title: The EU Nickel Directive revisited--future steps towards better protection against nickel allergy.
abstract: In July 2001, the EU Nickel Directive came into full force to protect European citizens against nickel allergy and dermatitis. Prior to this intervention, Northern European governments had already begun to regulate consumer nickel exposure. According to part 2 of the EU Nickel Directive and the Danish nickel regulation, consumer items intended to be in direct and prolonged contact with the skin were not allowed to release more than 0.5 µg nickel/cm2/week. It was considered unlikely that nickel allergy would disappear altogether as a proportion of individuals reacted below the level defined by the EU Nickel Directive. Despite this, the EU Nickel Directive part 2 was expected to work as an operational limit that would sufficiently protect European consumers against nickel allergy and dermatitis. This review presents the accumulation of epidemiological studies that evaluated the possible effect of this major public health intervention. Also, it evaluates recent exposure assessment studies that have been performed using the dimethyl glyoxime test. It is concluded that the EU Nickel Directive has started to change the epidemiology of nickel allergy in Europe but it should be revisited to better protect consumers and workers since nickel allergy and dermatitis remain very frequent.
authors.affiliation: Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, DK-2820 Hellerup, Denmark. jacpth01@geh.regionh.dk
authors.forename: Jacob P
authors.initials: JP
authors.lastname: Thyssen
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Uter
authors.forename: John
authors.initials: J
authors.lastname: McFadden
authors.forename: Torkil
authors.initials: T
authors.lastname: Menné
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Spiewak
authors.forename: Martine
authors.initials: M
authors.lastname: Vigan
authors.forename: Ana
authors.initials: A
authors.lastname: Gimenez-Arnau
authors.forename: Carola
authors.initials: C
authors.lastname: Lidén
mesh_terms: D000485:Allergens / Q000633:toxicity*; D003257:Consumer Product Safety / Q000331:legislation & jurisprudence*; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology / Q000517:prevention & control*; D005062:European Union; D005260:Female; D006801:Humans; D009532:Nickel / Q000592:standards* / Q000633:toxicity
chemical_list: D000485:Allergens; D009532:Nickel