In 1979, the inhabitants of a geographically defined area were examined for skin disorders of the hands and forearms. In 1982 this cohort was invited for re-examination. In persons with eczema, patch testing was performed. Irritant factors were found to play a rôle in 73% of the cases, whereas a contact allergy could be detected in 30%. The most frequent allergens were nickel sulphate (20%), potassium dichromate (6%) and cobalt chloride (4%). In some persons with a definite history of allergy to metals, no positive patch test with nickel, chromate or cobalt could be obtained; other mechanisms may be involved. Significantly more positive patch tests were found among persons with an eczema of longer than 2 years duration compared with persons with eczema present for a shorter period of time, indicating that many cases of eczema are primarily of irritant nature, but later complicated by sensitisation. In 41%, the eczema was healed. A poor healing tendency was observed in those with a combination of irritant and allergic eczema. Relatively few ascribed healing to medical treatment.

Hospital cleaning personnel were examined for occupational dermatoses. 356 persons were included in the study. The age ranged from 20 to 63 years with a mean of 40.1 years. The period prevalence rate of moderate and severe eczema was 12% (10% in men and 19% in women). In 88%, the eczema was of a duration longer than 2 years. Positive patch tests were found in 10% of men and 53% of women with eczema. The main allergens were nickel, cobalt, chromate and rubber chemicals. Positive tests to cleaning agents were rare. One case of contact allergy to sodium dichloro-iso-cyanurate and one to Iysol were diagnosed. Irritant factors played a major role in most cases (92%). Fungus infection as a cause or complication in hand eczema should not be left out of consideration: in 2 persons, a mycosis of hands and/or fingernails was diagnosed.

Summary An examination of the hands and forearms of about 1700 construction workers revealed that 133 of them (7.8%) had a form of eczema, whereas psoriasis was observed in twenty‐two (1.3%). Irritant dermatitis was the major diagnostic category and was found in sixty‐seven workers (4%); allergic contact eczema was found in 1.4%. The prevalence of eczema/dermatitis in different job categories varied between 5.9% in technicians and 12.6% in bricklayers and plasterers. A history of atopy was more prevalent in persons with irritant dermatitis (24%) than in those with other forms of eczema (15%) and the controls f 11%). Patch testing was performed with dichromate, cobalt, thiruammix and cpoxy resin in persons with eczema and in a control group of 307 workers without eczema. Positive patch tests were found in 15% of the workers with eczema and 5.5% of those in the control group. In carpenters, there was very little difference between the proportion of positive patch tests in workers with eczema (6.1%) and that in controls (4.3%), In bricklayers and plasterers, these percentages were 27.7% and 7.6%, respectively. In carpenters, an association between eczema and a history of frequent exposure to wood impregnants and solvents was found.

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