Allergic Contact Sensitization in an Adult Danish Population: Two Cross-sectional Surveys Eight Years Apart (The Copenhagen Allergy Study)

Nielsen, Niels; Linneberg, Allan; Menné, Torkil; Madsen, Flemming; Frølund, L.; Dirksen, Asger; Jørgensen, Torben

doi:10.1080/000155501750208155

Cited by 179 publications

(165 citation statements)

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“…On the other hand, it should be kept in mind that the high number of unequivocally (++/+++) allergic reactions in our study is a matter of serious concern. In population-based studies, the overall frequency of allergies to the FM alone is in the region of 1-2% [1]. In a model calculation [46], we estimated the prevalence of sensitisation (+ to +++) to the FM to range between 1.8 and 4.2%.…”

Section: Discussionmentioning

confidence: 99%

“…Contact allergies to fragrances are frequent: 1-2% of the general population [1] and more than 10% of patients attending for investigation of contact dermatitis are sensitised to the fragrance mix (FM) [2]. In general, fragrances are the second most common class of substances identified as causing positive patch test reactions.…”

confidence: 99%

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Another Look at Allergies to Fragrances: Frequencies of Sensitisation to the Fragrance Mix and Its Constituents

Schnuch

Geier

Uter³

et al. 2002

Exog Dermatol

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Background: Sensitisation to fragrances is generally diagnosed with the fragrance mix (FM), which should sensitively detect contact allergy to its single compounds (SCs). Objective: To study the frequency of sensitisation to the FM and to the SCs, and to evaluate the sensitivity of the FM to diagnose sensitisation to SCs. Methods: During a 4-year period, 4,900 patients were patch tested with the FM (8% pet.) and with its 8 SCs (1% pet.) by departments of dermatology participating in the multicentre project Information Network of Departments of Dermatology. Results: The overall frequency of sensitisation of the FM was 20.2%, that of SCs ranged from 6.8% (oak moss) to 0.6% (α-amylcinnamic aldehyde). Based on our results, we propose 3 groups of SCs according to their importance relative to the frequency of sensitisation: oak moss and iso-eugenol are considered very important, geraniol and α-amylcinnamic aldehyde appear less important in terms of frequency of sensitisation and the remaining allergens can be regarded as important. In 61% of the + reactions to the FM, no positive reaction to any SC was observed, whereas most ++ and +++ reactions to the FM were accompanied by a positive SC test result (69.1 and 93.6%, respectively). In contrast, a negative reaction to the FM was strongly associated with negative reactions to the SCs. Overall, the sensitivity of the FM was high (86.7, 95% confidence interval, CI: 83.7–89.3), but the positive predictive value was low (53.8, 95% CI: 50.6–56.9). Conclusion: The FM is a sensitive diagnostic tool to detect contact allergy to its single fragrance constituents. However, a + reaction to the FM without a history of fragrance allergy should be interpreted with caution. Epidemiological and regulatory discussions should address this important aspect, because the frequency of sensitisation as expressed by overall positive reactions (+ to +++) to the FM can be misleading.

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Section: Discussionmentioning

confidence: 99%

Another Look at Allergies to Fragrances: Frequencies of Sensitisation to the Fragrance Mix and Its Constituents

Schnuch

Geier

Uter³

et al. 2002

Exog Dermatol

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“…Leather products are now responsible for the main chromium exposure (42). The prevalence of chromium allergy in the background population is between 0.5% and 1.7% but considerably higher among consecutive eczema patients (1,(42)(43)(44). A suggestion on threshold levels for Cr (III) release and Cr (VI) content in leather products has been raised, as modifications in the leather manufacturing process can limit the content of Cr (III) and Cr (VI).…”

Section: Chromiummentioning

confidence: 99%

“…Contact allergy affects nearly 15-20% of the general population (1). Sensitization is caused by skin contact with low-molecular-weight haptens.…”

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confidence: 99%

Contact allergy epidemics and their controls*

2007

Self Cite

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Contact dermatitis can be severe and lead to sick leave as well as significant healthcare expenses. The aim of this review is to present the published knowledge on 6 historical epidemics of contact allergy to apply this knowledge on the prevention and control of future contact allergy epidemics. A historical review is performed on nickel, chromium, methylchloroisothiazolinone/methylisothiazolinone, methyldibromo glutaronitrile, formaldehyde, and para-phenylenediamine. The first cases of contact dermatitis are mostly occupational, whereas consumer cases appear later. There is often a latency period from the first cases are observed until an epidemic occurs, and the problem is recognized. Finally, no one seems to take responsibility of dealing with the situation, and there are no attempts of regulation until an epidemic is consolidated among consumers for many years. Steps should be taken to prevent contact allergy epidemics. It is essential that dermatologist, scientists, administrators, and consumers organize and structure known methods to accelerate the control of emerging contact allergens.

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“…Information on the prevalence of hand eczema, contact sensitivity and contact dermatitis in the general population can be obtained from cross-sectional studies that were performed recently (Thyssen et al, 2009;Nielsen et al, 2001aNielsen et al, , 2001bMortz et al, 2001;Sosted et al, 2005;Lerbaek et al, 2007). Several studies have investigated the incidence of hand eczema in the general population (Bo et al, 2008;Hald et al, 2008;Moberg et al, 2009;Lind et al, 2007).…”

Section: Hand Eczema In the General Populationmentioning

confidence: 99%