Sensitization to rubber components often accompanies allergic or nonallergic hand eczemas; however, without patch testing, the diagnosis can be missed.
Sensitizing rubber products contain multiple allergenic constituents; therefore, individuals are often allergic to several rubber allergens.
The allergens in rubber vary greatly depending upon the product and the country of origin. The composition of the same rubber product may change from lot-to-lot without the consumer being aware of any differences in the final product.
Rubber additives are the allergens most strongly associated with occupational contact dermatitis.
The rubber accelerators (thiurams, carbamates, thiazoles, and thioureas) cause the greatest amount of sensitivity among users of rubber products; in contrast, workers involved in the manufacture of rubber are more likely allergic to the amine antioxidants.
Vulcanization produces new allergens.
The amine antioxidants, especially IPPD, are highly sensitizing, and positive patch tests are typically intense.
An individual sensitized to components of rubber must take precautions not only with rubberized products used at work (gloves, masks, rubber bands, etc.) but also with personal products (elasticized garments, condoms, shoes, sporting equipment, etc.) and with nonrubber sources of the allergen(s) such as insecticides, fungicides, and medicaments.
For those sensitized to rubber, it is particularly important to identify specific gloves and shoes which are free of their allergens.
New glove manufacturing processes have been developed to produce accelerator-free medical gloves.
KeywordsRubber Allergens Accelerators Antioxidants Latex proteins Allergic contact dermatitis Allergic contact urticaria Occupational dermatitis Rubber industry Gloves Accelerator-free medical gloves Contraceptive devices Prevention
- American Contact Dermatitis Society’s database. http://www.contactderm.org/files/public/GloveFV.pdf. Accessed 15 April 2011
- Baginsky E (1979) Surveillance and reporting. A paper presented at occupational, industrial and plant dermatology conference, San Francisco, 26–29 Mar 1979Google Scholar
- Borak J, Slade MD, Russi M (2005) Risks of brain tumors in rubber workers: a meta-analysis. J Occup Environ Health 47:294–298Google Scholar
- Brandão FM (1990) Rubber. In: Adams RM (ed) Occupational skin disease. Saunders, Philadelphia, pp 462–485Google Scholar
- Burrows D (1972) Thiuram dermatitis and purpura. Contact Dermatitis News 12:333Google Scholar
- Calnan CD (1971) Lichenoid dermatitis from isopropylaminodiphenylamine. Contact Dermatitis News 4:237Google Scholar
- Estlander T (1990) Occupational skin disease in Finland. Observations made during 1974–1988 at the Institute of Occupational Health, Helsinki. Acta Derm Venereol (Stockh) 155(Suppl):1–85Google Scholar
- Fisher AA (1974) Allergic petechial and purpuric rubber dermatitis: the PPPP syndrome. Cutis 14:25–27Google Scholar
- Fregert S (1981) Manual of contact dermatitis, 2nd edn. Munksgaard, Copenhagen, pp 46–48Google Scholar
- de Groot AC (1994) Patch testing: test concentration and vehicles for 3700 chemicals. Elsevier, AmsterdamGoogle Scholar
- International Agency for Research on Cancer (IARC) (1986) Some chemicals used in plastics and elastomers, vol 39, IARC monographs on the evaluation of carcinogenic risk of chemicals to humans. International Agency for Research on Cancer, Geneva, p 155Google Scholar
- International Agency for Research on Cancer (IARC) (1987) Overall evaluations in carcinogenity: an update of IARC monographs, vol 1. International Agency for Research on Cancer, Lyon, pp 332–333Google Scholar
- Magnusson B, Möller H (1979) Contact allergy without skin disease. Acta Derm Venereol (Stockh) 59(Suppl):113–115Google Scholar
- Mitchell JM, Rook A (1979) Botanical dermatology. Greengrass, Vancouver, p 286Google Scholar
- Nielsen NH, Menné T (1992) Allergic contact sensitization in an unselected Danish population. The Glostrup Allergy Study, Denmark. Acta Derm Venereol (Stockh) 72:456–460Google Scholar
- Pesonen M, Jolanki R, Larese Filon F et al (2015) Patch test results of the European baseline series among patients with occupational contact dermatitis across Europe – analyses of the European Surveillance System on Contact Allergy network, 2002–2010. Contact Dermatitis 72:154–63CrossRefGoogle Scholar
- Plotnick H, Birmingham DJ (1993) Disulfiram alcohol facial flush in rubber industry (abstracts). In: Proceedings of the American contact dermatitis society annual meeting, Washington, DC, p 11Google Scholar
- Rich P, Belozer ML, Norris P et al (1991) Allergic contact dermatitis to two antioxidants in latex gloves: 4,4′-thiobis(6-tert-butyl-meta-cresol) (Lowinox 44 S36) and butylhydroxyanisole: allergic alternatives for glove-allergic patients. J Am Acad Dermatol 24:37–43PubMedCrossRefPubMedCentralGoogle Scholar
- Rubber World Magazine’s Blue book. http://www.rubberworld.com/bluebook. Accessed 15 April 2011
- Spina Bifida Association of America, Washington, DC. http://www.spinabifidaassociation.org/atf/cf/%7bEED435C8-F1A0-4A16-B4D8-A713BBCD9CE4%7d/LatexList09.pdf. Accessed 15 April 2011
- Stankevich VV, Vlasiuk MG, Prokoféva LG et al (1980) Hygienic assessment of organosulfur accelerators for vulcanization of rubbers for the food industry. Gig Sanit 10:88–89Google Scholar
- World Health Organization (WHO) (1983) Styrene, vol 26, Environmental health criteria. WHO, GenevaGoogle Scholar