Research group Anneli Julander

The research is focused on hazardous skin exposure to toxic and allergenic chemicals among workers and consumers, regulatory aspects, risk assessment and prevention. The group focuses on three major areas; 1) ex vivo and in vitro studies of skin absorption and penetration, 2) contact allergy and hand eczema in workers and in the general population, and 3) the role of skin as exposure route in comparison to inhalation and oral ingestion of metals.

Our research methods include experimental and analytical techniques to evaluate skin absorption, skin dose, inhalation exposure, biomonitoring, immunological markers for skin allergy and skin barrier function, and patch-testing to assess contact allergy. We also use epidemiological methodology to study hand eczema, contact allergy and occupational exposures.

The competence of the research group includes occupational and environmental medicine and dermatology, occupational hygiene, organic and analytical chemistry, material and surface chemistry, and regulatory aspects of skin exposure to chemicals.

Members of the group: Anneli Julander, Klara Midander
Associated members: Carola Lidén, Maria Lagrelius

Cobalt nanoparticles – risks for skin uptake an allergy?

It is not known if skin contact with allergenic metals in the form of nanoparticles will give rise to an increased contact allergy risk compared to other forms of metals. Furthermore, it is also unknown if metals in nanoform will affect the dose of metals that permeates to systemic circulation.

In the project, we measure release of cobalt ions from nanoparticles and microparticles in different artificial sweat solutions and water, as a measure for how much cobalt that may end up on skin from direct contact with particles. We have also assessed the elicitation response to cobalt nanoparticles in comparison with the corresponding dose in ion form for cobalt allergy in already cobalt allergic persons. In combination with this, we also study different immunological markers in the exposed skin, to evaluate if the nanoparticles initiate a stronger immune reaction.

The project will yield information on how the form of cobalt affects immunological parameters, which will result in increased understanding of risks associated with nanoparticle skin exposure. Within the project we collaborate with the Unit of Systems Biology, IMM, KI, the Department of Occupational and Environmental Dermatology at Lund University, and the Division of Surface Chemistry and Corrosion Science, KTH.

Financing

  • Swedish Research Council for Health, Working Life and Welfare
  • Hudfonden – genom EDVARD WELANDERS STIFTELSE OCH FINSENSTIFTELSEN

Contacts

Nickel on skin - what is normal and/or safe?

Nickel is the most common cause of contact allergy in women, men and young people in Sweden and Europe, despite protective legislation (REACH). Since 2001, when the nickel restriction came into full force, the prevalence in the population has not decreased to a predicted extent.

To strengthen the degree of protection within the nickel restriction, "prolonged contact" with the skin has been defined as more than 10 minutes on at least 3 occasions, or more than 30 minutes on at least one occasion within two weeks. This clarification is expected to cause the inclusion of more items in the restriction. How it affects the skin dose of nickel, which is directly decisive for the development of contact allergy and eczema, is at present unknown.

The aim of the project is to reduce the risk of hand eczema in already nickel allergic persons and prevent work-related skin disease caused by nickel, elucidating the importance of short-term, repeated skin contact with nickel in working life. By quantifying the nickel exposure of workers and nickel-allergic patients, conclusions can be drawn about normal levels of nickel on skin as well as safe skin doses and how the nickel load can be reduced. The results contribute to reduced nickel exposure and in the long run, sick leave due to skin disease. Furthermore, the results are important for legislation, occupational health care's disease prevention work and employers.

Research Support

  • AFA Försäkring

Contacts

Does increased hand hygiene because of Covid-19 affect work-related hand eczema and contact allergies?

During the Covid-19 pandemic, infectious disease control has included recommendations for intensified hand hygiene for the entire population: Wash your hands often! For occupational groups that cannot work from home or use protective gloves to a greater extent, the pandemic has led to new routines regarding hand hygiene and disinfection of surfaces and objects. In many cases, this means extremely frequent hand washing with soap and warm water as well as the use of disinfectants. As there has been a great shortage of alcohol-based hand sanitizers, many alternatives that do not only contain alcohol and moisturizing substances, have been used. The alternatives have often contained substances such as hydrogen peroxide which is known to be irritating to the skin.

