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Seidl U, Heine G. [Principles of allergy diagnostics]. Z Rheumatol 2023; 82:298-306. [PMID: 37017761 DOI: 10.1007/s00393-023-01343-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Allergies are frequent and approximately 30% of the general population in Germany are affected. The specific sensitization against an allergen is asymptomatic. On renewed allergen contact the symptoms are indicative of the underlying pathomechanism. A variety of different test procedures are available to identify allergic reactions. OBJECTIVE AND AIM In this review article the typical clinical symptoms of allergic reactions are assigned to mechanisms and possible test methods are presented and discussed. Current developments in recombinant serum diagnostics and cellular testing methods are presented.
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Affiliation(s)
- Ulrich Seidl
- Klinik für Dermatologie, Venerologie und Allergologie, am Universitätsklinikum Schleswig-Holstein Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland
| | - Guido Heine
- Klinik für Dermatologie, Venerologie und Allergologie, am Universitätsklinikum Schleswig-Holstein Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland.
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2
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Kang S, Lee K, Lim M. Estimation of multi-route exposures to various chemicals during Children's clay toy use. ENVIRONMENTAL RESEARCH 2022; 212:113500. [PMID: 35594962 DOI: 10.1016/j.envres.2022.113500] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/13/2022] [Accepted: 05/15/2022] [Indexed: 06/15/2023]
Abstract
Clay toys have been used as play materials and educational tools for children. Clay toys exhibit adherent properties, and may facilitate chemical ingestion via dermal absorption and oral (hand-to-mouth, HTM) exposures. Inhalation exposure also be considered when contain volatile chemicals. The purpose of this study was to estimate the exposure dose for chemicals in clay toys via three exposure routes, and to evaluate the relationship between the exposure contribution of each route considering both the chemical properties and children's age. Chemical analysis was conducted for 9 semi-volatile organic compounds (SVOCs), 17 volatile organic compounds (VOCs), and 7 metal elements in clay toys (n = 66) purchased from Korean market. Exposure factors for usage pattern of clay toys were conducted based on a nationally representative survey in Korea. A total of 12,144 (60.7%) children responded positively to playing with clay toys. Exposure to SVOCs and VOCs in clay toys via HTM, inhalation, and dermal absorption were estimated. The exposure level was the highest in styrene with 5.2 × 10-3 mg/kg-bw/day (95th percentile population), which was approximately 13% of the acceptable daily dose for styrene. In 3-year-old children, dermal absorption route contributed the highest at 59.2-100%. Chemicals with higher octanol-water partition coefficient (Kow) had the greater the contribution of the dermal absorption route and the weaker the contribution of the HTM route. In infants (0-2 years), the contribution via HTM exposure was higher than that in the other age groups. The contribution of inhalation exposure differed depending on the volatility of the chemicals. Furthermore, the exposure route contribution significantly differed due to age-dependent behavioral changes in children. These results suggest that the exposure assessments for children could be considered with multiple exposure routes related to chemical properties.
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Affiliation(s)
- Sohyun Kang
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Kiyoung Lee
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea; Institute of Health and Environment, Seoul National University. Seoul, South Korea
| | - Miyoung Lim
- Institute of Health and Environment, Seoul National University. Seoul, South Korea.
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3
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Bonamonte D, Hansel K, Romita P, Belloni Fortina A, Girolomoni G, Fabbrocini G, Patruno C, Napolitano M, Patrizi A, Argenziano G, Micali G, Pinton PC, Foti C, Stingeni L. Contact allergy in children with and without atopic dermatitis: an Italian multicenter study. Contact Dermatitis 2022; 87:265-272. [PMID: 35451136 PMCID: PMC9541036 DOI: 10.1111/cod.14130] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
Background Contact allergy and atopic dermatitis (AD) are both common inflammatory T cell‐mediated diseases and many factors may influence the prevalence of contact allergy in AD patients. In children, their possible correlation was debated with conflicting results. Objectives The present study aimed to assess the prevalence of contact sensitivity in children and to investigate the association with AD. Materials and methods A retrospective multicentre study on children aged from 0 to 14 years patch tested between January 2017 and December 2018 was performed. Children were consecutively patch tested with the SIDAPA (Società Italiana Dermatologia Allergologica Professionale Ambientale) baseline series. Results Among the 432 children investigated for contact allergy, 125 (28.9%) showed a positive reaction to at least one of the allergens tested, with a higher prevalence of positive patch test reactions in girls (32.3%) than in boys (25.0%). The most frequent contact allergens were nickel sulphate (10.2%), cobalt chloride (6.7%), methylisothiazolinone (3.7%), fragrance mix‐2 (3.2%), potassium dichromate (2.8%), fragrance mix‐1 (2.1%) and methylchloroisothiazolinone/methylisothiazolinone (2.1%). One‐hundred‐three children (23.8%) suffered from AD showing a higher prevalence of positive patch test (36.9%) compared to children without AD (26.4%). Conclusions Despite the topic being still controversial, the present study suggests a consistent prevalence of contact allergy among children with higher sensitivity rate among children with AD than without AD.
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Affiliation(s)
- Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Anna Belloni Fortina
- Unit of Pediatric Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Annalisa Patrizi
- Unit of Dermatology, IRCS Azienda Ospedaliero Universitaria, University of Bologna, Bologna, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | | | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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4
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Chen J, Yi Z, Sun R, Ning W, Zhou C, Tian Z, Sun C, Li Y. Analysis of Fragrance Allergens in Personal Care Products, Toys, and Water Samples: A Review. J AOAC Int 2021; 105:396-412. [PMID: 34951644 DOI: 10.1093/jaoacint/qsab156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/27/2021] [Accepted: 11/27/2021] [Indexed: 11/13/2022]
Abstract
Fragrance allergens (FAs) refer to these volatile or semi-volatile fragrance compounds that can cause irritation and negative reactions. A large number of emerging FAs are widely used in household goods, and cause contact allergy or allergic contact dermatitis in eczema population and the general population. It shows an increasing prevalence and is regarded as a concern to public health. Recently, more and more studies have focused on the analytical methods of FAs in a variety of samples with different matrices. Therefore, a systematic and comprehensive overview of recent progress of analysis of FAs in various samples is needed. In this review, the physical and chemical properties, applications, hazards, and the recent advances of sample preparation and determination methods of common FAs in personal care products, toys, and water samples are systematically and comprehensively summarized. Meanwhile, this review also discusses the advantages and limitations of different sample pretreatment and detection methods, thus offering a deep-going discussion of the development and future trends in this area.
