title: Epidemiology of contact allergy in adults.
abstract: BACKGROUND
  We aimed to determine the prevalence of contact sensitization in the general population and to investigate associations with important sociodemographic and medical characteristics.
  
  
  METHODS
  Within a population-based nested, case-control study in Germany, we performed patch tests with 25 standard allergens in 1141 adults (50.4% female, age median 50 years). Additional information was obtained by a dermatologic examination, a standardized interview, and blood analysis.
  
  
  RESULTS
  At least one positive reaction was exhibited by 40.0% of the subjects, with reactions most frequently observed to fragrance mix (15.9%), nickel (13.1%), thimerosal (4.7%), and balsam of Peru (3.8%). Women were sensitized more often than men (50.2% vs 29.9%, OR 2.36, CI 1.84-3.03), and this was also significant for fragrance mix, nickel, turpentine, cobalt chloride, and thimerosal. Contact sensitization was more frequent in subjects who reported adverse skin reactions (53.8% vs. 32.6%; OR 2.41, CI 1.85-3.14), and this was particularly true for sensitization to nickel (45.5% vs 8.8%, OR 8.64, CI 5.67-13.17) and fragrance mix (29.0% vs 14.0%, OR 2.51, CI 1.60-3.91) and the corresponding intolerance of fashion jewelry and fragrances. Contact sensitization decreased with increasing degree of occupational training (unskilled 45.9%, apprenticeship 40.1%, technical college 40.4%, and school of engineering 12.5%; P=0.023; trend test P=0.042). Significant associations of contact sensitization and presence of allergen-specific IgE antibodies, atopic eczema, or psoriasis were not observed. Frequency estimates for the general adult population based on these findings were 28.0% for overall contact sensitization and 11.4% for fragrance mix, 9.9% for nickel, and 3.2% for thimerosal.
  
  
  CONCLUSIONS
  It is concluded that contact allergy is influenced by sociodemographic parameters and plays an important role in the general population.
authors.affiliation: Institute of Social Medicine, Medical University Lübeck, Beckergrube 43047, 23552 Lübeck, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Schäfer
authors.forename: E
authors.initials: E
authors.lastname: Böhler
authors.forename: S
authors.initials: S
authors.lastname: Ruhdorfer
authors.forename: L
authors.initials: L
authors.lastname: Weigl
authors.forename: D
authors.initials: D
authors.lastname: Wessner
authors.forename: B
authors.initials: B
authors.lastname: Filipiak
authors.forename: H E
authors.initials: HE
authors.lastname: Wichmann
authors.forename: J
authors.initials: J
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D001453:Balsams / Q000009:adverse effects; D016022:Case-Control Studies; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects; D010328:Patch Tests; D010476:Perfume / Q000009:adverse effects; D011159:Population Surveillance; D013849:Thimerosal / Q000009:adverse effects
chemical_list: D001453:Balsams; D010476:Perfume; D013849:Thimerosal; D009532:Nickel; C025080:Peruvian balsam