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Although the science has progressed, there are still gaps in clinical and epidemiological research. Among others, the European Scientific Committee for Consumer Safety lists the following gaps. There are quite a number of them, so in this post we will consider missing clinical data.
Too little and not enough diverse clinical data.
More clinical data is needed on more fragrance substances to fully assess epidemiology of fragrance contact allergy and to identify the responsible substances for induction and elicitation of contact allergies in humans. Focusing on the EU, data from a broader range of countries is needed, as across Europe differences in exposure and use habits are expected.
Susceptible groups are understudied.
Very little is known about susceptible groups of the population. Data are needed to qualify and quantify the increase in risk of susceptible groups in order to provide a better protection of all consumers.
Influence of specific genetic variants on allergenic potential needs to be investigated.
Aberrant enzyme activity in certain individuals, often related to genetic enzyme polymorphisms, may result in an increased or reduced risk of sensitisation to prohaptens in certain individuals or populations. More research into the role of relevant traits is needed.
More dose specific data for all allergens is necessary.
Dose-response data from clinical studies are available for only a few allergens. To establish individual safe levels, such data are required for all established allergens of concern and covering an appropriate range of product types.
Testing needs to be done with oxidized fragrances.
Screening in dermatitis patients should be performed with air-exposed samples of such fragrance substances that in experimental studies have been demonstrated to act as prehaptens.
Patch testing is not always performed on the actual allergens
Patch testing should, if possible, be performed with the isolated true haptens formed from prehaptens and prohaptens to increase the possibility to diagnose allergy from these type of substances.
Testing needs to be done with oxidized fragrances.
Also, with regard to the animal data used in the opinion, several studies were of insufficient quality. Often, data on experimental results are not published but available only in company files and therefore not easily accessible.
