title: A link between skin and airways regarding sensitivity to fragrance products?
abstract: BACKGROUND
  Exposure to volatile fragrances is commonplace and may be related to various eye and airway symptoms. Skin exposure to fragrances is known to cause perfume contact allergy and eczema, but it is unknown whether eye or airway symptoms elicited by fragrance products are associated with contact allergy or eczema.
  
  
  OBJECTIVE
  To investigate if eye and airway symptoms elicited by fragrance products are associated with perfume contact allergy or hand eczema in a population-based sample.
  
  
  METHODS
  A questionnaire on eye and airway symptoms elicited by fragrance products was mailed to 1189 individuals who had recently participated in a Danish population-based study of allergic diseases. Results from the questionnaire about localization and character of the symptoms were compared with data on patch testing and 1-year prevalence of hand eczema collected during the health examination.
  
  
  RESULTS
  Positive, independent and significant (P < 0.05) associations were found between eye and airway symptoms elicited by fragrance products and perfume contact allergy (adjusted odds ratios 2.0-3.7) and hand eczema (adjusted odds ratios 1.6-2.6). In further analysis, similar and consistent results were found regarding severity of the symptoms. No associations were found between nickel contact allergy and the symptoms. Female sex and psychological vulnerability were independently associated with eye and airway symptoms elicited by fragrance products, but adjustment in multivariate analysis did not change the results regarding perfume contact allergy and hand eczema.
  
  
  CONCLUSIONS
  Individuals with perfume contact allergy and/or hand eczema, as opposed to those without, have more frequent and more severe eye or airway symptoms after exposure to volatile fragrance products. Having hand eczema has the greatest impact on reporting eye and airway symptoms elicited by fragrance products.
authors.affiliation: The National Allergy Reseasrch Centre for Consumer Products, Department of Dermatology, Gentofte University Hospital, Ledreborg Alle 40,1, DK-2820 Gentofte, Denmark. jeel@gentoftehosp.kbhamt.dk
authors.forename: J
authors.initials: J
authors.lastname: Elberling
authors.forename: A
authors.initials: A
authors.lastname: Linneberg
authors.forename: H
authors.initials: H
authors.lastname: Mosbech
authors.forename: A
authors.initials: A
authors.lastname: Dirksen
authors.forename: L
authors.initials: L
authors.lastname: Frølund
authors.forename: F
authors.initials: F
authors.lastname: Madsen
authors.forename: N H
authors.initials: NH
authors.lastname: Nielsen
authors.forename: J D
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D016535:Bronchial Hyperreactivity / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology; D001985:Bronchial Provocation Tests / Q000379:methods; D003718:Denmark / Q000453:epidemiology; D017449:Dermatitis, Allergic Contact / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D005128:Eye Diseases / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology; D005260:Female; D006229:Hand Dermatoses / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010476:Perfume / Q000009:adverse effects*; D012882:Skin Tests / Q000379:methods
chemical_list: D000485:Allergens; D010476:Perfume