ACD from synthetic tear gas is typical eczematous dermatitis, often accompanied by marked edema. Contact sensitization to the oleoresin of capsicum is not common, but it suggests the possibility that ingestion of foods containing capsicum (spicy and ethnic foods, such as Mexican and Chinese) may produce an eczematous contact-type dermatitis. Diffuse erythema has been reported from the ingestion of capsicum
PATCH TESTING WITH TEAR GASES
Great care must be taken in performing patch tests with tear gases, because the minimum irritating concentration is as low as 1 part in 100,000.
In Mace, CN is present in a 0.9% concentration. Patch tests may be performed with chemical Mace diluted 1 part with 100 parts acetone, which gives a 0.009% concentration of chloracetophenone. This concentration is not an irritant under a closed patch test and is sufficient to produce a positive allergic eczematous patch test reaction in sensitized individuals.
Patch tests with CS should be commenced with a 1:100,000 dilution in acetone. (It should be noted that CS dissolves with difficulty.) The other tear gases should be tested in a 1:100,000 dilution in ethanol to determine a concentration that is not irritating under a closed patch.
Capsicum may be tested in a 1% solution in ethanol.
MANAGEMENT OF TEAR GAS DERMATITIS
In sensitized individuals, the skin should be irrigated with copious amounts of water within a few minutes or dermatitis is inevitable. The lacrimator CS should also be removed with water as soon as possible. Although dry skin is unharmed initially by it, prolonged exposure may produce first- and second-degree burns and even ulceration. As soon as the individual begins to wash the powder off, a burning sensation and erythema occur but usually subside in an hour or so.
Barrier creams and petrolatum do not offer much protection from tear gas. Plastic clothing, including plastic helmets and visors, are the best protective devices available. Aluminum and or magnesium hydroxide (as found in antacid) apparently bind these agents and reduce bioavailability.
The treatment of primary irritation, burns, or allergic dermatitis from the tear gases is similar to the treatment of these conditions from other cause.
Ethylene Oxide Dermatitis
The most common types of cutaneous reactions to ethylene oxide gas are irritant reactions or burns, which may at times be severe. There are also a few reports of allergic reactions to this gas.
NATURE OF ETHYLENE OXIDE STERILIZATION
Ethylene oxide is a colorless, gaseous, simple epoxy compound whose sterilizing ability depends on its inherent toxic effect on all living cells. This most likely because of ethylene oxide’s ability to replace a hydrogen atom in protein molecules with hydroethyl (alkyl group), a process known as alkylation. Because this process is irreversible, the cell is killed. It is important, therefore, to remove all traces of ethylene oxide from the item sterilized before it comes into contact with human tissues. In addition, it is genotoxic.18
Gaseous ethylene oxide has become one of the major sterilizing agents of medical equipment and materials. Sterilization can be accomplished at low temperatures and humidity, thus avoiding damage to heat- or moisture-sensitive materials, as might occur with autoclave sterilization. Its highly diffusive nature and its permeability make it possible to sterilize through hermetically sealed plastic wrapping films, shipping cartons, and containers.
The ethylene oxide gas sterilization process consists of two essential parts: (a) sterilization by ensuring penetration of a sufficient concentration of the gas into all parts of load and (b) aeration until one is certain that all gas residues are eliminated from the sterilized items.
The Ethylene Oxide Subcommittee of the American National Standards Institute recommends the following precautions be taken to avoid the hazards of ethylene oxide sterilization:
1. Polyvinyl chloride or rubber materials sterilized with ethylene oxide should not be used within 7 days following sterilization, if stored at room temperatures.
2. Polyethylene (3 to 5 mL) and paper wrap are the best packaging materials. Nylon and polyvinylidine chloride are less permeable to ethylene oxide.
3. Polyvinyl chloride objects that have been gammairradiated should not be resterilized with ethylene oxide because large amounts of ethylene chlorohydrin will be formed.
4. “Disposable” items should be discarded after use because the by-products of later ethylene oxide sterilization may include ethylene chlorohydrin, which is a severe skin irritant.
5. Water droplets should be removed from material to be sterilized, to prevent the formation of ethylene glycol, a powerful irritant.
