Sensitization to epoxy resin systems in the wind turbine industry: an undesirable side-effect of renewable energies

Epoxy resin systems are widely used as adhesives, sealants, inks, paints and coatings. Their components are well-known strong skin sensitizers and have become a major cause of allergic contact dermatitis in the construction industry in recent years.¹

In this issue of the BJD, Christiansen et al.² present the results of a cross-sectional study in 180 highly epoxy-exposed workers from two wind turbine factories in Denmark and 41 nonexposed office workers. Patch testing with a panel of test substances including epoxy-containing products from the two factories revealed that almost 9% of production workers compared with none of the office workers were sensitized to an epoxy component. Resins based on the diglycidyl ethers of bisphenol A (DGEBA-R) and bisphenol F (DGEBA-F) were the most frequent sensitizers. Notably, sensitizations in one-quarter of the workers were not detected by the TRUE Test panel, which contains only DGEBA-R. Dermatitis affected about 40% of the sensitized workers based on clinical examination or self-reporting.

Usually, information on the prevalence of sensitization to epoxy components derives from patch test studies in individuals with dermatitis.^{1, 3} In contrast, Christiansen et al. performed patch tests regardless of the presence or absence of dermatitis, providing a clearer picture of the prevalence of sensitization to epoxy components in the wind turbine industry. Apart from prevalence studies, there is no need for routine patch testing, but in epoxy-exposed workers with suspected occupational dermatitis, tailored patch testing is required. Christiansen et al. showed that some epoxy-sensitized individuals are missed when only the TRUE Test panel is tested, stressing the need for patch testing a broader spectrum of epoxy resin components commercially available as test preparations.³ If the test remains negative and contact allergy is still suspected, patch testing of the patients’ own products should be considered; however, this requires extensive experience and diligence. Patch testing patients’ own products might still be the only way to discover contact allergies that are not otherwise detected.⁴

The high rate of workers sensitized to epoxy components in the wind turbine industry is alarming as such sensitizations frequently result in job discontinuation.⁵ Christiansen et al. found that the prevalence of sensitization to epoxy components was highest in the first year of exposed employment and decreased with increasing duration of exposed work, indicating its well-known short latency period and a healthy worker effect.^{1, 6} This suggests that the true prevalence of epoxy sensitization in this industry might be underestimated. Despite protection measures, the skin of workers handling epoxy resin systems is frequently contaminated.⁷ Hence, there is clearly a need for intensified prevention efforts including raising awareness among exposed workers and intensive training in correct use of personal protective equipment, as well as development and usage of epoxy resin systems with a lower sensitization potential.⁸ Prevention of sensitizations to epoxy components, and thus preserving the occupational health of the workforce in the wind turbine industry, is of particular importance considering the pursuit of renewable energies in light of climate change and the current European energy crisis.

Author contributions

Richard Brans: Conceptualization (lead); writing – original draft (lead); writing – review and editing (lead).