The Pharmaceutical and Cosmetic Industries
Depending on the type of product and exposition, several occupation-induced dermatoses may occur among workers in the pharmaceutical industry. They include irritation, contact allergy, photosensitivity, urticaria, acne venenata, and, less frequently, fixe
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The Pharmaceutical and Cosmetic Industries A. Goossens and 1. Geusens
Introduction
accidental exposure may cause a chemical burn, primary sensitization, and allergic contact dermatitis (Kanerva et al. 1994). An example from the pharmaceutical industry was reported by Foussereau et al. (1989): a chemical student working with the synthesis of pro~aine, accidentally spilled some drop lets of p-mtrobenzoyl chloride, a chemical intermediate, onto her forearm. After rinsing with water, an erythematous lesion developed (first-degree burn) that faded the next day. Two weeks later, however, she presented with a non-vesicular erythematous and edematous dermatitis on the same forearm and also the hand. Patch testing revealed contact allergy to this substance. In the pharmaceutical industry, people come into contact with both chemical intermediates and finished products. The risk of developing contact allergy is greatest for chemists and laboratory technicians, who are involved in research for new compounds, and for deaning personnel and technicians in general, who are oft~n less well protected than the workers in production umts (Sherertz 1994). Pharmacists are also exposed to medications when preparing compounded formulations, and the conditions they work in are similar to those of medical personnel (Foussereau et al. 1982). Here, we will concentrate on the pharmaceutical components responsible for occupation-related contact ~llergi~ reactions. Because little attention has been given In the hterature to cosmetie ingredients, we will mention them briefly first. The test concentrations and vehicles for the allergenic substances and chemical intermediates (listed alphabetically along with their CAS numbers, whenever possible) as reported in the literature are given in Table 1. The pharmaceutical products described are classified as is in Martindale (1993).
Depending on the type of product and exposition, several occupation-induced dermatoses may occur among workers in the pharmaceutical industry. They include irritation, contact allergy, photosensitivity, urticaria, acne venenata, and, less frequently, fixed drug eruption and steroid rosacea (H. Degreef, personal communication), and even toxic epidermal necrolysis (as was the case with the transcutaneous absorption of an intermediary product in the synthesis of tetramisole, an anthelminthic drug; Valsecchi et al. 1987). The dermatoses can be located at the site of contact, which is generally the hands in an occupational context. Airborne reactions on exposed and nonexposed (by partieies trapped under clothing) areas are not uncommon, and generalized reactions may occur due to inhalation or transcutaneous absorption. Workers in the pharmaceutical industry are considered to be particularly at risk for irritation and allergie contact dermatitis (Sherertz 1994). Irritant reactions are frequent but are rarely reported in the literature: occasionally, "epidemics" of such reactions have been described, as was the case in Israel, where pharmaceutical industry workers suffered from b
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