Background

Nickel is a common allergen.

Objective

To examine the epidemiology of nickel sensitivity in North America.

Methods

Retrospective, cross-sectional analysis of 44,097 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014. Nickel sensitivity was defined as a positive patch test for nickel. We evaluated the frequency of nickel sensitivity and patient demographics. For each positive reaction to nickel, we tabulated clinical relevance, occupational relatedness, and exposure sources.

Results

The average frequency of nickel sensitivity was 17.5% (1994-2014). Nickel sensitivity significantly increased over time (from 14.3% in 1994-1996 to 20.1% in 2013-2014 [P < .0001]). Nickel-sensitive patients were significantly more likely to be female, young, nonwhite, and atopic (have eczema and asthma) and/or have dermatitis affecting the face, scalp, ears, neck, arm, or trunk (P values ≤ .0474). Overall, 55.5% of reactions were currently clinically relevant; this percentage significantly increased over time (from 44.1% in 1994-1996 to 51.6% in 2013-2014 [P < .0001]). The rate of occupational relatedness was 3.7% overall, with a significant decrease over time (from 7.9% in 1994-1996 to 1.9% in 2013-2014 [P < .0001]). Jewelry was the most common source of nickel contact.

Limitations

Tertiary referral population.

Conclusions

Nickel allergy is of substantial public health importance in North America. The frequency of nickel sensitivity in patients referred for patch testing has significantly increased over a 20-year period.

中文翻译：

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镍敏感性流行病学：1994-2014年北美接触性皮炎组数据的回顾性横断面分析

背景

镍是一种常见的过敏原。

客观的

研究北美对镍敏感性的流行病学。

方法

回顾性横断面分析由1994年至2014年由北美接触性皮炎组织进行的44,097例患者斑贴试验。镍敏感性定义为镍的阳性斑贴试验。我们评估了镍敏感性的频率和患者的人口统计数据。对于镍的每个阳性反应，我们列出了临床相关性，职业相关性和暴露源。

结果

镍敏感性的平均频率为17.5％（1994-2014年）。镍敏感性随时间显着增加（从1994-1996年的14.3％增至2013-2014年的20.1％[ P  <.0001]）。对镍敏感的患者更有可能是女性，年轻，非白人和特应性（患有湿疹和哮喘）和/或患有影响面部，头皮，耳朵，颈部，手臂或躯干的皮炎（P值≤.0474） 。总体而言，目前有55.5％的反应与临床相关；该百分比随时间显着增加（从1994-1996年的44.1％增至2013-2014年的51.6％[ P  <.0001]）。总体上，职业相关性率为3.7％，随时间的推移显着下降（从1994-1996年的7.9％降至2013-2014年的1.9％[ P <.0001]）。珠宝是最常见的镍接触源。

局限性

大专推荐人口。

结论

镍过敏在北美具有重要的公共卫生意义。在过去的20年中，转诊至斑贴试验的患者对镍的敏感度显着增加。