Nickel in tap water

Nickel analyses of tap water from several sources in Copenhagen gave up to 490 + 10^-4 g + 1^-1 in the first 250 ml portions. Hot water gave higher values than cold water. After flushing for 5 min, low values were found. Considerable variation from time to time and from tap to tap was found. Drinking of only the first portion in the morning might have an influence on nickel hand eczema.     

Nickel on the Swedish market before the Nickel Directive

Nickel allergy is by far the most frequent contact allergy, affecting 10-15% of women in the general population, and causing dermatitis and hand eczema. The EU Nickel Directive, aimed at the prevention of nickel allergy, comes fully into force by July 2001. The Directive covers piercing materials, items in contact with the skin, and requirements on resistance to wear. We carried out a study of the prevalence on the market, before the Nickel Directive, of items that release nickel and of nickel in piercing posts. Nickel release, as shown by a positive dimethylglyoxime (DMG) test, was detected in 25% of 725 items intended for direct and prolonged contact with the skin. Of 15 posts intended for use during epithelialization after piercing, 60% contained more than 0.05% nickel. These products do not comply with the requirements of the EU Nickel Directive. It is suggested that experts in contact dermatitis participate in the prevention of nickel allergy by explaining its effects: the r le of skin exposure and which parts of an item are in contact with the skin, and the crucial question of nickel release versus nickel content.     

Nickel dermatitis - Nickel excretion

Nickel excretion in urine in four females sensitive to nickel with an intermittent dyshidrotic eruption was measured with flameless atomic absorption. Excretion of nickel was found to be increased in association with outbreaks of vesicles. The results support the idea that the chronic condition was maintained by ingestion of nickel in food.     

Nickel on the Swedish market. Follow-up after implementation of the Nickel Directive

The Nickel Directive aims at the prevention of sensitization and elicitation of nickel dermatitis. It limits nickel release from, and nickel content in, certain items. The Directive came into full force by July 2001. The aim of this study was to investigate the frequency on the market of items that release nickel and of nickel content in piercing posts, 2 years after coming into force of the Directive. Of special interest was to study changes compared to the situation in 1999, when a baseline study had been carried out. Nickel release from 786 items covered by the Nickel Directive was tested with the dimethylglyoxime (DMG) test, and nickel content in 18 piercing posts was analysed. Nickel release was shown from 8% of items intended for direct and prolonged contact with the skin, and 17% of the piercing posts contained too much nickel, a decrease compared to 1999. There has been significant adaptation to the requirements of the Nickel Directive. The DMG test is useful for screening for nickel release and for monitoring the market. Provided there is further adaptation to the requirements, the risk of sensitization and elicitation of nickel dermatitis will be significantly reduced.     

Nickel excretion in urine after oral administration *

In recent years the importance of internal exposure to nickel in patients with recurrent hand eczema and nickel allergy has become evident. The present study was performed in order to investigate the value of urinary nickel determinations as an index of oral nickel intake. After oral administration of 5.6 mg nickel (as the sulfate), increased nickel excretion was found over the following 2–3 days. We conclude that consecutive urinary nickel determinations are able to disclose variations in oral intake of nickel.     

Nickel sensitivity in the general population

The incidence of nickel sensitivity in a population above the age of 10 was examined through epicutaneous tests with 5% nickel sulphate performed on certain school and occupational test subjects and on subjects at a home for elderly people. Nickel sensitivity was observed in 4.5% (in 44 cases of 980 tested subjects), in 8% of the females and in 0.8% of the males. In 42 of the 44 nickel-sensitive subjects there was a history of dermatitis from metal contact. At the time of testing, 16 (34%) of the nickel-sensitive subjects revealed eczema. A manifest nickel sensitivity was thus found in 1.6% of all tested subjects, in 2.8% of females and in 0.4% of males. Nickel sensitivity and a simultaneous hand eczema was noted in 0.9% of the tested population, in 1.6% of females and in 0.2% of males. Hand eczemas were rarer (20.5%) in the nickel-sensitive subjects in the population study than in the nickel-sensitive patients tested at the same time in the clinic (56.6%). No case of nickel sensitivity was occupationally related.     

