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Predictive tests are of value in forecasting the response of a population to a sensitizer; diagnostic testing is used to determine what substances may actually be producing dermatologic problems. Skin sensitization predictive and diagnostic data for the eleven most frequently encountered skin sensitizers in Western Europe, Canada and the United States are reviewed. These compounds include two drugs (benzocaine and neomycin), two cosmetic ingredients (p-phenylenediamine and balsam of Peru), four preservatives (formaldehyde, ethylenediamine, parabens and mercurials) and three ingredients of wearing apparel (nickel, chromium and thiram). Many of the data were collected by the North American Contact Dermatitis Group and the International Contact Dermatitis Research Group on tests with 1,200 and 4,825 dermatologic patients, respectively; the remainder were obtained by individual investigators with smaller groups of subjects. The data obtained by various investigators are discussed in relation to the factors which affect the extent and degree of sensitization which they can cause.

Although hexavalent chromium, Cr(VI), is a potent sensitizer and inducer of allergic contact dermatitis and is found in many common materials, no standard or guideline currently exists for protection against these effects in environmental exposure. There appears to be a generalized allergenic potential among the various compounds of Cr(VI). Estimates of the prevalence of Cr sensitivity in the population are uncertain, but range from about 2% of the total population in Finland to as high as 20% in U.S. populations with a dermatitis. Based on the thresholds reported for nine separate patch-test studies and statistical analysis of the aggregate dose-response relationship from 72 separate observations from these studies and on studies of allergic responses to bleaches and detergents, the effective threshold for elicitation of allergic contact dermatitis in sensitized populations is about 10 ppm (mg/L) Cr(VI) (as chromium) in solution. Based on evaluation of the literature on cement dermatitis, the threshold concentration of extractable Cr(VI) in solid material may be as low as 10 ppm (microgram/g). For ingestion of Cr(VI), the lowest observed effect level (LOEL) dose for elicitation is 0.26 microgram/kg. In calculating the threshold concentration of Cr(VI) in soil for elicitation of contact dermatitis, extractability must be taken into account.

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