Allergic Contact Dermatitis to Operating Room Scrubs and Disinfectants

Dermatitis. 2019 Nov/Dec;30(6):363-370. doi: 10.1097/DER.0000000000000525.

Abstract

Background: Both surgical personnel and patients undergoing procedures are exposed regularly to different antiseptic chemicals in various forms. Little is known about the ingredients in these antiseptics and the risk these products may provoke allergic contact dermatitis.

Objective: The aim of the study was to identify and characterize common allergens in surgical scrubs and patient surgical cleansers that health care workers and surgical patients may encounter in the perioperative period.

Methods: DailyMed website was searched using numerous terms for surgical disinfectants. Products used for health care worker handwashing/scrubbing or patient surgical cleansing/disinfecting were included. Each product's ingredients were recorded; those found on the 2017 American Contact Dermatitis Society (ACDS) Core Allergen Series were noted from each product.

Conclusions: A total of 1940 products were identified, of which 267 were included in the analysis. A total of 66.3% contained iodine, 25.8% contained chlorhexidine digluconate, and 2.6% contained chloroxylenol. Within the group analyzed, 1586 ingredients were identified. Of these, 241 were ACDS Core Series allergens. Most products contained a single ACDS allergen. There were significant differences in allergens based on product type and active ingredient, with iodine-containing products having the fewest number of allergens. The most common ACDS allergens found were cocamide diethanolamide (22.5%), fragrance (21.7%), lanolin (19.5%), propylene glycol (6.7%), alkyl glucosides (6.0%), and sorbic acid derivatives (5.6%).

MeSH terms

  • Allergens / adverse effects*
  • Anti-Infective Agents, Local / adverse effects*
  • Anti-Infective Agents, Local / chemistry
  • Chlorhexidine / adverse effects
  • Chlorhexidine / analogs & derivatives
  • Dermatitis, Allergic Contact / etiology*
  • Dermatitis, Contact / etiology
  • Dermatitis, Occupational / etiology
  • Hand Disinfection
  • Hand Sanitizers / adverse effects*
  • Hand Sanitizers / chemistry
  • Health Personnel
  • Humans
  • Lanolin / adverse effects
  • Operating Rooms
  • Perfume / adverse effects
  • Povidone-Iodine / adverse effects
  • Propylene Glycol / adverse effects
  • Surgical Procedures, Operative*
  • Xylenes / adverse effects

Substances

  • Allergens
  • Anti-Infective Agents, Local
  • Hand Sanitizers
  • Perfume
  • Xylenes
  • chloroxylenol
  • Propylene Glycol
  • Lanolin
  • Povidone-Iodine
  • chlorhexidine gluconate
  • Chlorhexidine