Contact allergy to fragrances: frequencies of sensitization from 1996 to 2002. Results of the IVDK*

Abstract

Increasing frequencies of sensitization to the fragrance mix (FM) have been acknowledged as a serious problem for many years. It is well known that the single compounds (SCs) of the FM contribute differently to the FM patch rest reactions. In this study, we were interested in the time trends of the FM, the SCs, Myroxylon pereirae resin (MP; balsam of Peru) and oil of turpentine (OT) as possible further indicators of perfume allergy and analysed the data collected by the Information Network of Departments of Dermatology multicentre project from 1996 to 2002. During the study period (1996-2002), the FM [8% petrolatum (pet.)], MP (25% pet.) and OT (1% pet.) were tested in 59,298, 59,334 and 59,478 patients, respectively. SCs were tested in a selected group of patients, ranging from n = 1083 to n = 1924 per year. A significant increase in the proportions of patients with positive reactions to FM, MP and OT between 1996 and 1998 is noted, and a significant decline from 1999 to 2002 (Cochrane Armitage trend test, P < 0.0001). The highest frequency of sensitization to the FM was 13.1% in 1999, and the lowest 7.8% in 2002. The number of concomitant reactions to OT, a surrogate marker for terpenes, in FM-positive patients was significantly increased between 1997 and 1999. Reactions to SCs in FM-positive patients were observed in 29.9% (oak moss absolute) to 5.9% (geraniol). There was no time trend in reactions to SCs, although the relative share was increased for isoeugenol, cinnamic aldehyde and geraniol in 1999. In summary, we report for the first time, a significant decline in sensitization to the FM, very probably due to a reduced exposure (less potent allergens used in fine fragrances, possibly less use of natural ingredient-based cosmetics and lowered use concentration of important fragrance allergens). The differences in ranking of SCs could stimulate (a) a redefinition of the FM and (b) a differentiated preventive and regulatory approach, with oak moss and isoeugenol being regulated strictly by prohibition, concentration limits further reconsidered and/or health warnings and clearly less noxious substances like geraniol treated less restrictively.

Fragrance Compound Geraniol Forms Contact Allergens on Air Exposure. Identification and Quantification of Oxidation Products and Effect on Skin Sensitization

“…Geraniol gives a higher frequency of positive reactions compared to limonene and linalool (8), and pure geraniol shows a higher sensitizing potency in the LLNA compared to pure linalool (3) and pure limonene (unpublished results), which means that allergic reactions to geraniol could occur. The metabolic oxidation of alcohols to aldehydes is known (40), and another possible route for hapten formation from geraniol is via metabolism in the skin to geranial.…”

“…One of the fragrance chemicals included in FM I is geraniol (trans-3,7-dimethyl-2,6-octadiene-1-ol) 2 ( Figure 1). It is considered to be a weak allergen and is responsible for only 5% of the positive patch test reactions to the individual compounds of FM I (8). Geraniol occurs naturally in large amounts in various plant materials, for example, in rose, citronella, and palmarosa.…”

‘Read this and be safe!’ Comparison of regulatory processes for communicating risks of personal care products to European and South African consumers

“…Even some natural substances added to these products can be sensitizers or irritants (e.g., fragrances; [9]). Some examples of health effects associated with common ingredients used in PCPs are endocrine disruption [10][11][12][13], allergies [9,[14][15][16][17][18][19], associations with asthma [10] and birth defects [20]. Although, not all consumers develop obvious negative effects when using PCPs and benefit from these products, some persons suffer considerable health problems from the hazardous ingredients in PCPs.…”

Design and Feasibility of an International Study Assessing the Prevalence of Contact Allergy to Fragrances in the General Population: The European Dermato-Epidemiology Network Fragrance Study

“…Moreover, one controversial issue is the reliability of reactions to a fragrance mix [18,19,20]. On one hand, a fragrance mix represents recognized fragrance materials; on the other hand, there are concerns that positive reactions to the fragrance mix really reflect contact sensitization to individual constituents.…”