Evidence map›Paper›PMID 40460887›Full record

ArticleContact dermatitis2025

Epidemiology of Sensitivity to Nickel, Cobalt and Chromium in Israel: A Retrospective Cohort Study.

Daniel Hilewitz, Akiva Trattner, Asher Hackett, Adi Raviv, Yehonatan Noyman, Stav Endelman, Dan Slodownik, Danny Daniely, Rivka Friedland, Daniel Mimouni and 1 more

Abstract read
In one paragraph

Article in Contact dermatitis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Daniel HilewitzDepartment of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.ORCID https://orcid.org/0009-0000-2274-4332
Akiva TrattnerDepartment of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.
Asher HackettDepartment of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.
Adi RavivDepartment of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.
Yehonatan NoymanDepartment of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.
Stav EndelmanDepartment of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.
Dan SlodownikFaculty of Medicine, Tel Aviv University, Tel Aviv, Israel.ORCID https://orcid.org/0000-0001-6560-2625
Danny DanielyFaculty of Medicine, Tel Aviv University, Tel Aviv, Israel.ORCID https://orcid.org/0000-0002-8852-9384
Rivka FriedlandFaculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Daniel MimouniDepartment of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.
Igor SnastDepartment of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNickel, cobalt and chromium are three common allergens included in the European baseline series (EBS). It was shown that sensitivity to nickel and cobalt is more frequent among young women, most commonly due to contact with inexpensive jewellery, while sensitivity to chromium is more common among older men. Israel is located in West Asia and hosts the largest Jewish population in the world. There is limited data regarding the epidemiology of these metals in Israel or in the Mediterranean region.

objectiveTo investigate the epidemiology of sensitivity to nickel, cobalt and chromium in the EBS in a single center in Israel between 2009 and 2023.

methodsRetrospective cohort study that included all patients who underwent patch testing with the EBS in a tertiary center in Israel between 2009 and 2023.

resultsOf 5234 consecutive patients (1679 males [32.1%]) 2158 (41%) were sensitive to nickel, 541 (10.3%) to cobalt and 383 (7.3%) to chromium. During the study period, nickel sensitivity was stable and was associated with female sex and age 18-40 years. Among both sexes, cobalt sensitivity decreased significantly from 11.7% in 2009-2011 to 7.9% in 2020-2023 and was associated with female sex and age < 18 years. Chromium sensitivity decreased significantly from 11.1% in 2009-2011 to 5% in 2020-2023 and was associated with male sex and older age (> 60 years). Among both sexes, cobalt strongly co-reacted with nickel (OR = 1.69, 95% CI 1.38-2.06, p < 0.001) and chromium (OR = 3.57, 95% CI 2.67-4.55, p < 0.001). Nickel-cobalt co-sensitization was significantly more common among patients with strong (++) or very strong (+++) nickel sensitivity compared to patients with weak (+) sensitivity. Males, but not females, with nickel sensitivity positively co-reacted with chromium. Among patients with nickel sensitivity, the strong (++) or very strong (+++) reaction (36.3%) was significantly more common compared to patients with cobalt or chromium sensitivity.

conclusionIn this retrospective Israeli study, the prevalence of sensitivity to nickel was stable but much higher compared to European and North American studies, highlighting the necessity for multicenter and general population studies and possibly a legislation regarding nickel restriction of items with prolonged contact with the skin. Cobalt and chromium sensitivities decreased and were in line with previous studies.

Indexed as

ChromiumCobaltDermatitis, Allergic ContactNickelAdolescentAdultAgedFemaleHumansIsraelJewelryMaleMiddle AgedPatch TestsRetrospective StudiesSex FactorsChromiumCobaltNickelallergic contact dermatitiscross‐reactionsepidemiologymetalspatch test

Identifiers

PMID40460887
PMCPMC12318911

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.