30-5.Objectives The study analyzed skin diseases in a population sample of Finnish farmers descriptively and in the process validated the question "Do you have a skin disease now?" Methods All farmers from one Finnish municipality were surveyed for dermatoses, first with a questionnaire and then with a clinical examination of those who reported dermatoses. Another population of farmers answered a set of questions in~n~ediately before a clinical examination, and the self-report of current dermatosis was validated.Results Eczema was diagnosed for 66% of the women and 53% of the Inen who had reported dermatosis in the questionnaire study 6 to 12 months earlier. Toe-web maceration, psoriasis, folliculitis, and acne were, after eczema, the most frequent diagnoses (in that order). In more than 50% of the cases, the location of clinically determined dermatoses corresponded with the skin disease areas reported 6 to 12 months earlier. In the validation study, everyone who reported a skin disease immediately before the clinical examination were found to have a skin disease. In addition 22% of those not reporting dermatosis were found to have a skin disease. Toeweb maceration was the most colnlnon dermatosis not reported by the farmers.C O~C~U S~O~~S Finnish farmers suffered from the same type of dermatoses as other populations. The prevalence of eczema and hand eczema was similar to that of other risk populations. A self-report of current dermatosis is probably a good indicator of the point prevalence of explicit skin diseases in populations.

SUSITAIVAL P, HUSMAN L, HORSMANHEIMO M, NOTKOLA V, HUSMAN K. Prevalence of hand dermatoses among Finnish farmers. Scand J Work Environ Health 1994;20:206-12. OBJECTIVES -The goal of this study was to determine the prevalence and risk factors of hand dermatosis among farmers. METHODS -A questionnaire survey was carried out in a geographically defined sample of the Finnish farming population between the ages of 18 and 64 years (N = 10 847). RESULTS -The one-year prevalence of self-reported hand and forearm dermatoses was 16% for the women and 7% for the men. These figures were similar to the prevalence of hand eczema in two large Scandinavian questionnaire surveys. The highest one-year prevalence of hand dermatoses was found for women on farms with more than nine dairy cows (20%). Atopy (both the personal history of atopic dermatitis and respiratory atopy), female gender, and, among the women, also age under 35 years were the most important risk factors for the occurrence of hand dermatosis. Work-related risk factors were handling disinfectants daily, handling silage preservatives, milking cows, and machine servicing. CONCLUSIONS -Occupationalrisk factors for hand dermatoses were found, especially for dairy farming. The results may be useful for the prevention of hand dermatoses in farming since they direct attention to related occupational hazards, and they may also aid vocational guidance for the atopic population. In order to lower the prevalence of hand dermatoses in dairy farming, both preventive and protective measures should become everyday practice in farming work.

In a population of 2005 Finnish farmers, 172 (8.6%) reported hand or forearm dermatoses in a self-administered questionnaire. 138 (80%) of them attended a clinical examination. Skin prick tests (SPTs) were done to 80% and patch tests (PTs) to 77% of the examined farmers. 93% of hand dermatoses were eczema and 70% were considered work-related. Cow allergy was found in 41 of 104 prick- and patch-tested farmers (39%). Immediate allergy to cow epithelium was encountered in a total of 28/41, in 20 with SPTs, and in 8 only with 20 min PTs. Delayed contact allergy to cow dander was found in 27/41. The result suggests that in addition to SPTs using commercial cow epithelium extract, PTs using fresh cow dander should also be done, and both immediate and delayed responses should be read.

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