Metal Allergy pp 197-209 | Cite as

Metals in Coins

  • Kelsey E. Hirotsu
  • Jennifer K. Chen


Coins in current circulation are made of diverse alloys, with copper-nickel constituting the most widely used alloy in coins worldwide. Coins have been reported to be a relevant source of exposure to nickel and copper and may result in exacerbation or elicitation of allergic contact dermatitis particularly to nickel in select clinical settings. Allergic contact dermatitis to coins is dependent on many variables, including local factors affecting nickel release (e.g., humidity, temperature, pH); duration, type, and frequency of exposure; skin barrier factors affecting individual susceptibility (e.g., xerosis, preexisting hand dermatitis); as well as baseline nickel allergy prevalence for the region. In this chapter, we review relevant methodologies and literature to date evaluating metal deposition on the skin and induction of allergic contact dermatitis. Patients who handle coins occupationally and consumers with nickel allergy appear to be at particular risk. Coins should not be overlooked as a potential source of allergen exposure.


  1. 1.
    Thyssen JP, et al. Coin exposure may cause allergic nickel dermatitis: a review. Contact Dermatitis. 2013;68(1):3–14.CrossRefGoogle Scholar
  2. 2.
    Williams SP. Nickel dermatitis from coins. Contact Dermatitis. 1999;40:61–2.CrossRefGoogle Scholar
  3. 3.
    Stevenson J. Coins. The New York Times, 1991.Google Scholar
  4. 4.
    Kuwahara RT, Skinner RB 3rd, Skinner RB Jr. Nickel coinage in the United States: the history of a common contact allergen. West J Med. 2001;175(2):112–4.CrossRefGoogle Scholar
  5. 5.
    Hamann CR, et al. The cost of nickel allergy: a global investigation of coin composition and nickel and cobalt release. Contact Dermatitis. 2013;68(1): 15–22.CrossRefGoogle Scholar
  6. 6.
    Menne T, et al. Patch test reactivity to nickel alloys. Contact Dermatitis. 1987;16(5):255–9.CrossRefGoogle Scholar
  7. 7.
    Standardisation, E.C.f., CEN, EN 1811:2011. Reference test method for release of nickel from all post assemblies which are inserted into pierced parts of the human body and articles intended to come into direct and prolonged contact with the skin. 2011.Google Scholar
  8. 8.
    Thyssen JP, et al. Sensitivity and specificity of the nickel spot (dimethylglyoxime) test. Contact Dermatitis. 2010;62(5):279–88.CrossRefGoogle Scholar
  9. 9.
    Sivasankar B. Engineering Chemistry. New Delhi: McGraw-Hill; 2008.Google Scholar
  10. 10.
    Thyssen JP, et al. A spot test for detection of cobalt release - early experience and findings. Contact Dermatitis. 2010;63(2):63–9.CrossRefGoogle Scholar
  11. 11.
    Allenby CF, Basketter DA. Minimum eliciting patch test concentrations of cobalt. Contact Dermatitis. 1989;20(3):185–90.CrossRefGoogle Scholar
  12. 12.
    Julander A, et al. New UK nickel-plated steel coins constitute an increased allergy and eczema risk. Contact Dermatitis. 2013;68(6):323–30.CrossRefGoogle Scholar
  13. 13.
    Fournier PG, Govers TR. Contamination by nickel, copper and zinc during the handling of euro coins. Contact Dermatitis. 2003;48(4):181–8.CrossRefGoogle Scholar
  14. 14.
    Liden C, Carter S. Nickel release from coins. Contact Dermatitis. 2001;44(3):160–5.CrossRefGoogle Scholar
  15. 15.
    Boman A, et al. Dissolving of copper by synthetic sweat. Contact Dermatitis. 1983;9(2):159–60.CrossRefGoogle Scholar
  16. 16.
    Black H. Dermatitis from nickel and copper in coins. Contact Dermatitis Newsletter. 1972;12:326–7.Google Scholar
  17. 17.
    Suarez CP, Fernandez-Redondo V, Toribio J. Bingo-hall worker's occupational copper contact dermatitis from coins. Contact Dermatitis. 2002;47(3):182.CrossRefGoogle Scholar
  18. 18.
