Irritant dermatitis, allergic contact dermatitis (ACD) and urticarial reactions have been associated with chemical rubber accelerators present in latex and nitrile/synthetic rubber gloves. In this study, patients reporting to a dermatology clinic with glove associated ACD were allergy patch tested with the North American Contact Dermatitis Group standard rubber allergen series, medical history taken and asked to identify and supply "problem gloves" which they associated with their ACD and if possible "non-problem gloves'. Medical exam, surgical and industrial-type rubber and nitrile gloves from patients were assessed for chemical content including: zinc dithiocarbamates, thiurams, mercaptobenzothiazole (MBT) and its disulfide, dimorpholine, diphenylguanidine, thiourea, and phenylene diamine. Only zinc di-ethyl - (ZDEC) and zinc dibutyl dithiocarbamate (ZDBC), MBT and dimorpholine were found in glove extracts. Considerable discordance was found between clinical patch test results and glove chemical content. Approximately 37% of patients had no discordance. However, similar percents of patients identified "problem gloves" that did not contain their patch test positive allergen or provided "nonproblem gloves" containing the patch test positive allergen. The lowest glove allergen levels associated with a patch test-confirmed ACD were 584, 283 and 590 mu g/g glove of ZDEC, ZDBC and MBT, respectively. Discordance between the allergy patch test and glove chemical accelerator content may be in part attributed to both false positive/negative allergy patch test rates and misidentification of problem/ non-problem gloves due to the delay between glove usage and clinical ACD manifestation.
The Toxicologist. Society of Toxicology 48th Annual Meeting and ToxExpo, March 15-19, 2009, Baltimore, Maryland