Self-reported Nickel Allergy among Schoolchildren: Trends in Prevalence, Risk Factors, and Atopic Comorbidity

Nickel allergy is common among children. The present study investigated prevalence trends of self-reported nickel allergy, risk factors, and atopic comorbidity among children. Eight-year-old children from Norrbotten County, Sweden, were recruited in 1996 (n = 3,430), 2006 (n = 2,585), and 2017 (n = 2,785). Self-reported nickel allergy decreased from 7.7% (2006) to 6.1% (2017; p = 0.024) and was significantly more common among girls. In 1996, only children with atopic dermatitis answered questions on nickel allergy. Among children with atopic dermatitis, no significant decrease was seen over the years 1996 to 2017. Ear piercing (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.39-2.68 and OR 5.57, 95% CI 3.71-8.38) and female sex (OR 4.05, 95% CI 2.68-6.13 and OR 1.73, 95% CI 1.09-2.74) were risk factors for self-reported nickel allergy in 2006 and 2017, respectively. Self-reported nickel allergy was significantly more prevalent among children with atopic dermatitis than without in 2006 (12.3% vs 6.4%; p < 0.001) and 2017 (11.5% vs 5.1%; p < 0.001), and among children with allergic rhinitis in 2017 (8.6% vs 4.7%; p = 0.015). In conclusion, we found a decreasing prevalence of self-reported nickel allergy, but not among children with atopic dermatitis. Ear piercing and female sex were strongly associated with nickel allergy. Our findings also suggest that nickel allergy is associated with atopic dermatitis and allergic rhinitis.

Nickel release from metallic earrings: A survey of the Danish market and validation of the nickel spot test

BACKGROUND

Exposure to nickel-releasing ear-piercing jewellery may explain the persistently high prevalence of nickel allergy in Europe. While nickel release from earrings is regulated, field studies show that the regulation is not always respected. More knowledge is needed regarding the risk of piercing exposure including suitable screening methods.

OBJECTIVE

To examine the proportion of earrings on the Danish market that release more nickel than allowed, and to validate the use of the dimethylglyoxime (DMG) test as a screening tool.

METHODS

A total of 304 earrings were purchased and tested with the DMG test and X-ray fluorescence spectrometry. The level of nickel release was quantified in a selected subsample of 100 earrings by the European reference test EN 1811. The DMG spot test was validated against EN 1811 at different thresholds.

RESULTS

Excessive nickel release according to the European regulation was found in 45 (14.8%) tested earrings. The sensitivity of the DMG test decreased with reduced levels of nickel release (sensitivity of 45.2% at ≥0.2 μg/cm2 /week vs 61.1% at >0.5 μg/cm2 /week).

CONCLUSION

Excessive nickel release is common in earrings on the Danish market. Because of low sensitivity, the DMG test has limited use in screening of earrings for research but may still be used clinically.

A Comprehensive Artificial Sweat Study for Quantitation of Nickel and Other Inorganic Elements Released from Imitation Earrings Purchased in Istanbul Market

Element sensitization is frequent cause of allergic contact dermatitis, and Ni is the main reason for this condition owing to daily use of different Ni-containing items. European Union established a limit of 0.2 μg/cm²/week Ni release for the items by the Ni Directive in 2004. The aim of this study was to determine the amount of element release of imitation earrings sold in different points of Istanbul with different prices and consider the element release levels including 29 trace and toxic elements. After calculation of released nickel amounts, 31.80% of earrings (71 of 223) were observed over the limit of European Commission Directive's migration limit. Minimum and maximum nickel release amounts were found as 0.21 and 30.11 μg/cm²/week, respectively, and mean level was found 3.24 μg/cm²/week among 71 positive earrings. Results showed that essential part of imitation earrings used especially by women release nickel particles over the European Commission Directive's migration limit. In addition, other elements such as Cu, Cr, and Co were found to be in the structure of the imitation earrings, as well as high amounts of toxic element Pb.

Patch testing in Lao medical students

Background

Dermatological services in Laos, South East Asia are limited to the capital and patch testing is currently not available, so no data exists regarding the common cutaneous allergens in this population.

Objectives

The aim of this study was to document positive patch tests in medical students without evidence of contact dermatitis in Laos.

Patients/Materials/Methods

One hundred and fifty medical students were patch tested using TRUE Test^® panels 1 to 3 (35 allergens). Readings were taken at Days 2 and 4.

Results

Thirty-eight students (25.3%) had a positive reaction to at least one allergen, accounting for 52 reactions in total. The proportion of the students with positive patch test reading was significantly higher in the female [33/96 (34%)] than in the male [5/54 (9%)], p<0.001. The most common allergens were: nickel (10%), gold (6.6%), thiomersal (6.6%), cobalt dichloride (2%) and p-tert-Butylphenol formaldehyde resin (2%). Balsam of Peru (0.66%), black rubber mix (0.66%), Cl+Me-Isothiazolinone (0.66%), fragrance mix 1 (0.66%), quinolone mix (0.66%), methyldibromo glutaronitrile (0.66%), mercapto mix (0.66%), epoxy resin (0.66%), paraben mix (0.66%), thiuram (0.66%) and wool alcohols (0.66%) accounted for all of the other positive reactions.

