Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112 |
Resumo: | Introduction: Metals are a common cause of allergic contact dermatitis. After the introduction of the EU Nickel Directive (1994/27/CE; 2004/96/EC) and, more recently, the Cement Directive (2003/53/EC) there has been a significant decrease in sensitization to metals mainly in the Nordic countries. The applicability of these directives and their impact in the Portuguese population is unknown.Material and Methods: A retrospective study (1992-2011) was carried out in our patch test clinic to assess the temporal trend of metal sensitization (nickel [Ni], cobalt [Co] and chromium [Cr]) along the last 20 years, particularly considering age, sex and its relation with occupational activity.Results: Out of 5 250 consecutively patch-tested patients, 1 626 (31%) were reactive to at least one metal (26.5% to Ni; 10.0% to Co and 7.9% to Cr). Women had a higher prevalence of sensitization to Ni (34.4% vs 8.9%) whereas men were more reactive to Cr (11.5% vs 5.0%). Nickel sensitization did not decrease significantly over the years, although in recent years among women sensitized to nickel the percentage of younger patients (16-30 years-old) is significantly lower (p < 0.001). Chromium sensitization significantly decreased, particularly in men (r = -0.535), and mainly in the construction workers (r = -0.639). Chromium reactivity associated with the shoe dermatitis has remained stable.Discussion: We emphasize the higher and stable percentage of nickel sensitized individuals suggesting, so far, a low impact from the EU Ni directive, although a decreasing percentage in the the younger group among Ni sensitized women may suggest a beneficial effect is becoming evident is this age group. On the contrary, the impact of the directive regarding the modification of Cr in cement seems to be effective. There is now a need to regulate chromium content in leather products, namely in shoes.Conclusions: The regulation of interventional measures related either to the manufacture and trade of adornments or professional use will better protect the population of allergy to metals.Keywords: Dermatitis, Allergic Contact; Chromium; Cobalt; European Union; Metals; Nickel; Patch Tests; Portugal. |
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Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European DirectivesAlergia de Contacto a Metais num Período de 20 Anos no Centro de Portugal: Implicações das Directivas EuropeiasIntroduction: Metals are a common cause of allergic contact dermatitis. After the introduction of the EU Nickel Directive (1994/27/CE; 2004/96/EC) and, more recently, the Cement Directive (2003/53/EC) there has been a significant decrease in sensitization to metals mainly in the Nordic countries. The applicability of these directives and their impact in the Portuguese population is unknown.Material and Methods: A retrospective study (1992-2011) was carried out in our patch test clinic to assess the temporal trend of metal sensitization (nickel [Ni], cobalt [Co] and chromium [Cr]) along the last 20 years, particularly considering age, sex and its relation with occupational activity.Results: Out of 5 250 consecutively patch-tested patients, 1 626 (31%) were reactive to at least one metal (26.5% to Ni; 10.0% to Co and 7.9% to Cr). Women had a higher prevalence of sensitization to Ni (34.4% vs 8.9%) whereas men were more reactive to Cr (11.5% vs 5.0%). Nickel sensitization did not decrease significantly over the years, although in recent years among women sensitized to nickel the percentage of younger patients (16-30 years-old) is significantly lower (p < 0.001). Chromium sensitization significantly decreased, particularly in men (r = -0.535), and mainly in the construction workers (r = -0.639). Chromium reactivity associated with the shoe dermatitis has remained stable.Discussion: We emphasize the higher and stable percentage of nickel sensitized individuals suggesting, so far, a low impact from the EU Ni directive, although a decreasing percentage in the the younger group among Ni sensitized women may suggest a beneficial effect is becoming evident is this age group. On the contrary, the impact of the directive regarding the modification of Cr in cement seems to be effective. There is now a need to regulate chromium content in leather products, namely in shoes.Conclusions: The regulation of interventional measures related either to the manufacture and trade of adornments or professional use will better protect the population of allergy to metals.Keywords: Dermatitis, Allergic Contact; Chromium; Cobalt; European Union; Metals; Nickel; Patch Tests; Portugal.Introdução: Os metais são causa frequente de dermatite de contacto alérgica. Desde a introdução da Directiva Comunitária do Níquel (1994/27/CE; 2004/96/CE) e, mais recentemente, da Directiva do Cimento (2003/53/CE), nos países nórdicos tem havido uma diminuição da sensibilização aos metais. A aplicabilidade destas medidas e o seu impacto permanece por avaliar em Portugal.Material e Métodos: Foi realizado um estudo retrospectivo (1992-2011) na Consulta de Alergologia Cutânea com o principal objectivo de analisar a variação dos padrões de sensibilização aos metais (níquel [Ni], cobalto [Co] e crómio [Cr]) ao longo de 20 anos, em particular no que se refere ao género, grupo etário e relação com a actividade profissional.Resultados: Do total de 5 250 doentes estudados, em 1 626 (31%) observámos pelo menos um teste epicutâneo positivo a um metal (26,5% ao Ni; 10,0% ao Co e 7,0% ao Cr). A prevalência de sensibilização ao Ni era significativamente maior nas mulheres (34,4% versus 8,9%) e ao Cr nos homens (11,5% versus 5,0%). Não