Occupational dermatitis to facial personal protective equipment in health care workers: A systematic review

• Type of Material: Article
• Authors: Jiade Yu, Harvard Medical School; Jennifer K. Chen, Stanford University; Christen M. Mowad, Geisinger Medical Center; Margo Reeder, University of Wisconsin; Sara Hylwa, Hennepin Healthcare; Sarah Chisolm, Emory University; Cory A. Dunnick, University of Colorado; Ari M. Goldminz, Harvard Medical School; Sharon E. Jacob, Loma Linda University; Peggy A. Wu, University of California Davis; Jonathan Zippin, Weill Cornell Medical College; Amber Reck Atwater, Duke University
• Language: English
• Date: 2021-01-11
• Publisher: MOSBY-ELSEVIER
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Published by Elsevier on behalf of the American Academy of Dermatology, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jaad.2020.09.074
• Title of Journal or Parent Work: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
• Volume: 84
• Issue: 2
• Start Page: 486
• End Page: 494
• Grant/Funding Information: None.
• Keywords: personal protective equipment; medical face mask; acne; face mask; mask; Science & Technology; N95; contact dermatitis; irritant contact dermatitis; occupational dermatoses; Dermatology; CONTACT-DERMATITIS; procedure mask; surgical mask; systematic review; MASK; N95 respirator; N95 mask; allergic contact dermatitis; occupational dermatitis; respirator; contact urticaria; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery

Abstract

Background: Prolonged wear of facial protective equipment can lead to occupational dermatoses. Objective: To identify important causes of occupational dermatoses from facial protective equipment. Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using PubMed and Embase databases. Articles were included if they reported occupational dermatoses caused by surgical/procedure masks or N95 respirators, or both. Results: We identified 344 articles, and 16 were suitable for inclusion in this review. Selected articles focused on facial occupational dermatoses in health care workers. Allergic contact dermatitis to the elastic straps, glue, and formaldehyde released from the mask fabric was reported. Irritant contact dermatitis was common on the cheeks and nasal bridge due to pressure and friction. Irritant dermatitis was associated with personal history of atopic dermatitis and prolonged mask wear (>6 hours). Acneiform eruption was reported due to prolonged wear and occlusion. Contact urticaria was rare. Limitations: Only publications listed in PubMed or Embase were included. Most publications were case reports and retrospective studies. Conclusion: This systematic review from members of the American Contact Dermatitis Society highlights cases of occupational dermatitis to facial protective equipment, including potential offending allergens. This work may help in the diagnosis and treatment of health care workers with facial occupational dermatitis.