Nickel dermatitis in infants

8 cases of allergic contact dermatitis to nickel in infants are reported. All showed a papular dermatitis matching the sites of contact. Patch testing was performed on 3 patients, 2 were tested to nickel sulfate in pet. at concentrations of 1.0%, 1.5%, 2.0%. 1 was tested to 2.5% alone. All developed ++ reactions at each concentration tested. We observed a strong association of nickel dermatitis with atopy; 7 of 8 patients had a family history of atopy and 5 of 8 had features of coexistent atopic dermatitis. The relationship between atopy and allergic contact dermatitis is briefly reviewed. Nickel dermatitis may aggravate atopic dermatitis; avoidance of metal contact is crucial in the management of these patients.     

A case of allergic contact dermatitis due to nickel in underground water

A 26-year-old Korean woman with nickel allergy continued to have recurrent facial lesions even after avoiding the usual sources of nickel. As another possible source of nickel, underground water at her house, which had been used by her for 3 years, was analyzed by atomic absorption spectrophotometry. Nickel contents in 8 different domestic tap waters and another underground water sample were also measured by plasma scan. Nickel contents in the patient's underground water were 9 times higher on average than those in domestic tap water. Patch tests with 2 concentrated underground water samples gave positive results. The other underground water sample also contained a higher amount of nickel than tap water. Therefore, we suggest that the underground water was a source of our patient's nickel contact dermatitis, and should be considered as a rare but possible source of nickel contact dermatitis.     

Nickel release from coins

Nickel allergy is the most frequent contact allergy and is also one of the major background factors for hand eczema. The clinical significance of nickel release from coins was discussed when the composition of euro coins was decided. Current European coinage is dominated by cupro-nickel coins (Cu 75; Ni 25); other nickel-containing and non-nickel alloys are also used. Nickel release from used coinage from the UK, Sweden and France was determined. It was shown that nickel ions are readily available on the surface of used coins. After 2 min in artificial sweat, approximately 2 microg of nickel per coin was extracted from cupro-nickel coins. Less nickel was extracted from non-nickel coins. Nickel on the surface was mainly present as chloride. After 1 week in artificial sweat approximately 30 microg/cm2 was released from cupro-nickel coins: less nickel was released from coins made of other nickel alloys. Theoretically, several microg of nickel salts may be transferred daily onto hands by intense handling of high-nickel-releasing coins.     

Nickel release from nickel particles in artificial sweat

Nickel is widely used in a broad range of products, primarily made of alloys, used by humans on a daily basis. Previous assessments have shown that skin contact with some such products may cause nickel allergic contact dermatitis, induced by the release of nickel. However, data on nickel release from small nickel particles in artificial sweat for assessment of potential risks of workers in nickel-producing and nickel-using facilities are not available. The objective of this study was to fill this knowledge gap by determining nickel release from fine nickel powder ( approximately 4 microm diameter) of different loadings varying from 0.1 to 5 mg/cm(2), when immersed in artificial sweat. The amount of nickel released increased with increasing particle loading, whereas the highest release rate per surface area of particles was observed for the medium particle loading, 1 mg/cm(2), at current experimental conditions. All particle loadings showed time-dependent release rates, reaching a relative steady-state level of less than 0.1 microg/cm(2)/hr after 12 hr of immersion, whereby less than 0.5% of the nickel particle loading was released. Nickel release from particles was influenced by the surface composition, the active surface area for corrosion, particle size, and loading.     

Nickel allergy and orthodontic treatment

OBJECTIVES: Tolerance induction to prevent development of nickel allergy has been suggested with permanent dental braces. We wanted to find out which effect orthodontic treatments had had on the development of nickel allergy in university students. STUDY DESIGN: We examined and patch tested 153 students, of whom 113 had a history of pierced skin, and 70 a history of orthodontic treatment roughly 10 years earlier. RESULTS: All except one student with pierced skin were females. Development of nickel allergy was significantly associated with skin piercing (54% compared with 12%). At the time of the study, there was a slight but non-significant difference in the prevalence of nickel allergy between students who had been subjects for orthodontic treatment (49%) compared with non-treated ones (58%) if they had pierced skin. There were no significant differences in the development of nickel allergy among students who had had permanent dental braces before (50%) or after skin piercing (48%). However, from 40 students without skin piercing four of 11 (three males) with a history of permanent braces had developed nickel allergy, as compared with none of 22 (P = 0.008) without orthodontic treatment suggesting possibility of sensitization through dental devices. CONCLUSIONS: Orthodontic treatment may not lead to tolerance induction on all occasions, and sensitization through permanent devices seems to be possible.     

