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There is widespread concern regarding the safety of silver-mercury amalgam dental restorations, yet little evidence to support their harm or safety. We examined whether mercury dental amalgams are adversely associated with cognitive functioning in a cross-sectional sample of healthy working adults. We studied 550 adults, 30-49 years of age, who were not occupationally exposed to mercury. Participants were representative of employees at a major urban medical center. Each participant underwent a neuropsychologic test battery, a structured questionnaire, a modified dental examination, and collection of blood and urine samples. Mercury exposure was assessed using a) urinary mercury concentration (UHg); b) the total number of amalgam surfaces; and c) the number of occlusal amalgam surfaces. Linear regression analysis was used to estimate associations between each marker of mercury exposure and each neuropsychologic test, adjusting for potential confounding variables. Exposure levels were relatively low. The mean UHg was 1.7 microg/g creatinine (range, 0.09-17.8); the mean total number of amalgam surfaces was 10.6 (range, 0-46) and the mean number of occlusal amalgam surfaces was 6.1 (range, 0-19). No measure of exposure was significantly associated with the scores on any neuropsychologic test in analyses that adjusted for the sampling design and other covariates. In a sample of healthy working adults, mercury exposure derived from dental amalgam restorations was not associated with any detectable deficits in cognitive or fine motor functioning. [ABSTRACT FROM AUTHOR]

Several contact allergens are tested at concentrations which might cause irritant reactions. In this study we investigated whether the reactivity to a standard irritant is useful in identifying subjects with hyperreactive skin yielding a higher rate of doubtful or irritant reactions. Sodium lauryl sulfate (SLS) 0.5% (aqua) was tested in addition to the standard series routinely for 5 years in the Department of Dermatology, Dortmund. For data analysis, we compared reactions at D3 to the standard series, the vehicle/emulsifier and preservative series and benzoyl peroxide to the reactions obtained with SLS. Proportions were standardized for age and sex. The association between reactivity to a certain allergen and SLS reactivity as a dichotomous outcome, controlled for age and sex as potential confounders, was assessed with logistic regression analysis. Results showed that of the 1600 tested patients, 668 (41.8%) had an irritant reaction to SLS which exceeded 2 + in only 41 patients. Seasonal variation was statistically significant, showing reduced SLS reactivity in summer vs. winter. Patients with irritant reactions to SLS showed significantly more erythematous reactions to the following 10 allergens of the standard series: fragrance mix, cobalt chloride, balsam of Peru (Myroxylon pereirae), lanolin alcohol, 4-phenylenediamine base (PPD), propolis, formaldehyde, N -isopropyl-N ′-phenyl-p -phenylenediamine (IPPD), benzocaine, and 4-tert -butylphenol-formaldehyde resin. No significant differences regarding strong positive allergic reactions were observed. Concerning other allergens, significantly more erythematous reactions were observed in SLS-reactive patients to benzoyl peroxide, octyl gallate, cocamidopropyl betaine, Amerchol L-101, tert -butylhydroquinone, and triethanolamine. In the SLS-reactive group of patients, the reaction index was negative for 10 allergens of the standard series compared to only 5 in the SLS non-responder group. For the first... [ABSTRACT FROM AUTHOR]

To quantify the independent impact of potential risk factors for nickel contact allergy (NCA), a multifactorial Poisson regression analysis of standardized anamnestic and patch test data (with nickel sulfate, 5% in petrolatum) was performed, comprising 74 940 patients assessed in the 33 German and Austrian contact dermatitis units of the Information Network of Departments of Dermatology (IVDK) between 1992 and 2000. NCA was observed in 15.5% patients. Female sex was the strongest risk factor (prevalence ratio 3.74, 95% CI: 3.51–3.98). Risk increased monotonically and significantly with decreasing age. Atopic dermatitis was not a risk factor. The year of patch test had no influence on NCA risk. Significant variation of risk between occupations was observed. In conclusion, our multifactorial analysis was able to quantify the impact of established risk factors and additionally address other, e.g. occupational, factors yet unidentified. [ABSTRACT FROM AUTHOR]

