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Fibreglass dermatitis

Author: Niket Shah, Medical Student, University of Otago, Wellington, New Zealand. Medical editor: Dr Helen Gordon, Auckland, New Zealand.DermNet NZ Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell. July 2020.


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What is fibreglass and what is it used for?

Fibreglass is a man-made fibrous form of glass produced through a process called pultrusion, where multiple products (including sand) are exposed to high temperatures. They are then inserted through small holes to form glass filaments. Fibreglass in itself is a chemically inert substance.

Fibreglass is used in a wide range of industries, as it has excellent thermal, acoustic, and electrical insulation properties. It is also used to reinforce other materials such as plastic.

Fibreglass

What is fibreglass dermatitis?

Fibreglass dermatitis is a form of mechanical irritant contact dermatitis [1]. It is caused by the penetration of the stratum corneum of the skin by small fragments or spicules of fibreglass [2].

Less frequently, allergic contact dermatitis may develop to the resins that coat the fibreglass fragments [3].

Fibreglass dermatitis can occur in various occupational settings that involve the creation and use of fibreglass, including:

  • The construction industry
  • The electronics industry
  • Factories producing fibreglass-reinforced plastics
  • The production of insulation panels
  • The wind energy industry.

Occupational and recreational use of fibreglass

Who gets fibreglass dermatitis?

Fibreglass dermatitis may affect anyone who has been exposed to direct contact with fibreglass, particularly in an occupational setting.

Non-occupational fibreglass dermatitis includes frictional injury from items manufactured using fibreglass, such as hockey sticks and the skin of surfboards.

High concentrations of airborne fibreglass particles can also cause fibreglass dermatitis [3].

What are the clinical features of fibreglass dermatitis?

Fibreglass dermatitis is usually an acute presentation. Chronic fibreglass dermatitis is rare, as tolerance develops to fibreglass with long-term exposure [2].

Fibreglass dermatitis affects the exposed areas of the face, neck, forearms, and hands. Flexural surfaces such as antecubital fossa and wrists may be particularly troubled due to sweat, increased fibre accumulation, and friction at these sites.

Clinical findings in fibreglass dermatitis may include [1]:

  • Papules, vesicles, and excoriations
  • Redness of the affected skin
  • Scale, lichenification, and desquamation
  • Itching
  • Less commonly, ulceration and fissures, and a burning sensation.

Family members may sometimes develop fibreglass dermatitis if they come in contact with the worker's clothing.

The amount of mechanical irritation to the skin by fibreglass relates to [1–3]:

  • The type and extent of exposure to fibreglass
  • How deeply the fibres have penetrated the skin
  • Environmental factors, such as high temperature and humidity
  • The diameter of the fibre (thick fibres produce more irritation)
  • The length of the fibre (short fibres produce more irritation).

How is fibreglass dermatitis diagnosed?

Detailed clinical history and examination of the patient are essential to determine exposure to fibreglass and other risk factors for developing fibreglass dermatitis.

A skin-stripping test may be performed to confirm the diagnosis.

  • Adhesive tape is used to repeatedly strip the affected skin.
  • Potassium hydroxide solution is added to a sample of stripping to make it easier to see the fibres.
  • Fibreglass fibres are observed on examination of the strippings under polarised light microscopy [2,4].

Other methods of diagnosis include:

What is the differential diagnosis for fibreglass dermatitis?

Fibreglass dermatitis may be mistaken for [1]:

What is the treatment for fibreglass dermatitis?

Treatment for symptomatic fibreglass dermatitis may involve [2]:

What is the outcome of fibreglass dermatitis?

The prognosis of fibreglass dermatitis is variable, depending on the presentation and severity. It may self-resolve within a few days if there are few particles present in the skin. It tends to recur following re-exposure [2].

How can fibreglass dermatitis be prevented?

Personal protective equipment and clothing for workers are vital to the prevention of fibreglass dermatitis. This may involve the use of gloves, for workers directly handling fibreglass products, and wearing multiple layers of protective clothing. This clothing should be washed separately to avoid any chances of contamination [2].

Thorough cleaning of occupational environments is essential to remove any residual fibreglass particles and to prevent further exposure.

Barrier creams and emollients have not been shown to be useful in the prevention of fibreglass dermatitis and may make it worse [2].

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References

  1. Book: Dermatology. Ed Bolognia, JL, Jorizzo JL, Schaffer JV. Fourth edition. Elsevier/Saunders.
  2. Camacho I, Rajabi-estarabadi A, Eber AE, Griggs JW, Margaret SI, Nouri K, et al. Fiberglass dermatitis: clinical presentations, prevention, and treatment – a review of literatures. Int J Dermatology 2019; 58: 1107–11. Available from: onlinelibrary.wiley.com/doi/abs/10.1111/ijd.14407 [accessed 8 July 2020]
  3. Nogueira A, Morais P, Cunha AP, Azevedo F, Nogueira A, Morais P, et al. Systemic allergic contact dermatitis to fiberglass in a factory worker of wind turbine blades. Cutan Ocul Toxicol 2011; 30: 228–30. Available from: www.tandfonline.com/doi/full/10.3109/15569527.2010.543944 [accessed 8 July 2020]
  4. Sertoli A, Francalanci S, Giorgini S. Fiberglass Dermatitis. In: Handbook of Occupational Dermatology. Springer, Berlin, Heidelberg; 2000. p. 122–34.

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