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Affiliation(s)
- Jing Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China.,Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310057 China
| | - Zonghui Yi
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Rui Sun
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Wei Ning
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Chen Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Ziyi Tian
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Chengjun Sun
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China.,Provincial Key Laboratory for Food Safety Monitoring and Risk Assessment of Sichuan, Chengdu, 610041 China
| | - Yongxin Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China.,Provincial Key Laboratory for Food Safety Monitoring and Risk Assessment of Sichuan, Chengdu, 610041 China
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5
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Contact allergen sensitivity in children with contact dermatitis. Turk Arch Pediatr 2021; 56:51-56. [PMID: 34013230 DOI: 10.14744/turkpediatriars.2020.79577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 07/02/2020] [Indexed: 11/20/2022]
Abstract
Objective Irritant contact dermatitis and Allergic contact dermatitis are two distinct forms of contact dermatitis. Allergic contact dermatitis is a Type 4 (delayed-type) hypersensitivity reaction that occurs during subsequent contact with an allergen to a previously sensitized person. The number of allergens that cause allergic contact dermatitis is increasing day by day. Although it is not the gold standard for the detection of these allergens, skin patch testing is a very helpful method. This study aimed to determine the most common contact allergens in the pediatric age group. Material and Methods All patients with the diagnosis of contact dermatitis who underwent a skin patch test (TRUE TEST) in the department of Pediatric Allergy and Immunology between March 2017-February 2018 were enrolled in this study. The patch test was evaluated 72 hours later by the same physician and interpreted as recommended by the American Academy of Dermatology. In addition to the patient files, demographic and clinical characteristics, localization of lesions, and itch score according to visual analog scale were recorded. Results A total of 80 children enrolled in the study; 45 (56.3%) were girls and 35 (43.7%) were boys. The mean age of the children was 7.37±3.84 years and 57.5% of the patients who underwent skin patch testing had a positive response to at least one or more allergens. The most common allergens were Nickel sulfate, CI + Me-Isothiazolinone, Thiuram Mix, Formaldehyde, and P-tert-butylphenol formaldehyde resin (14.8%, 10%, 6.3%). There was no difference in terms of age, sex, duration of complaints, and pruritus score according to nickel sensitization. Conclusion In the presence of chronic dermatitis in children, allergic contact dermatitis should be considered in the differential diagnosis. The culprit allergen should be determined. Also, the most common contact allergen is Nickel Sulphate in the world and the increased sensitization to other allergens is due to the increased contact of children with cosmetics and different contact allergens.
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Mahler V, Nast A, Bauer A, Becker D, Brasch J, Breuer K, Dickel H, Drexler H, Elsner P, Geier J, John SM, Kreft B, Köllner A, Merk H, Ott H, Pleschka S, Portisch M, Spornraft-Ragaller P, Weisshaar E, Werfel T, Worm M, Schnuch A, Uter W. S3 Guidelines: Epicutaneous patch testing with contact allergens and drugs - Short version, Part 2. J Dtsch Dermatol Ges 2020; 17:1187-1207. [PMID: 31765083 DOI: 10.1111/ddg.13971] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Epicutaneous patch testing is the diagnostic standard for the detection of allergic contact dermatitis. The present guidelines are aimed at residents and board-certified physicians in the fields of dermatology and allergology as well as other medical specialties involved in establishing the indication for patch testing and its execution in patients with contact dermatitis and other forms of delayed-type hypersensitivity. The target audience also includes other health care providers and insurance funds. Based on a systematic literature search and a formal consensus process (S3), the guidelines were developed by dermatologists in collaboration with pediatricians, occupational medicine physicians, nursing staff as well as patient representatives. The systematic methodological approach and appraisal of evidence upon which the recommendations are based are outlined in a separate method report that also contains evidence tables. The guidelines address general aspects of patch testing as well as medicolegal issues. The recommendations given relate to topics such as the indication for patch testing, informed patient consent, as well as the choice of test substances, test chambers and test site, duration of exposure, reading times and interpretation of test reactions. Furthermore, recommendations are provided with respect to endogenous and exogenous factors, specific patient groups (children, pregnant women, immunosuppressed individuals) as well as possible risks and adverse events associated with patch testing using contact allergens.
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Affiliation(s)
- Vera Mahler
- Department of Dermatology, University Medical Center, Friedrich Alexander University, Erlangen, Germany.,Paul Ehrlich Institute, Langen, Germany
| | - Alexander Nast
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergology, Division of Evidence-based Medicine (dEBM), Berlin, Germany
| | - Andrea Bauer
- Department of Dermatology, University Medical Center, Dresden Technical University, Dresden, Germany
| | - Detlef Becker
- Department of Dermatology, University Medical Center, Mainz, Germany
| | - Jochen Brasch
- Department of Dermatology, Venereology und Allergology, University Medical Center, Kiel, Germany
| | - Kristine Breuer
- Dermatology Practice (Dermatologie Reinbek), Reinbek, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology und Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Hans Drexler
- Institute for Occupational, Social and Environmental Medicine, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Johannes Geier
- Information Network of Dermatology Departments in Germany (IVDK), Göttingen University Medical Center, Göttingen, Germany
| | - Swen Malte John
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Burkhard Kreft
- Department of Dermatology and Venereology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | | | - Hans Merk
- Professor of Dermatology and Allergology, Former Chairman of the Department of Dermatology, RWTH University, Aachen, Germany
| | - Hagen Ott
- Division of Pediatric Dermatology and Allergology, Children's Hospital Auf der Bult, Hannover, Germany
| | - Silvia Pleschka
- German Allergy and Asthma Foundation (Deutscher Allergie- und Asthmabund e.V.), Mönchengladbach, Germany
| | - Maria Portisch
- Department of Dermatology, University Medical Center, Friedrich Alexander University, Erlangen, Germany
| | | | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, University Medical Center, Heidelberg, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Margitta Worm
- Department of Dermatology, Venereology und Allergology, Charité - University Medicine, Berlin, Germany
| | - Axel Schnuch
- Information Network of Dermatology Departments in Germany (IVDK), Göttingen University Medical Center, Göttingen, Germany
| | - Wolfgang Uter
- Institute for Medical Informatics, Biometrics and Epidemiology (IMBE), Medical Faculty, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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Paulsen E, Andersen KE. Compositae sensitization in Danish children and adolescents. Contact Dermatitis 2020; 83:296-300. [PMID: 32542786 DOI: 10.1111/cod.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Compositae plant sensitization in children is relatively frequent. From 1995-2006, we found a prevalence of 1.8% sesquiterpene lactone (SL) mix/parthenolide patch test positives among consecutive eczema patients <18 years. OBJECTIVES To report the results of patch test screening for Compositae sensitization in patients <18 years in the last 13 years. METHODS Children and adolescents <18 years, diagnosed with Compositae sensitization between 2007 and 2019, were included. RESULTS Among 388 children tested, 12 (3%) were Compositae-sensitized, and 11 (2.8%) had positive reactions to SL mix. Compositae mix 5% pet. elicited positive reactions in six of seven patients tested, and dandelion extract 2.5% pet. in six of 10 patients tested. The mean age of the five girls and seven boys was 9.4 years and 11.7 years, respectively. Eleven children had a personal and one a family history of atopy, and 11 children had hand eczema. Only two were mono-sensitized to Compositae. CONCLUSIONS SL mix is a suitable screening agent among children and adolescents in our area, well supplemented with Compositae mix 5% and dandelion extract. The study emphasizes the importance of Compositae screening in children with a personal and/or family history of atopy, hand eczema or widespread airborne dermatitis, summer exacerbation, and plant exposure.
