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Notes: Background During the 1980s routine wearing of gloves in dentistry was recommended by health authorities in several countries. However, prolonged glove use is associated with side-effects of irritant and allergic origin. Objectives To investigate the extent of glove use and self-reported glove intolerance reactions among Swedish dentists, and to examine how far IgE-mediated allergy to natural rubber latex (NRL) occurs in subjects who report rapid itching when in contact with protective gloves. Subjects/methods A postal questionnaire was answered by 3083 of 3500 licensed dentists, a response rate of 88%. Of the dentists who reported rapidly occurring itching of the hands from gloves, 131 of 170 attended a clinical examination including a skin prick test (SPT) and a serological examination (RAST) for IgE-mediated allergy. Results Seventy-three per cent of the dentists reported daily glove use of more than 2 h, 48% more than 6 h a day, and 6% reported no use. NRL gloves were used most frequently (P 〈 0·001) and were the main material that elicited symptoms (P 〈 0·001). Female dentists reported more frequent glove use than males, as did young dentists (P 〈 0·001) compared with older ones. Females also preferred vinyl gloves. Glove intolerance reactions were reported by 723 (23%) dentists, [females 28%, males 21% (P 〈 0·001)] and were more common in younger dentists. Of the 417 dentists with reported hand eczema during the previous year, 54% reported glove intolerance, compared with 20% of the dentists without hand eczema (P 〈 0·001). A logistic regression analysis including hand eczema, age, sex and atopy showed that all these factors contributed significantly to the risk of glove intolerance, and that hand eczema was a stronger factor than atopy. In 15 of 131 (11%) dentists examined for reported glove-related itch, latex allergy was verified by SPT and/or RAST. Glove-related conjunctivis, rhinitis and asthma, in contrast to skin symptoms, showed a significant association with IgE-mediated allergy to NRL. Conclusions Swedish dentists show good compliance with the recommendations for routine glove use. Intolerance reactions are frequently reported, especially by dentists with hand eczema, which emphasizes the need for preventive skin care programmes. Glove-related symptoms from mucous membranes showed a higher association with IgE-mediated allergy to NRL than reported itching of the skin, a fact that should be considered when composing screening questionnaires for NRL sensitization

Notes: Aims:  The aims were to study health-related quality of life (HRQL) in patients with hand eczema, and to compare two different instruments for assessment of HRQL.Methods:  100 consecutive hand eczema patients (51 females and 49 males) at an occupational dermatology clinic completed the generic questionnaire Short Form-36 (SF-36), and the dermatology specific Dermatology Life Quality Index (DLQI). To compare the instruments factor analysis, with a polychoric correlation matrix as input, was performed, thus taking the ordinal aspect of the data into account.Results:  HRQL was affected by hand eczema, measured with both SF-36 and DLQI. The mean (SD) sum scores of DLQI was 7.4 (5.8), no difference between genders. However, the SF-36 showed more impaired HRQL for females than for males in the mental health dimension. There was a high correlation between the instruments for physical health, but lower for mental health.Conclusions:  Hand eczema has an impact on HRQL, and both SF-36 and DLQI are suitable instruments. Our conclusion from the factor analysis is that the SF-36 measures mental health better than the DLQI. The choice of instrument to be used in a specific study depends on the purpose of the study. A generic instrument has the advantage of making comparisons with other diseases possible. The SF-36 also appears suitable for use in hand eczema studies where gender differences in HRQL are of interest.

Notes: Hand eczema and contact allergy in Swedish dentists were studied in a multidisciplinary project. The aims of the study were to establish diagnoses, to investigate the occurrence of contact allergy, in particular to (meth)acrylates, and to evaluate certain consequences of hand eczema. A postal questionnaire on skin symptoms, atopy and occupational experience was mailed to 3500 dentists aged 〈65 years, and licensed 1965–1995. The response rate was 88%. Among dentists living in 3 major cities, 14.9% (n=191) reported hand eczema during the previous year. They were invited to a clinical examination, including patch testing with a standard and a dental series. 158/191 (83%) dentists attended, and hand eczema diagnosis was confirmed in 149/158 (94%). Irritant contact dermatitis was diagnosed in 67% and allergic contact dermatitis in 28%. On patch testing, 50% presented at least 1 positive reaction. The most frequent allergens were nickel sulfate, fragrance mix, gold sodium thiosulfate and thiuram mix. 7 (5%) had positive reactions to (meth)acrylates, all to 2-hydroxyethyl methacrylate and 6 also to ethyleneglycol dimethacrylate. 38% had consulted a physician, 4% had been on sick-leave and 1% had changed occupational tasks due to hand eczema. No dentist with allergy to acrylates had been on sick-leave or changed occupation. It is concluded that dentistry is a high-risk occupation for hand eczema, and that irritant contact dermatitis is most common. The prevalence of contact allergy to acrylates was below 1% in the population of responding dentists, and in most cases did not have serious medical, social or occupational consequences.