Dentist's occupational asthma, rhinoconjunctivitis, and allergic contact dermatitis from methacrylates.
BACKGROUND
Allergic contact dermatitis (ACD) caused by (meth)acrylates (MA) is common in dental personnel. MAs have also caused asthma and rhinoconjunctivitis, but asthma, rhinoconjunctivitis and ACD caused by MAs in the same patient appears to be very rare.


METHODS
Occupational asthma and rhinoconjunctivitis were diagnosed in a dentist according to patient history, PEF monitoring, and a work-simulated bronchial provocation test. ACD was diagnosed by skin-patch testing with MAs with the occlusive Finn Chamber-technique.


RESULTS
The patient's skin-prick test reactions to common environmental allergens and MAs were negative. The total IgE was not elevated. Occupational asthma was diagnosed by a specific inhalation challenge test in which the patient handled liquid dental MAs for 30 min causing a delayed 23% reduction in FEV1. The provocation test also resulted in rhinoconjunctivitis. On patch testing, positive reactions were provoked by several MAs including 2-hydroxyethyl methacrylate (2-HEMA) to which the patient was occupationally exposed. The patient has not been able to continue her work with dental MAs.


CONCLUSIONS
A case of occupational asthma, rhinoconjunctivitis and ACD caused by dental acrylate compounds is presented. Patients with respiratory hypersensitivity from MAs have to stop working with MAs, whereas patients with ACD from MAs need to avoid direct contact with MAs, but can often continue in their present job if they use no-touch techniques.
Lindström
M
M
Finnish Institute of Occupational Health, Topeliuksenkatu 41 b, FIN-00250 Helsinki, Finland.
Alanko
Kristina
K
Keskinen
H
H
Kanerva
L
L
D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis; D016535:Bronchial Hyperreactivity / Q000139:chemically induced / Q000175:diagnosis; D003233:Conjunctivitis, Allergic / Q000139:chemically induced* / Q000175:diagnosis; D003816:Dentists, Women; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005387:Finland; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008689:Methacrylates / Q000009:adverse effects*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis; D011237:Predictive Value of Tests; D012221:Rhinitis, Allergic, Perennial / Q000139:chemically induced* / Q000175:diagnosis; D012720:Severity of Illness Index; D012882:Skin Tests; D013147:Spirometry; D014797:Vital Capacity / Q000502:physiology
D008689:Methacrylates; D007073:Immunoglobulin E