Factory worker surrounded by allergen-filled dust, symbolizing occupational dermatitis.

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Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"Discover how airborne allergens in your workplace might be the root cause of your persistent skin issues, and what you can do about it."

Occupational allergic contact dermatitis can be a diagnostic puzzle, especially when the culprits are obscure workplace allergens that lack readily available testing materials or clear guidelines in existing research. This article explores two compelling cases where individuals developed severe allergic reactions traced back to a specific chemical compound used in their workplace.

The focus is on N-(4-hydroxyphenyl)benzenesulfonamide (HPBS), a chemical intermediate vital in producing heat-sensitive recording materials commonly utilized in the healthcare sector. Understanding how HPBS triggers allergic reactions—particularly through airborne exposure—can significantly improve workplace safety and employee health.

This analysis not only sheds light on the challenges of diagnosing such conditions but also emphasizes the importance of multidisciplinary consultation and thorough testing when occupational skin diseases are suspected. By examining these cases, we aim to provide insights into preventing and managing similar situations in workplaces worldwide.

The Case Files: Unveiling the Culprit

Factory worker surrounded by allergen-filled dust, symbolizing occupational dermatitis.

Two men, aged 53 and 58, sought medical help for severe dermatitis affecting their faces—particularly their eyelids, lips, and noses. Additionally, they experienced eczema on their necks and occasional widespread lesions on their trunks and elbow folds. Beyond the relentless itching, they reported burning sensations, accompanied by redness, swelling, and subsequent skin peeling.

A significant pattern emerged: their symptoms intensified during the workweek but diminished or disappeared entirely when they were off work. Both men were employed as laborers in a factory that produced polyethylene terephthalate (PET) films, essential for heat-sensitive recording materials used in healthcare. Their duties included weighing and emptying bags of fine, white powders—intermediates in the PET film production process.

Inadequate Ventilation: Both patients noted that the factory's ventilation was insufficient, leading to substantial airborne exposure to the powders.
High Temperatures: The work environment was often hot, causing them to sweat, which further exacerbated the issue as the powders stuck to their skin.
Protective Gear Shortcomings: Despite wearing overalls, masks, glasses, and gloves, they still experienced direct and airborne skin exposure. One patient even developed additional lesions where his glasses were stored in his overall pockets, while the other had dermatitis under his watch strap.

Further investigation revealed that the composition of the powders had recently changed, with the addition of 4-(p-tosyl)catechol (PTC) and HPBS. This discovery prompted thorough patch testing with allergens from standard series and cosmetic series to pinpoint the causative agent.

Turning the Tide: Solutions and Prevention

These cases underscore the critical importance of a comprehensive approach to diagnosing and managing occupational dermatitis. Identifying specific allergens like HPBS requires thorough patch testing, multidisciplinary collaboration, and a keen understanding of workplace conditions. Employers must prioritize adequate ventilation, appropriate protective equipment, and continuous monitoring of chemical exposures to safeguard their employees' health. Ultimately, proactive measures and heightened awareness can transform workplaces into safer, healthier environments for all.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/cod.13135, Alternate LINK

Title: Occupational Airborne Allergic Contact Dermatitis Caused By N -(4-Hydroxyphenyl)Benzenesulfonamide

Subject: Dermatology

Journal: Contact Dermatitis

Publisher: Wiley

Authors: Olivier Aerts, Evelyne Mangodt, Katrien Smets, Michelle Mertens, Lieve Constandt, An Goossens

Published: 2018-10-17

Everything You Need To Know

What is occupational allergic contact dermatitis, and how is it related to the article's context?

Occupational allergic contact dermatitis is a skin condition triggered by exposure to allergens in the workplace. In this context, the article focuses on cases caused by the chemical compound N-(4-hydroxyphenyl)benzenesulfonamide (HPBS) found in heat-sensitive recording materials. This dermatitis manifests as severe skin reactions, such as eczema and lesions, primarily on the face and other exposed areas. These reactions occur because the skin comes into contact with HPBS, leading to an allergic response.

What is the significance of HPBS in causing allergic reactions, according to the article?

HPBS, or N-(4-hydroxyphenyl)benzenesulfonamide, is a chemical intermediate crucial in the production of heat-sensitive recording materials used in healthcare settings. Its significance lies in its potential to cause occupational allergic contact dermatitis, particularly when exposure is airborne. The article highlights how workers handling materials containing HPBS can develop severe skin reactions. This is critical because it underscores the need for vigilance in workplaces where HPBS is present, emphasizing the importance of preventative measures like adequate ventilation and protective equipment to safeguard employee health.

Why is thorough patch testing and multidisciplinary consultation important in diagnosing occupational dermatitis?

The article emphasizes the importance of patch testing and multidisciplinary consultation in diagnosing occupational allergic contact dermatitis. When individuals display symptoms, such as the two factory workers described in this context, standard allergy tests may not identify the root cause. Specific tests are required to identify the causative agent and to help differentiate the reaction from other sources of contact dermatitis. Patch testing with substances like HPBS is crucial for pinpointing the allergen, and a collaborative approach among medical professionals helps ensure an accurate diagnosis and effective treatment.

How do factors like ventilation, temperature, and protective gear affect the severity of occupational dermatitis?

Inadequate ventilation, high temperatures, and shortcomings in protective gear can worsen occupational allergic contact dermatitis. In the cases presented, the factory lacked sufficient ventilation, leading to airborne exposure to HPBS. The heat also exacerbated the situation by causing workers to sweat, which increased skin exposure to the allergen. Even with protective gear, such as overalls, masks, and gloves, exposure still occurred. These factors highlight the need for employers to prioritize workplace safety by improving ventilation, providing adequate protective equipment, and monitoring for chemical exposures.

What measures can be taken to prevent occupational allergic contact dermatitis in the workplace?

Preventing occupational allergic contact dermatitis involves proactive measures such as adequate ventilation, appropriate protective equipment, and continuous monitoring of chemical exposures. Implementing these strategies can protect employees from contact with allergens like HPBS. Employers should also consider the importance of readily available testing materials and clear guidelines to aid in the diagnosis and management of such conditions. Heightened awareness and a comprehensive approach to workplace safety are key to transforming environments into safer, healthier places for employees, as the cases in the article illustrate.