Nickel allergy following European Union regulation in Denmark, Germany, Italy and the U.K

TY - JOUR

T1 - Nickel allergy following European Union regulation in Denmark, Germany, Italy and the U.K

AU - Garg, S

AU - Thyssen, J P

AU - Uter, W

AU - Schnuch, A

AU - Johansen, J D

AU - Menné, T

AU - Belloni Fortina, A

AU - Statham, B

AU - Gawkrodger, D J

PY - 2013/10

Y1 - 2013/10

N2 - Background Nickel allergy is common worldwide. It is associated with hand dermatitis, and sensitization is often induced by nickel-releasing jewellery. The European Union (EU) introduced legislation to control nickel content and release from jewellery and other consumer items through the EU Nickel Directive 1994, which came into force in 2001 and is now part of the REACH regulation. Objectives To examine the effects of the EU nickel regulations on the prevalence of nickel allergy in four European countries. Methods Nickel patch-test data from 180 390 patients were collected from national databases in Denmark, Germany, Italy and the U.K. from between 1985 and 2002 to 2010. Patients with suspected allergic contact dermatitis who had been patch tested with nickel sulfate 5% in petrolatum were included in the analysis. The main outcomes studied were the percentage of positive results to nickel patch tests, and changes in trends with time in an age- and sex-stratified analysis. Results A statistically significant decrease in nickel allergy was observed in Danish, German and Italian women aged below 30 years. In female patients in the U.K. this was observed between 2004 and 2010. In young men, a statistically significant decrease in nickel allergy was observed in Germany and the U.K., whereas a nonsignificant increase was observed in Italy. Conclusions There has been a reduction in the prevalence of nickel allergy in young women, contemporaneous with the introduction of the nickel regulation. A reduction is also suggested in men in Germany and the U.K. A causative effect of the regulatory intervention is the most likely explanation. What's already known about this topic? Nickel allergy affects 10-15% of women in the general population and is associated with hand eczema. Previous studies have shown a decrease in nickel allergy in young women in Denmark and Germany since regulations to control nickel release were implemented. What does this study add? Postregulation, a significant decrease in nickel allergy was seen in women with suspected dermatitis aged below 30 years in all four countries studied, and in men aged below 30 years in the U.K. and Germany, although an increase was seen in young Italian men. This study of 180 390 patients shows that the EU nickel regulations are starting to reduce nickel allergy in young men and women, although allergy remains prevalent and more work needs to be done to improve compliance with the regulations.

AB - Background Nickel allergy is common worldwide. It is associated with hand dermatitis, and sensitization is often induced by nickel-releasing jewellery. The European Union (EU) introduced legislation to control nickel content and release from jewellery and other consumer items through the EU Nickel Directive 1994, which came into force in 2001 and is now part of the REACH regulation. Objectives To examine the effects of the EU nickel regulations on the prevalence of nickel allergy in four European countries. Methods Nickel patch-test data from 180 390 patients were collected from national databases in Denmark, Germany, Italy and the U.K. from between 1985 and 2002 to 2010. Patients with suspected allergic contact dermatitis who had been patch tested with nickel sulfate 5% in petrolatum were included in the analysis. The main outcomes studied were the percentage of positive results to nickel patch tests, and changes in trends with time in an age- and sex-stratified analysis. Results A statistically significant decrease in nickel allergy was observed in Danish, German and Italian women aged below 30 years. In female patients in the U.K. this was observed between 2004 and 2010. In young men, a statistically significant decrease in nickel allergy was observed in Germany and the U.K., whereas a nonsignificant increase was observed in Italy. Conclusions There has been a reduction in the prevalence of nickel allergy in young women, contemporaneous with the introduction of the nickel regulation. A reduction is also suggested in men in Germany and the U.K. A causative effect of the regulatory intervention is the most likely explanation. What's already known about this topic? Nickel allergy affects 10-15% of women in the general population and is associated with hand eczema. Previous studies have shown a decrease in nickel allergy in young women in Denmark and Germany since regulations to control nickel release were implemented. What does this study add? Postregulation, a significant decrease in nickel allergy was seen in women with suspected dermatitis aged below 30 years in all four countries studied, and in men aged below 30 years in the U.K. and Germany, although an increase was seen in young Italian men. This study of 180 390 patients shows that the EU nickel regulations are starting to reduce nickel allergy in young men and women, although allergy remains prevalent and more work needs to be done to improve compliance with the regulations.

U2 - 10.1111/bjd.12556

DO - 10.1111/bjd.12556

M3 - Journal article

C2 - 23909687

SN - 0007-0963

VL - 169

SP - 854

EP - 858

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 4

ER -