Nickel release from earrings purchased in the United States: The San Francisco earring study

BackgroundNickel sensitization is frequent among US patients with dermatitis and in the general population. In Europe, decreasing prevalences of nickel sensitization are observed as a result of the European Union Nickel Directive. However, no directive exists in the United States.ObjectivesWe sought to examine nickel release from inexpensive earrings and discuss possible methods of reducing nickel exposure among consumers.MethodsA total of 34 different stores and artists were visited. A total of 277 earrings were purchased and examined with the dimethylglyoxime (DMG) test.ResultsDMG-positive earrings were identified from local artists (69%) and tourist stores (42.9%) but also chain stores targeting young (24.1%) and mature (1.7%) women. No correlation between price and outcome of DMG testing was identified.LimitationsOur study does not reflect buying trends in the United States. Pretreatment of earrings with artificial sweat was not performed and the DMG may lead to both false-positive and false–negative results.ConclusionsNickel exposure from inexpensive earrings is frequent in the United States. A regulatory governmental intervention may be warranted.