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Affiliation(s)
- Evy Paulsen
- Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Klaus E Andersen
- Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Belloni Fortina A, Caroppo F, Tadiotto Cicogna G. Allergic contact dermatitis in children. Expert Rev Clin Immunol 2020; 16:579-589. [DOI: 10.1080/1744666x.2020.1777858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Francesca Caroppo
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Giulia Tadiotto Cicogna
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
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Mahler V, Nast A, Bauer A, Becker D, Brasch J, Breuer K, Dickel H, Drexler H, Elsner P, Geier J, John SM, Kreft B, Köllner A, Merk H, Ott H, Pleschka S, Portisch M, Spornraft‐Ragaller P, Weisshaar E, Werfel T, Worm M, Schnuch A, Uter W. S3‐Leitlinie: Durchführung des Epikutantests mit Kontaktallergenen und Arzneimitteln – Kurzfassung Teil 2. J Dtsch Dermatol Ges 2019; 17:1187-1207. [DOI: 10.1111/ddg.13971_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Vera Mahler
- Hautklinik Universitätsklinikum ErlangenFriedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen
- Paul‐Ehrlich‐Institut Langen
| | - Alexander Nast
- Division of Evidence‐based Medicine (dEBM)Klinik für DermatologieVenerologie und AllergologieCharité – Universitätsmedizin Berlin Berlin
| | - Andrea Bauer
- Klinik und Poliklinik für Dermatologie Universitätsklinikum Carl Gustav CarusTechnische Universität Dresden Dresden
| | | | - Jochen Brasch
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Schleswig‐Holstein Kiel
| | | | - Heinrich Dickel
- Klinik für DermatologieVenerologie und AllergologieSt. Josef‐Hospital, Ruhr‐Universität Bochum Bochum
| | - Hans Drexler
- Institut für Arbeits‐Sozial‐ und Umweltmedizin der Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen
| | - Peter Elsner
- Klinik für HautkrankheitenUniversitätsklinikum Jena Jena
| | - Johannes Geier
- Informationsverbund Dermatologischer Kliniken (IVDK) e.V. an der Universitätsmedizin Göttingen Göttingen
| | - Swen Malte John
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück Osnabrück
| | - Burkhard Kreft
- Klinik und Poliklinik für Dermatologie und VenerologieUniversitätsklinikum (Saale) Halle
| | | | - Hans Merk
- Univ.‐Professor für Dermatologie & AllergologieDirektor (em.) der Hautklinik – RWTH Aachen University Aachen
| | - Hagen Ott
- Hannoversche Kinderheilanstalt (HKA): Kinder‐ und Jugendkrankenhaus auf der Bult Hannover
| | | | - Maria Portisch
- Hautklinik Universitätsklinikum ErlangenFriedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen
| | | | - Elke Weisshaar
- BerufsdermatologieHautklinikUniversitätsklinikum Heidelberg Heidelberg
| | - Thomas Werfel
- Klinik für DermatologieAllergologie und VenerologieMedizinische Hochschule Hannover Hannover
| | - Margitta Worm
- Klinik für DermatologieVenerologie und Allergologie Charité – Universitätsmedizin Berlin Berlin
| | - Axel Schnuch
- Informationsverbund Dermatologischer Kliniken (IVDK) e.V. an der Universitätsmedizin Göttingen Göttingen
| | - Wolfgang Uter
- Institut für MedizininformatikBiometrie und Epidemiologie (IMBE)Medizinische Fakultät der Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen
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Felmingham C, Davenport R, Bala H, Palmer A, Nixon R. Allergic contact dermatitis in children and proposal for an Australian Paediatric Baseline Series. Australas J Dermatol 2019; 61:33-38. [PMID: 31630402 DOI: 10.1111/ajd.13169] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/22/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) is an increasingly common diagnosis in children. The objectives of this study were to review our experience with ACD in children in tertiary settings, to ascertain the spectrum of allergens in this population and to subsequently propose the first Australian Paediatric Baseline Series for patch testing. METHODS We conducted a retrospective analysis of patch test data from 1993 to 2017 from two tertiary referral patch-testing centres in Melbourne, Victoria. RESULTS A total of 511 children were patch tested during the study period. Of these, 58.3% (298/511) of children tested had a positive patch test, and 65.1% (194/298, or 38.0% of the total) had a relevant positive patch test. The most common relevant patch test reactions were fragrance mix, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and methylisothiazolinone (MI), Myroxylon pereirae, nickel sulphate, and colophonium. CONCLUSION Allergic contact dermatitis is not uncommon in children, and patch testing should be considered in children with suspected ACD or with recalcitrant atopic dermatitis. Based on our experience over 25 years, we propose the first Australian Paediatric Baseline Series.
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Affiliation(s)
- Claire Felmingham
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, Australia
| | - Rachael Davenport
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, Australia
| | - Harini Bala
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, Australia
| | - Amanda Palmer
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, Australia
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Francuzik W, Geier J, Schubert S, Worm M. A case-control analysis of skin contact allergy in children and adolescents. Pediatr Allergy Immunol 2019; 30:632-637. [PMID: 31077617 DOI: 10.1111/pai.13069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/25/2019] [Accepted: 05/02/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Contact sensitization in children is increasing. The offending allergens differ depending on patient age and sex. We aimed to determine the sensitization profiles in children (aged 6-12) and adolescents (aged 13-18), to compare these to a control group of adults (aged 60-66), and to evaluate differences in sensitization patterns between working and non-working adolescents. PATIENTS/MATERIALS/METHODS We analyzed Information Network of Departments of Dermatology (IVDK) data from 2009 to 2016 using multiple logistic regression analysis. Of the 99 082 patients documented in the IVDK database, 591 children, 2451 adolescents and 12 122 adults were included in further analysis. RESULTS Nickel was the most frequent contact allergen among all age-groups. Children and adolescents showed significantly lower reaction rates to fragrance mix, methyldibromo-glutaronitrile, methylisothiazolinone, and propolis than adults. Positive reactions to sorbitan sesquioleate and mercapto mix among children and to cobalt among adolescents were significantly more frequent than in adults. Working adolescents had more often positive reactions to methyl(chloro)isothiazolinone (skin lesions predominantly on hands) and paraben mix (skin lesions predominantly on feet) when compared to non-working peers. Patch-tested children were more often diagnosed with atopic dermatitis than adults (P < 0.0001). CONCLUSIONS Contact allergens display age-specific patterns, which should be considered in a standardized series targeting different patient populations (children and adolescents). Employed adolescents should preferably be tested with the baseline series to optimize allergen identification.
