Rubber

Abstract

Sensitization to rubber components often accompanies allergic or nonallergic hand eczemas; however, without patch testing, the diagnosis can be missed. Sensitizing rubber products contain multiple allergenic constituents; therefore, individuals are often allergic to several rubber allergens. The allergens in rubber vary greatly depending upon the product and the country of origin. The composition of the same rubber product may change from lot-to-lot without the consumer being aware of any differences in the final product. Rubber additives are the allergens most strongly associated with occupational contact dermatitis. The rubber accelerators (thiurams, carbamates, thiazoles, and thioureas) cause the greatest amount of sensitivity among users of rubber products; in contrast, workers involved in the manufacture of rubber are more likely allergic to the amine antioxidants. Vulcanization produces new allergens. The amine antioxidants, especially IPPD, are highly sensitizing, and positive patch tests are typically intense. An individual sensitized to components of rubber must take precautions not only with rubberized products used at work (gloves, masks, rubber bands, etc.) but also with personal products (elasticized garments, condoms, shoes, sporting equipment, etc.) and with nonrubber sources of the allergen(s) such as insecticides, fungicides, and medicaments. For those sensitized to rubber, it is particularly important to identify specific gloves and shoes which are free of their allergens. New glove manufacturing processes have been developed to produce accelerator-free medical gloves.