Tag Archive for: nickel allergic contact dermatitis

nickel workshop

Nickel Workshop

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On June 23, 2016, a historic event occurred – the first US Nickel Workshop.  Thought leaders from medicine, industry and regulation came together to discuss the issue of nickel dermatitis,  appropriate uses of nickel, and the integral role of nickel in society at the first North American Workshop on Nickel Dermatitis. This workshop was sponsored and coordinated by the Nickel Institute, who brought toxicologists and dermatologists together with conscientious companies representing various consumer product sectors. The group stressed the importance of nickel release, not nickel content in determining risk of becoming allergic to nickel and having a nickel dermatitis reaction if you are already allergic to nickel.

Removing nickel from our environment is not possible, because it is one of the most abundant metals on our planet and it has many beneficial uses where it cannot be reasonably substituted (e.g. stainless steel) . What is possible, though, is to use it in the safest ways possible. For example, nickel is safely used in several types of stainless steels. Nickel is also used as nickel-plated carbon fibers in the composite case of personal cell phones to keep our brains safe from the electromagnetic energy generated from by cell phone use. A top priority was discussed at the nickel workshop of removing high nickel-release materials from use in piercing posts (used in jewelry) by using appropriate low nickel-releasing materials (e.g. surgical stainless steel, high quality gold, etc.) since piercing directly introduces releasednickel to an open wound. This is especially important for children who, if sensitized, have a lifetime to deal with the consequences.

The Nickel Institute will be putting together a full report from the Nickel Workshop, which will be made available online on the Nickel Institute website at https://www.nickelinstitute.org  Dr. Jennifer Chen, MD, a dermatologist from Stanford University, presented the background of nickel allergy in the US at the Nickel Workshop in addition to developing an outreach education webinar on this topic available to the public https://www.dermatitisacademy.com/webinars/  The webinar discusses that EU regulations have decreased nickel allergy in ear pierced young women from 16.6% down to 6.9%. The estimated savings of $2 billion over the last 20 years is massive and that could translate into an even bigger savings with the US population.

At the Nickel Workshop, Dr. Sharon Jacob, MD, a dermatologist from Loma Linda presented the situation of nickel dermatitis in children in North America, noting that nickel allergy is found at an early age and is thought to be largely due to ear piercing in young girls.  She reported that an estimated 11% of the US general population is currently sensitized to nickel, which includes an estimated 8,133,603 children!  She also stated that a significant proportion of these could be prevented by utilizing safer metals in piercing.  Dr. Jacob ended her presentation at the Nickel Workshop with a slide that said:

‘You can’t tell an adult they can’t pierce and smoke… but you can protect a child.’

To learn more about nickel allergy and sensitization, please visit the Dermatitis Academy page dedicated to nickel https://www.dermatitisacademy.com/nickel-page/ which includes information on the low nickel diet, how to DMG test metal objects to screen for nickel release, a quiz on sources of nickel and a general population questionnaire on nickel sensitization.  https://emg.wufoo.com/forms/nickel-allergic-contact-dermatitis-survey/

 

 

Nickel Summit Webinar

Nickel Contact Dermatitis Summit Webinar

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Nickel Contact Dermatitis Summit

For 53 years, nickel has been unparalleled as the most common allergen documented in patch-tested patients of all ages worldwide, which we call attention to as the Nickel Contact Dermatitis Summit approaches.  And yet, nickel sensitivity is a much wider problem than the documentation suggests, as Peltonen alarmingly and poignantly pointed out over 30 years ago: “half of the subjects sensitized to nickel have never consulted a doctor because of their nickel dermatitis; still fewer have visited a dermatologist”.    In the US we are in the midst of a prospering hidden nickel epidemic akin to that seen in Europe prior to nickel regulation legislation.  There are millions of adults and children sensitized each year – the rates are UNACCEPTABLE, because this is a PREVENTABLE cause of allergic contact dermatitis.  The Nickel Summit webinar by Dr. Jennifer Chen discusses the impact of nickel allergy in the US and the lack of regulation.

 

Article Synopsis

Below is a summary of an article speaking more to this topic.

Synopsis by Janna Vassantachart, MD Loma Linda University School of Medicine

Article: Goldenberg A, Vassantachart J, Lin EJ, Lampel HP, Jacob SE. Nickel Allergy in US Adults-A 53-Year Review of Indexed Cases. Dermatitis. 2015 Jul 14.

For 53 years, nickel has been unparalleled as the most common allergen documented in patch-tested US patients of all ages. In 1994, the European Union (EU) decreased rates of sensitization by enacting a Nickel Directive to regulate nickel release to no more than 0.5 µg/cm2/week. No such directive currently exists in the USA.

This study conducted a literature review of peer-reviewed adult nickel dermatitis cases published within the United States to identify trends over the past decades, sources of nickel sensitization, and regional variations.  It highlights the problem we are encountering at the top of the nickel contact dermatitis summit.   The results of the study demonstrated:

  • Between 1962 and 2015, there were 74 articles published reporting 18,251 cases of nickel sensitivity in US adults.
  • Over the past decades, the frequency of published articles on nickel sensitivity has continuously increased with a significant correlation (r = 0.798, P = 0.057). Compared to only one article published between 1960 and 1970, in the last 5 years, 30 articles have been published.
  • Five articles reported occupational exposures such as a stethoscope, chalk, and a military-issued lanyard chain from an identification neck tag (aka ‘‘dog tag’’). The most commonly reported nonoccupational sources were Essure contraceptive microinserts and Amplatzer septal occluders for atrial septal defects.
  • Geographically, 27 US states have had at least 1 reported case of adult nickel dermatitis.

Most nickel dermatitis cases seen clinically are neither patch-tested nor captured in the literature, allowing for a prospering hidden nickel epidemic towards the nickel summit. However, this study reveals that even the literature has seen a significant increase in published cases over the past decades. Rising rates of US nickel ACD highlight the need for medical professionals, legislators, and manufacturers to advocate for an EU-like Nickel Directive to regulate the release of free nickel.