    Flint GN. A metallurgical approach to metal contact dermatitis. Contact Dermatitis. 1998;39(5):213–21.CrossRefGoogle Scholar
  19. 19.
    Pedersen NB, et al. Release of nickel from silver coins. Acta Derm Venereol. 1974;54(3):231–4.PubMedGoogle Scholar
  20. 20.
    Nestle FO, Speidel H, Speidel MO. Metallurgy: high nickel release from 1- and 2-euro coins. Nature. 2002;419(6903):132.CrossRefGoogle Scholar
  21. 21.
    Menne T, Solgaard P. Temperature-dependent nickel release from nickel alloys. Contact Dermatitis. 1979;5(2):82–4.CrossRefGoogle Scholar
  22. 22.
    Agency DEP. Risk Assessment Targeted Report: Nickel as Used in Euro Coins. Copenhagen. 1999:1–42.Google Scholar
  23. 23.
    Liden C, Skare L, Vahter M. Release of nickel from coins and deposition onto skin from coin handling--comparing euro coins and SEK. Contact Dermatitis. 2008;59(1):31–7.CrossRefGoogle Scholar
  24. 24.
    Jellesen MS, et al. Nickel-containing coins: a health risk for nickel-sensitive individuals? Br J Dermatol. 2006;155(6):1301–2.CrossRefGoogle Scholar
  25. 25.
    Liden C, et al. Deposition of nickel, chromium, and cobalt on the skin in some occupations - assessment by acid wipe sampling. Contact Dermatitis. 2008;58(6):347–54.CrossRefGoogle Scholar
  26. 26.
    Jensen P, et al. Occupational hand eczema caused by nickel and evaluated by quantitative exposure assessment. Contact Dermatitis. 2011;64(1):32–6.CrossRefGoogle Scholar
  27. 27.
    Staton I, et al. Dermal nickel exposure associated with coin handling and in various occupational settings: assessment using a newly developed finger immersion method. Br J Dermatol. 2006;154(4):658–64.CrossRefGoogle Scholar
  28. 28.
    Gawkrodger DJ, McLeod CW, Dobson K. Nickel skin levels in different occupations and an estimate of the threshold for reacting to a single open application of nickel in nickel-allergic subjects. Br J Dermatol. 2012;166(1):82–7.CrossRefGoogle Scholar
  29. 29.
    Liden C, et al. Assessment of skin exposure to nickel, chromium and cobalt by acid wipe sampling and ICP-MS. Contact Dermatitis. 2006;54(5):233–8.CrossRefGoogle Scholar
  30. 30.
    Julander A, et al. Skin deposition of nickel, cobalt, and chromium in production of gas turbines and space propulsion components. Ann Occup Hyg. 2010;54(3):340–50.Google Scholar
  31. 31.
    Fisher AA. Coin dermatitis. Cutis. 1984;33(6):530–6. 543PubMedGoogle Scholar
  32. 32.
    Morgan JK. Observations on the persistence of skin sensitivity with reference to nickel eczema. Br J Dermatol. 1953;65(3):84–94.CrossRefGoogle Scholar
  33. 33.
    Aberer W, Kranke B. The new EURO releases nickel and elicits contact eczema. Br J Dermatol. 2002;146(1):155–6.CrossRefGoogle Scholar
  34. 34.
    Foti C, et al. Provocative use test of 1 euro coin in nickel-sensitized subjects. Contact Dermatitis. 2005;52(3):167–8.CrossRefGoogle Scholar
  35. 35.
    Seidenari S, et al. Reactivity to euro coins and sensitization thresholds in nickel-sensitive subjects. J Eur Acad Dermatol Venereol. 2005;19(4):449–54.CrossRefGoogle Scholar
  36. 36.
    Nucera E, et al. Positive patch tests to Euro coins in nickel-sensitized patients. Br J Dermatol. 2004;150(3):500–3.CrossRefGoogle Scholar
  37. 37.
    Rothman S. Hypersensitiveness to metal coins. JAMA. 1931;97:336.CrossRefGoogle Scholar
  38. 38.
    Gollhausen R, Ring J. Allergy to coined money: nickel contact dermatitis in cashiers. J Am Acad Dermatol. 1991;25(2 Pt 2):365–9.CrossRefGoogle Scholar
  39. 39.
    Husain SL. Nickel coin dermatitis. Br Med J. 1977;2(6093):998.CrossRefGoogle Scholar
  40. 40.
    Bettley FR. Nickel contact dermatitis. Contact Dermatitis Newsletter. 1979;9:198.Google Scholar
  41. 41.
    van Ketel WG. Occupational contact with coins in nickel-allergic patients. Contact Dermatitis. 1985;12(2):108.CrossRefGoogle Scholar
  42. 42.
