Changes in the pattern of sensitization to common contact allergens in Denmark between 1985–86 and 1997–98, with a special view to the effect of preventive strategies

Abstract

The objective of the present study is to describe any changes in the prevalence of sensitization to common contact allergens in patch-tested patients over a 12-year period. Attention is given to possible effects of preventive strategies introduced in Denmark regarding nickel and chromate sensitization during that period, and particular areas of concern are identified. Members of the Danish Contact Dermatitis Group collected patch-test results from consecutive eczema patients as well as information about exposures and demographic variables over a 6-month period in 1985-86. The investigation was repeated in 1997-98 in the same clinics, at the same time of year, using identical methods and patch-test substances, including nickel sulphate 5%, potassium dichromate 0.5% and fragrance mix 8%. Nickel was the most common contact allergen in both study periods, followed by the fragrance mix. In children 0-18 years of age, the frequency of nickel allergy decreased from 24.8% in the first study period to 9.2% in the second study period (P < 0. 0008). Fragrance mix allergy doubled in frequency from 4.1% in 1985-86 to 9.9% in 1997-98, an increase that affected all age groups. Contact allergy to potassium dichromate decreased significantly from 3.0% in the first period to 1.2% in the second period (P = 0. 001). The decrease was seen in both sexes and was most pronounced among those of working age. No other significant changes were found in the frequency of sensitization to common allergens over the 12-year observation period.

Nickel release from earrings purchased in the United States: The San Francisco earring study

“…32 Although this may be explained by changing confounding variables, the increase is steepest during the 1980s (which is in accordance with patch test results from Europe). 14,15,33 Finally, nickel continues to be responsible for clinical disease among young US residents. 34 Thus, there are indications to suggest that many US residents are continuously exposed to nickel and that the nickel epidemic remains to be sufficiently managed.…”

“…14,[16][17][18] Unfortunately, reports demonstrate that the EU directive is not always followed, [37][38][39] although violation of the nickel directive may lead to fines, detention, and even imprisonment. Nevertheless, it is foreseen that an effect from these directives could prevent nickel sensitization in millions of EU citizens.…”

“…8 In 1990 and 1994, respectively, nickel directives were passed in Denmark and the European Union (EU) to diminish nickel release in consumer products. 12,13 The effect of these directives has so far been suggested in clinical [14][15][16] and populationbased 17,18 material. Because no such directive exists in the Unites States, we decided to purchase and examine costume earrings from a US city.…”

The prevalence of allergic contact sensitization in a general population in Tromso, Norway

“…A recent Danish study of schoolgirls suggested that implementation of the nickel-exposure regulation from the early 1990s protected females from becoming sensitized to nickel (23). This trend has not been seen in adults yet, but a falling rate of sensitization is expected in Europe (18).…”

“…Indeed, some highly relevant allergens then were missed. However, the allergens of Panel 1 are estimated to cover over 90% of the most relevant allergens (15,18).…”