Original Article

Nickel allergy from adolescence to adulthood in the TOACS cohort

Corresponding Author

Charlotte G. Mortz

Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, DK-5000 Odense C, Denmark

Charlotte G. Mortz, Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, DK-5000 Odense C, Denmark. Tel: +45 65415025; Fax: +45 66123819. E-mail: [email protected]Search for more papers by this author

Carsten Bindslev-Jensen,

Carsten Bindslev-Jensen

Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, DK-5000 Odense C, Denmark

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Klaus E. Andersen,

Klaus E. Andersen

Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, DK-5000 Odense C, Denmark

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Charlotte G. Mortz,

Corresponding Author

Charlotte G. Mortz

Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, DK-5000 Odense C, Denmark

Carsten Bindslev-Jensen,

Carsten Bindslev-Jensen

Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, DK-5000 Odense C, Denmark

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Klaus E. Andersen,

Klaus E. Andersen

Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, DK-5000 Odense C, Denmark

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First published: 22 May 2013

https://doi.org/10.1111/cod.12055

Citations: 38

Conflicts of interest: The authors have declared no conflicts. Funding: This work was supported by Aage Bang's Foundation, and Odense University Hospital Research Council. SmartPractice Denmark donated TRUE Test® and supplied the nickel dilution series.

Disclosure: Klaus E. Andersen is an advisor and Charlotte G. Mortz is an investigator for SmartPractice, Denmark.

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Summary

Background In 1995, we established a cohort of 1501 unselected eighth-grade schoolchildren to investigate the course of nickel allergy into adult life.

Objectives To follow the course of nickel allergy and clinically relevant nickel dermatitis over 15 years from adolescence to adulthood, and the effect of ear piercing, atopic dermatitis and degree of nickel patch test reactivity.

Methods One thousand two hundred and six young adults from the cohort were asked to complete a questionnaire and participate in a clinical examination including patch testing with TRUE Test® including a nickel dilution series.

Results The questionnaire was answered by 899 (74.6%), and 442 (36.7%) had patch tests performed. The point prevalence of nickel allergy was 11.8% (clinical relevance 80.8%). The 15-year incidence rate was 6.7%. Most new sensitizations were clinically relevant with strong reactions, and many participants reacted to low concentrations. Only a few positive reactions were lost. Nickel allergy was more common among women with childhood atopic dermatitis, whereas no association with ear piercing was found. However, there was a significantly higher prevalence of nickel allergy among women ear pierced before implementation of the nickel regulation in Denmark.

Conclusion This follow-up study in young adults 15 years after leaving primary school showed a high prevalence and a high incidence rate of nickel allergy, despite the nickel regulation. Most reactions from childhood could be reproduced and were clinically relevant. In women, childhood atopic dermatitis was associated with nickel allergy in adulthood, whereas only ear piercing before the Danish nickel regulation was associated with adult nickel allergy.