Adolescent and young adult males who have sex with men (MSM) remain at high risk of HIV infection. Many sexual risk factors have been identified, yet the role of substance use remains controversial. We assess the extent to which urban young MSM report being 'high' on drugs or alcohol during sex and the association between being 'high' and unprotected anal intercourse (UAI). During summer 2000, 3,075 MSM aged 15-25 years completed a 20-minute interview for the Community Intervention Trial for Youth Project. Participants were asked about their last sexual contact with main and nonmain partners, including whether they were 'high on drugs or alcohol.' 18.6% of MSM with a main partner reported being high during their last sexual encounter; 25.0% reported UAI. Among men with a nonmain partner, 29.3% reported being high, and 12.3% reported UAI. Being high was associated with unprotected receptive anal intercourse with nonmain partners (odds ratio = 1.66, p = .02). HIV prevention should include messages about the potential dangers of drinking and drug use in situations where sexual encounters with nonmain partners may occur. [ABSTRACT FROM AUTHOR]

Clinical epidemiology (CE) is considered unable to estimate morbidity concerning either contact sensitization (CS) or allergic contact dermatitis (ACD) at the population level. Drug-utilization research (DUR) methods estimate the morbidity of suitable diseases based on prescription data for disease-specific drugs. Our objective was to estimate population figures for incidence and prevalence of ACD and CS based on sales data for patch test material in Germany and on patient data from the Information Network of Departments of Dermatology (IVDK). Approximately 600,000 standard series are sold per year in Germany, according to the 2 main manufacterers. This raw sales figure was corrected for certain effects (discarded preparations, proportion of formerly patch-tested patients, proportion of patients with ACD seeking medical advice) to obtain an estimate of the denominator of patients eligible for patch testing annually, and combined with patch test results from the Information Network of Departments of Dermatology (IVDK). In 17.8% (of 9,266 IVDK patients) ACD was established. Extrapolated to the general population, an incidence of ACD of between 1.7 and 7 per 1000 per year was estimated, depending on whether conservative or more liberal assumptions concerning the above effects were made. Of 78,067 IVDK patients tested between 1992 and 2000, 46.8% had at least 1 positive reaction (+ to + + +), and 22.7% had at least 1 stronger positive reaction (+ + or + + +).The 9-year prevalence of CS was estimated to lie between 4.0% and 16.6% for the first outcome, and between 2.0% and 8.1% for the second. Concerning single allergens, 1.9–4.5 million individuals are probably sensitized to nickel, and 1.4–3.4 million to fragrance mix among the German population of 82 million inhabitants. The morbidity data found in this study are in good accordance with data from population-based epidemiological studies. In comparison to these, the CE-DUR approach seems... [ABSTRACT FROM AUTHOR]

Background: Allergic contact sensitization to ‘para amino’ compounds is frequent and the spectrum of cross-reactivity between members of this chemical group is variable. Methods: A retrospective analysis of clinical patch test data obtained with a special test series in the centres of the Information Network of Departments of Dermatology (IVDK) between 1995 and 1999. Results: In the 638 patients tested with the above test panel positive reactions were observed most often to p- aminoazobenzene (16.2%), p- phenylenediamine (14.1%), p- toluylenediamine (10.0%), followed by 4,4′-diaminodiphenylmethane (8.5%), Disperse Orange 3 (8.4%) and p- aminophenol (3.1%). Among the 544 patients tested with p- phenylenediamine and all seven additional ‘para amino’ compounds, concordance between reactions varied greatly. The stronger the positive test reaction to p- phenylenediamine, p- toluylenediamine or p- aminoazobenzene, the more frequently additional positive reactions to the other compounds were observed. Conclusions: A screening employing several ‘para amino’ compounds is necessary to describe the individual spectrum of allergic contact sensitization, as there is no reliable marker substance. Further research should aim at (i) establishing the mechanism of cross-reactivity to ‘para amino’ compounds and (ii) identifying exposures in the environment. Background: Allergic contact sensitization to ‘para amino’ compounds is frequent and the spectrum of cross-reactivity between members of this chemical group is variable. Methods: A retrospective analysis of clinical patch test data obtained with a special test series in the centres of the Information Network of Departments of Dermatology (IVDK) between 1995 and 1999. Results: In the 638 patients tested with the above test panel positive reactions were observed most often to p- aminoazobenzene (16.2%), p- phenylenediamine (14.1%), p- toluylenediamine... [ABSTRACT FROM AUTHOR]

