Occupational Allergic Contact Dermatitis due to Rubber Additives in Tunisia: A 27‐Year Retrospective Study of Clinical and Occupational Characteristics

BACKGROUND: Rubber additives are established causes of occupational allergic contact dermatitis (OACD), but data from North Africa are scarce. OBJECTIVES: To characterize OACD due to rubber additives in a Tunisian tertiary referral population and assess its impact on fitness for work. METHODS: A retrospective study included all adult patients diagnosed with OACD to rubber additives between 1998 and 2025. Patch testing was performed with the European baseline series, with additional rubber series in selected cases. Clinical, occupational and allergological data were analysed. Associations with MOAHLFA index and temporal trends were assessed using logistic regression. RESULTS: Eighty patients were included. Thiurams were the most frequent sensitizers (74%), followed by benzothiazole derivatives (24%) and p-phenylenediamine derivatives (14%). The healthcare sector predominated (51%) and gloves were the main exposure source (88%). Sensitization to multiple rubber additive families occurred in 19% of cases. No significant associations were found with MOAHLFA index after adjustment and no significant temporal trends were observed. Workplace adaptation was required in all cases and OACD met criteria for compensation as an occupational disease in 92%. CONCLUSIONS: OACD due to rubber additives remains frequent and is associated with a substantial occupational impact, emphasizing the need for preventive measures.