Multicentre patch test study of air-oxidized ethoxylated surfactants

Area of Science:

• Dermatology
• Occupational Health
• Toxicology

Background:

• Hand eczema is frequently linked to occupational wet work involving water and surfactants.
• Ethoxylated surfactants can oxidize, forming byproducts that are potential contact sensitizers.
• Human sensitization to oxidized surfactants requires further investigation.

Purpose of the Study:

• To investigate human sensitization to oxidized ethoxylated surfactants.
• To identify specific oxidation products responsible for allergic reactions.
• To compare the irritant and sensitizing potential of oxidized versus non-oxidized surfactants.

Main Methods:

• A multicenter study involving 528 dermatitis patients in the Stockholm region.
• Patch testing with oxidized and non-oxidized ethoxylated surfactants and identified oxidation compounds.
• Morphologic descriptive system for reading patch test reactions, including erythema, edema, papules, and vesicles.

Main Results:

• 61 patients showed irritant reactions to surfactants.
• 18 patients exhibited allergic-type reactions (erythema, edema, papules, vesicles), primarily to oxidized surfactants and products.
• Retesting of 9 patients confirmed allergy only to acetaldehyde.

Conclusions:

• Oxidized ethoxylated surfactants possess a higher irritant potential than their non-oxidized counterparts.
• Technical grade oxidized surfactants may pose a lower sensitization risk than pure oxidized surfactants.
• Formaldehyde and acetaldehyde are significant potential allergens formed during autoxidation, leading to unexpected exposures.