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Affiliation(s)
- Wojciech Francuzik
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), University Medical Center Göttingen, Göttingen, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), University Medical Center Göttingen, Göttingen, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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12
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Kim JH, Seok K. Combined Assessment of Preschool Childrens' Exposure to Substances in Household Products. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E733. [PMID: 30823488 PMCID: PMC6427443 DOI: 10.3390/ijerph16050733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/21/2019] [Accepted: 02/21/2019] [Indexed: 11/24/2022]
Abstract
Understanding how indoor-air contaminants affect human health is of critical importance in our developed society. We assessed the combined exposure by inhalation of preschool children and children to household products. A total of 1175 families with 72 infants, 158 toddlers, 230 children, and 239 youths were surveyed to determine the combined respiratory exposure concentrations and amounts associated with 21 substances in eight household product groups. We determined the mean concentrations of these substances in each product, and derived reference toxicity values based on the information gathered in order to identify respiratory health risks. On average, cleaners were used at a rate of 1.0 × 10³ g/month, while coating agents and other substances were used at 43 g/month. The combined inhalation exposure concentrations of methanol to infants and toddlers were 5.1 and 4.2 mg/m³ per month, respectively, with values of 2.1 and 1.7 mg/m³ for isopropanol, respectively. Risks to preschool children and children should be assessed on the basis of the toxicity values of combined exposed hazardous substances, as well as their combined concentrations and amounts. This exposure assessment approach can be used to establish improved guidelines for products that may pose inhalation hazards to preschool children and children.
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Affiliation(s)
- Joo-Hyon Kim
- Division of Chemical Research, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, Korea.
| | - Kwangseol Seok
- Division of Chemical Research, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, Korea.
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13
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Atopic and Contact Dermatitis. Clin Immunol 2019. [DOI: 10.1016/b978-0-7020-6896-6.00044-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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14
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Yıldız H. Prevalence of dermatoses among pediatric patients in a secondary hospital in Eskisehir, Turkey: A cross-sectional study. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2018. [DOI: 10.25000/acem.438360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
BACKGROUND Contact hypersensitivity is common in adolescents, but data in the literature are limited. Adolescents often use cosmetics, wear jewelry, and obtain tattoos, which can be sources of allergens. METHODS This was a retrospective, noninterventional cohort study of 100 adolescents (aged 13-18; 74 girls, 26 boys) who were consecutively patch tested. RESULTS We detected contact hypersensitivity in 51 of the 100 patch-tested patients (51%): 52.7% of the girls and 46.2% of the boys were sensitized. The most common allergens were nickel (17%), thimerosal (12%), para-phenylenediamine (8%), cobalt (7%), and fragrance mix I (6%). Thirteen percent of the reactions did not appear until the seventh day. The majority of clinical lesions affected the hands and face. The most common contact allergens were mercury derivatives, lanolin, and para-phenylenediamine in boys and nickel, thimerosal, para-phenylenediamine, cobalt, and fragrance mix I in girls. Of the 47 adolescents with atopic dermatitis 51.1% had contact hypersensitivity. In this group, skin care product ingredients were the typical allergens (25.5%). The most common contact allergens of those with atopic dermatitis were nickel (12.8%), lanolin (10.6%), and thimerosal (8.5%). CONCLUSION Contact hypersensitivity is common in adolescents. For patients with therapy-resistant skin lesions affecting the face and hands, patch testing with an evaluation for 7 days is recommended. Our results provide the first data on frequency of contact hypersensitivity in this age group in Hungary. Metals, fragrances, mercuric derivatives, dyeing materials, and skin care products were the most common allergens.
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Affiliation(s)
| | - Erzsébet Temesvári
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - Ilona Németh
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - Miklós Sárdy
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - Györgyi Pónyai
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
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Kim JH, Lee D, Lim H, Kim T, Suk K, Seo J. Risk assessment to human health: Consumer exposure to ingredients in air fresheners. Regul Toxicol Pharmacol 2018; 98:31-40. [DOI: 10.1016/j.yrtph.2018.05.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 05/18/2018] [Accepted: 05/28/2018] [Indexed: 01/06/2023]
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17
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Warshaw EM, Aschenbeck KA, DeKoven JG, Maibach HI, Taylor JS, Sasseville D, Belsito DV, Fowler JF, Zug KA, Zirwas MJ, Fransway AF, DeLeo VA, Marks JG, Pratt MD, Mathias T. Epidemiology of pediatric nickel sensitivity: Retrospective review of North American Contact Dermatitis Group (NACDG) data 1994-2014. J Am Acad Dermatol 2018; 79:664-671. [DOI: 10.1016/j.jaad.2018.02.071] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 02/02/2018] [Accepted: 02/09/2018] [Indexed: 11/29/2022]
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18
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Contact Dermatitis in Atopic Dermatitis Children—Past, Present, and Future. Clin Rev Allergy Immunol 2018; 56:86-98. [DOI: 10.1007/s12016-018-8711-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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19
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Özçelik S, Kulaç İ, Yazıcı M, Öcal E. Distribution of childhood skin diseases according to age and gender, a single institution experience. Turk Arch Pediatr 2018; 53:105-112. [PMID: 30116131 DOI: 10.5152/turkpediatriars.2018.6431] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 02/21/2018] [Indexed: 11/22/2022]
Abstract
Aim Studies on pediatric skin diseases in Turkey are not yet sufficient. It was aimed to characterize the prevalence of skin diseases, age and gender distribution in children living in the Erzincan region. Material and Methods 10,115 children aged 0-16 years who reached to our outpatient clinic between 01.11.2014 and 30.11.2016 were included in the study. The frequency, age and gender distribution of the skin diseases were examined. The cases were divided into 4 groups; infantile period (0-2 years), preschool period (3-5 years), school period (6-11 years) and adolescence period (12-16 years). Skin diseases were categorized in 10 groups. A total of 148 skin diseases were identified. Results 5376 of the patients were female (%53.14) and 4739 were male (%46.86). The most common disease groups are; infectious diseases (24.62%), eczema (21.95%), acne&follicular diseases (18.45%) and allergic skin diseases (11.02%). The most common diseases were acne vulgaris (17.82%), warts (10.03%) and irritant contact dermatitis (9.42%). The most common skin diseases in regard of different age groups are; contact dermatitis in the 0-2 years and 3-5 years age groups, warts in the 6-11 years age group, and acne vulgaris in 12-16 years age group. Conclusion Most common diseases in our study are diseases that can be reduced by preventive health care and health education programs. There is a need for broad-based epidemiological studies in this area to establish preventive health care policies and to develop education programs.
