Polysensitization in the European general population: The EDEN Fragrance Study

M.L.A. Schuttelaar, R.F. Ofenloch, M. Bruze, P. Elsner, M. Gonçalo, L. Naldi, A. Svensson, T.L. Diepgen

Research output: Contribution to journalMeeting AbstractAcademic


INTRODUCTION: Polysensitization is currently defined as contact sensitization to three or more non-related allergens of the European baseline series. Reported prevalences of polysensitization are mainly from clinical populations, as studies in the general population are scarce. OBJECTIVES: To determine the prevalences of polysensitization in the European general population. MATERIALS AND METHODS: In five European countries (The Netherlands, Germany, Italy, Portugal and Sweden) a random sample (N=3119) from the general population (18-74 years) was patch tested. Patch testing was performed according to the International Contact Dermatitis Research Group guidelines. Both TRUE Test and investigator-loaded chamber systems were used, testing for a total of 47 allergens, including the individual fragrance allergens of fragrance mix (FM) I and FM II. Reading was performed at day 3. Polysensitization was defined as sensitization to 3 or more non-related allergens. The following positive reactions were pooled as one: FM I and one or more substances of FM I; FM II and one or more substances of FM II; carba mix and thiuram mix; mercapto mix and 2-mercaptobenzothiazole; formaldehyde, quaternium 15, diazolidinyl urea and imidazolidinyl urea. RESULTS: Overall, the age-standardized prevalence of polysensitization was 2.6% (95% confidence interval [CI] 2.1-3.2). The agestandardized prevalences stratified per country were: The Netherlands: 4.0% (95% CI 2.5-6.0); Germany: 3.2% (95% CI 2.3-4.4); Portugal: 2.6% (95% CI 1.5-4.3); Sweden: 1.5% (95% CI 0.7-2.9); Italy 1.1% (95% CI 0.5-2.3). Of the polysensitized population, the majority was female ≥ 40 years (42.0%) and minority was male <40 years (8.6%). The age-standardized prevalences of one positive reaction was 19.2% (95% CI 17.9-20.7) and of one or two positive reactions (oligosensitization) was 25.6% (95% CI 24.1-27.2). Avoidance rates due to skin complaints were higher in polysensitized subjects compared to oligosensitized subjects and compared to subjects with negative patch test reactions. Avoidance of leave on products: polysensitized 44.3%; oligosensitized 32.9%; negative patch tests 23.7%. Avoidance of household or functional products: polysensitized 29.1%; oligosensitized 18.3%; negative patch tests 12.0%. CONCLUSION: Prevalences of polysensitization in the general population are presented for countries across Europe for the first time. Differences in prevalences are seen between different countries. Higher avoidance rates of scented products due to skin complaints were reported for leave-on and household or functional products in polysensitized subjects.
Original languageEnglish
Pages (from-to)46
Number of pages1
Issue numberSuppl.1
Publication statusPublished - 1-Oct-2018
Event14th Congress of the European Society of Contact Dermatitis (ESCD), 18–20 October 2018, Milan, Italy - Milan, Italy
Duration: 17-Oct-201820-Oct-2018
Conference number: 14


  • 2 mercaptobenzothiazole
  • allergen
  • diazolidinyl urea
  • formaldehyde
  • fragrance
  • germall 115
  • quaternium 15
  • thiram
  • unclassified drug
  • adult
  • allergy rapid test
  • avoidance behavior
  • conference abstract
  • contact dermatitis
  • contact sensitization
  • controlled study
  • female
  • Germany
  • household
  • human
  • Italy
  • major clinical study
  • male
  • Netherlands
  • patch test
  • population
  • Portugal
  • prevalence
  • random sample
  • Sweden

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