Conclusion

This study represents the first documented patch test results in Lao medical students and in the adult Lao population. The results of this study will inform any future research into contact allergy in Laos and give an insight into the background level of contact sensitivity in this population.

Nickel dermatitis from earrings 15 years after EU directive implementation: a clinical-epidemiological study and a market survey in Rome, Italy

BACKGROUND

Nickel (Ni) dermatitis remains a highly prevalent allergic condition in Italy. There is a continuous need for clinical and epidemiological surveillance to evaluate whether or not European Ni Directive has been effective in contact allergy prevention.

OBJECTIVES

To assess the prevalence of Ni dermatitis among patch-tested patients and self-interviewed school students and to analyse Ni release from earlobe jewellery.

METHODS

Results of patch tests performed in 2006-2007, 2015-2016 and 2017-2018 were retrieved. A questionnaire was compiled by 315 secondary school students. Ni release from earring parts was analysed with the EN1811:2015 method.

RESULTS

A significant time trend of decreasing Ni positivity from 2006-2007 to 2017-2018 was observed both in the overall population (44.1% in 2006-2007, 33.0% in 2015-2016, 31.6% in 2017-2018, P < 0.0001) and in female patients (P < 0.0001). Conversely, change was not significant in males (P = 0.16). Decrease was significant for all age groups, except for those aged >60 years (P = 0.51). Among 242 students who reported earring use, 130 (54%) reported symptoms at earlobes, mostly associated with jewellery of materials other than gold and silver (59% of those with earlobe symptoms). Ni release exceeded the migration limit in 4/21 (20%) earring parts.

CONCLUSIONS

A high prevalence of Ni dermatitis and earlobe symptoms were found in Rome. A decreasing time trend was noted, with a significant decline in Ni sensitivity compared to the situation observed right after Ni Directive implementation. This most likely represents the consequence of reduced Ni content in earring parts, although a major care in the use of Ni-containing objects could contribute to explain these findings.

Affinity induced immobilization of adenylate cyclase from the crude cell lysate for ATP conversion

The development of an orientation immobilization technique via affinity between polyhistidine tags and metal ions aims at maintaining biocatalytic activity of the enzymes. In this work, to tackle the issue of the immobilization of adenylate cyclase (AC), a simple and effective approach of synthesizing iminodiacetic acid (IDA)-Ni²⁺ particles was applied for simultaneously purifying and immobilizing his-tagged AC. We chose agarose particles as carriers, and then decorated them with IDA, leading to the formation of a coordination combination of Ni²⁺. The porous carriers with a large pore size of 50 nm and a specific surface area of 45.8 m²/g exhibited favorable enzymatic activity and loading capacity. The optimal pH of the immobilized enzyme increased from 8.0 to 9.0 and the optimal temperature increased from 30 °C to 35 °C, compared to the free AC. Moreover, the immobilized AC retained a residual activity of approximately 80% after storing it at 25 °C for 48 h, whereas only 40% of the activity was left in the free AC at the same conditions. Maximum yield of cyclic adenosine-3', 5'- monophosphate (cAMP) reached up to the summit of the reaction. The immobilized AC by affinity adsorption will provide a promising route for the industrial production of cAMP.

Assessment of nickel and cobalt release from jewelry from a non-nickel directive country

BACKGROUND

A directive restricting nickel release from jewelry and other skin-contact products has not been initiated in Thailand or in the United States. The prevalence of nickel and cobalt allergies is increasing, and the main cause of sensitization seems to be jewelry.

OBJECTIVES

We aimed to investigate nickel and cobalt release from jewelry available in Thai marketplaces and to study the factors associated with nickel and cobalt release.

METHODS

Used costume jewelry items were collected from volunteers. They were tested with the dimethylglyoxime and cobalt tests.

RESULTS

Five hundred fifty-one items, including belt buckles, bracelets, earrings, necklaces, rings, and watches, were tested; 216 (39.2%) gave positive dimethylglyoxime tests, and 206 (37.4%) gave positive cobalt tests. The factors that determined nickel or cobalt release were shopping location and jewelry price. Cobalt-containing jewelry could be identified by its dark color.

CONCLUSIONS

A large proportion of the jewelry sold in Thai markets release nickel or cobalt.

