title: Nickel release from earrings purchased in the United States: the San Francisco earring study.
abstract: BACKGROUND
  Nickel sensitization is frequent among US patients with dermatitis and in the general population. In Europe, decreasing prevalences of nickel sensitization are observed as a result of the European Union Nickel Directive. However, no directive exists in the United States.
  
  
  OBJECTIVE
  We sought to examine nickel release from inexpensive earrings and discuss possible methods of reducing nickel exposure among consumers.
  
  
  METHODS
  A total of 34 different stores and artists were visited. A total of 277 earrings were purchased and examined with the dimethylglyoxime (DMG) test.
  
  
  RESULTS
  DMG-positive earrings were identified from local artists (69%) and tourist stores (42.9%) but also chain stores targeting young (24.1%) and mature (1.7%) women. No correlation between price and outcome of DMG testing was identified.
  
  
  CONCLUSIONS
  Our study does not reflect buying trends in the United States. Pretreatment of earrings with artificial sweat was not performed and the DMG may lead to both false-positive and false-negative results.
  
  
  CONCLUSIONS
  Nickel exposure from inexpensive earrings is frequent in the United States. A regulatory governmental intervention may be warranted.
authors.affiliation: National Allergy Research Centre, Department of Dermatology, Gentofte University Hospital, Gentofte, Denmark. jacpth01@geh.regionh.dk
authors.forename: Jacob Pontoppidan
authors.initials: JP
authors.lastname: Thyssen
authors.forename: Howard Ira
authors.initials: HI
authors.lastname: Maibach
mesh_terms: D002140:California; D017449:Dermatitis, Allergic Contact / Q000209:etiology; D004431:Ear, External; D009532:Nickel / Q000009:adverse effects / Q000032:analysis*; D010091:Oximes; D014481:United States
chemical_list: D010091:Oximes; C013501:dimethylglyoxime; D009532:Nickel