01-05-2018
The data collected are truly alarming - the population of nickel contact allergy patients is steadily growing and may already number approx. 1 billion people worldwide! Existing treatment regimens (based mainly on prevention and avoidance of exposure to nickel, which for some occupational groups is not even feasible) are failing and detailed testing of products for nickel content is not having the desired effect. Why does nickel contact allergy occur, what mechanisms drive it and why is it present in such a huge number of people?
Mechanism of symptoms
Contact allergy is a specific hypersensitivity of the body to haptens (low molecular weight chemicals) or proteins contained in chemicals, induced by direct contact between the antigen and the skin (hence the name allergy). The mechanism that plays a major role in the development of contact allergy is based on the reaction of a specific allergen, recognised by a receptor located on a lymphocyte. This reaction initiates a whole series of responses that lead to the development of symptoms at the site of skin contact with the antigen (e.g. on the wrist under a watch bracelet, on the abdomen under a belt buckle, on the hands of hairdressers working with scissors, etc.) - erythema, swelling, blisters, itching, which, with prolonged exposure to the allergen, lead to scaling of the skin, inflammatory thickening of the stratum corneum, lichenisation. Nickel, on the other hand, is a component of everyday objects that come into contact with the skin over a long period of time: jewellery, cutlery, coins, metal parts of clothing, various household appliances. It is therefore not surprising that contact allergy to nickel is an increasingly common problem that can be considered in personal, social and occupational terms.
Epidemiology
Based on demographic analyses, 2 risk factors for contact allergy to nick el have been identified - female gender and age between 30-60 years. In order to realise the magnitude of the problem, European data (compiled by ESSCA, European Surveillance System on Contact Allergies) on the prevalence of contact allergy to nickel should be quoted: approx. 20% women, 6% men, 18% adolescents and children. Among sufferers, the largest group was in the age range 30-60 years, i.e. in the period of highest occupational activity. The most exposed occupational groups are hairdressers, cashiers, beauticians, health care workers. In Poland, occupational skin diseases are the 6th most frequent group of occupational diseases and annually contribute to about 200 000 sick leaves (Social Insurance Institution data from 2007), which translates into huge losses for the state budget.
Summary
The problem of nickel allergy is growing steadily and successive data show an increase in the incidence of the disease, which is why effective prevention and targeted treatment methods are so important.