Risk assessment for nickel contact allergy

Nickel is one of the most common allergens causing allergic contact dermatitis worldwide. The aim of the study was to evaluate the contributing factors to nickel contact allergy (NiCA) in Asians who have a unique culture and lifestyle. We randomly selected 324 previously patch-tested patients, 162 nickel patch test (PT)-positive patients and 162 nickel PT-negative patients. The patients were telephone interviewed for their lifestyle information. Most of the nickel PT-positive patients (93.2%) were female with a mean age of 38.9 ± 13.3 years compared with the other group of nickel PT-negative patients who had a smaller proportion of females (76.5%) with an older mean age of 44.1 ± 14.9 years (P = 0.001). Multivariate analysis was able to establish that the significant risk factors for NiCA were female sex (odds ratio [OR], 6.38; 95% confidence interval [CI], 2.15-18.94), young age (OR, 0.98; 95% CI, 0.96-1.00), occupation with long periods of exposure to metal (OR, 3.08; 95% CI, 1.18-8.02), seafood (OR, 1.96; 95% CI, 1.17-3.27) and canned food consumption (OR, 3.12; 95% CI, 1.17-8.33) (P < 0.05). The adjusted factors found to associate with NiCA were female sex, young age, occupation with long periods of exposure to metal, seafood and canned food consumption.

Mobile Phone Dermatitis in Children and Adults: A Review of the Literature

Background: Mobile phones have been reported to cause allergic contact dermatitis (ACD). Methods: A comprehensive online literature review was conducted through the National Library of Medicine (Pubmed MEDLINE) using appropriate medical subject headings and keywords. Results: Thirty-seven cases of mobile phone-related ACD were found. Six studies evaluating allergen release from mobile phones were found. Conclusions: Case reports of mobile phone-associated ACD have risen rapidly in number since 2000. Case reports highlight mobile phone ACD in both pediatric and adult populations in many countries. Metal allergens, notably nickel and chromium, were frequently implicated in mobile phone associated ACD. Nickel release from mobile phones appears to be common and has been reported in both cheap and expensive mobile phones, including phones covered under the EU Nickel Directive.

Nickel and cobalt release from jewellery and metal clothing items in Korea

BACKGROUND

In Korea, the prevalence of nickel allergy has shown a sharply increasing trend. Cobalt contact allergy is often associated with concomitant reactions to nickel, and is more common in Korea than in western countries.

OBJECTIVE

The aim of the present study was to investigate the prevalence of items that release nickel and cobalt on the Korean market.

MATERIALS AND METHODS

A total of 471 items that included 193 branded jewellery, 202 non-branded jewellery and 76 metal clothing items were sampled and studied with a dimethylglyoxime (DMG) test and a cobalt spot test to detect nickel and cobalt release, respectively.

RESULTS

Nickel release was detected in 47.8% of the tested items. The positive rates in the DMG test were 12.4% for the branded jewellery, 70.8% for the non-branded jewellery, and 76.3% for the metal clothing items. Cobalt release was found in 6.2% of items. Among the types of jewellery, belts and hair pins showed higher positive rates in both the DMG test and the cobalt spot test.

CONCLUSION

Our study shows that the prevalence of items that release nickel or cobalt among jewellery and metal clothing items is high in Korea.

The cost of nickel allergy: a global investigation of coin composition and nickel and cobalt release

BACKGROUND

Nickel is widely used in coins; nickel may cause contact allergy and allergic contact dermatitis in those who handle them.

OBJECTIVES

To investigate alloy use, coin composition and nickel and cobalt release for a worldwide selection of currently circulating coins.

MATERIALS AND METHODS

Eight hundred and fifty coins of 361 different denominations or issues from 52 countries were collected and analysed with X-ray fluorescence spectrometry and nickel and cobalt spot tests.

RESULTS

Copper-nickel was the most frequently identified coin alloy, being observed in 100 denominations (28%), followed by aluminium-bronze (62, 17%). In total, 239 denominations released nickel (28%). Coins from Bolivia, Brazil and Costa Rica did not release nickel. Fewer than one-third of the denominations or issues from China, India, the euro area and Indonesia released nickel. In the United States, the Russian Federation, Japan, and Mexico, one-third or more of the denominations released nickel.

CONCLUSIONS

This worldwide selection of circulating coins covered countries with 75% of the world population, and shows that the majority of the world population lives in countries where coins release nickel. Pertinently, ∼ 40% of circulating coin denominations do not release nickel.

Surveillance of contact allergies: methods and results of the Information Network of Departments of Dermatology (IVDK)

Contact allergy (CA) surveillance networks provide information to a multitude of stakeholders, which is indispensable for evidence-based decision-making in the field of prevention. Methods and results of the German surveillance system on CA are reviewed and discussed with reference to other systems. The German network structure comprises 56 departments of dermatology and includes all patients who are patch-tested for suspected CA. Data analysis considers the results of patch testing and further pertinent information for each patient. Following aspects are addressed: (i) the description of the clinical population, (ii) evaluation of patch test reactions, (iii) relationship between patch test results and population characteristics. Trend analyses on chromate (decreasing), epoxy resin (increasing) and nickel (heterogeneous) served as examples for surveillance system analyses, with the identification of sentinel events, as well as proof of success or failure of prevention. In addition, external data sources can be used such as sales data of patch test preparations to estimate frequencies of sensitization on a population level. National prescription data of drugs and statistics of labelling of preservatives on cosmetics can be included, the latter two approaches allowing for risk estimates conferred by specific allergens.