title: Chromate Allergy in Northern Israel in Relation to Exposure to Cement and Detergents.
abstract: BACKGROUND
  The prevalence of chromate allergy has declined worldwide in the last decades.
  
  
  OBJECTIVE
  The aim of the study was to assess tendencies in chromate allergy in northern Israel and its possible causes.
  
  
  METHODS
  Retrospective analysis of patch test data during 1999-2013 and a review of the medical records of patients with chromate allergy were conducted.
  
  
  RESULTS
  A total of 4846 consecutive patients were patch tested, of whom 146 (3%) were found to be chromate sensitive. The prevalence of chromate allergy decreased significantly from 4.7% in 1999-2001 to 2.8% in 2002-2004 (P = 0.02). Since then, no significant fluctuations have occurred. A gradual and consistent decline in chromate allergy was recorded among women from 4.8% in 1999-2001 to 2.3% in 2008-2010. Cement (18.4%) was the most frequent source of exposure and was mainly observed in men. The frequency of clinically relevant cement exposure increased significantly from 7.7% in 2002-2004 to 28.7% in 2011-2013 (P = 0.04), whereas the frequency of relevant detergent exposure decreased significantly from 25% in 1999-2001 to 5.7% in 2011-2013 (P = 0.04). Hand (68.5%) was the most frequently involved anatomical site.
  
  
  CONCLUSIONS
  The prevalence of chromate allergy in northern Israel is stable in the general population and gradually decreasing among women. These changes may be caused by reduced exposure to water-soluble hexavalent chromium in detergents but not in cement.
authors.affiliation: From the *Department of Dermatology and †Institute of Endocrinology, Diabetes and Metabolism and Internal Medicine D, Rambam Medical Center and RB Rappaport Faculty of Medicine-Technion, Haifa, Israel.
authors.forename: Khalaf
authors.initials: K
authors.lastname: Kridin
authors.forename: Reuven
authors.initials: R
authors.lastname: Bergman
authors.forename: Mogher
authors.initials: M
authors.lastname: Khamaisi
authors.forename: Sara
authors.initials: S
authors.lastname: Weltfriend
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002840:Chromates / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003902:Detergents / Q000737:chemistry; D004781:Environmental Exposure; D005260:Female; D006229:Hand Dermatoses / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D002840:Chromates; D003902:Detergents