Contact allergy to rubber accelerators in consecutively patch tested Danish eczema patients: A retrospective observational study from 1990 to 2019.

BACKGROUND: Rubber accelerators are used in the production of rubber gloves and may cause contact allergy. OBJECTIVES: To estimate long-term trend and prevalence of contact allergy to rubber accelerators for a 30-year period in Denmark, high-risk occupations, and exposures. METHODS: Data from all patients with contact dermatitis consecutively patch tested at the department of Skin and Allergy Gentofte hospital with the rubber accelerators from the European baseline series (EBS) from 1990 to 2019, were analysed. Further, patients under suspicion of rubber accelerator contact allergy were additionally patch-tested with rubber accelerators from the specialised rubber series from 2005 to 2019 and these were additional extracted. RESULTS: The overall prevalence of contact allergy to one or more of the rubber accelerators from the EBS series was 2.7% with a significant decline in the first 12-years, followed by a stable frequency in the past 18-years. Associations with occupational contact dermatitis, hand dermatitis, and leg/foot dermatitis were found. Wet-work occupations were most often affected and gloves the most frequent exposure. CONCLUSIONS: Contact allergy to one or more of the rubber accelerators from the EBS is frequent and has been unchanged for several decades, which calls for prevention.

Rubber gloves in orthopaedic surgery (part II): Cooke and Goodyear; Halsted and Caroline's gloves of love; from cotton to rubber after Perthes' experiments; double glove technique with Urist.

PURPOSE: This study determines the timeline for surgeons adopting rubber gloves and the double glove technique in the operating room for orthopaedic surgery. MATERIAL AND METHODS: Using the vague historical terms of discovery, acceptance, commonplace, and consistency, we analyzed the influence of the different actors in each period. RESULTS: Cotton or silk was used for early gloves; they were permeable, sometimes coated with paraffin. Uses of rubber date to the 1600 s when the Mesoamericans used rubber to make shoes. After the discovery of rubber in 1735 by the French scientist Charles de la Condamine in Peru, the rubber glove was imagined in 1834 and done for the first time by R. F. Cooke. The acceptance of rubber gloves arrived when the Goodyear-Rubber Society began to manufacture rubber gloves. Halsted, at Johns Hopkins Hospital, negotiated in 1889 with the Goodyear Rubber Company to produce thin rubber gloves to protect his nurse's hands from the dermatologic effects of the carbolic acid used to sterilize instruments. Commonplace to protect patients from bacteria of hand surgeons necessitated several decades. Dr. Joseph Bloodgood (Halsted's senior resident) remarked that gloving the surgeon with rubber gloves reduced the infection rate. Still, surgeons were reluctant to wear gloves that impaired the sense of touch. Laboratory experiments performed by G. Perthes on cotton and rubber gloves were necessary to generalize rubber gloves for practice in orthopaedic surgery. Consistency of the double-glove technique arrived during World War II when M. Urist proposed the double protection against bites from bone or bullet fragments while exploring war wounds. Only in 1965, when The Ansell Rubber Company utilized gamma irradiation as a low-cost method of sterilizing the gloves they produced, did disposable gloves become sterile. CONCLUSION: This article helps to understand the detailed discussions before surgical gloves' modern operating equipment.

[ALLERGIC CONTACT DERMATITIS DUE TO NITRILE RUBBER GLOVES: ETHYL ISOTHIOCYANATE AND BUTYL ISOTHIOCYANATE AS POSSIBLE CAUSATIVE CHEMICALS].

BACKGROUND: The causative chemicals responsible for nitrile rubber glove-induced allergic contact dermatitis have not been fully elucidated. SUBJECT: This case involved a 36-year-old female, who developed an erythematous rash on her hands after one and a half months of wearing nitrile rubber gloves at her workplace. METHODS: Patch tests were performed using the gloves as is, and the Japanese standard allergen 2008 and their components. The gloves were chemically analyzed and several detected substances were subjected to further patch testing. RESULTS: The patient exhibited positive patch test reactions to nitrile rubber gloves as is, as well as to the dithiocarbamate mix and thiuram mix in the Japanese standard allergen 2008. Further patch testing revealed positive reactions to zinc diethyldithiocarbamate (ZDEC) and tetraethylthiuram disulfide (TETD) and weak positive reactions to zinc dimethyldithiocarbamate (ZDMC) and tetramethylthiuram monosulfide (TMTM). Chemical analysis revealed that ethyl isothiocyanate (EITC) and butyl isothiocyanate (BITC), which might have been produced from dithiocarbamate-type accelerators (DTCs) or thiuram-type accelerators (thiurams) during the vulcanization process, were present in the nitrile rubber gloves the patient used at her workplace, as was ZDBC. No other DTCs or thiurams were detected. Patch testing of the detected materials produced positive reactions to EITC and BITC, but not to ZDBC. CONCLUSION: We diagnosed the patient with allergic contact dermatitis due to the EITC and BITC present in nitrile rubber gloves, and considered that alkyl isothiocyanate might also have played a causative role. We propose that nitrile rubber gloves should be produced without using vulcanization accelerators.

