成人接触性过敏的流行病学

Epidemiology of contact allergy in adults.

作者信息

Schäfer T, Böhler E, Ruhdorfer S, Weigl L, Wessner D, Filipiak B, Wichmann H E, Ring J

机构信息

Institute of Social Medicine, Medical University Lübeck, Beckergrube 43047, 23552 Lübeck, Germany.

出版信息

Allergy. 2001 Dec;56(12):1192-6. doi: 10.1034/j.1398-9995.2001.00086.x.

DOI:10.1034/j.1398-9995.2001.00086.x

PMID:11736749

Abstract

BACKGROUND

We aimed to determine the prevalence of contact sensitization in the general population and to investigate associations with important sociodemographic and medical characteristics.

METHODS

Within a population-based nested, case-control study in Germany, we performed patch tests with 25 standard allergens in 1141 adults (50.4% female, age median 50 years). Additional information was obtained by a dermatologic examination, a standardized interview, and blood analysis.

RESULTS

At least one positive reaction was exhibited by 40.0% of the subjects, with reactions most frequently observed to fragrance mix (15.9%), nickel (13.1%), thimerosal (4.7%), and balsam of Peru (3.8%). Women were sensitized more often than men (50.2% vs 29.9%, OR 2.36, CI 1.84-3.03), and this was also significant for fragrance mix, nickel, turpentine, cobalt chloride, and thimerosal. Contact sensitization was more frequent in subjects who reported adverse skin reactions (53.8% vs. 32.6%; OR 2.41, CI 1.85-3.14), and this was particularly true for sensitization to nickel (45.5% vs 8.8%, OR 8.64, CI 5.67-13.17) and fragrance mix (29.0% vs 14.0%, OR 2.51, CI 1.60-3.91) and the corresponding intolerance of fashion jewelry and fragrances. Contact sensitization decreased with increasing degree of occupational training (unskilled 45.9%, apprenticeship 40.1%, technical college 40.4%, and school of engineering 12.5%; P=0.023; trend test P=0.042). Significant associations of contact sensitization and presence of allergen-specific IgE antibodies, atopic eczema, or psoriasis were not observed. Frequency estimates for the general adult population based on these findings were 28.0% for overall contact sensitization and 11.4% for fragrance mix, 9.9% for nickel, and 3.2% for thimerosal.

CONCLUSIONS

It is concluded that contact allergy is influenced by sociodemographic parameters and plays an important role in the general population.

摘要

背景

我们旨在确定普通人群中接触性致敏的患病率，并调查其与重要社会人口统计学和医学特征之间的关联。

方法

在德国一项基于人群的巢式病例对照研究中，我们对1141名成年人（50.4%为女性，年龄中位数50岁）进行了25种标准变应原的斑贴试验。通过皮肤科检查、标准化访谈和血液分析获取了更多信息。

结果

40.0%的受试者至少出现一种阳性反应，最常观察到的反应是对香料混合物（15.9%）、镍（13.1%）、硫柳汞（4.7%）和秘鲁香脂（3.8%）的反应。女性比男性更容易致敏（50.2%对29.9%，比值比2.36，可信区间1.84 - 3.03），这在香料混合物、镍、松节油、氯化钴和硫柳汞方面也具有统计学意义。报告有皮肤不良反应的受试者中接触性致敏更常见（53.8%对32.6%；比值比2.41，可信区间1.85 - 3.14），在对镍（45.5%对8.8%，比值比8.64，可信区间5.67 - 13.17）和香料混合物（29.0%对14.0%，比值比2.51，可信区间1.60 - 3.91）的致敏以及相应的对时尚首饰和香料不耐受方面尤其如此。接触性致敏随着职业培训程度的提高而降低（无技能者45.9%，学徒40.1%，技术学院40.4%，工程学院12.5%；P = 0.023；趋势检验P = 0.042）。未观察到接触性致敏与变应原特异性IgE抗体、特应性皮炎或银屑病之间存在显著关联。基于这些发现对普通成年人群的频率估计为：总体接触性致敏为28.0%，香料混合物为11.4%，镍为9.9%，硫柳汞为3.2%。