Prevalence and Risk Factors of Occupational Contact Dermatitis to Formaldehyde and Glutaraldehyde and their Co-Reactivity in Dental Professionals

Maya Lyapina¹*, Assya Krasteva, PhD¹, Maria Dencheva, PhD¹, Mariana Tzekova, PhD¹, Mariela Deliverska, PhD², Angelina Kisselova-Yaneva, PhD, ScD¹.

¹Sofia Medical University, Sofia, Republic of Bulgaria

²Institute for Legal Studies, BAS, Sofia, Republic of Bulgaria

*Corresponding author: Maya Lyapina, MD, Department of Hygiene, Medical Ecology and Nutrition, Medical Faculty,

Medical University. 15 Blvd “Acad. Ivan Evstr. Geshov”, 1431 Sofia, Bulgaria. Phone: +359887161768. E-mail:

Published: June 25, 2013


Background: In dental practice concomitant exposure to formaldehyde and glutaraldehyde is a common occurrence. The objective of the study is to evaluate the incidence of occupational contact dermatitis to formaldehyde and glutaraldehyde in dental professionals and the manifestation of co-reactivity.

Methods and Results: This study involved 78 participants (30 dental professionals and 48 referents). A questionnaire survey as well as skin patch testing with formaldehyde and glutaraldehyde was conducted. The incidence of occupational contact dermatitis to formaldehyde among the population investigated was 28.2%, and of glutaraldehyde, 24.4%. Occupational contact dermatitis to formaldehyde was found to be of a significantly higher incidence among dental professionals. A stronger irritant effect of the formaldehyde, with a significantly higher incidence and the relative risk of specifically the upper respiratory tract (р = 0.029) and respiratory system (р = 0.002) as well as skin (р = 0.019) symptoms among the subjects experiencing formaldehyde contact dermatitis was demonstrated. Allergic predisposition plays an important role as a risk factor of sensitization to glutaraldehyde and of co-reactivity.

Conclusions: The results indicate high rates of sensitization to formaldehyde and glutaraldehyde. Co-reactivity was found mainly among the non-occupationally exposed people. Atopy does not appear to be a risk factor for formaldehyde-specific allergic contact dermatitis, although it is so for glutaraldehyde-specific allergic contact dermatitis. Screening patch-testing for multiple dental compounds would be beneficial for early diagnosis, as well as for occupational risk assessment and management.

formaldehyde; glutaraldehyde; allergic contact dermatitis; dental professionals.

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