Nickel penetration through rubber gloves

Positive patch tests confirm nickel penetration through rubber gloves. Dimethylglyoxime (DMG) results indicate that nickel reactivity may occur where DMG testing is negative.     

Nickel allergy and hand eczema

A clinical study was performed in 66 female patients with hand eczema and contact allergy to nickel. They were drawn from a basic material of 165 patients with nickel allergy in which hand eczema occurred in 86 cases (52%). The hand eczema started at an average age of 32 years and it had been preceded by a metal hypersensitivity for an average of 6 years. The eczema was found to be chronic with a mean duration up to the time of examination of 8 years. It was associated with secondary eruptions in half of the cases. The hand eczema showed a low degree of relevance with regard to dependance of occupation or vacation, as well as to exacerbation of the dermatitis after a direct contact with nickel-coated objects. The clinical examination disclosed in 77% a pompholyx, i.e. a symmetric vesicular eruption mainly located on the palms and volar aspects of fingers, and sides of fingers. The eczema often showed a periodic activity, with about 15 annual eruptions in the pompholyx cases. It is concluded that simple external contact with the metal can hardly explain the most common clinical pattern of the hand eczema in nickel allergy.     

Nickel dermatitis provoked by buttons in blue jeans

A total of 79 nickel-sensitive patients (65 women, 14 men) were examined with regard to a present or past eczema corresponding to contact with metallic buttons in blue jeans; 63% of the women and 64% of the men had or had had eczema of this kind. Among 40% of the women below 30 years this was the primary site of manifestation. The seriousness of this sensitivity is illustrated by the fact that two-thirds of the nickel sensitive patients with button dermatitis had or had had eczema of the hands. The conclusion is that blue jean buttons should be made of a material which does not contain nickel, for instance zinc alloys which are presently used for some metallic buttons, or they should be designed in such a way that the button does not directly contact the skin.     

Nickel/magnesium interactions in nickel-sensitive patients

Experimentally demonstrated interactions between Ni²⁺ and Mg²⁺ were examined in human beings. 110 subjects patch-test-positive to 10μl aq. NiSO₄ 0.1 M were solutions into groups of 30.50 and 30 people. Each subgroup was tested to 10μl NiSO₄ 0.1 M solution as a control and to mixed solutions containing NiSO₄ 0.1 M together with. respectively MgSO₄ 0.1 and 0.3. 0.3 and 0.5 and 0.5 and 1 M. On increasing the applied concentrations of MgSO₄, the % of patients with reduced or suppressed nickel reactions, with 1 exception, proportionally increased. The exception concerned testing with 0.5 M. where a paradoxically exacerbating increase in nickel reactions was seen in a majority of nickel-sensitive subjects. MgCl₂ aq. at 0.3. 0.5 and 1 M concentrations was not able to reduce the cutaneous patch test positive reactions to NiCl₂ 0.1 M in 25 sensitive patients. On increasing the applied concentrations of MgCl₂ both the number and intensity of patch test reactions to NiCl₂ proportionally increased. A supposed role of the sulfate and chloride counterions in the penetration of nickel was examined in 30 NiSO₄ 5% patch-test-positive testing to 10μl of aq, NisO₄ 0.1 M. NiCl₂ 0.1 M. NiSO₄ 0.1 M + MgCl₂ 0.3 M, NiCl₂ 0.1 M + MgSO₄ 0.3 Na₂SO₄ 0.3. NiSO₄ 0.1 M + Na₂ SO₄ 0.3 M, NiSO₄ 0.1 M + Na₂SO₄ 0.3 NiCl₂ 0.1 M+ NACl 0.3 M the findings suggest that the addition OF sulfate or chloride to nickel could determine the formation of different Ni complexes directed toward different targets, one Mg²⁺ -dependent, the other Mg²⁺ -independent.