benzoate) and washed before assay did not stimulate glucose oxidation of indicator granulocytes; and (b) NWF granulocytes prepared from cells unable to generate high levels of toxic oxygen metabolites, i.e. cells prepared anaerobically or from a patient with chronic granulomatous disease, also failed to stimulate indicator granulocytes. Human granulocytes placed in contact with NWF show an oxidative burst and become recognizable to other phagocytes. Free radical scavengers are effective in minimizing this recognition conferred on NWF-procured granulocytes.

A case-control study of carcinomas of the nose and paranasal sinuses in the woolen textile manufacturing industry.

A population-based case-control study was conducted in Biella, which is located in northwestern Italy, to investigate the reported association between sinonasal carcinomas and woolen fabrics production. The study included 33 cases diagnosed during 1976-1988 (14 adenocarcinomas, 11 epidermoid carcinomas, 3 other specified carcinomas, 1 unspecified carcinoma, and 4 cases without histologic confirmation) and 131 controls. No association was found with smoking. As reported previously, excess risks were observed in wood and furniture workers (odds ratio [OR] = 4.4, 95% confidence interval [95% CI] = 1.41-13.4) and in the leather industry (OR = 3.5, 95% CI = 0.6-20.3). Odds ratios in the wood and furniture industry were 22.0 (95% CI = 4.4-124.0) for adenocarcinomas and 0.9 (95% CI = 0.4-8.3) for epidermoid carcinomas. No association was found with the woolen textile or garment industries (OR = 0.8, 95% CI = 0.2-2.8), nor with farming, construction, metal works, and transport. Odds ratios for the textile industry did not vary with length of exposure or histologic type. Power for detecting an odds ratio of 3.0 at the 95% level of significance was 40%.

Pulmonary function studies in 15 to 18 years age workers exposed to dust in industry.

Pulmonary function tests (VC, FEV1% and FEF25-75%) were evaluated in 15 to 18 years age workers employed in slate pencil industry exposed to silica dust, in wool carpet industry exposed to wool dust and in diamond cutting and polishing exposed to carbon dust. These values were compared with the values obtained in clinically healthy non-smokers of the same age group. The results revealed significant impairment of VC in diamond workers, and FEF25-75% in slate pencil workers. When the values were observed according to smoking habits in diamond workers, VC, FEV1 and FEF25-75% were all significantly reduced in smokers whereas in non-smokers only VC was lowered significantly. Among slate pencil workers FEF25-75% was significantly reduced in both smokers and non-smokers. Wool dust exposed workers showed reduced values than normal subjects. The detailed results including the prevalence of various pulmonary impairments were presented.

[Nasal and pharyngeal mucous membrane in workers of artistic weaving plants]. / Blona sluzowa nosa i gardla u pracowników tkalni artystycznej.

68 persons employed at the production of fabrics from wool and flax, have been subjected to otolaryngological examinations. Chronic atrophic catarrh of mucous membrane of nose and pharynx was found in all 8 persons employed in tapestry weaving mill and in 44 among 60 employees of a weaving mill operated manually. Atrophic changes occurred most frequently both in the nose and the pharynx, less frequently only in the nose, and the least frequently only in the pharynx. Chronic atrophic catarrh of upper respiratory tract mucous membrane was found to be more frequent among those with the length of employment above 5 years than those with shorter employment, though this difference was not statistically significant. No correlation was found between the occurrence of chronic catarrh of upper respiratory tract and hearing damage.

Cytotoxicity study of high temperature wool (HT wool) by cell magnetometric evaluation.