Allergic contact dermatitis caused by synthetic rubber gloves in healthcare workers: Sensitization to 1,3-diphenylguanidine is common.

BACKGROUND: The frequency of allergic contact dermatitis has significantly increased in healthcare workers since the transition from latex to synthetic rubber gloves, with 1,3-diphenylguanidine being identified as the most frequently implicated allergen. OBJECTIVES: To highlight the role of 1,3-diphenylguanidine as the culprit allergen in contact allergies to synthetic rubber gloves, to propose recommendations for patch testing, and to discuss alternatives for sensitized subjects. MATERIALS AND METHODS: Patch test data from healthcare workers who developed hand dermatitis after wearing rubber gloves and who reacted positively to glove samples and rubber additives were collected from September 2010 to December 2017 in a Belgian hospital. RESULTS: A total of 44 caregivers were included in this study. Patch tests showed that: (a) 84% of the study population reacted positively to carba mix; (b) 86% reacted positively to 1,3-diphenylguanidine; and (c) 13 (30%) reacted positively to thiuram mix. Half of the subjects reacted positively to gloves containing 1,3-diphenylguanidine, whereas none reacted to accelerator-free gloves. CONCLUSION: The most commonly identified allergen was 1,3-diphenylguanidine, far ahead of thiurams, which were previously described as the most sensitizing accelerators. The use of 1,3-diphenylguanidine-free gloves is recommended. No subject reacted to gloves without accelerators, thus confirming their efficiency among accelerator-sensitized patients. We recommend that 1,3-diphenylguanidine be added to the European baseline series.

Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014.

BACKGROUND: Healthcare workers (HCWs) are at risk of developing occupational skin disease (OSD). OBJECTIVES: To ascertain the causes of OSD in Australian HCWs in a tertiary referral clinic. METHODS: A retrospective review was performed of patients assessed at the Occupational Dermatology Clinic in Melbourne from 1993 to 2014. RESULTS: Of 685 HCWs assessed in the clinic over a period of 22 years, 555 (81.0%) were diagnosed with OSD. The most common diagnosis was irritant contact dermatitis (ICD) (79.1%), followed by allergic contact dermatitis (ACD) (49.7%). Natural rubber latex allergy was also relatively frequent (13.0%). The major substances causing ACD were rubber glove chemicals (thiuram mix and tetraethylthiuram disulfide), preservatives (formaldehyde, formaldehyde releasers, and isothiazolinones), excipients in hand cleansers, which are hard-to-avoid weak allergens, and antiseptics. ACD caused by commercial hand cleansers occurred more frequently than ACD caused by alcohol-based hand rubs (ABHRs). Occupational ICD was mostly caused by water/wet work and hand cleansers, and environmental irritants such as heat and sweating. CONCLUSIONS: Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD.

Effects of wearing rubber gloves on activities of the forearm and shoulder muscles during different dishwashing stages.

[Purpose] The present study examined the effects of wearing rubber gloves on the activities of the forearm and shoulder muscles during two dishwashing stages. [Subjects] This study included 10 young females. [Methods] The participants performed two dishwashing stages (washing and rinsing) with and without rubber gloves. The activities of the wrist flexor and upper trapezius muscles were measured using wireless electromyography. [Results] During the washing stage, the activities of the wrist flexor and upper trapezius muscles were significantly greater without gloves than with gloves when performing the same tasks. However, during the rinsing stage, the activities of these muscles did not differ significantly according to the use of gloves. [Conclusion] Dishwashers should wear gloves during the washing stage to prevent wrist and shoulder pain.

Glove Manufacturing: Opportunities and Challenges in Control Engineering.

The glove manufacturing industry has seen tremendous growth recently, spurred on by the COVID-19 pandemic. A long-standing shortage of supply of disposable medical gloves has highlighted an urgent need to increase production capacity. This requires glove manufacturers to be quick in adopting best practices, in line with Industry 4.0, in order to optimize various aspects of the industry. Unfortunately, information available in the existing literature is, however, limited due to the confidential nature of the majority of research in this area. This article discusses some opportunities and challenges related to this important chemical industry, from the perspective of control engineering. These insights can point to some interesting directions of future work.

Enhanced antibacterial activity of NR latex gloves with raspberry-like PMMA-N,N,N-trimethyl chitosan particles.

Raspberry-like poly(methyl methacrylate) (PMMA) latex particles stabilized with silica nanoparticles (SiNPs) were prepared via the Pickering emulsion polymerization for use as substrate of N,N,N-trimethyl chitosan (TMC) adsorption. With the aims to simultaneously reduce the surface friction and improve the antibacterial activity of rubber gloves, the synthesized PMMA-SiNPs(TMC) particles were electrostatically deposited onto a sulphur prevulcanized natural rubber (SPNR) latex film. From SEM and AFM analyses, the results showed the highest surface coverage of PMMA-SiNPs(TMC) particles on the surface of SPNR film of 41% and the surface roughness of 69nm. The coated SPNR film exhibited effective antibacterial activity especially against S. aureus. Therefore, this investigation would be useful for fabrication of special gloves with antibacterial properties.