title: Concurrent sensitization to metals and occupation.
abstract: BACKGROUND
  Cosensitization to nickel, cobalt and chromium occurs in the general population and in some occupational groups.
  
  
  OBJECTIVE
  To estimate the isolated and concurrent occurrence of nickel, cobalt and chromium contact sensitization and their association with individual and occupational risk factors.
  
  
  METHODS
  Twelve thousand four hundred and ninety-two patients were patch tested with the European baseline series between 1997 and 2004 in north-eastern Italy. The associations between patch test results and patient characteristics and occupations were investigated by means of multinomial logistic regression analysis.
  
  
  RESULTS
  Of the patients, 34.7% (4334 patients) had one or more positive patch test reactions to metals. As compared with those with negative reactions to all three metals, nickel sensitization was significantly higher in females than in males, not only as monosensitization, but also as cosensitization with cobalt, with chromium, or with both metals. Building and related trades workers showed positive reactions to chromium + nickel [odds ratio (OR) 1.99; 95% confidence interval (CI) 1.05-3.76) and chromium + cobalt (OR 2.61; 95% CI 1.46-4.67]. Cleaning workers showed a high prevalence of nickel, chromium, nickel + chromium and nickel + cobalt + chromium cosensitization (ORs 1.29, 1.66, 2.11, and 1.79, respectively). An excess risk for cosensitization to all three metals was found in textile and leather workers (OR 2.19; 95% CI 1.10-4.33), and in bartenders (OR 2.10; 95% CI 1.03-4.26).
  
  
  CONCLUSIONS
  Some occupational groups are more likely to develop nickel, cobalt and chromium cosensitization.
authors.affiliation: Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste 34129, Italy. frui@units.it
authors.forename: Francesca
authors.initials: F
authors.lastname: Rui
authors.forename: Massimo
authors.initials: M
authors.lastname: Bovenzi
authors.forename: Andrea
authors.initials: A
authors.lastname: Prodi
authors.forename: Anna Belloni
authors.initials: AB
authors.lastname: Fortina
authors.forename: Ilaria
authors.initials: I
authors.lastname: Romano
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Corradin
authors.forename: Francesca Larese
authors.initials: FL
authors.lastname: Filon
mesh_terms: D000328:Adult; D002857:Chromium / Q000009:adverse effects; D003035:Cobalt / Q000009:adverse effects; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000453:epidemiology*; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010328:Patch Tests / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D008670:Metals; D002857:Chromium; D003035:Cobalt; D009532:Nickel