    Kanerva L, Estlander T, Jolanki R. Bank clerk's occupational allergic nickel and cobalt contact dermatitis from coins. Contact Dermatitis. 1998;38(4):217–8.CrossRefGoogle Scholar
  43. 43.
    Nigam PK, Saxena AK. Metal content of Indian coins. Contact Dermatitis. 1988;18(5):309–10.CrossRefGoogle Scholar
  44. 44.
    Preininger T. Oberempfindlichkeit gegen Nickelgeld. Dermatol Wochenschr. 1934;99:1082–4.Google Scholar
  45. 45.
    Marcussen PV. Ecological considerations on nickel dermatitis. Br J Ind Med. 1960;17:65–8.PubMedPubMedCentralGoogle Scholar
  46. 46.
    Agrup G. Hand eczema and other hand dermatoses in south Sweden. Acta Derm Venereol. 1969;61Google Scholar
  47. 47.
    Cronin E. Contact dermatitis. Edinburgh: Churchill Livingstone; 1980.Google Scholar
  48. 48.
    Ippen HF. Berufsdermatosen. Dermatosen. 1987;35:181–2.Google Scholar
  49. 49.
    Fischer T. Occupational nickel dermatitis. In: Maibach HI, Menne T, editors. Nickel and the skin: immunology and toxicology. Boca Raton, FL: CRC Press; 1989.Google Scholar
  50. 50.
    Sanchez-Perez J, et al. Taxi driver's occupational allergic contact dermatitis from nickel in euro coins. Contact Dermatitis. 2003;48(6):340–1.CrossRefGoogle Scholar
  51. 51.
    Gilboa R, Al-Tawil NG, Marcusson JA. Metal allergy in cashiers. An in vitro and in vivo study for the presence of metal allergy. Acta Derm Venereol. 1988;68(4):317–24.PubMedGoogle Scholar
  52. 52.
    Meding B, Swanbeck G. Occupational hand eczema in an industrial city. Contact Dermatitis. 1990;22(1):13–23.CrossRefGoogle Scholar
  53. 53.
    Shum KW, et al. Occupational contact dermatitis to nickel: experience of the British dermatologists (EPIDERM) and occupational physicians (OPRA) surveillance schemes. Occup Environ Med. 2003;60(12):954–7.CrossRefGoogle Scholar
  54. 54.
    Uter W, et al. Risk factors for contact allergy to nickel - results of a multifactorial analysis. Contact Dermatitis. 2003;48(1):33–8.CrossRefGoogle Scholar
  55. 55.
    Nielsen NH, et al. Effects of repeated skin exposure to low nickel concentrations: a model for allergic contact dermatitis to nickel on the hands. Br J Dermatol. 1999;141(4):676–82.CrossRefGoogle Scholar
  56. 56.
    Rasanen L, Tuomi ML. Diagnostic value of the lymphocyte proliferation test in nickel contact allergy and provocation in occupational coin dermatitis. Contact Dermatitis. 1992;27(4):250–4.CrossRefGoogle Scholar
  57. 57.
    European Reference Group. Report requested by the Royal Swedish mint: nickel allergy and coins. Stockholm: A European Provocation Study; 1997. p. 1–8.Google Scholar
  58. 58.
    Christensen OB, Moller H. External and internal exposure to the antigen in the hand eczema of nickel allergy. Contact Dermatitis. 1975;1(3):136–41.CrossRefGoogle Scholar
  59. 59.
    Zhai H, et al. Provocative use test of nickel coins in nickel-sensitized subjects and controls. Br J Dermatol. 2003;149(2):311–7.CrossRefGoogle Scholar
  60. 60.
    Biesterbos J, Yazar K, Liden C. Nickel on the Swedish market: follow-up 10 years after entry into force of the EU Nickel Directive. Contact Dermatitis. 2010;63(6):333–9.CrossRefGoogle Scholar
  61. 61.
    Thyssen JP. Nickel and cobalt allergy before and after nickel regulation--evaluation of a public health intervention. Contact Dermatitis. 2011;65(Suppl 1):1–68.CrossRefGoogle Scholar
  62. 62.
    Committee, T.E.S.A.. Opinion of the scientific advisory committee to examine the toxicity and ecotoxicity of chemical compounds (CSTE) on ‘nickel in euro coins’ at 24 October 1997.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Kelsey E. Hirotsu
    • 1
  • Jennifer K. Chen
    • 2
  1. 1.Stanford University School of MedicineRedwood CityUSA
  2. 2.Department of Dermatology, Stanford University School of MedicineRedwood CityUSA

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