CONTACT: Missy Gough (847) 330-0101, ext. 384 [email protected]
Karen Klickmann (847) 330-0101, ext. 341 [email protected]
NICKEL AND LATEX ALLERGIES PRESENT GROWING ALLERGY EPIDEMIC
NEW YORK, NY (October 28, 1998) - The popular trend in body piercing, beyond traditional locations such as the earlobes, has brought upon an equally unpopular trend in allergic reactions. Locations such as the upper portions of the ears, lips, nose, nasal septum, tongue, navel, breasts and genitalia, are frequently chosen for piercing and have displayed a variety of allergic responses.
Speaking today at the American Academy of Dermatology's Derm Update '98, David E. Cohen, MD, M.P.H., Assistant Professor of Dermatology, New York University School of Medicine, New York, NY, discussed the wave of metal allergies that are the result of the body piercing trend, as well as the dramatic increase in the incidence of latex allergies.
Decorative devices made of a variety of materials have been employed in piercing procedures. Costume jewelry is often made of alloys which contain different metals. Nickel, cobalt and chrome are frequently present in costume-grade rings, studs and barbells used in body piercing. Allergy to piercing jewelry, particularly earrings, is common and frequently seen when allergenic metals are utilized. Among all chemical allergens capable of producing an allergic skin disease, nickel is the most common allergen in North America.
For the metal family, chrome and cobalt trail nickel in their degree of allergenicity.
"Despite their presence in many metal objects, the quality and mixture of the metals is an important factor in determining the allergenicity of the jewelry. Surgical-grade stainless steel and titanium probably represent safer materials, even for those allergic to some of the aforementioned metals," Dr. Cohen said. "When piercing any part of the body, always use caution and utilize only safe and sterile equipment. At the first sign of infection, or allergy, consult your dermatologist."
In the past 10 years, allergy to natural rubber latex (NRL) products has become widespread within populations exposed to high levels of rubber. In response to the increasing incidence and awareness of both HIV and the hepatitis virus in the late '80s, and the adoption of "universal precautions," the use of personal protective equipment such as latex gloves became the standard of care. It is estimated that more than 5.6 million American health care workers use more than seven billion pairs of gloves each year.
"Allergies to NRL products have become widespread, affecting not only health care workers but much of the population, including children and housekeepers. Latex and its additives, materials widely used in the manufacturing of protective barrier and medical equipment, as well as everyday household objects, have been identified as the causative agents of various types of dermatoses and other allergic reactions, including more severe anaphylactic reactions," Dr. Cohen said.
A few of the hundreds of items which have been found to cause allergic reactions include: disposable gloves, soft casts, operating room masks, adhesive strips, along with balloons, diapers, incontinence pads, feeding nipples, water toys and equipment, and even zippered plastic storage bags.
There are three well-recognized reactions to NRL products. Irritant contact dermatitis, which results from the direct action of chemicals found in latex or other glove components on the skin, is not directly affected by the immune system. The extent of the reaction depends on other physical parameters such as duration of exposure, skin contact and skin temperature. Irritant contact dermatitis causes erythema (redness), pruritus (itching) and edema, followed by lichenified (thickened), crusted plaques on the exposed area.
Another common reaction to NRL products is allergic contact dermatitis, also known as delayed-type hypersensitivity. It is caused by the body's sensitization, usually to accelerators used in the manufacturing of the products. The reaction usually begins within 48 to 72 hours of contact and directly involves the interaction of the immune system and depends upon the person's genetic susceptibility.
Immediate-type hypersensitivity, like allergic contact dermatitis, requires previous sensitization. This reaction is the most potentially dangerous and deaths have occurred due to anaphylaxis. Burning, stinging, sneezing, itching and scratching, asthma, and conjunctivitis should not be ignored and a dermatologist should be contacted immediately.
In today's modern world, NRL is widespread. Therefore, eliminating the use of NRL is not a viable option. However, the scope of the NRL allergic population does warrant the need for improvements in the manufacturing, production and handling of these products for the workplace and for everywhere these products are utilized. Manufacturers are already researching and producing disposable gloves to reduce all types of skin reactions. Other manufacturers are encouraged to follow this trend.
The American Academy of Dermatology is the largest medical society representing physicians who specialize in treating conditions of the skin, hair and nails.
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REFERENCE NOTE:
Cohen, D.E., M.D.; Brancaccio, R.R., M.D.; What is New in Clinical Research in Contact Dermatitis, Dermatologic Clinics, January 1997, pp. 137-148.
Cohen, D.E., M.D.; et al.; American Academy of Dermatology's Position Paper on Latex Allergy, Journal of the American Academy of Dermatology, July 1998, pp. 98-106.
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