References

1 Mortz C G, Lauritsen J M, Bindslev-Jensen C, Andersen K E. Prevalence of atopic dermatitis, asthma, allergic rhinitis, and hand and contact dermatitis in adolescents. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis Br J Dermatol 2001: 144: 523–532.
10.1046/j.1365-2133.2001.04078.x
CAS PubMed Web of Science® Google Scholar
2 Nielsen N H, Linneberg A, Menné T, Madsen F, Frolund L, Dirksen A, Jorgensen T. Allergic contact sensitization in an adult Danish population: two cross-sectional surveys eight years apart (the Copenhagen Allergy Study) Acta Derm Venereol 2001: 81: 31–34.
10.1080/000155501750208155
CAS PubMed Web of Science® Google Scholar
3 Thyssen J P, Linneberg A, Menné T, Nielsen N H, Johansen J D. Contact allergy to allergens of the TRUE-test (panels 1 and 2) has decreased modestly in the general population Br J Dermatol 2009: 161: 1124–1129.
10.1111/j.1365-2133.2009.09325.x
CAS PubMed Web of Science® Google Scholar
4 Dotterud L K, Smith-Sivertsen T. Allergic contact sensitization in the general adult population: a population-based study from Northern Norway Contact Dermatitis 2007: 56: 10–15.
10.1111/j.1600-0536.2007.00980.x
CAS PubMed Web of Science® Google Scholar
5 Schafer T, Bohler E, Ruhdorfer S, Weigl L, Wessner D, Filipiak B, Wichmann H E, Ring J. Epidemiology of contact allergy in adults Allergy 2001: 56: 1192–1196.
10.1034/j.1398-9995.2001.00086.x
CAS PubMed Web of Science® Google Scholar
6 Mortz C G, Lauritsen J M, Bindslev-Jensen C, Andersen K E. Nickel sensitization in adolescents and association with ear piercing, use of dental braces and hand eczema. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS) Acta Derm Venereol 2002: 82: 359–364.
10.1080/000155502320624096
CAS PubMed Web of Science® Google Scholar
7 Memon A A, Friedmann P S. Studies on the reproducibility of allergic contact dermatitis Br J Dermatol 1996: 134: 208–214.
10.1111/j.1365-2133.1996.tb07603.x
CAS PubMed Web of Science® Google Scholar
8 Hindsen M, Bruze M, Christensen O B. Individual variation in nickel patch test reactivity Am J Contact Dermat 1999: 10: 62–67.
10.1016/S1046-199X(99)90001-5
CAS PubMed Google Scholar
9 Schmidt M, Goebeler M. Nickel allergies: paying the Toll for innate immunity J Mol Med (Berl) 2011: 89: 961–970.
10.1007/s00109-011-0780-0
CAS PubMed Web of Science® Google Scholar
10 Larsson-Stymne B, Widstrom L. Ear-piercing –a cause of nickel allergy in schoolgirls? Contact Dermatitis 1985: 13: 289–293.
10.1111/j.1600-0536.1985.tb02580.x
PubMed Web of Science® Google Scholar
11 Nielsen N H, Menné T. Nickel sensitization and ear piercing in an unselected Danish population. Glostrup Allergy Study Contact Dermatitis 1993: 29: 16–21.
10.1111/j.1600-0536.1993.tb04530.x
CAS PubMed Web of Science® Google Scholar
12 Menné T, Rasmussen K. Regulation of nickel exposure in Denmark Contact Dermatitis 1990: 23: 57–58.
10.1111/j.1600-0536.1990.tb00093.x
CAS PubMed Web of Science® Google Scholar
13 The Commission of the European Communities. European Parliament and Council Directive 94/27/EC of 30 June 1994 amending for the 12th time Directive 76/769/EEC on the approximation of the laws, regulations and administrative provisions of the Member States relating to restrictions on the marketing and use of certain dangerous substances and preparations Off J Eur Commun 1994: 37: 1–2.
Google Scholar
14 Thyssen J P, Uter W, McFadden J, Menné T, Spiewak R, Vigan M, Gimenez-Arnau A, Lidén C. The EU Nickel Directive revisited –future steps towards better protection against nickel allergy Contact Dermatitis 2011: 64: 121–125.
10.1111/j.1600-0536.2010.01852.x
PubMed Web of Science® Google Scholar
15 Thyssen J P, Johansen J D, Menné T, Nielsen N H, Linneberg A. Nickel allergy in Danish women before and after nickel regulation N Engl J Med 2009: 360: 2259–2260.
10.1056/NEJMc0809293
CAS PubMed Web of Science® Google Scholar
16 Schnuch A, Wolter J, Geier J, Uter W. Nickel allergy is still frequent in young German females –probably because of insufficient protection from nickel-releasing objects Contact Dermatitis 2011: 64: 142–150.
10.1111/j.1600-0536.2010.01841.x
PubMed Web of Science® Google Scholar
17 Caroe C, Andersen K E, Mortz C G. Fluctuations in the prevalence of nickel and cobalt allergy in eczema patients patch tested after implementation of the nickel regulation in Denmark Contact Dermatitis 2011: 64: 126–131.
10.1111/j.1600-0536.2010.01832.x
PubMed Web of Science® Google Scholar
18 Thyssen J P, Johansen J D, Carlsen B C, Menné T. Prevalence of nickel and cobalt allergy among female patients with dermatitis before and after Danish government regulation: a 23-year retrospective study J Am Acad Dermatol 2009: 61: 799–805.
10.1016/j.jaad.2009.03.030
CAS PubMed Web of Science® Google Scholar
19 Lindberg M, Edman B, Fischer T, Stenberg B. Time trends in Swedish patch test data from 1992 to 2000. A multi-centre study based on age- and sex-adjusted results of the Swedish standard series Contact Dermatitis 2007: 56: 205–210.
10.1111/j.1600-0536.2006.01063.x