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Affiliation(s)
- Sinan Özçelik
- Department of Dermatology, Erzincan University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey
| | - İbrahim Kulaç
- Division of Pathology, Mardin Public Hospital, Mardin, Turkey
| | - Mustafa Yazıcı
- Department of Dermatology, Erzincan University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Esra Öcal
- Department of Dermatology, Erzincan University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey
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Kim JH, Kim T, Yoon H, Jo A, Lee D, Kim P, Seo J. Health risk assessment of dermal and inhalation exposure to deodorants in Korea. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 625:1369-1379. [PMID: 29996434 DOI: 10.1016/j.scitotenv.2017.12.282] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/20/2017] [Accepted: 12/23/2017] [Indexed: 05/26/2023]
Abstract
In Korea, humidifiers that include biocidal ingredients have caused serious lung injuries and deaths. After these incidents, public concern regarding the use of chemicals in products (i.e., chemical phobia) increased. Frequent health risk assessments and stringent management of consumer products are, therefore, of paramount importance to reduce these serious occurrences. In this study, the irritative and respiratory health effects of deodorants were assessed in relation to dermal and inhalation exposure. In total, 64 deodorants were divided into 5 groups by application type, and health risk assessments were conducted on each group. In total, 26 fragrance ingredients and 27 biocidal ingredients were analyzed and assessed according to their risk to human health. Exposure assessment was performed in two steps. In the tiered 1 assessment (screening), the 95th exposure factor values were used to estimate exposure to assume the worst-case scenario. The maximum concentration in the deodorants was used without considering the application type. In the tiered 2 assessment (detail assessment), the 75th exposure factor values were used to estimate the assumed reasonable exposure to ingredients. In these assessments, the maximum concentration used in the exposure models was determined by the product purpose and application type. The values input into the exposure algorithms were developed via the exposure route. Of the selected fragrance and biocidal active ingredients, 18 fragrance and 13 biocidal ingredients were detected in the deodorants that were assessed. From the results of the tiered 1 assessment, it was necessary for tiered 2 risk assessments to be conducted for 6 ingredients for the inhalation route, and 13 ingredients for the dermal route. The inhalation margin of exposure of ingredients in deodorants of gel/trigger/spray types for home/car and fabric/air usage was above the target margin of exposure. The health risk of 6 evaluated ingredients was relatively low for the inhalation route of exposure. This study showed that the assessed ingredients have no health risks at their maximum concentrations in deodorants. The approach discussed in this study should be used to establish improved guidelines for specific ingredients in consumer products, and for setting limits for newly developed raw materials that may pose dermal and inhalation hazard.
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Affiliation(s)
- Joo-Hyon Kim
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, South Korea
| | - Taksoo Kim
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, South Korea
| | - Hyojung Yoon
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, South Korea
| | - Areum Jo
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, South Korea
| | - Daeyeop Lee
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, South Korea
| | - Pilje Kim
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, South Korea
| | - Jungkwan Seo
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, South Korea.
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Lee M, Kim JH, Lee D, Kim J, Lim H, Seo J, Park YK. Health Risk Assessment on Hazardous Ingredients in Household Deodorizing Products. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E744. [PMID: 29652814 PMCID: PMC5923786 DOI: 10.3390/ijerph15040744] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/05/2018] [Accepted: 04/09/2018] [Indexed: 01/03/2023]
Abstract
The inhalation of a water aerosol from a humidifier containing disinfectants has led to serious lung injuries in Korea. To promote the safe use of products, the Korean government enacted regulations on the chemicals in various consumer products that could have adverse health effects. Given the concern over the potential health risks associated with the hazardous ingredients in deodorizing consumer products, 17 ingredients were analyzed and assessed according to their health risk on 3 groups by the application type in 47 deodorizing products. The risk assessment study followed a stepwise procedure (e.g., collecting toxicological information, hazard identification/exposure assessment, and screening and detailed assessment for inhalation and dermal routes). The worst-case scenario and maximum concentration determined by the product purpose and application type were used as the screening assessment. In a detailed assessment, the 75th exposure factor values were used to estimate the assumed reasonable exposure to ingredients. The exposed concentrations of seven ingredients were calculated. Due to limitation of toxicity information, butylated hydroxyl toluene for a consumer’s exposure via the dermal route only was conducted for a detailed assessment. This study showed that the assessed ingredients have no health risks at their maximum concentrations in deodorizing products. This approach can be used to establish guidelines for ingredients that may pose inhalation and dermal hazards.
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Affiliation(s)
- Minjin Lee
- School of Environmental Engineering, University of Seoul, Seoulsiripdaero 163, Dongdaemun-gu, Seoul 02504, Korea.
- Consumer Product & Environment Business Division, KOTITI Testing & Research Institute, 111 Sagimakgol-ro, Jungwon-gu, Seongnam-si, Gyeonggi-do 13202, Korea.
| | - Joo-Hyon Kim
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, Korea.
| | - Daeyeop Lee
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, Korea.
| | - Jaewoo Kim
- Consumer Product & Environment Business Division, KOTITI Testing & Research Institute, 111 Sagimakgol-ro, Jungwon-gu, Seongnam-si, Gyeonggi-do 13202, Korea.
| | - Hyunwoo Lim
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, Korea.
| | - Jungkwan Seo
- Division of Risk Assessment, National Institute of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon 22689, Korea.
| | - Young-Kwon Park
- School of Environmental Engineering, University of Seoul, Seoulsiripdaero 163, Dongdaemun-gu, Seoul 02504, Korea.
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22
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Zafrir Y, Trattner A, Hodak E, Eldar O, Lapidoth M, Ben Amitai D. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review. Pediatr Dermatol 2018; 35:76-86. [PMID: 29143366 DOI: 10.1111/pde.13333] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND/OBJECTIVES Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. METHODS The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. RESULTS Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). CONCLUSION Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background.
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Affiliation(s)
- Yaron Zafrir
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel
| | - Akiva Trattner
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmillia Hodak
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oren Eldar
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Moshe Lapidoth
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Laser Unit, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Dan Ben Amitai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
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23
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Dórea JG. Abating Mercury Exposure in Young Children Should Include Thimerosal-Free Vaccines. Neurochem Res 2017; 42:2673-2685. [PMID: 28439753 DOI: 10.1007/s11064-017-2277-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/11/2017] [Accepted: 04/19/2017] [Indexed: 12/27/2022]
Abstract
Pediatric immunization is essential to prevent, control and eradicate children`s infectious diseases. Newborns and infants in less developed countries have a concentrated schedule of Thimerosal-containing vaccines (TCVs); pregnant mothers are also immunized with TCVs. Metabolic changes during early development are demonstrably an important risk factor for ethylmercury (EtHg) effects on neurodevelopment, while exposure to Thimerosal sensitizes susceptible individuals to life-long contact dermatitis. Concerns regarding toxicity of Hg have moved rich nations to withdraw it from medicines and, in particular, Thimerosal from pediatric vaccines; it has been more than 20 years since rich countries started using Thimerosal-free vaccines. TCVs and Thimerosal-free vaccines show dissimilar profiles of adverse effects. Thimerosal-free vaccines have shown a decrease in contact dermatitis, while TCVs showed a significant association with increased risk of tic disorders; in some circumstances, EtHg in combination with other neurotoxic substances negatively impacted neurobehavioral tests. In studies that explored vaccines and risk of tics, Thimerosal was a necessary factor. However, when the binary exposure to organic Hg forms (TCV-EtHg and fish-MeHg) was considered, effects on neurobehavioral tests were inconsistent. CONCLUSIONS (a) The indiscriminate use of pediatric-TCVs in less developed countries carries an unjustifiable and excessive EtHg exposure with an unnecessary risk of neurotoxicity to the developing brain; (b) measurable benefits (of Thimerosal-free) and measurable risks of tic disorders have been associated with the (Thimerosal-containing) type of vaccine;
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Affiliation(s)
- José G Dórea
- Professor Emeritus, Faculty of Health Sciences, Universidade de Brasília, 70919-970, Brasília, DF, Brazil.
