Allergic contact dermatitis in healthcare workers

Background Allergic contact dermatitis is a common occupational skin disease among healthcare workers (HCWs). Aims This study describes causes of allergic contact dermatitis in New Zealand HCWs. Methods All HCWs undergoing patch testing between July 2008 and January 2020 at a public hospital patch test clinic and between June 2019 and January 2020 at a private dermatology clinic were included. Data collected included patient demographics, occupation, results of patch testing and pre- and post-patch test diagnoses. Results Out of 837 patients tested, 67 were HCWs. The mean age of HCWs was 41 years (SD 14) and 58 (87%) were female. The most common occupations were nurses (40%), allied health (22%) and doctors (18%). Forty-six (69%) patients had a background of atopic dermatitis. Hand dermatitis was the most common presentation (49%), followed by facial/neck dermatitis (25%). Thirty-eight (57%) had at least one positive reaction on patch testing, including 19 (28%) with a positive result of current relevance. There were 16 relevant reactions to rubber accelerators, 11 to fragrances, 10 to preservatives and 6 to corticosteroids. The most frequent relevant allergens were methylisothiazolinone/methylchloroisothiazolinone (4%), hydroxyisohexyl 3-cyclohexene carboxaldehyde (4%) and methylisothiazolinone (4%). Conclusions The most common allergens in HCWs were rubber chemicals, fragrances, preservatives and topical corticosteroids. Important allergens for patch testing HCWs are outlined, in particular, those with hand dermatitis should be tested to a rubber series.