{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T16:05:25Z","timestamp":1785600325319,"version":"3.56.0"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,11,25]],"date-time":"2019-11-25T00:00:00Z","timestamp":1574640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In 2001, the EU nickel directive was introduced to prevent contact allergy to nickel. Contact allergy to palladium and\/or cobalt is often seen together with contact allergy to nickel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the contact allergy prevalence of nickel, palladium, and cobalt allergy before and after the introduction of the EU nickel directive in consecutive patients with dermatitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of patch test results from 1995\u20132016 was performed (n = 18\u2009264). Chi\u2010square tests were used to examine trends for nickel, palladium, and cobalt across test years. Logistic regression was used for associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of nickel allergy decreased significantly in the youngest age group (6\u201330\u2009years) for both female and male patients from 1995\u20131999 to 2012\u20132016: females: 33.4% to 19.1% (<jats:italic>P<\/jats:italic>&lt;\u2009.001); males: 5.9% to 2.1% (<jats:italic>P<\/jats:italic>&lt;\u2009.05). The concomitant reactions between nickel and palladium and nickel and cobalt among young females, respectively, also decreased significantly. Isolated palladium and cobalt allergy remained stable (1.4% and 2.3%, respectively) during the same time period for both men and women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence of nickel has decreased among young females and males suspected of contact allergy in Southern Sweden after the introduction of the EU nickel directive. There has been no change in isolated palladium or cobalt allergy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cod.13422","type":"journal-article","created":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T16:13:23Z","timestamp":1571415203000},"page":"218-226","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Prevalence of contact allergy to metals: nickel, palladium, and cobalt in Southern Sweden from 1995\u20132016"],"prefix":"10.1111","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2606-5588","authenticated-orcid":false,"given":"Lisbeth","family":"Rosholm Comstedt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Dahlin","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Dermatology Lund University, Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2919-3227","authenticated-orcid":false,"given":"Magnus","family":"Bruze","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Dermatology Lund University, Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"\u00c5kesson","sequence":"additional","affiliation":[{"name":"Clinical Studies Sweden \u2010 Forum South Sk\u00e5ne University Hospital Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Hinds\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Dermatology Lund University, Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Pont\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Dermatology Lund University, Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marl\u00e9ne","family":"Isaksson","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Dermatology Lund University, Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Svedman","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Dermatology Lund University, Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14167"},{"key":"e_1_2_7_3_1","unstructured":"General advice regarding ear piercing. 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