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24
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Lubbes S, Rustemeyer T, Sillevis Smitt JH, Schuttelaar ML, Middelkamp-Hup MA. Contact sensitization in Dutch children and adolescents with and without atopic dermatitis - a retrospective analysis. Contact Dermatitis 2016; 76:151-159. [DOI: 10.1111/cod.12711] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 09/10/2016] [Accepted: 09/20/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Stefanie Lubbes
- Department of Dermatology; Academic Medical Centre, University of Amsterdam; 1100 DD Amsterdam The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology; VU University Medical Centre; 1081 HV Amsterdam The Netherlands
| | - Johannes H. Sillevis Smitt
- Department of Dermatology; Academic Medical Centre, University of Amsterdam; 1100 DD Amsterdam The Netherlands
| | - Marie Louise Schuttelaar
- Department of Dermatology; University Medical Centre Groningen; 9700 RB Groningen The Netherlands
| | - Maritza A. Middelkamp-Hup
- Department of Dermatology; Academic Medical Centre, University of Amsterdam; 1100 DD Amsterdam The Netherlands
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Rodrigues DF, Goulart EMA. Patch-test results in children and adolescents: systematic review of a 15-year period. An Bras Dermatol 2016; 91:64-72. [PMID: 26982781 PMCID: PMC4782649 DOI: 10.1590/abd1806-4841.20163927] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 09/01/2014] [Indexed: 12/31/2022] Open
Abstract
The number of studies on patch-test results in children and adolescents has
gradually increased in recent years, thus stimulating reviews. This paper is a
systematic review of a 15-year period devoted to studying the issue. Variations
pertaining to the number and age groups of tested children and/or adolescents,
the number of subjects with atopy/atopic dermatitis history, the quantity, type
and concentrations of the tested substances, the test technique and type of data
regarding clinical relevance, must all be considered in evaluating these
studies, as they make it harder to formulate conclusions. The most common
allergens in children were nickel, thimerosal, cobalt, fragrance, lanolin and
neomycin. In adolescents, they were nickel, thimerosal, cobalt, fragrance,
potassium dichromate, and Myroxylon pereirae. Knowledge of this matter aids
health professionals in planning preventive programs aimed at improving
children's quality of life and ensuring that their future prospects are not
undermined.
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26
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Rodrigues DF, Goulart EMA. Patch test results in children and adolescents. Study from the Santa Casa de Belo Horizonte Dermatology Clinic, Brazil, from 2003 to 2010. An Bras Dermatol 2016; 90:671-83. [PMID: 26560213 PMCID: PMC4631233 DOI: 10.1590/abd1806-4841.20153902] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 11/12/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Patch testing is an efficient method to identify the allergen responsible for
allergic contact dermatitis. OBJECTIVE To evaluate the results of patch tests in children and adolescents comparing these
two age groups' results. METHODS Cross-sectional study to assess patch test results of 125 children and adolescents
aged 1-19 years, with suspected allergic contact dermatitis, in a dermatology
clinic in Brazil. Two Brazilian standardized series were used. RESULTS Seventy four (59.2%) patients had "at least one positive reaction" to the patch
test. Among these positive tests, 77.0% were deemed relevant. The most frequent
allergens were nickel (36.8%), thimerosal (18.4%), tosylamide formaldehyde resin
(6.8%), neomycin (6.4%), cobalt (4.0%) and fragrance mix I (4.0%). The most
frequent positive tests came from adolescents (p=0.0014) and females (p=0.0002).
There was no relevant statistical difference concerning contact sensitizations
among patients with or without atopic history. However, there were significant
differences regarding sensitization to nickel (p=0.029) and thimerosal (p=0.042)
between the two age groups under study, while adolescents were the most
affected. CONCLUSION Nickel and fragrances were the only positive (and relevant) allergens in children.
Nickel and tosylamide formaldehyde resin were the most frequent and relevant
allergens among adolescents.
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Thomas W, Werner A, Frank A, Matthias A, Tilo B, Thomas D, Regina FH, Uwe G, Annice H, Julia K, Alexander K, Alexander N, Katja N, Hagen O, Bernhard P, Martin R, Martin S, Peter SG, Jochen S, Thomas S, Doris S, Margitta W. Leitlinie Neurodermitis [atopisches Ekzem; atopische Dermatitis]. J Dtsch Dermatol Ges 2015; 14:e1-75. [DOI: 10.1111/ddg.12884] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
| | - Aberer Werner
- Österreichische Gesellschaft für Dermatologie und Venerologie
| | - Ahrens Frank
- Gesellschaft für Pädiatrische Allergologie und Umweltmedizin e.V
| | - Augustin Matthias
- Arbeitsgemeinschaft Gesundheitsökonomie und Evidenzbasierte Medizin der Deutschen Dermatologischen Gesellschaft
| | | | - Diepgen Thomas
- Arbeitsgemeinschaft Berufs- und Umweltdermatologie der Deutschen Dermatologischen Gesellschaft
| | - Fölster-Holst Regina
- Arbeitsgemeinschaft Pädiatrische Dermatologie der Deutschen Dermatologischen Gesellschaft
| | | | | | | | - Kapp Alexander
- Deutsche Gesellschaft für Allergologie und Klinische Immunologie
| | - Nast Alexander
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V. (Moderation)
| | - Nemat Katja
- Berufsverband der Kinder- und Jugendärzte e.V
| | - Ott Hagen
- Deutsche Gesellschaft für Kinder- und Jugendmedizin e.V
| | - Przybilla Bernhard
- Arbeitsgemeinschaft Allergologie der Deutschen Dermatologischen Gesellschaft
| | | | | | | | | | | | - Staab Doris
- Arbeitsgemeinschaft Neurodermitisschulung e.V
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de Waard-van der Spek FB, Darsow U, Mortz CG, Orton D, Worm M, Muraro A, Schmid-Grendelmeier P, Grimalt R, Spiewak R, Rudzeviciene O, Flohr C, Halken S, Fiocchi A, Borrego LM, Oranje AP. EAACI position paper for practical patch testing in allergic contact dermatitis in children. Pediatr Allergy Immunol 2015; 26:598-606. [PMID: 26287570 DOI: 10.1111/pai.12463] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Allergic contact dermatitis (ACD) in children appears to be on the increase, and contact sensitization may already begin in infancy. The diagnosis of contact dermatitis requires a careful evaluation of a patient's clinical history, physical examination, and skin testing. Patch testing is the gold standard diagnostic test. METHODS Based on consensus, the EAACI Task Force on Allergic Contact Dermatitis in Children produced this document to provide details on clinical aspects, the standardization of patch test methodology, and suggestions for future research in the field. RESULTS We provide a baseline list of test allergens to be tested in children with suspected ACD. Additional tests should be performed only on specific indications.