Our project idea is to study how the frequency of hand eczema and exposure to skin irritants / allergens is affected following the changed hygiene routines during Covid-19. The purpose is to reduce the risk of hand eczema (contact and irritation eczema) during periods of intensified infectious disease control, and to avoid short sick leave due to skin disease. The goal is to contribute with better knowledge of how the skin can be protected in occupational groups that are not normally used to manage the impact of increased handwashing. Through questionnaire studies and registers for disease burden as well as prescription of cortisone creams, we can investigate whether hand eczema is increasing in the Stockholm Region. Through in-vitro studies with the contact allergen in soaps and other products for cleaning the skin, we will study how known allergens will penetrate the skin when the skin barrier is constantly and repeatedly damaged as a result of increased contact with water and disinfectants.

Research Support

  • AFA Försäkring

Contacts

Hand eczema and contact allergy in adolescents

Hand eczema and contact allergy are common in adults. Little is known about the prevalence in young people. Hand eczema and contact allergy have been studied within the BAMSE birth cohort at the age of 16. Web based questionnaire and clinical examination including patch testing for contact allergy were used. The project will increase knowledge about hand eczema and contact allergy in adolescence, and associations with atopy, skin exposure, and genetic risk factors. This is expected to contribute to enhanced diagnosis and counselling by health care, and preventive measures in schools and workplaces for reduction of contact allergy and hand eczema. Within the project we collaborate with the following KI departments: Institute of Environmental Medicine, Department of Medicine Solna, Department of Clinical Science and Education, Stockholm South General Hospital, and with the Centre for Occupational and Environmental Medicine, Region Stockholm, Karolinska University Hospital, and Sachs' Children's Hospital.

Financing

  • AFA Insurance
  • Karolinska Institutet
  • Region Stockholm
  • Swedish Research Council for Health, Working Life and Welfare (FORTE)
  • Welander-Finsen Foundation/HudFonden

Contacts

Carola Lidén

Professor Emeritus/Emerita

Maria Lagrelius

Affiliated to research

Hazardous skin exposure, allergy and dermatitis

Use of hazardous chemicals is increasing. Skin exposure to skin sensitizers results in contact allergy and dermatitis. Harmful effects can be prevented by exposure reduction. We have developed methods to record and quantify hazardous skin exposure, local effects and occurrence of sensitizers. We are studying hazardous skin exposure and skin disease in consumers and workers. This has generated new knowledge about exposure to and effects by sensitizing metals (nickel, cobalt, and chromium in leather), preservatives in paint and cosmetics, hair dye substances, fragrances and plastic chemicals, and skin irritants. The research is expected to result in enhanced risk assessment and risk management for reduction of health risks.

Main collaborators

Institute of Environmental Medicine, KI; Centre for Occupational and Environmental Medicine, Region Stockholm; Gothenburg University; KTH Royal Institute of Technology; Lund University; National Allergy Research Centre, Denmark; St. John's Institute of Dermatology, Guy’s Hospital, London, UK; University of Erlangen/Nürnberg, Germany; University of Strasbourg, France

Financing

  • AFA Insurance
  • Swedish Asthma and Allergy Research Foundation
  • Swedish Research Council for Health, Working Life and Welfare (FORTE)
  • Welander-Finsen Foundation/HudFonden

Contacts

Carola Lidén

Professor Emeritus/Emerita

Skin absorption of metals - barrier properties, kinetics, and mixed exposure

Contact allergy to nickel, cobalt and chromium affects 20% of the general population in Europe. The sensitizing key events are well studied for these metals, but skin barrier penetration is sorely under-researched and not included in the OECD validated test guidelines or in the Integrated Approaches to Testing and Assessment (IATA) for skin irritation or sensitization. Development of artificial 3D-skin models has resulted in commercialised state-of-the-art models, some approved for sensitization and/or corrosion tests and few also for absorption. The conventional diffusion cell tests for skin absorption is developed for organic chemicals. The suitability of either conventional absorption tests or 3D skin models for assessment of metal skin absorption, need to be researched to provide relevant data on metal absorption kinetics as these may differ from organic substances.

We will study absorption kinetics following exposure to allergenic metals in different forms by continuous monitoring of metal concentrations by ICP-MS directly coupled to an in vitro exposure system containing the organ barrier, i.e. 3D skin models or piglet/human skin. Results will provide kinetic information of high resolution, that allow detailed comparison of transport kinetics between the four different models. Accumulation of metals retained in the skin barrier will be quantified post exposure to provide information on the build-up of a reservoir that can have implications for immune system response.

The project will give us a general understanding of skin exposure to sensitizing metals in different forms, and especially mixed exposure to several metals at the same time. The latter is expected to affect the skin's ability to absorb and accumulate the metals which may impact the activation of the immune system and thus the risk of allergy and contact dermatitis following such exposure.

Contacts