Trends in contact allergy to fragrance mix I in consecutive Danish eczema patients over three decades; a cross-sectional study from 1986 to 2015

Summary

Background

For more than 30 years, fragrance mix I (FMI) has been the most important screening marker for fragrance contact allergy. Meanwhile, governmental and corporate initiatives have been implemented, aimed at reducing sensitization to fragrance allergens, including the single constituents of FMI.

Objectives

To examine trends in contact allergy to FMI from 1986 to 2015 in dermatitis patients, and test the hypothesis that sensitization to the fragrance screening marker has decreased within recent years.

Methods

Cross-sectional registry study on patch test results to FMI among consecutively tested dermatitis patients from a single university clinic across three 10-year periods. From 2006-2015, data on eczema location according to MOAHLFAA, clinical relevance of sensitization, and cosmetic exposures were available.

Results

Of 24,168 patients, 7.8% (95% CI: 7.4-8.1%) were sensitized to FMI. For women, a significant trend (p=0.004) was observed for an increase in sensitization to FMI across the three decades. From 2011-2015, the prevalence of contact allergy to FMI increased significantly for both women (8.0% versus 10.4%, p=0.002) and men (4.4% versus 7.3%, p=0.002) compared to the previous 5-year period. From 2006-2015, clinical relevance was established in 78.2% of FMI positive patients with no differences over time. An increase (28.6% versus 36.1%, p=0.05) in FMI positive patients suffering from facial dermatitis was observed for the period 2011-2015 compared to 2006-2010.

Conclusions

The prevalence of contact allergy to FMI has been increasing within recent years. No effect of previous preventive initiatives could be demonstrated.

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