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P02 Analysis of coupled patch test reactions to nickel, cobalt and chromate

Concomitant sensitizations to Nickel, Cobalt and Chromate are often observed among patch test patients. However, the reasons for being sensitized to two or more of these substances are not completely understood. Examination of IVDK (http://www.ivdk.org) patch test results with multivariate procedures has been conducted to further elucidate the mechanisms involved with these sensitizations and potential exposure factors that may have led to the concomitant sensitizations. Gender, age, occupational dermatitis, and construction work were considered and examined with multivariate logistic regression models with the dependent response variable being concurrent reactions to a metal pair versus no reactions. In addition to the aforementioned anamnestic data, examination of a poly‐sensitizations variable (reactions to 1, 2, or 3 standard series allergens other than Nickel, Cobalt or Chromate) provided information regarding general susceptibility to positive patch test reactions. Combined reactions to Cobalt and Chromate were strongly linked to construction work (OR = 11.23 (7.46, 16.90)) and occupational dermatitis. Female patch test patients had a higher odds of a positive patch test reaction to both Nickel and Cobalt (OR = 4.73 (3.81, 5.87)). Sensitization to other, unrelated standard series substances was associated with concurrent reactions to all of the metal pairs. The association between construction work and Cobalt‐Chromate reactions corresponds with the hypothesis that cement exposures lead to cobalt‐chromate sensitizations. Individual susceptibility to delayed‐type sensitizations, as represented by the poly‐sensitization variable, also appears to be associated with coupled sensitizations to metals and warrants further examination.