Contact sensitivity and urticaria in "wet" work

A selected group of 142 hospital "wet" workers with hand eczema was studied. 91% were female. Atopy (58%), metal dermatitis (41%), and hand eczema prior to the current wet work (67%) were more common than in the total cohort to which these patients belonged. Patch tests were carried out on 120 patients and prick tests on 41 with a history of contact urticaria. Water, cleaning agents, hand disinfectants, the wearing of gloves and other trivial irritant factors were claimed to have elicited the current episodes of hand eczema in 92.3% of cases. In 35%, a considerable part of the exposure to irritant factors took place at home or during leisure time. Delayed contact sensitivity was found in 45 patients, nickel, cobalt, balsam of Peru and rubber chemicals being the most common allergens. Nickel and/or cobalt allergy was found in approximately half of the patients with contact allergy. Positive prick tests relevant for contact urticaria were found in 22 patients, and were most often obtained with various foods or rubber gloves. Although contact sensitivity and contact urticaria were common, they seemed to play a minor rôle in the etiology of the current hand eczema compared to endogenous factors and trivial irritants.