The EU Nickel Directive revisited-future steps towards better protection against nickel allergy

Abstract

In July 2001, the EU Nickel Directive came into full force to protect European citizens against nickel allergy and dermatitis. Prior to this intervention, Northern European governments had already begun to regulate consumer nickel exposure. According to part 2 of the EU Nickel Directive and the Danish nickel regulation, consumer items intended to be in direct and prolonged contact with the skin were not allowed to release more than 0.5 µg nickel/cm2/week. It was considered unlikely that nickel allergy would disappear altogether as a proportion of individuals reacted below the level defined by the EU Nickel Directive. Despite this, the EU Nickel Directive part 2 was expected to work as an operational limit that would sufficiently protect European consumers against nickel allergy and dermatitis. This review presents the accumulation of epidemiological studies that evaluated the possible effect of this major public health intervention. Also, it evaluates recent exposure assessment studies that have been performed using the dimethyl glyoxime test. It is concluded that the EU Nickel Directive has started to change the epidemiology of nickel allergy in Europe but it should be revisited to better protect consumers and workers since nickel allergy and dermatitis remain very frequent.

Alergia de Contacto a Metais num Período de 20 Anos no Centro de Portugal: Implicações das Directivas Europeias

“…15,[21][22][23] No entanto, a aplicação destas medidas preventivas tem exercido efeitos positivos na sensibilização, reduzindo significativamente a percentagem da população sensibilizada ao Ni, sobretudo nos países nórdicos, pioneiros nesta iniciativa. 14,15,24 Comprovando o interesse destas medidas verifica-se que a sensibilização ao Ni na Dinamarca é significativamente inferior nas mulheres jovens cujas orelhas foram furadas depois da implementação destas medidas que regulamentam a quantidade de níquel libertada pelos adornos metálicos (odds ratio 1,20 vs 3,34).…”

“…13 Desde a introdução destas Directivas comunitárias, nos países nórdicos tem havido uma diminuição da sensibilização aos metais. 14,15 A aplicabilidade destas medidas e o seu grau de impacto permanece por avaliar em Portugal.…”

Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

“…jewellery often results in skin sensitization and dermatitis at the site of skin contact. Several field studies have recently demonstrated that nickel release in concentrations that result in sensitization and dermatitis remains common in Europe and the United States (Thyssen and Menne 2010;Thyssen et al 2011b). …”

Allergic Contact Dermatitis in Children

“…The proportion of positive patch test reactions to nickel sulfate has remained stable at 10%-20% among young female German dermatitis patients (< 18 years) since the beginning of the new millennium (Schnuch et al, 2011 (Uter et al, 2009). There may be several explanations for this finding (Thyssen et al, 2011), but it is generally accepted that excessive nickel release from consumer items is one of the most important single factors (Schnuch & Uter, 2003).…”