title: Contact sensitization to fragrances in the general population: a Koch's approach may reveal the burden of disease.
abstract: BACKGROUND
  Contact sensitization to fragrance mix (FM) I and Myroxylon pereirae (MP) is common among European patients with dermatitis. Recently, FM II was included in the European baseline series as an additional marker of fragrance sensitization.
  
  
  OBJECTIVE
  This literature review aims to assess the prevalence of fragrance sensitization in the general population, and to suggest how future population-based studies and questionnaires should be constructed, better to assess the prevalence and burden of fragrance sensitization. This is of relevance as it is often difficult to establish causality in biological systems.
  
  
  METHODS
  A systematic review of the literature was carried out by searching Pubmed-Medline, Biosis and contact dermatitis textbooks.
  
  
  RESULTS
  Nineteen studies were identified, of which 13 were performed among adults. Sample sizes varied between 82 and 2545 tested subjects, and 11 648 subjects were tested in total. The median prevalence of FM and MP sensitization among adults was 2.3% (women, 1.7%; men, 1.3%) and 1.1% (women, 1.4%; men, 0%), respectively.
  
  
  CONCLUSIONS
  Based on the reliability of patch test data from the general population and exposure data obtained from patients with dermatitis, the prevalence and burden of fragrance sensitization in the general population is significant.
authors.affiliation: National Allergy Research Centre, Department of Dermatology and Allergology, Gentofte University Hospital, Gentofte, Denmark. jacpth01@geh.regionh.dk
authors.forename: J P
authors.initials: JP
authors.lastname: Thyssen
authors.forename: T
authors.initials: T
authors.lastname: Menné
authors.forename: A
authors.initials: A
authors.lastname: Linneberg
authors.forename: J D
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D017677:Age Distribution; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D029904:Myroxylon / Q000009:adverse effects*; D010328:Patch Tests / Q000706:statistics & numerical data; D010476:Perfume / Q000009:adverse effects*; D028321:Plant Preparations / Q000009:adverse effects*; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D010476:Perfume; D028321:Plant Preparations