Toxic skin reactions caused by tributyltin oxide (tbto) in socks

During some hot summer-days in 1973 about 70 cases of acute feet dermatitis were reported among soldiers from one regiment. They had used newly laundered socks from the same batch. The socks were disinfected with a solution containing TBTO and a quarternary ammonium compound, but by mistake a roughly 7 times too high concentration of the solution had been used. Patch tests with TBTO, quarternary ammonium compound and standard substances were negative. There was no suspicion of phototoxicity in these cases, but according to the literature TBTO may be photodynamic and several case reports relate specifically to sunny summerdays. We consider our cases to be due to the primary irritant properties of TBTO. As the span between optimal concentration for disinfection and the primary irritant concentration is narrow, we consider it inappropriate to use this substance for disinfection of textiles which are to be in direct contact with the skin until it has been established whether, for example, sweat may extract TBTO from treated fibres.