Writer: Vanessa Ngan, employees writer
Related data References: Guide: Fisher's Get in touch with Dermatitis. Ed Rietschel RL, Fowler JF. Lippincott Williams & Wilkins 2001 On DermNet NZ: Hand care in healthcare workers Dermatitis Allergic communicate with dermatitis Patch testing Natural latex allergy Surgical gloves Other websites: IPPD (N-isopropyl-N’-phenyl-paraphenylenediamine) – EECDRG Leather and Shoe Research Association of New Zealand Books:
See the DermNet NZ bookstore
Allergy to rubber accelerators Allergy to rubber
Allergic reactions to rubber can be due to allergy to natural latex sap or to one of the many chemicals used in the manufacturing of rubber. The types of chemicals used in the manufacturing of rubber include:
accelerators activators antidegradants (antioxidants, antiozonants) vulcanizing agents retarders reinforcing agents fillers pigments processing aids blowing agents
Allergy can probably occur to any of these chemicals, although rubber accelerators seem to cause the greatest problems.
Positive patch test to thiuram Dermatitis from rubber gloves Positive patch tests thiuram (2+) & mercapto (1+) Reaction to rubber in underpants Communicate with allergy to rubber accelerators What are rubber accelerators?
Rubber accelerators are chemicals used to speed up the manufacturing process of rubber (vulcanisation). This process makes untreated natural rubber latex suitable for use in the manufacture of many rubber products. There are many types of rubber accelerators in use but those listed below cause most cases of rubber contact dermatitis:
Chemical Formula CAS number Benzothiazoles 2-Mercaptobenzothiazole N-cyclohexyl-2-benzothiazolesulfenamide Dibenzothiazyl disulfide Morpholinylmercaptobenzothiazole C7H5NS2 C13H16N2S2 C14H8N2S4 C11H12N2S20 149-30-4 95-33-0 120-78-5 102-77-2 Carba chemicals Dithiocarbamates Zinc diethyldithiocarbamate Zinc dibutyldithiocarbamate Diphenylguanidine C10H20N2S4Zn C18H36N2S4Zn C13H13N3 14324-55-1 136-23-2 102-06-7 Thiurams tetramethylthiuram monosulfide tetramethylthiuram disulfide tetraethylthiuram disulfide dipentamethylenethiuram disulfide C6H12N2S3 C16H12N2S4 C10H20N2S4 (C5H10NCS3)2 97.74.5 137-26-8 97-77-8 120-54-7 Hexamethylenetetramine (methenamine) (CH2)6N4 100-97-0 What products contain rubber accelerators?
Nearly all rubber compounds contain rubber accelerators. The list below shows the widespread use of rubber products that we may come into make contact with with daily: Householdrecreational rubber products
anti-slip carpet backing balloons elastic bands garden hoses and gloves kitchen gloves pillows and mattresses rubber gloves rubber handled sports equipment, e.g. golf club and raquet tennis racquet handles rubber handles (e.g. bicycles, car steering wheel) rubber kitchen utensils rubber swim caps and goggles
Clothing and footwear
elastic in underwear and swimwear rubber boots sport shoes slippers rubber insoles of shoes elasticised waistbands brassiere cups
Cosmetics and healthcare products
rubber make-up sponges diaphragms rubber latex condoms thiuram is in the oral drug Antabuse (used to treat alcoholism)
Work sources
commercial and agricultural fungicides and pesticides conveyor belts dental dams earphones elastic bandages electrical cords examination and surgical gloves gas masks lining for fuel tanks protective rubber aprons rubber hoses, seals and cables rubber mats rubber stoppers in medical syringes rubber tires and tubes safety goggles shock absorbers springs stethoscopes veterinary products, e.g. flea and tick sprayspowders
It is often difficult to know which rubber product contains which rubber accelerants. Often the manufacturer of the product will not know either.
What are the reactions to rubber accelerators?
The rash is known as allergic get hold of dermatitis. It can occur in many areas and in any of several patterns. The following table describes some of the common areas where rubber accelerator allergy may occur, the usual cause, and any distinguishing features of the allergy.
