Prevalence of Contact Allergy to Rubber Accelerators From the European Baseline Series in Dermatitis Patients: A Systematic Review and Meta-Analysis.

Rubber accelerators are chemicals used as vulcanizers in the production of rubber items and may cause contact allergy (CA). The aim of this study was to assess the worldwide prevalence of CA to rubber accelerators from the European baseline series among dermatitis patients. A comprehensive literature search across PubMed, Embase, and Web of Science yielded 106 studies with 826 543 individuals patch tested between 1984 and 2023. Meta-analysis showed pooled prevalence rates of 2.55% for thiuram mix, 0.86% for mercapto mix, and 0.83% for mercaptobenzothiazole. Marked geographical variations were observed: North America and Asian regions showed the highest prevalences whereas Europe had lower rates. Comparisons before and after the year 2000 revealed a decline in CA to all three accelerators. Sub-analysis of the extended rubber series revealed the prevalence of CA to tetraethylthiuram disulphide of 3.73% and to zinc diethyldithiocarbamate of 0.60%. The prevalence of CA to carba mix was 3.96%. These findings underscore the public health implications of rubber accelerator-induced CA. Strengthened preventive measures and regulatory efforts, including improved labelling, safe limits of rubber gloves, and reduced use of high-risk accelerators are needed to mitigate disease burden. The results emphasise a need for ongoing surveillance, especially concerning extended rubber series.