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Affiliation(s)
| | - Ulf Darsow
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Germany
| | - Charlotte G Mortz
- Department of Dermatology & Allergy Center, Odense University Hospital, Odense, Denmark
| | - David Orton
- Department of Dermatology & Allergy, Hillingdon Hospitals NHS Foundation Trust, Uxbridge (London), UK
| | - Margitta Worm
- Department of Dermatology and Allergy, Allergy-Center Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Antonella Muraro
- Department of Pediatrics, Padua General University Hospital, Padua, Italy
| | | | - Ramon Grimalt
- Department of Dermatology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Odilija Rudzeviciene
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Carsten Flohr
- Department of Paediatric Allergy & Dermatology, St John's Institute of Dermatology, St Thomas' Hospital & King's College London, London, UK
| | - Susanne Halken
- Department of Pediatrics, Odense University Hospital, Odense, Denmark
| | - Alessandro Fiocchi
- Department of Pediatrics - Chief Division of Allergy, Pediatric Hospital Bambino Gesu, Roma, Vatican City, Italy
| | - Luis Miguel Borrego
- Department of Allergology/Immunology, CUF Descobertas Hospital, Lisbon and NOVA Medical School, Lisbon, Portugal
| | - Arnold P Oranje
- Department of Dermatology, Dermicis Skin Hospital, Alkmaar, Foundation Pediatric Dermatology, Rotterdam, The Netherlands
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Young individuals with atopic disease and asthma or rhinoconjunctivitis may have clinically relevant contact allergies. Dermatitis 2015; 25:115-9. [PMID: 24819284 DOI: 10.1097/der.0000000000000037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children and adolescents with atopic disease who have allergic asthma and/or rhinitis with and without atopic dermatitis may have hidden, clinically relevant contact allergies. OBJECTIVE The objective of this study was to survey contact allergies in children and adolescents who had been offered allergen-specific immunotherapy and accepted (exposed)/not accepted (unexposed) such treatment. METHODS Thirty-seven exposed and 24 unexposed individuals with atopic disease were patch tested with a standard series supplemented with aluminum chloride hexahydrate, an empty Finn Chamber, and 8 antigen preparations. RESULTS In the exposed group, 18 allergies were detected in 13 individuals with atopic disease when excluding reactions to aluminum and antigen preparations, whereas the corresponding figures for the unexposed group were 9 and 6, respectively (non-significant difference). Independent of the allergen-specific immunotherapy, significantly more (P = 0.013) individuals with atopic dermatitis had at least 1 contact allergy. Clinically relevant allergies were represented by sesquiterpene lactone mix, para-tertiary butylphenol-formaldehyde resin, tixocortol pivalate, and colophony. CONCLUSIONS Clinically relevant contact allergies are not uncommon in children and adolescents with atopic disease, which is why patch testing always should be considered in the management of dermatitis in individuals with atopic disease.
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Toholka R, Wang YS, Tate B, Tam M, Cahill J, Palmer A, Nixon R. The first Australian Baseline Series: Recommendations for patch testing in suspected contact dermatitis. Australas J Dermatol 2014; 56:107-15. [DOI: 10.1111/ajd.12186] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/30/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Ryan Toholka
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc; Melbourne Victoria Australia
| | - Yi-Shi Wang
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc; Melbourne Victoria Australia
- W Skin and Laser Clinic; Mount Elizabeth Novena Specialist Centre; Singapore
| | - Bruce Tate
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc; Melbourne Victoria Australia
| | - Mei Tam
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc; Melbourne Victoria Australia
| | - Jennifer Cahill
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc; Melbourne Victoria Australia
| | - Amanda Palmer
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc; Melbourne Victoria Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation Inc; Melbourne Victoria Australia
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Abstract
Allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction. During the last decade, there has been a heightened awareness of this disease in the pediatric population. The gold standard for diagnosis is patch testing. The prevalence of positive patch tests in referred children with suspected ACD ranges from 27 to 95.6 %. The most common allergens in children in North America are nickel, neomycin, cobalt, fragrance, Myroxylon pereirae, gold, formaldehyde, lanolin/wool alcohols, thimerosal, and potassium dichromate. The relationship between ACD and atopic dermatitis (AD) is complicated with conflicting reports of prevalence in the literature; however, in a patient with dermatitis not responding to traditional therapies, or with new areas of involvement, ACD should be considered as part of the work-up.
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Fonacier LS, Aquino MR, Mucci T. Current strategies in treating severe contact dermatitis in pediatric patients. Curr Allergy Asthma Rep 2013; 12:599-606. [PMID: 22993109 DOI: 10.1007/s11882-012-0305-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Allergic contact dermatitis in children is underdiagnosed and undertreated, and its incidence is increasing. Appropriate history taking and the suspicion for allergic contact dermatitis is essential, and patch testing remains the gold standard in diagnosis. Avoidance of the offending allergen, once identified, is the first goal of treatment. Medical therapies include topical corticosteroid and topical immunomodulators. In severe cases, oral corticosteroids or immunomodulators are utilized, although prospective randomized trials for the treatment of this disease in children are lacking. A PubMed literature search was performed to identify publications on allergic contact dermatitis in the pediatric population with the keywords: dermatitis, children, allergic contact dermatitis, pediatrics, contact hypersensitivity, contact allergy, treatment, and management. This review will address the major principles behind the diagnosis and management of this disease in the pediatric population, and highlight useful strategies that may result in improved treatment of this condition.
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Affiliation(s)
- Luz S Fonacier
- Section of Allergy and Immunology, Winthrop University Hospital, Mineola, NY 11501, USA.
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Affiliation(s)
- Julia M Kwan
- Department of Dermatology, Naval Medical Center San Diego, CA, USA
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Gittler JK, Krueger JG, Guttman-Yassky E. Atopic dermatitis results in intrinsic barrier and immune abnormalities: implications for contact dermatitis. J Allergy Clin Immunol 2012; 131:300-13. [PMID: 22939651 DOI: 10.1016/j.jaci.2012.06.048] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 06/29/2012] [Indexed: 01/14/2023]
Abstract
Atopic dermatitis (AD), as well as irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), are common skin diseases. These diseases are characterized by skin inflammation mediated by activated innate immunity or acquired immune mechanisms. Although AD, ICD, and ACD can be encountered in pure forms by allergists and dermatologists, patients with AD often present with increased frequency of ICD and ACD. Although a disturbed barrier alone could potentiate immune reactivity in patients with AD through increased antigen penetration, additional immune mechanisms might explain the increased susceptibility of atopic patients to ICD and ACD. This review discusses cellular pathways associated with increased skin inflammation in all 3 conditions and presents mechanisms that might contribute to the increased rate of ICD and ACD in patients with AD.
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Brandão MHT, Gontijo B. Contact sensitivity to metals (chromium, cobalt and nickel) in childhood. An Bras Dermatol 2012; 87:269-76. [DOI: 10.1590/s0365-05962012000200012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 03/20/2011] [Indexed: 11/22/2022] Open
Abstract
Metals, especially nickel, are the most common contact allergens in children. Recent data has shown increased incidence of allergy in industrialized countries. Sensitization can occur at any age, even in neonates. Costume jewelry, particularly earrings, is linked to increased sensitization to nickel. Sensitization to cobalt often occurs by the use of costume jewelry. The most common source of sensitization to chromium is leather. Due to the absence of a specific therapy, the main treatment is to identify and avoid the responsible allergens. This article presents an updated view on the epidemiological and clinical aspects of contact allergy to metals, focusing on prevention strategies and risk factors, and warns about possible and new sources of contact.