houve diminuição significativa da sensibilização ao Ni ao longo dos 20 anos, mas o contributo da faixa etária dos 16-30 anos no total de mulheres sensíveis a este metal decresceu de forma significativamente estatística ao longo dos anos (p < 0,001). A sensibilização ao Cr decresceu sobretudo nos homens (r = -0,535), muito particularmentenos casos relacionados com a construção civil (r = -0,639), enquanto a reatividade ao Cr relacionado com o uso de calçadose manteve estável.Discussão: A manutenção dos elevados níveis de sensibilização ao níquel denota ainda uma fraca implementação das Directivascomunitárias mas a redução da percentagem de mulheres jovens poderá significar já algum efeito positivo nesta faixa etária. Ao contrário, a Directiva referente à redução do Cr no cimento parece estar a ter os seus efeitos positivos. Há, contudo, necessidade de interferir com o conteúdo em Cr no couro natural utilizado no calçado.Conclusões: A regulamentação da implementação de medidas interventivas relacionadas quer com o fabrico e comércio de adornos quer a nível profissional permitirá uma melhor protecção da população da alergia aos metais.Palavras-chave: Dermatite de Contacto Alérgica; Metais; Níquel; Cobalto; Crómio; Testes Epicutâneos; Portugal; União Europeia.Ordem dos Médicos2014-06-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112oai:ojs.www.actamedicaportuguesa.com:article/4112Acta Médica Portuguesa; Vol. 27 No. 3 (2014): May-June; 295-303Acta Médica Portuguesa; Vol. 27 N.º 3 (2014): Maio-Junho; 295-3031646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112/3976https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112/4119Teixeira, VeraCoutinho, InêsGonçalo, Margaridainfo:eu-repo/semantics/openAccess2022-12-20T11:03:16Zoai:ojs.www.actamedicaportuguesa.com:article/4112Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:18:42.027004Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives Alergia de Contacto a Metais num Período de 20 Anos no Centro de Portugal: Implicações das Directivas Europeias |
title |
Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives |
spellingShingle |
Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives Teixeira, Vera |
title_short |
Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives |
title_full |
Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives |
title_fullStr |
Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives |
title_full_unstemmed |
Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives |
title_sort |
Allergic Contact Dermatitis to Metals over a 20-Year Period in the Centre of Portugal: Evaluation of the Effects of the European Directives |
author |
Teixeira, Vera |
author_facet |
Teixeira, Vera Coutinho, Inês Gonçalo, Margarida |
author_role |
author |
author2 |
Coutinho, Inês Gonçalo, Margarida |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Teixeira, Vera Coutinho, Inês Gonçalo, Margarida |
description |
Introduction: Metals are a common cause of allergic contact dermatitis. After the introduction of the EU Nickel Directive (1994/27/CE; 2004/96/EC) and, more recently, the Cement Directive (2003/53/EC) there has been a significant decrease in sensitization to metals mainly in the Nordic countries. The applicability of these directives and their impact in the Portuguese population is unknown.Material and Methods: A retrospective study (1992-2011) was carried out in our patch test clinic to assess the temporal trend of metal sensitization (nickel [Ni], cobalt [Co] and chromium [Cr]) along the last 20 years, particularly considering age, sex and its relation with occupational activity.Results: Out of 5 250 consecutively patch-tested patients, 1 626 (31%) were reactive to at least one metal (26.5% to Ni; 10.0% to Co and 7.9% to Cr). Women had a higher prevalence of sensitization to Ni (34.4% vs 8.9%) whereas men were more reactive to Cr (11.5% vs 5.0%). Nickel sensitization did not decrease significantly over the years, although in recent years among women sensitized to nickel the percentage of younger patients (16-30 years-old) is significantly lower (p < 0.001). Chromium sensitization significantly decreased, particularly in men (r = -0.535), and mainly in the construction workers (r = -0.639). Chromium reactivity associated with the shoe dermatitis has remained stable.Discussion: We emphasize the higher and stable percentage of nickel sensitized individuals suggesting, so far, a low impact from the EU Ni directive, although a decreasing percentage in the the younger group among Ni sensitized women may suggest a beneficial effect is becoming evident is this age group. On the contrary, the impact of the directive regarding the modification of Cr in cement seems to be effective. There is now a need to regulate chromium content in leather products, namely in shoes.Conclusions: The regulation of interventional measures related either to the manufacture and trade of adornments or professional use will better protect the population of allergy to metals.Keywords: Dermatitis, Allergic Contact; Chromium; Cobalt; European Union; Metals; Nickel; Patch Tests; Portugal. |
publishDate |
2014 |
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2014-06-30 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112 oai:ojs.www.actamedicaportuguesa.com:article/4112 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112/3976 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4112/4119 |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 27 No. 3 (2014): May-June; 295-303 Acta Médica Portuguesa; Vol. 27 N.º 3 (2014): Maio-Junho; 295-303 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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