Location Cause Features Hands Rubber gloves Rubber finger guards Rubber handgrips Oral Antabuse® Rash caused by rubber gloves often distinguished by sharp cut-off at wrist May be worse over pressure areas May be similar to a photodermatitis Thiuram in oral Antabuse may cause swelling of the hands and feet and water blisters on the hands and fingers Face Rubber cosmetic applicators,
office 2010 Home And Student product key, e.g. eyeshadow sponge, eyelash curler Rubber swim or safety goggles Rubber headphones Surgicalexamination gloves worn by dentist or doctor Rubber pillows Rash occurs mainly on the eyelids where rubber cosmetic sponges have been used Rash my occur around the mouth or any site of the body where dentist or doctor's hands touch the skin Feet Shoes made with rubber, e.g. sneakers, tennis shoes Rubber insoles for shoes Rubber boots Rubber cements used in joining shoe uppers, the outer leather and linings Rubber box toes, the most common cause of shoe dermatitis Rash usually begins on the base of the big toe and gradually extends to the other toes and onto the feet Recurrent eruptions may occur over many years and may be misdiagnosed as psoriasis, eczema or athlete's foot Can often become disabling without proper diagnosis and treatment Genitals Condoms Contraceptive diaphragms Penile and perianal dermatitis Vaginitis and vulvitis Other parts of the body Rubber as a component of fabrics used in underwear such as girdles,
office 2010 Standard 64 bit, bras and infant panties Rubber in elasticated underwear Rubber in upholstered furniture Rubber carpet underlay Rash localised to areas of speak to with the garment Rubber infant panties may produce an occlusive, macerating and irritating rash in the diaper area Elbow rash has occurred from padded arms of furniture How did I become allergic to rubber accelerators?
Chronic exposure is a likely reason. Surgeons,
microsoft office 2010 Standard, nurses,
office Home And Business 2010 serial, dentists, hairdressers and others who wear rubber gloves for work purposes can often develop sensitivity to natural rubber latex and rubber accelerators. In these cases allergy to rubber may come as a consequence of trying to protect your hands from other allergens.
Am I allergic to rubber accelerators?
Allergy to rubber accelerators is diagnosed by the clinical history and by special allergy tests, patch tests. These tests may identify which specific rubber accelerators you have an allergy to. Thiuram mix tests four thiuram chemicals with one test. One of these four will cause about 9 out of 10 cases of allergy to thiuram mix. Similarly, mercapto mix tests for 3 chemicals in the one test. You can self-test a rubber product for allergy, but this should only be done only after first talking with your dermatologist. Do this only with articles that are designed to stay on the skin, such as underwear or shoes. Initially, allow the article to be in get in touch with with your skin of your forearm for a short period of time, say 1 hour. For the next 4 days look for any reaction. If no reaction occurs slowly lengthen the period of communicate with with your skin to a maximum of 48 hours. Do not test insecticides or other chemical products in this way.
What should I do to avoid rubber accelerator allergy?
The best way to avoid rubber accelerator allergy is by being aware of products that contain rubber accelerators. However, it is generally difficult to determine which products contain rubber accelerators and which don't. Minimize your exposure to all rubber products. Use alternative products made of vinyl,
office 2010 Home And Business x86, plastic, wood, leather or fabric. Even though some rubber gloves are labelled 'hypoallergenic' it is wise to get in touch with the manufacturer to determine if they contain any of the rubber accelerators you are allergic to. Vinyl gloves may be a suitable alternative although some people are allergic to both rubber and vinyl. Tactylon® gloves are a good alternative for most people. Be aware that some non-rubber gloves provide less protection against viruses and certain chemicals than rubber gloves. Discuss the requirements of your gloves with your suppliermanufacturer. If you are sensitive to rubber accelerators and undergoing dental work or surgery, you should inform your dentist or doctor so they can either use alternative gloves that are free of rubber accelerators, or patch test you in advance with the gloves they plan to use. Avoid shoes made with rubber accelerators. Test shoes by wearing them for a few days and watch for a rash or have shoes patch tested. Any socks or stockings that have been worn with shoes that cause an allergy may become contaminated with rubber. These should not be worn again, as even washing may not remove the contaminant. Non-rubber condoms (e.g. Durex Avanti) and plastic diaphragms may be suitable contraceptive alternatives. Cover padded arms of upholstered furniture with a towel and avoid walking barefoot on rubber-underlayed carpets.
Treatment of rubber accelerator allergy
Treatment of the rash caused by rubber accelerators is with medications that are used to treat acute dermatitiseczema. Shoe dermatitis needs to be properly diagnosed and treated. Get hold of dermatitis of the feet can often become infected with Staphylococcus aureus (it can also be confused with the fungal infection, tinea pedis). Acute dermatitis can be treated with wet dressings of Burrow's solution or dilute vinegar. Short courses of systemic corticosteroids may speed up healing. Chronic shoe dermatitis may need to be managed with prolonged treatment of topical corticosteroids andor coal tar and emollients. It is essential that you wear shoes free of the causative allergens.