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Choi ZH. Analytical study on nickel content in ceramic, metal and plastic materials. ANALYTICAL SCIENCE AND TECHNOLOGY 2011. [DOI: 10.5806/ast.2011.24.6.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Masuck I, Hutzler C, Jann O, Luch A. Inhalation exposure of children to fragrances present in scented toys. INDOOR AIR 2011; 21:501-511. [PMID: 21615504 DOI: 10.1111/j.1600-0668.2011.00727.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED When utilized in the perfuming of children's toys, fragrances capable of inducing contact allergy in human skin may also become bioavailable to children via the inhalation route. The aim of this study was to determine the area-specific emission rates of 24 fragrances from a plasticized PVC reference material that was meant to mimic a real plastic toy. This material was introduced into an emission chamber for 28 days at handling conditions or at worst-case conditions. As a result, fragrances can be separated into three categories according to their emission rates ranging from 0.0041 to 16.2 mg/m² × h, i.e., highly volatile, semivolatile, and low-volatile compounds. Compounds of the first and second categories were monitored with decreasing emission rates. Substances of the third category were detected with increasing emission rates over time. Further, higher temperatures led to higher emission rates. The emission concentration of fragrances from four real scented toys varied between 1.10 and 107 μg/m³ at day 1 in the test chamber. Therefore, short-term inhalation exposure to fragrances originating from toys was in the range of 0.53-2700 ng/kg BW/d for the children of age 1 and older. Long-term exposure to these fragrances was calculated in the range of 2.2-220 ng/kg BW/d. PRACTICAL IMPLICATIONS Besides household products and cosmetics, fragrances can be found in toys for children. Some fragrances are known contact allergens in the skin, but there is a lack of information on their effects in the human respiratory tract. Here, we analyzed and categorized fragrances present in a plasticized PVC reference material according to their emission profiles and volatility. We also demonstrate that volatile fragrances are being emitted from real toys and thus may get inhaled under consumer conditions to different extents.
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Affiliation(s)
- I Masuck
- Department of Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany.
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Allergische Kontaktekzeme bei Kindern. Monatsschr Kinderheilkd 2011. [DOI: 10.1007/s00112-011-2427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Estimation of dermal and oral exposure of children to scented toys: Analysis of the migration of fragrance allergens by dynamic headspace GC-MS. J Sep Sci 2011; 34:2686-96. [DOI: 10.1002/jssc.201100360] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 06/27/2011] [Accepted: 07/03/2011] [Indexed: 11/07/2022]
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Simonsen AB, Deleuran M, Johansen JD, Sommerlund M. Contact allergy and allergic contact dermatitis in children - a review of current data. Contact Dermatitis 2011; 65:254-65. [DOI: 10.1111/j.1600-0536.2011.01963.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bonitsis NG, Tatsioni A, Bassioukas K, Ioannidis JPA. Allergens responsible for allergic contact dermatitis among children: a systematic review and meta-analysis. Contact Dermatitis 2011; 64:245-57. [DOI: 10.1111/j.1600-0536.2010.01860.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kasper-Sonnenberg M, Sugiri D, Wurzler S, Ranft U, Dickel H, Wittsiepe J, Hölzer J, Lemm F, Eberwein G, Altmeyer P, Kraft M, Krämer U, Wilhelm M. Prevalence of nickel sensitization and urinary nickel content of children are increased by nickel in ambient air. ENVIRONMENTAL RESEARCH 2011; 111:266-273. [PMID: 21168833 DOI: 10.1016/j.envres.2010.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Revised: 11/01/2010] [Accepted: 11/10/2010] [Indexed: 05/30/2023]
Abstract
In a cross-sectional study performed in 2000, an unexpected positive association between nickel (Ni) in ambient air, urinary Ni content and the prevalence of Ni sensitization in a subgroup of 6-yr-old children living near a steel mill was observed. Between 2005 and 2006, in a different and larger study population, we examined if Ni from ambient air or urinary Ni concentration was related to Ni sensitization in children living next to Ni-emitting steel mills. We studied 749 school beginners living in four Ni-polluted industrial areas of North Rhine-Westphalia, Germany. We assessed Ni in ambient air, Ni in urine from children and mothers, and Ni in tap water, conducted patch tests in children (including the NiSO(4)-dilution test) and collected questionnaire data. Statistics were done by linear and logistic regression analyses, adjusted for covariates. At increased Ni concentration in ambient air (unit of increase: 10 ng/m(3)), urinary Ni concentrations rose in both mothers (9.1%; 95% CI: 6.8-11.4%) and children (2.4%; 95% CI: 0.4-4.4%). The prevalence of Ni sensitization in children was associated with increased Ni from ambient air (unit of increase: 18 ng/m(3); odds ratio 1.28; 95% CI: 1.25-1.32) and urinary Ni concentration (unit of increase: 7.1 μg/L; odds ratio 2.4; 95% CI: 1.20-4.48). Ni in ambient air of areas with Ni-emitting factories contributes to internal Ni exposure in residents via inhalation and, furthermore, is a risk factor for the development of Ni sensitization in children.
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Affiliation(s)
- Monika Kasper-Sonnenberg
- Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Universitaetsstr. 150, 44780 Bochum, Germany.
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Schnabel E, Schoefer Y, Chen CM, Schäfer T, Behrendt H, Ring J, Wichmann HE, Heinrich J. Sensitization to contact allergens and bronchial hyper-responsiveness. Contact Dermatitis 2010; 63:157-63. [PMID: 20690939 DOI: 10.1111/j.1600-0536.2010.01772.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Exposure to contact allergens and specific allergic sensitization to them are common, but possible related health effects have been rarely studied. OBJECTIVES We aimed to analyse possible associations between contact sensitization to nickel sulfate and fragrance mix I and lung function parameters or bronchial hyper-responsiveness. METHODS Within a population-based study in Augsburg, 1052 adults performed lung function tests, including forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC) and bronchial hyper-responsiveness (BHR). Patch tests were performed, and information was assessed by medical examinations and interviews. Logistic regression models were applied to study associations between contact allergies and lung function parameters. RESULTS Women were sensitized significantly more often than men to nickel [odds ratio (OR) 3.97, 95% confidence interval (CI) 2.50-6.29] and fragrance mix I (OR 2.28, 95% CI 1.50-3.46). Patch test results for nickel and fragrance mix I did not influence mean FEV(1) and FVC % predicted values. However, in women, a higher rate of BHR was associated with positive patch test reactions to fragrance mix I (OR 2.24, 95% CI 1.11-4.52). CONCLUSIONS Contact sensitization to fragrance mix I is associated with a higher rate of BHR in women. Thus, in women with contact allergy to fragrances, airway obstruction should be considered as a possible co-morbidity.
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Affiliation(s)
- Eva Schnabel
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.
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Wollenberg A, Schnopp C. Evolution of Conventional Therapy in Atopic Dermatitis. Immunol Allergy Clin North Am 2010; 30:351-68. [DOI: 10.1016/j.iac.2010.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Janach M, Kühne A, Seifert B, French LE, Ballmer-Weber B, Hofbauer GFL. Changing delayed-type sensitizations to the baseline series allergens over a decade at the Zurich University Hospital. Contact Dermatitis 2010; 63:42-8. [DOI: 10.1111/j.1600-0536.2010.01727.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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