OBJECTIVES: We performed a cytotoxicity study by cell magnetometry, measured lactate dehydrogenase (LDH) activity by enzyme assay, detected DNA ladder formation, and performed morphological examination by electron microscopy in order to evaluate the safety of high temperature wool (HT wool), an asbestos substitute, using long and short chrysotile fibers (CF) as positive controls and phosphate buffered saline (PBS) as a negative control. METHODS: Alveolar macrophages were isolated from male Fisher rats. Following the addition of iron oxide particles (Fe(3)O(4)) to macrophages, HT wool, long or short CF was added. Then, the remanence strength was measured for 20 min after magnetization by an external field. Percent LDH release was calculated after determining LDH activity. DNA was detected using an apoptosis detection kit. Morphological observation was performed by taking electron micrographs of macrophages in the groups treated with HT wool and long- and short-CF. RESULTS: Rapid relaxation, an indicator of decay of cytotoxicity, was observed by cell magnetometry immediately after magnetization was ended in the groups treated with HT wool and PBS, showing that HT wool causes no harmful effect on the cytoskeleton. The CF-treated groups had higher LDH activity than the PBS- and HT wool-treated groups. No fragmentation of DNA was observed in any group. In morphological observation, cytotoxicity in macrophages was lower in the HT wool-treated groups than in the CF-treated groups. CONCLUSIONS: The results suggest that HT wool has no cytotoxicity, as evaluated by cell magnetometry, enzyme assay, DNA ladder detection and morphological examination.

Contact sensitization in patients with lower extremity dermatitis in the South Moravian region, Czech Republic.

OBJECTIVES: The aim of the study was to determine the frequency of contact sensitization in patients with lower extremity dermatitis. METHODS: Between the years 2001 and 2007, the authors investigated 462 patients (mean age 49.1 years, 196 men and 266 women) with the eczema/dermatitis localized on their lower extremities, including feet. The patients were investigated with epicutaneous tests of the European Standard Series and also with other special patch tests. RESULTS: The most frequent allergens were balsam of Peru, 44/462 (9.5%); wool alcohols, 41/462 (8.9%); nickel sulphate, 39/462 (8.4%); propolis, 35/462 (7.6%); fragrance mix, 34 (7.4%) and colophony, 29/462 (6.3%). CONCLUSIONS: In patients with lower extremity dermatitis the frequency of contact sensitization is still high, and therefore investigation with epicutaneous tests should belong to the routine dermatological diagnostic procedure in these patients.

Lanolin allergy: history, epidemiology, responsible allergens, and management.

Allergy to lanolin has been recognized by dermatologists for decades. This review summarizes the history, epidemiology, and allergenicity of lanolin and its derivatives. "The lanolin paradox" and the safety of pharmaceutical-grade lanolin products are also discussed.

Study of skin-fabric interactions of relevance to decubitus: friction and contact-pressure measurements.

BACKGROUND/PURPOSE: Prolonged pressure as well as friction and shear forces at the skin-textile interface are decisive physical parameters in the development of decubitus. The present article describes the contact phenomena at the skin-textile interface and the development of a purpose-built textile friction analyser (TFA) for the tribological assessment of skin-fabric interactions, in connection with decubitus prevention. METHODS: Interface pressure distributions were recorded in the pelvic and femoral regions between supine persons and a foam mattress. Fabrics made of various natural and synthetic yarns were investigated using the TFA. A vertical load of 7.7 kPa was applied to the swatches, simulating high interface pressures at the skin-fabric interface and clinical conditions of bedridden persons. Fabrics were rubbed in reciprocating motions against a validated skin-simulating material to determine static as well as dynamic friction coefficients (COFs). RESULTS: Maximum contact pressures ranged from 5.2 to 7.7 kPa (39-58 mmHg) and exceeded the capillary closure pressure (32 mmHg) in all investigated bedding positions. For both COFs, a factor of 2.5 was found between the samples with the lowest and highest values. Our results were in a similar range to COFs found in measurements on human skin in vivo. The results showed that our test method can detect differences of 0.01 in friction coefficients. CONCLUSION: TFA measurements allow the objective and reliable study of the tribology of the skin-textile biointerface and will be used to develop medical textiles with improved performance and greater efficacy for decubitus prevention.