Proactive surveillance of contact allergies: an important component of the risk management strategy for skin sensitizers

Risk assessment serves to ensure that dermal exposure to skin sensitizers does not result in the acquisition of allergic skin disease. Traditionally, the approach adopted was one of comparative analysis, involving benchmarking against other allergens of known potency. More recently, efforts have been made to embrace a quantitative risk assessment (QRA) approach. However, the accuracy of any risk assessment is reflected in the extent to which it meets the fundamental objective stated above. Thus, clinical experience is of key importance. There exists the possibility for the originators of risk assessments relating to chemicals that possess skin-sensitizing potential to work directly with the clinical community to proactively obtain this experience through specific surveillance programmes. This forms the focus of this review article. The current status of the QRA approach is considered initially. A recently published example of one such surveillance programme that was undertaken as a collaborative initiative between industry and the clinical community is then reviewed. Finally, a possible strategy for the future is presented, in which it is suggested that surveillance strategies might be deployed in certain situations as an adjunct to the initial risk assessment. It is hoped that such a framework might further improve the efficacy of future approaches to skin sensitization risk assessment.