Rare Case of Type I Hypersensitivity Reaction to Sodium Hypochlorite Solution in a Healthcare Setting
Open accessAbstract
Sodium hypochlorite is a clear yellowish solution with a characteristic odour of chlorine and is commonly used as a disinfectant and a bleaching agent. It is used in various healthcare settings for its fast-acting and broad-spectrum antimicrobial activity. It is a known irritant and there are some reports that it can also cause allergic contact dermatitis of type IV hypersensitivity. We report a case of work-related type I hypersensitivity to sodium hypochlorite, presenting with recurrent urticarial rash and a positive prick test reaction to this chemical. He was subsequently excused from further exposure with no further recurrences of the urticarial rash. To the best of our knowledge, this is the first such reported case due to work in the healthcare setting.
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In human skin, irritation and disruption of barrier function, alteration of the commensal microbiome, allergy, and contact hypersensitivity are expected outcomes of inappropriate topical HOCl product use not compliant with standard of care.
“In human skin (as a function of concentration, pH, and exposure time), irritation and disruption of barrier function, alteration of the commensal microbiome, allergy, and contact hypersensitivity are expected outcomes of inappropriate topical HOCl product use not compliant with standard of care ( Figure 5D ) (142, 143).”
From Hypochlorous Acid: From Innate Immune Factor and Environmental Toxicant to Chemopreventive Agent Targeting Solar UV-Induced Skin Cancer (2022) · cites this paper as [142]
Indiscriminate HOCl-dependent induction of chlorination stress might be associated with adverse irritant effects.
“Also, in the context of balancing HOCl-related organ toxicity and therapeutic effects, it should be mentioned that the indiscriminate HOCl-dependent induction of chlorination stress might be associated with adverse irritant effects (51, 141–144).”
From Hypochlorous Acid: From Innate Immune Factor and Environmental Toxicant to Chemopreventive Agent Targeting Solar UV-Induced Skin Cancer (2022) · cites this paper as [142]
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Snell, J. A., Jandova, J., & Wondrak, G. T. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.887220 · Cited by 37 · see citing works
- Authors
- Chia Shi Zhe, G., Green, A., Fong, Y. T., Lee, H. Y., & Ho, S. F.
- Affiliations
- National University Health System (SG)
- Singapore General Hospital (SG)
- Ministry of Manpower (SG)
- Venue
- BMJ Case Reports
- Publisher
- BMJ
- Published
- 2016-10-21
- Volume
- 2016
- Pages
- bcr2016217228
- ISSN
- 1757-790X (ISSN-L)
- PMC
- PMC5093827
- OpenAlex
- W2536207389
- Cited by
- 37
- References
- 7
- Citations by year
- 2025: 2 · 2024: 5 · 2023: 2 · 2022: 10 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 1
- FWCI
- 3.98
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- BMJ Case Reports (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
- Keywords
- sodium hypochlorite, immediate hypersensitivity, occupational allergy, urticarial rash, skin prick test, healthcare workers, occupational exposure, allergen avoidance
- MeSH terms
- Humans, Hypersensitivity, Immediate, Male, Operating Room Technicians, Recurrence, Skin Tests, Sodium Hypochlorite, Solutions, Urticaria, Occupational Exposure, Young Adult
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