ปกติอักเสบ eczematous มักจะมาพร้อมเครื่องได้แก่ ACD จากแก๊สน้ำตาที่สังเคราะห์ได้ Sensitization ติดต่อไป oleoresin ของพริกหวานไม่ทั่วไป แต่แนะนำเป็นไปได้ว่า กินอาหารที่ประกอบด้วยพริกหวาน (ชนกลุ่มน้อย และเผ็ดอาหาร เม็กซิโกและจีน) อาจผลิตเป็นผิวหนังอักเสบชนิดติดต่อ eczematous Erythema กระจายได้ถูกรายงานจากกินพริกหวานโปรแกรมทดสอบ ด้วยแก๊สน้ำตาดูแลที่ดีต้องใช้ในการทดสอบโปรแกรมปรับปรุง ด้วยแก๊สน้ำตา เนื่องจากความเข้มข้นระคายเคืองต่ำสุดอยู่ในระดับต่ำที่ 1 part ใน 100000 ในเมซ CN อยู่ในเข้มข้น 0.9% ทดสอบโปรแกรมปรับปรุงอาจทำงานกับเมซเคมีผสมส่วนที่ 1 กับชิ้นส่วน 100 อะซิโตน 0.009% เข้มข้นของ chloracetophenone ซึ่งได้ ความเข้มข้นนี้ไม่ออกฤทธิ์การระคายเคืองภายใต้การทดสอบโปรแกรมปรับปรุงที่ปิด และเพียงพอในการผลิตปฏิกิริยาบวกแพ้ eczematous แพทช์ทดสอบในบุคคล sensitized ควรจะเริ่มดำเนินการทดสอบโปรแกรมปรับปรุง ด้วย CS กับเจือจาง 1:100,000 ในอะซิโตน (มันควรจะตั้งข้อสังเกตว่า CS ละลาย ด้วยความยากลำบาก) ก๊าซน้ำตาอื่น ๆ ควรจะทดสอบในเจือจาง 1:100,000 ในเอทานอลเพื่อกำหนดความเข้มข้นที่ไม่เคืองใต้ปะปิด พริกหวานอาจมีทดสอบในการแก้ปัญหา 1% ในเอทานอลจัดการของแก๊สน้ำตาอักเสบIn sensitized individuals, the skin should be irrigated with copious amounts of water within a few minutes or dermatitis is inevitable. The lacrimator CS should also be removed with water as soon as possible. Although dry skin is unharmed initially by it, prolonged exposure may produce first- and second-degree burns and even ulceration. As soon as the individual begins to wash the powder off, a burning sensation and erythema occur but usually subside in an hour or so. Barrier creams and petrolatum do not offer much protection from tear gas. Plastic clothing, including plastic helmets and visors, are the best protective devices available. Aluminum and or magnesium hydroxide (as found in antacid) apparently bind these agents and reduce bioavailability. The treatment of primary irritation, burns, or allergic dermatitis from the tear gases is similar to the treatment of these conditions from other cause.Ethylene Oxide DermatitisThe most common types of cutaneous reactions to ethylene oxide gas are irritant reactions or burns, which may at times be severe. There are also a few reports of allergic reactions to this gas.NATURE OF ETHYLENE OXIDE STERILIZATIONEthylene oxide is a colorless, gaseous, simple epoxy compound whose sterilizing ability depends on its inherent toxic effect on all living cells. This most likely because of ethylene oxide’s ability to replace a hydrogen atom in protein molecules with hydroethyl (alkyl group), a process known as alkylation. Because this process is irreversible, the cell is killed. It is important, therefore, to remove all traces of ethylene oxide from the item sterilized before it comes into contact with human tissues. In addition, it is genotoxic.18 Gaseous ethylene oxide has become one of the major sterilizing agents of medical equipment and materials. Sterilization can be accomplished at low temperatures and humidity, thus avoiding damage to heat- or moisture-sensitive materials, as might occur with autoclave sterilization. Its highly diffusive nature and its permeability make it possible to sterilize through hermetically sealed plastic wrapping films, shipping cartons, and containers. The ethylene oxide gas sterilization process consists of two essential parts: (a) sterilization by ensuring penetration of a sufficient concentration of the gas into all parts of load and (b) aeration until one is certain that all gas residues are eliminated from the sterilized items. The Ethylene Oxide Subcommittee of the American National Standards Institute recommends the following precautions be taken to avoid the hazards of ethylene oxide sterilization:1. Polyvinyl chloride or rubber materials sterilized with ethylene oxide should not be used within 7 days following sterilization, if stored at room temperatures.2. Polyethylene (3 to 5 mL) and paper wrap are the best packaging materials. Nylon and polyvinylidine chloride are less permeable to ethylene oxide.3. Polyvinyl chloride objects that have been gammairradiated should not be resterilized with ethylene oxide because large amounts of ethylene chlorohydrin will be formed.4. “Disposable” items should be discarded after use because the by-products of later ethylene oxide sterilization may include ethylene chlorohydrin, which is a severe skin irritant.5. Water droplets should be removed from material to be sterilized, to prevent the formation of ethylene glycol, a powerful irritant.
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