CAS PubMed Web of Science® Google Scholar
20 Thyssen J P, Menné T, Lidén C, White I R, White J, Spiewak R, Johansen J D. Excessive nickel release from earrings purchased from independent shops and street markets –a field study from Warsaw and London J Eur Acad Dermatol Venereol 2011: 25: 1021–1026.
10.1111/j.1468-3083.2010.03909.x
CAS PubMed Web of Science® Google Scholar
21 Simonsen A B, Deleuran M, Johansen J D, Sommerlund M. Contact allergy and allergic contact dermatitis in children –a review of current data Contact Dermatitis 2011: 65: 254–265.
10.1111/j.1600-0536.2011.01963.x
CAS PubMed Web of Science® Google Scholar
22 Thyssen J P, Johansen J D, Linneberg A et al. The association between null mutations in the filaggrin gene and contact sensitization to nickel and other chemicals in the general population Br J Dermatol 2010: 162: 1278–1285.
10.1111/j.1365-2133.2010.09708.x
CAS PubMed Web of Science® Google Scholar
23 Mortz C G, Bindslev-Jensen C, Andersen K E. Prevalence, incidence rate and persistence of Contact Allergy and Allergic Contact Dermatitis in the TOACS cohort: a 15 years follow-up Br J Dermatol 2013: 168: 318–325.
10.1111/bjd.12065
CAS PubMed Web of Science® Google Scholar
24 Susitaival P, Kanerva L, Hannuksela M, Jolanki R, Estlander T. Tuohilampi questionnaire for epidemiological studies of contact dermatitis and atopy People Work 1996: 10: 1–26.
Google Scholar
25 Schultz Larsen F, Diepgen T, Svensson Å. The occurrence of atopic dermatitis in north Europe: an international questionnaire study J Am Acad Dermatol 1996: 34: 760–764.
10.1016/S0190-9622(96)90009-2
CAS PubMed Web of Science® Google Scholar
26 Susitaival P, Flyvholm M A, Meding B, Kanerva L, Lindberg M, Svensson A, Olafsson J H. Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure Contact Dermatitis 2003: 49: 70–76.
10.1111/j.0105-1873.2003.00159.x
CAS PubMed Web of Science® Google Scholar
27 Lindberg M, Matura M. Patch testing In: Contact Dermatitis, J D Johansen, P J Frosch, J P Lepoittevin (eds): Berlin, Heidelberg, Springer-Verlag, 2011: pp. 439–464.
10.1007/978-3-642-03827-3_24
Web of Science® Google Scholar
28 Wilkinson D S, Fregert S, Magnusson B et al. Terminology of contact dermatitis Acta Derm Venereol 1970: 50: 287–292.
CAS PubMed Web of Science® Google Scholar
29 Mortz C G, Lauritsen J M, Bindslev-Jensen C, Andersen K E. Contact allergy and allergic contact dermatitis in adolescents: prevalence measures and associations. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS) Acta Derm Venereol 2002: 82: 352–358.
10.1080/000155502320624087
PubMed Web of Science® Google Scholar
30 Thyssen J P, Johansen J D, Menné T, Nielsen N H, Linneberg A. Effect of tobacco smoking and alcohol consumption on the prevalence of nickel sensitization and contact sensitization Acta Derm Venereol 2010: 90: 27–33.
10.2340/00015555-0772
PubMed Web of Science® Google Scholar
31 Thyssen J P, Menné T, Johansen J D. Nickel release from inexpensive jewelry and hair clasps purchased in an EU country –are consumers sufficiently protected from nickel exposure? Sci Total Environ 2009; 407: 5315–5318.
10.1016/j.scitotenv.2009.06.034
CAS PubMed Web of Science® Google Scholar
32 Josefson A, Farm G, Meding B. Validity of self-reported nickel allergy Contact Dermatitis 2010: 62: 289–293.
10.1111/j.1600-0536.2010.01702.x
CAS PubMed Web of Science® Google Scholar
33 Fors R, Persson M, Bergstrom E, Stenlund H, Stymne B, Stenberg B. Nickel allergy –prevalence in a population of Swedish youths from patch test and questionnaire data Contact Dermatitis 2008: 58: 80–87.
10.1111/j.1600-0536.2007.01257.x
CAS PubMed Web of Science® Google Scholar
34 Madsen J T, Andersen K E. Outcome of a second patch test reading of TRUE test on D6/7 Contact Dermatitis 2013: 68: 94–97.
10.1111/cod.12004
PubMed Web of Science® Google Scholar
35 Jensen C D, Andersen K E. Course of contact allergy in consecutive eczema patients patch tested with TRUE Test panels 1 and 2 at least twice over a 12-year period Contact Dermatitis 2005: 52: 242–246.
10.1111/j.0105-1873.2005.00555.x
CAS PubMed Web of Science® Google Scholar
36 Nielsen N H, Linneberg A, Menné T, Madsen F, Frolund L, Dirksen A, Jorgensen T. Incidence of allergic contact sensitization in Danish adults between 1990 and 1998; the Copenhagen Allergy Study, Denmark Br J Dermatol 2002: 147: 487–492.
10.1046/j.1365-2133.2002.04668.x
CAS PubMed Web of Science® Google Scholar
37 Thyssen J P, Linneberg A, Engkilde K, Menné T, Johansen J D. Contact sensitization to common haptens is associated with atopic dermatitis: new insight Br J Dermatol 2012: 166: 1255–1261.
10.1111/j.1365-2133.2012.10852.x
CAS PubMed Web of Science® Google Scholar

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Volume68, Issue6

June 2013

Pages 348-356

Nickel allergy from adolescence to adulthood in the TOACS cohort

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Nickel allergy from adolescence to adulthood in the TOACS cohort

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