Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital, Herlev-Gentofte, Hellerup, Denmark.
Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev-Gentofte, Hellerup, Denmark.
Contact Dermatitis. 2021 Nov;85(5):514-522. doi: 10.1111/cod.13925. Epub 2021 Jul 17.
In March 2014, the European Commission issued a new regulation restricting the content of hexavalent chromium (Cr) in leather to no more than 3 mg/kg. We previously performed a questionnaire study in January 2014 to characterize our patients with Cr contact allergy prior to regulatory intervention.
To assess whether clinical characteristics, self-reported sources of Cr exposure, and burden of disease changed in patients with Cr allergy over time.
A questionnaire study was performed among 172 adult dermatitis patients with Cr allergy and 587 age- and sex-matched dermatitis patients without Cr allergy. A questionnaire was sent to all dermatitis patients patch tested from 2003 to 2018 in August 2019.
The overall response rate was 61.2% (759/1241). Patients with Cr allergy were still more commonly affected by current foot dermatitis (odds ratio [OR] 3.82, 95% confidence interval [CI] 2.07-7.08) and hand dermatitis (OR 1.98, 95% CI 1.13-3.49) compared with controls diagnosed during 2013 to 2018. The proportion of patients with Cr allergy reporting dermatitis caused by leather exposure did not change during 2003 to 2012 vs 2013 to 2018 (71.0% vs 66.2%, P = .5). Furthermore, estimates on occupational performance and disease severity (eg, current dermatitis), number of anatomical locations with dermatitis, worst-case dermatitis, and effect on work were similar in patients with Cr allergy for 2003 to 2012 vs 2013 to 2018.
No immediate sign of improvement was found in patients with Cr allergy concerning severity of disease and dermatitis from leather exposures 5 years after adoption of the regulation against hexavalent Cr in leather. The regulation may have to be revised for better protection of those already sensitized.
2014 年 3 月，欧盟委员会发布了一项新规定，将皮革中六价铬（Cr）的含量限制在不超过 3mg/kg。在此之前，我们在监管干预之前于 2014 年 1 月进行了一项问卷调查研究，以描述我们的 Cr 接触过敏患者的情况。
评估 Cr 过敏患者的临床特征、自我报告的 Cr 暴露源和疾病负担是否随时间发生变化。
我们对 172 名患有 Cr 过敏的成年皮炎患者和 587 名年龄和性别匹配的无 Cr 过敏的皮炎患者进行了问卷调查研究。2019 年 8 月，我们向所有在 2003 年至 2018 年期间进行斑贴试验的皮炎患者发送了一份调查问卷。
总体回复率为 61.2%（759/1241）。与在 2013 年至 2018 年期间诊断为对照的患者相比，Cr 过敏患者当前足部皮炎（比值比 [OR]3.82，95%置信区间 [CI]2.07-7.08）和手部皮炎（OR 1.98，95%CI 1.13-3.49）的发病率仍然更高。与 2003 年至 2012 年相比，2013 年至 2018 年期间报告因皮革暴露而引起皮炎的 Cr 过敏患者比例并未改变（71.0%比 66.2%，P=.5）。此外，在 2003 年至 2012 年与 2013 年至 2018 年期间，Cr 过敏患者的职业表现和疾病严重程度（例如当前皮炎）、皮炎发生的解剖部位数量、最严重皮炎以及对工作的影响等方面的估计值相似。
在皮革中六价 Cr 规定实施 5 年后，Cr 过敏患者的疾病严重程度和皮革暴露引起的皮炎未见明显改善。可能需要对该法规进行修订，以更好地保护已致敏人群。