The preservative iodopropynyl butylcarbamate (IPBC) (0.1% in petrolatum) was tested in 4883 consecutive patients for 18 months between January 1998 and June 1999. With regard to the MOAHLFA-Index, the study population comprised 37% males; 17% with occupational and 19% with atopic dermatitis; 31% with hand, 10% with leg and 17% with face dermatitis; 61% were age 40 and above. According to readings at D3, 0.3% were allergic to IPBC, with 14 + and 2 + + reactions. Doubtful or irritant reactions occurred twice as frequently. Patients exposed for 24 h (n = 1814) reacted less frequently (0.1%) than the remaining patients exposed for 48 h (0.5%). Considering the possibility that a certain proportion of + reactions could be false positive, the reaction pattern was evaluated. More than 80% of the positive reactions displayed a crescendo or plateau time pattern. Furthermore, 18 of 43 doubtful reactions (?) appeared as late as D3 (thus, these could be false negative), whereas the majority of doubtful reactions occurred earlier and displayed a decrescendo pattern (corresponding to a typical irritant pattern). In conclusion, the large proportion of ‘?’ reactions may be due not only to the irritant potential of the substance, but also to test concentrations not being high enough to elicit an allergic reaction. We propose that higher concentrations of IPBC (0.3%) should be evaluated in a study also addressing suitable validation tests like ROAT or PUT. [ABSTRACT FROM AUTHOR]

Presents information on a study which assessed the role of potential occupational risk factors for fragrance contact allergy. Methods; Results; Discussion.

Investigates the seasonal variability of patch test results in contact dermatitis. Influence of irritant reactions on the variability; Surveillance data on seasonal variations from the German Information Network of Departments of Dermatology; Association between allergen reactivity and environmental factors.

Contact allergy to oil of turpentine was reported to have become rare. However, the evaluation of standardized data of 45,005 patients tested 1992–1997 in 30 Dermatological Centers associated with the German-Austrian Information Network of Departments of Dermatology (IVDK) showed an increase in positive patch test reactions to turpentine from 0.5% during the years 1992–1995, up to 1.7% in 1996 and 3.1% in 1997. In particular, 17,347 patients tested in 1996–1997 were evaluated in detail by comparing 431 individuals with positive patch test reactions with the rest of the group found negative to turpentine. Using the so-called MOAHLFA index, the following characteristics were shown. Turpentine allergy (a) was found to be significantly less frequent in men and in patients with occupational dermatitis, (b) showed no difference in its association with atopic dermatitis, (c) patients with turpentine allergy had significantly less symptoms of the hands, more symptoms of the legs or in the face and (d) were significantly more often aged over 60 years. Also, patients sensitized to turpentine had increased rates of additional sensitizations. The definite reason for the increase in turpentine sensitization in the population tested here is not clear. Therefore, a detailed exposure analysis is necessary; the new increase in turpentine allergies may be due to popular topical remedies or household chemicals. [ABSTRACT FROM AUTHOR]

Sensitization rates to contact allergens vary between centers and are influenced by sex and age. Eliminating the latter 2 factors by standardization of data by age and sex, the present analysis adresses possible differences between centers remaining after elimination of these confounders and analyzes other factors which might influence rates e.g., the MOAHL index. Overall standardized rates were well within the range reported in previous studies and may be regarded as representing the rates were well within the range reported in previous studies and my be regarded as representing the rates of the "patch test population" in Central Europe (e.g., nickel sulfate 12.9% of fragrance mix 10.5%,balsam of Peru 7.3%, thimerosal 5.6%). For this analysis data of those departments which contributed more than 2000 patients, or of those with extreme proportions concerning sex, age and occupational cases were selected. Patients from these 10 departments differed considerably with regard to the items of the MOAHL index and with regard to standarized rates. The items of the MOAHL index proved to be suitable for describing different patch test populations and for explaining some differences between centers. Only 'atopic dermatitis' seems to have little influence on (standardized ) rate. Face dermatitis is not yet represented in the MOAHL index, but should be included, together with age >40 years in an extended index (acronym: MOAHLFA). Regional allergen exposure (with striking differences between East Germany, West Germany and to a lesser extent. In addition, sociological factors may influence sensitization rates, which is exemplified by high rates of nickel allergy in a socially defined subgroup. Future studies should focus on these factors as well as on factors concerning patch test practices and quality control. [ABSTRACT FROM AUTHOR]