Allergic Contact Dermatitis in the Operating Room: A Comprehensive Analysis of Surgical Scrubs and Disinfectants.

BACKGROUND Sterility and sanitation are fundamentals in the operating room. However, little is known about the ingredients of these disinfectant products and their risk of allergic contact dermatitis. OBJECTIVE The aim of the study was to identify and characterize common allergens in surgical scrubs and patient surgical cleansers that health care workers and surgical patients may encounter in the perioperative period. METHODS DailyMed website was searched using numerous terms for surgical disinfectants. Products used for health care worker handwashing/scrubbing or patient surgical cleansing/disinfecting were included. Each product's ingredients were recorded; the 2017 American Contact Dermatitis Society (ACDS) Core Allergen Series allergens present in each product were noted. CONCLUSIONS A total of 1940 products were identified, of which 267 products were included in the analysis. A total of 66.3% contained iodine, 25.8% contained chlorhexidine digluconate, and 2.6% contained chloroxylenol. Among these products, 1586 ingredients were identified. Of these, 241 were ACDS Core Series allergens. Most products contained 1.0 ACDS allergen. There were significant differences in allergens based on product type and active ingredient with iodine-containing products having the fewest number of allergens. The most common ACDS allergens were cocamide diethanolamide (22.5%), fragrance (21.7%), lanolin (19.5%), propylene glycol (6.7%), alkyl glucosides (6.0%), and sorbic acid derivatives (5.6%). Again, there was variation in allergen type based on product type and active ingredient.