D2.63 - Airborne allergic contact dermatitis in a textile worker: role of formaldehyde and methylisothiazolinones

Introduction: Airborne allergic contact dermatitis (ACD) is rarely reported in the textile industry. Its diagnosis is often challenging due to the complexity and diversity of treatments applied to fabrics. The aim of our study was to describe a case of airborne ACD in a textile worker, with an impact on medical fitness for work.

Case report: The patient was a 39-year-old woman with a history of systemic lupus erythematosus, working as a machine operator in a garment factory. She was exposed to plant-based and synthetic textile dust, dyes, and textile finishes, with an adjacent ironing station. For two years, she had experienced pruritic erythematous-vesicular lesions progressing to desquamation, affecting the face, neck, and upper chest, with episodes of eyelid edema. Patch testing using the European standard series revealed sensitization to formaldehyde and methylisothiazolinones. A diagnosis of airborne ACD was established. The occupational origin was suspected due to the work-related pattern of symptoms since they occurred on working days and markedly improved on leaves, the correlation between lesion sites and exposure to airborne agents, and the relevance of patch test results. Formaldehyde can be present in certain fabrics as a preservative and in formaldehyde-releasing resins used as anti-wrinkle agents. It is released in textile dust during cutting and garment production, as well as in vapors emitted when ironing treated synthetic fabrics. Similarly, methylisothiazolinones may be present in these fabrics as preservatives. Given the ubiquity of these allergens in the factory, the patient’s fitness for work was compromised.

Conclusions: This case highlights the diagnostic challenges of airborne ACD in the textile industry and underscores the importance of targeted occupational investigations and improved traceability of chemical treatments in fabrics to prevent and manage work-related allergies.