title: Occupational allergic contact dermatitis caused by sterile non-latex protective gloves: clinical investigation and chemical analyses.
abstract: BACKGROUND
  An increased frequency of occupational contact hand dermatitis among surgical operating theatre personnel has been noticed.
  
  
  OBJECTIVE
  To evaluate patients with occupational contact dermatitis caused by their rubber gloves, and to describe a method for analysing the content of the allergens in the gloves.
  
  
  METHODS
  Patch tests were performed with the baseline series, a rubber chemical series, and the patients' own gloves. A method for analysing 1,3-diphenylguanidine (DPG) and cetylpyridinium chloride in the gloves was developed.
  
  
  RESULTS
  Contact allergy to thiuram mix was found in 8 of 16 patients, whereas 12 of 16 patients reacted to DPG. In 7 of 8 patients, contact allergy to cetylpyridinium chloride was found. In the patients' gloves, cetylpyridinium chloride and DPG were detected at higher concentrations on the inside of the gloves than on the outside. Most patients had worked for decades in their present occupations, but their hand dermatitis had only been present for months.
  
  
  CONCLUSIONS
  Contact allergy to DPG in gloves has been disputed, but, in this study, we were able to confirm the presence of DPG and cetylpyridinium chloride in the causative gloves by using a modified method for the analysis. The presence of these chemicals in gloves caused an increase in occupational contact dermatitis in surgical operating theatre personnel.
authors.affiliation: Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden                                     Department of Dermatology, Skåne University Hospital, SE-221 85 Lund, Sweden                                     Department of Dermatology, Central Hospital, SE-291 85 Kristianstad, Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Pontén
authors.forename: Nils
authors.initials: N
authors.lastname: Hamnerius
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
authors.forename: Christer
authors.initials: C
authors.lastname: Hansson
authors.forename: Christina
authors.initials: C
authors.lastname: Persson
authors.forename: Cecilia
authors.initials: C
authors.lastname: Svedman
authors.forename: Kirsten
authors.initials: K
authors.lastname: Thörneby Andersson
authors.forename: Ola
authors.initials: O
authors.lastname: Bergendorff
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D002594:Cetylpyridinium / Q000009:adverse effects*; D002851:Chromatography, High Pressure Liquid; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005932:Gloves, Surgical / Q000009:adverse effects*; D006146:Guanidines / Q000009:adverse effects*; D006229:Hand Dermatoses / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D013893:Thiram / Q000009:adverse effects*
chemical_list: D000891:Anti-Infective Agents, Local; D006146:Guanidines; D013893:Thiram; C027773:diphenylguanidine; D002594:Cetylpyridinium