AISI 316L Stainless-Steel Ear Piercing Post Assembly Does Not Cause Dermatitis in Nickel-Sensitive Subjects

Ingber, Arieh; Hershko, Klilah; Horev, Liran

doi:10.1159/000076801

Cited by 8 publications

(11 citation statements)

References 12 publications

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“…The safety of piercing in relation to the use of different metallic alloys has been scarcely investigated. Even the use of high-quality stainless steel ear-piercing post assemblies may not exclude allergic reactions in those who are allergic to nickel (32). Ingber et al (32) studied the clinical reaction after ear-piercing with post assemblies containing AISI 316 L stainless steel in 25 individuals with proven nickel allergy.…”

Section: Discussionmentioning

confidence: 99%

Nickel allergy in a Danish population 25 years after the first nickel regulation

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Nickel allergy in a Danish population 25 years after the first nickel regulation

et al. 2017

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“…In 2005, the first category was changed to include all items inserted into pierced parts of the body (not only during epithelialization), and the limit was changed from nickel content to nickel release (<0.2 μg/cm 2 per week). The change was based on a report evaluating the safety of piercing post assemblies on limited scientific evidence …”

Section: Prevention and Regulatory Interventionsmentioning

confidence: 99%

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

et al. 2019

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Nickel is the most frequent cause of contact allergy worldwide and has been studied extensively. This clinical review provides an updated overview of the epidemiology, exposure sources, methods for exposure quantification, skin deposition and penetration, immunology, diagnosis, thresholds for sensitization and elicitation, clinical pictures, prevention, and treatment. The implementation of a nickel regulation in Europe led to a decrease in the prevalence of nickel allergy, and changes in the clinical picture and disease severity. Nevertheless, the prevalences of nickel allergy in the European general population are approximately 8% to 19% in adults and 8% to 10% in children and adolescents, with a strong female predominance. Well‐known consumer items such as jewellery and metal in clothing are still the main causes of nickel allergy and dermatitis, although a wide range of items for both private and occupational use may cause dermatitis. Allergic nickel dermatitis may be localized to the nickel exposure site, be more widespread, or present as hand eczema. Today, efficient methods for exposure quantification exist, and new insights regarding associated risk factors and immunological mechanisms underlying the disease have been obtained. Nevertheless, questions remain in relation to the pathogenesis, the persistent high prevalence, and the treatment of severe cases.

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“…The scientific background for this change is not clear, however. Prior to the amendment, Ingber et al performed a small study on AISI316L stainless steel ear‐piercing‐post assemblies with a nickel content between 10% and 14% (382). Ear Piercing Manufacturers of Europe Ltd, Spalding, UK, supported the study financially.…”

Section: Introductionmentioning

confidence: 99%

“…Ear Piercing Manufacturers of Europe Ltd, Spalding, UK, supported the study financially. Nickel release from piercing‐post assemblies was between 0.11 and 0.21 µg nickel/cm 2 /week for 10 unused posts (382). Ingber et al argued that a nickel release limit would be a more appropriate protective regulation than a nickel content limit (382).…”

Section: Introductionmentioning

confidence: 99%

Nickel and cobalt allergy before and after nickel regulation – evaluation of a public health intervention

Thyssen

2011

Contact Dermatitis

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Over the 20th century, the frequent use of nickel in consumer products resulted in an increasing prevalence of nickel allergy. Risk items included suspenders in the 1950s-1960s; buttons, zippers and rivets in the 1970s; and ear-piercing jewellery in the 1980s. When subjects allergic to nickel were exposed to nickel in high concentrations, it often resulted in allergic nickel contact dermatitis and hand eczema. In 1990, the Danish government began to regulate consumer nickel exposure as a response to the increasing nickel allergy problem. In 1994, the EU Nickel Directive was passed, a regulation that was based on the Danish and Swedish nickel regulations. These major public health interventions were expected to change the epidemiology of nickel allergy and dermatitis in Europe. Furthermore, it was debated whether nickel would be replaced by cobalt in inexpensive jewellery and result in higher prevalence of cobalt allergy. An evaluation of the possible effects of the European nickel regulations is of importance to ensure protection of consumers and dermatitis patients. This doctoral thesis aimed to evaluate the effects of regulatory interventions on nickel exposure by investigating the development of nickel allergy and dermatitis before and after nickel regulation. Furthermore, a change in the association between nickel allergy and hand eczema was evaluated. The nickel spot test was validated to determine its value when used for screening purposes. Possible explanations for the persistence of nickel allergy were explored including genetic predisposition and consumer nickel exposure from jewellery and accessories. A cobalt spot test was developed and validated. Finally, it was evaluated whether a cobalt allergy epidemic had replaced the nickel allergy epidemic after nickel regulation in terms of increasing cobalt sensitization and cobalt exposure. The thesis showed that the prevalence of nickel allergy decreased significantly after nickel regulation in young Danish women from the general population (18-35 years) and in young Danish female dermatitis patients from a university patch test clinic (0-30 years). Stratification by ear-piercing status revealed that women ear pierced before 1990 had a significantly higher prevalence of nickel allergy and dermatitis than women ear pierced after 1990. Furthermore, the association between hand eczema and nickel allergy decreased in young women aged 18-35 years when a comparison was made between women who were patch tested and questioned in, respectively, 1990 and 2006. Despite the decreasing prevalence of nickel allergy, this condition remains prevalent in young Danish women, as about 10% are nickel allergic. Genetic predisposition to nickel allergy was evaluated by investigating the possible association between filaggrin null mutation status and nickel allergy. A positive association was found but it was also concluded that environmental nickel exposure is of much greater importance. Thus, of 354 consumer items purchased from 36 different stores in Copenhagen, 22% released ni...

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AISI 316L Stainless-Steel Ear Piercing Post Assembly Does Not Cause Dermatitis in Nickel-Sensitive Subjects

Cited by 8 publications

References 12 publications

Nickel allergy in a Danish population 25 years after the first nickel regulation

Nickel allergy in a Danish population 25 years after the first nickel regulation

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

Nickel and cobalt allergy before and after nickel regulation – evaluation of a public health intervention

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