Allergies: Ubiquity of plastics raises health concerns

Montreal, Canada - Dermatologists may have to go to some lengths to determine whether their patients are allergic to plastics or are having a reaction to products containing plastics, says Linda Moreau, M.D., F.R.C.PC., a dermatologist and assistant professor of dermatology at the McGill University Health Center (MUHC) in Montreal, Canada.

Dr. Moreau says that plastic is ubiquitous in today’s world. It is present in cosmetics, toys, food packaging, a host of household items, flooring, wall coverings, shoes, medications and medical tubing. Fragrances and personal care products may contain phthlates, a plasticizer.

Plasticizers

From the practical standpoint of the manufacturer, plasticizers in plastics make products flexible, so that they are resilient and there is less breakage, says Dr. Moreau, who is based at MUHC’s contact dermatitis unit at the Royal Victoria Hospital.

The hospital-s contact dermatitis unit conducts diagnostic patch testing to assess the presence of allergic contact dermatitis, photocontact dermatitis, contact urticaria, and some types of drug eruptions. The clinicians at the unit also evaluate and treat occupational dermatitis. There are over 300 standardized allergens available.

The use of plastics has led and continues to provoke a range of reactions, such as contact dermatitis or urticaria. Still, while consumers are living in a very plastic world, dermatological reactions, such as an allergy to plastics, are rare, according to Dr. Moreau.

Other ingredients

Not only are plasticizers present in products, but stabilizers and other additives are present as well, she says.

"Plasticizers are not the only ingredient," Dr. Moreau says. " Other additives are equally important. "

The list of ingredients is not indicated on many of the plastic products, placing the onus on the dermatologist to contact the manufacturer if faced with a patient who developed an allergic reaction with the suspicion being exposure to plastic.

"If you don∈t find out the ingredients of the product, you won∈t find out what the allergy is, " Dr. Moreau says.
Irritant vs. allergy

"There may be instances where the reaction is an irritant dermatitis and not an allergy. You might need to go to the manufacturer and get supplemental information about what are the ingredients in the products, to test for the appropriate battery of allergens, " she says.

Dr. Moreau stresses that the manufacturer may not provide a complete list of ingredients. "If you do contact the manufacturer to find out what are the ingredients, you may or may not get a list of ingredients used in that product, " she says.

Phthlates

Increasingly, there has been a focus in the lay media on the health effects of plastics. Phthlates, in particular, have been a target of negative attention.

"Phthlates have been linked recently to bad press. They have been linked in studies to things like respiratory effects and allergic asthma, " Dr. Moreau tells Dermatology Times.

For its part, the European Union (EU) imposed a permanent ban on the use of six phthlates in toys designed for oral applications in children ages 3 and younger.The ban calls for such products to contain 0.1 percent concentration or less of six phthlates: DINP, DBP, DIDP, DNOP, DEHP and BBP.

The EU has had temporary bans in place since 1999. The bans were based on animal studies that have demonstrated risks with these products, according to Dr. Moreau."Plastics are everywhere in our environment, " she says, and plasticizers are also being studied for their role in IgE-mediated allergies.

In studies using a mouse model, some phthlates have been shown to aggravate atopic dermatitis. Phthlate esters have demonstrated a relationship to allergic asthma in animal studies. Moreover, there is evidence of phthlates being endocrine disruptors. Plasticizers can also be found in occupations where individuals are exposed to metals and are working with cutting fluids. DT