Occupational dermatitis to 2,3-epoxypropyl trimethyl ammonium chloride

4 workers developed hand dermatitis in an automated starch modification process plant. 2,3-epoxypropyl trimethyl ammonium chloride (EPTMAC), a quaternary ammonium compound used as a cationizing chemical, produced allergic reactions in all 4 patients. They had only been in contact with EPTMAC for a short time before developing dermatitis, which indicates that EPTMAC is a strong sensitizer. Immunohistochemistry and electron microscopy showed the features of an allergic patch test. An industrial hygiene project was initiated at the factory to prevent new cases. It revealed many risks of skin contact with the process chemicals. Thus an automated process does not guarantee protection.