Skip Navigation


Occupational Medicine Advance Access originally published online on March 26, 2009
Occupational Medicine 2009 59(4):270-272; doi:10.1093/occmed/kqp042
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
59/4/270    most recent
kqp042v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Nagendran, V.
Right arrow Articles by Heise Garvey, L.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Nagendran, V.
Right arrow Articles by Heise Garvey, L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2009. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Short Reports

IgE-mediated chlorhexidine allergy: a new occupational hazard?

Vasantha Nagendran1, Jennifer Wicking2, Anjali Ekbote1, Theresa Onyekwe3 and Lene Heise Garvey4

1 Department of Immunology and Allergy, Epsom and St Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton, Surrey SM5 1AA, UK
2 Department of Biochemistry and Haematology, Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK
3 Department of Occupational Health, Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK
4 Danish Anaesthesia Allergy Centre, Allergy Clinic 4222 and Department of Anaesthesia 4231, Rigshospitalet, Copenhagen, Denmark

Background Chlorhexidine is an effective antimicrobial agent commonly used in UK hospitals, primarily for skin decontamination. Recent UK infection control guidelines recommend the use of 2% chlorhexidine solution in specific clinical settings, thus increasing chlorhexidine use by health care workers (HCWs). Chlorhexidine has been widely reported to cause IgE-mediated allergic reactions (from urticaria and angioedema to anaphylaxis) among patients undergoing surgery/invasive procedures. Despite its widespread use in health care settings, there are no reports of clinically confirmed occupational IgE-mediated chlorhexidine allergy.

Aims To identify cases of chlorhexidine allergy among health care workers.

Methods A questionnaire was distributed among HCWs in wards and operating theatres at a UK district general hospital to raise awareness of potential chlorhexidine allergy and to invite those with possible clinical allergy to come forward for further testing. Diagnosis was based on an appropriate clinical history with positive serum-specific IgE to chlorhexidine and/or positive skin prick testing.

Results Four cases of occupational IgE-mediated allergy to chlorhexidine were identified.

Conclusions Despite its excellent antimicrobial properties, chlorhexidine is an occupational allergen. We suggest that chlorhexidine allergy be included in the differential diagnosis of HCWs presenting with work-related allergic symptoms. Increased awareness and easier access to chlorhexidine-specific IgE serological testing should facilitate early diagnosis of affected HCWs, allowing appropriate avoidance measures to be instigated—thus reducing the risk of potentially severe allergic reactions in the future.

Keywords      Chlorhexidine; occupational allergy; Type I hypersensitivity

Correspondence to: Vasantha Nagendran, Department of Immunology and Allergy, Epsom and St Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton, Surrey SM5 1AA, UK. Tel: +44 (0)208 296 3212; fax: +44 (0)208 641 9193; e-mail: nagendran{at}doctors.org.uk


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.