Table 2.

General characteristics of 14 cases of occupational allergic reactions to chlorhexidine

Reference	Country	Age	Gender	Occupational activity	Allergic history	Type of exposure	Clinical picture	Diagnosis	Management/Treatment	Health outcome
Nagendran et al., 2009	UK	31	Female	Oncology-nurse	No	Chlorhexidine hand-washes	Itching and redness of wrists and forearms, urticaria	Clinical, SPT sIgE	3 months after switching to non-chlorhexidine hand washes	Resolution of symptoms
Nagendran et al., 2009	UK	51	Female	Theatre-nurse	No	Chlorhexidine hand-washes	Itching and urticarial rash	Clinical sIgE	Switching to non-chlorhexidine hand washes	Resolution of symptoms
Nagendran et al., 2009	UK	35	Female	Endoscopy nurse	No	Powdered latex gloves + chlorhexidine hand-washes	Itching, redness of hands, rhinitis	Clinical, SPT sIgE	Avoiding wearing powdered latex gloves	Persistence of symptoms
Nagendran et al., 2009	UK	43	Female	Domestic nurse	No	Chlorhexidine hand-washes	Hand dermatitis with secondary infection, urticaria of forearms	Clinical, SPT sIgE	Flucloxacillin and Dermovate, avoiding wearing powdered latex gloves	Resolution of symptoms
Toholka and Nixon, 2013	Australia	21	Female	Graduate nurse	No	Chlorhexidine-based skin cleansers	Facial erythematous, pruritic eruption with localized edema	Clinical Patch tests	Oral corticosteroids, avoiding chlorhexidine-based skin cleansers	Resolution of symptoms
Toholka and Nixon, 2013	Australia	20	Female	Nursing student	No	Chlorhexidine-based hand rub	Papular eruption	Clinical Patch tests	Avoiding chlorhexidine-based hand rub and other products	Resolution of symptoms
Toholka and Nixon, 2013	Australia	21	Female	Nursing student	Yes (atopic eczema)	Chlorhexidine-based skin cleansers	Recurrent episodes of dermatitis	Clinical Patch tests	Avoiding chlorhexidine-based other products	Resolution of symptoms
Toholka and Nixon, 2013	Australia	28	Female	Intensive care nurse	No	Chlorhexidine-based skin cleansers	Recurrent episodes of dermatitis	Clinical Patch tests	Avoiding chlorhexidine-based products	Resolution of symptoms
Waclawaski et al., 1989	UK	54	Female	Nursing auxiliary	No	Chlorhexidine aerosols	Asthma	Clinical Spirometry	Not available	Not available
Waclawaski et al., 1989	UK	43	Female	Midwife	No	Chlorhexidine aerosols	Asthma	Clinical Spirometry	Not available	Not available
Wittczak et al., 2013	Poland	46	Female	Nurse in the internal medicine ward	No	Use of chlorhexidine as disinfectant in different medical procedures	Non-productive cough and dyspnea with wheezing	Clinical SPT sIgE Specific challenge tests	Not available	Not available
Wittczak et al., 2013	Poland	34	Female	Nurse in the pediatric nephrology ward	No	Use of chlorhexidine as disinfectant in different medical procedures	Recurrent non-productive cough, dyspnea with wheezing, rhinorrhea and paroxysmal sneezing	Clinical, SPT sIgE Specific challenge tests	Not available	Not available
Wittczak et al., 2013	Poland	45	Female	Nurse in the cardiology ward	No	Tooth brushing with chlorhexidine-containing toothpaste	Dyspnea and urticaria	Clinical, SPT SIgE Specific challenge tests (stopped due to anaphylactic reaction)	Not available	Not available
Vu et al., 2017	Australia	49	Female	Endoscopy technician	Yes (contact dermatitis, allergy to aspirin)	Chlorhexidine-based hand rub	Urticaria on the hands and arms, chest tightness, dyspnea	Clinical, SPT, Patch tests	Avoiding chlorhexidine-based products	Resolution of symptoms

sIgE: Specific IgE; SPT: Skin Prick Test