title: Occupational contact dermatitis caused by D-limonene.
abstract: BACKGROUND
  Limonene is widely used as a fragrance substance and solvent in cleansing products. Oxidized limonene is a frequent contact allergen among consumers of cosmetics, personal care products, and scented household cleaning products. Less is known about the sources of occupational exposure and occupational contact dermatitis caused by limonene.
  
  
  OBJECTIVE
  To report 14 patients with occupational contact allergy to limonene.
  
  
  METHODS
  The patients were examined in 2008-2013. An in-house preparation of oxidized limonene was patch tested as 3% and 5% in petrolatum from 2008 to August 2010, and after this as 3%, 1% and 0.3% pet. From 2012 onwards, a commercial test substance of limonene hydroperoxides was also used. We assessed the patients' occupational and domestic exposure to limonene.
  
  
  RESULTS
  Occupational limonene allergy was observed in workers who used limonene-containing machine-cleaning detergents and hand cleansers, and in workers who used limonene-containing surface cleaners and dishwashing liquids similar to those used by consumers. In 3 cases, the occupational limonene allergy resulted from work-related use of limonene-containing, leave-on cosmetic products.
  
  
  CONCLUSIONS
  Limonene is a frequent occupational sensitizer in hand cleansers and cleaning products. Occupational limonene contact allergy may also be caused by exposure to cosmetic products scented with limonene.
authors.affiliation: Occupational Medicine, Finnish Institute of Occupational Health, FI-00250, Helsinki, Finland.
authors.forename: Maria
authors.initials: M
authors.lastname: Pesonen
authors.forename: Sari
authors.initials: S
authors.lastname: Suomela
authors.forename: Outi
authors.initials: O
authors.lastname: Kuuliala
authors.forename: Maj-Len
authors.initials: ML
authors.lastname: Henriks-Eckerman
authors.forename: Kristiina
authors.initials: K
authors.lastname: Aalto-Korte
mesh_terms: D053138:Cyclohexenes / Q000009:adverse effects* / Q000032:analysis; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000209:etiology*; D003902:Detergents / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D000077222:Limonene; D010328:Patch Tests; D013729:Terpenes / Q000009:adverse effects* / Q000032:analysis
chemical_list: D053138:Cyclohexenes; D003902:Detergents; D013729:Terpenes; D000077222:Limonene
keywords: contact allergy; d-limonene; limonene hydroperoxides; occupational contact dermatitis; oxidation of limonene; patch testing