Prevalence of contact allergy to metals: nickel, palladium, and cobalt in Southern Sweden from 1995–2016

Abstract

Background In 2001, the EU nickel directive was introduced to prevent contact allergy to nickel. Contact allergy to palladium and/or cobalt is often seen together with contact allergy to nickel. Objectives To compare the contact allergy prevalence of nickel, palladium, and cobalt allergy before and after the introduction of the EU nickel directive in consecutive patients with dermatitis. Methods A retrospective analysis of patch test results from 1995–2016 was performed (n = 18 264). Chi‐square tests were used to examine trends for nickel, palladium, and cobalt across test years. Logistic regression was used for associations. Results The prevalence of nickel allergy decreased significantly in the youngest age group (6–30 years) for both female and male patients from 1995–1999 to 2012–2016: females: 33.4% to 19.1% (P < .001); males: 5.9% to 2.1% (P < .05). The concomitant reactions between nickel and palladium and nickel and cobalt among young females, respectively, also decreased significantly. Isolated palladium and cobalt allergy remained stable (1.4% and 2.3%, respectively) during the same time period for both men and women. Conclusions The prevalence of nickel has decreased among young females and males suspected of contact allergy in Southern Sweden after the introduction of the EU nickel directive. There has been no change in isolated palladium or cobalt allergy.

Ceramic Coating in Cemented Primary Total Knee Arthroplasty is Not Associated With Decreased Risk of Revision due to Early Prosthetic Joint Infection

“…A prevalence rate of 1.1% was documented, consistent with reports in the literature [39]. There is evidence suggesting the prevalence is linked to metal exposure [40], and accordingly, metal sensitivity can be increasingly anticipated in the setting of revision surgery. Female patients with exposure to nickel containing jewellery are more likely to have metal sensitivity, thus explaining the female selection bias for ceramic-coated knee components in this study.…”

Quantification of aluminium release from Finn chambers under different in vitro test conditions of relevance for patch testing

“…Several Swedish studies are currently ongoing to investigate whether Al release from Finn chambers could influence diagnostic outcomes. This has also been discussed recently for isolated palladium allergy 23 . From a chemical point of view, release of Al from Al Finn chambers could be of concern for current patch‐test diagnostic outcomes.…”

Experimental evaluation of nickel and cobalt release from tools and self‐reported prevalence of nickel and cobalt allergy in the German hairdressing trade

“…Notwithstanding, it has also been pointed out that nickel allergy is still frequent and thus continuously poses a health risk within the EU – especially in the female population 13 . Due to the fact that there are no regulations regarding the usage restrictions of cobalt, a change in the prevalence of cobalt allergy was not witnessed 14 . Current data have shown that nickel and cobalt allergy is frequent in the professional group of hairdressers 15,16 .…”

“…The release of contact allergens from metal tools in the hairdressing trade poses a health threat to the workforce in terms of developing contact allergy and consequently allergic contact dermatitis. A decrease of the prevalence of nickel allergy in the EU has been observed after the REACH regulation has been implemented 10–14 . Notwithstanding, it has also been pointed out that nickel allergy is still frequent and thus continuously poses a health risk within the EU – especially in the female population 13 .…”