Formaldehyde 2% is not a useful means of detecting allergy to formaldehyde releasers— results of the ESSCA network, 2015-2018

Whitehouse H, Uter W, Geier J, Ballmer-Weber B, Bauer A, Cooper S, Czarnecka-Operacz M, Dagmar S, Dickel H, Fortina AB, Gallo R, Gimenez-Arnau AM, Johnston GA, Filon FL, Mahler V, Pesonen M, Rustemeyer T, Schuttelaar MLA, Valiukeviciene S, Weisshaar E, Werfel T, Wilkinson SM (2020)

Publication Type: Journal article

Publication year: 2020

Journal

DOI: 10.1111/cod.13691

Abstract

Background: Studies suggest that patch testing with formaldehyde releasers (FRs) gives significant additional information to formaldehyde 1% aq. and should be considered for addition to the European baseline series (EBS). It is not known if this is also true for formaldehyde 2% aq. Objectives: To determine the frequency of sensitization to formaldehyde 2% aq. and co-reactivity with FRs. To establish whether there is justification for including FRs in the EBS. Materials and Methods: A 4-year, multi-center retrospective analysis of patients with positive patch test reactions to formaldehyde 2% aq. and five FRs. Results: A maximum of 15 067 patients were tested to formaldehyde 2% aq. and at least one FR. The percentage of isolated reactions to FR, without co-reactivity to, formaldehyde 2% aq. for each FR were: 46.8% for quarternium-15 1% pet.; 67.4% imidazolidinyl urea 2% pet.; 64% diazolidinyl urea 2% pet.; 83.3% 1,3-dimethylol-5, 5-dimethyl hydantoin (DMDM) hydantoin 2% pet. and 96.3% 2-bromo-2-nitropropane-1,3-diol 0.5% pet. This demonstrates that co-reactivity varies between FRs and formaldehyde, from being virtually non-existent in 2-bromo-2-nitropropane-1,3-diol 0.5% pet. (Cohen's kappa: 0, 95% confidence interval [CI] −0.02 to 0.02)], to only weak concordance for quaternium-15 [Cohen's kappa: 0.22, 95%CI 0.16 to 0.28)], where Cohen's kappa value of 1 would indicate full concordance. Conclusions: Formaldehyde 2% aq. is an inadequate screen for contact allergy to the formaldehyde releasers, which should be considered for inclusion in any series dependant on the frequency of reactions to and relevance of each individual allergen.

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Involved external institutions

Oxford University Hospitals NHS Foundation Trust United Kingdom (GB) University of Groningen / Rijksuniversiteit Groningen Netherlands (NL) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Vrije Universiteit Amsterdam (VU) / University Amsterdam Netherlands (NL) Chapel Allerton Hospital United Kingdom (GB) Poznan University of Medical Sciences / Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu Poland (PL) Georg-August-Universität Göttingen Germany (DE) Kantonsspital St.Gallen Switzerland (CH) Università degli Studi di Trieste Italy (IT) Universitätsklinikum Heidelberg Germany (DE) Technische Universität Dresden Germany (DE) Finnish Institute of Occupational Health (FIOH) / Työterveyslaitos (TTL) Finland (FI) Autonomous University of Barcelona (UAB) / Universitat Autònoma de Barcelona Spain (ES) Ruhr-Universität Bochum (RUB) Germany (DE) University of Leicester United Kingdom (GB) Universität Bern Switzerland (CH) Lithuanian University of Health Sciences / Lietuvos sveikatos mokslų universitetas (LSMU) Lithuania (LT) University of Padua / Universita degli Studi di Padova Italy (IT) University of Genova / Università degli Studi di Genova Italy (IT)

How to cite

APA:

Whitehouse, H., Uter, W., Geier, J., Ballmer-Weber, B., Bauer, A., Cooper, S.,... Wilkinson, S.M. (2020). Formaldehyde 2% is not a useful means of detecting allergy to formaldehyde releasers— results of the ESSCA network, 2015-2018. Contact Dermatitis. https://doi.org/10.1111/cod.13691

MLA:

Whitehouse, Heather, et al. "Formaldehyde 2% is not a useful means of detecting allergy to formaldehyde releasers— results of the ESSCA network, 2015-2018." Contact Dermatitis (2020).

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