Hand eczema and wet work: dose–response relationship and effect of leaving the profession

Carøe, Tanja K.; Ebbehøj, Niels Erik; Bonde, Jens Peter; Flachs, Esben M.; Agner, Tove

doi:10.1111/cod.12934

Cited by 35 publications

(41 citation statements)

References 25 publications

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“…However, in the present study neither contact sensitization nor wet work at baseline increased the risk of persistence of eczema, which is in line with two Scandinavian (Danish) follow‐up studies that did not find any relationship between contact sensitization and a poor prognosis . Information on wet work was registered at baseline and some patients who performed wet work at the time of recognition had changed profession or work procedures to limit exposure at follow‐up …”

Section: Discussionsupporting

confidence: 90%

Factors influencing prognosis for occupational hand eczema: new trends

et al. 2019

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Summary Background Variables traditionally reported to influence the prognosis of occupational hand eczema (OHE) are atopic dermatitis (AD) and contact sensitization. However, recent studies indicate that lifestyle factors may be of major importance. Objectives To identify factors influencing the prognosis in a cohort of patients with recognized OHE. Methods In this register‐based cohort study, individuals with hand eczema recognized as occupational disease in the period January 2010–December 2011 were identified using files from Labor Market Insurance Denmark and included in the study. At baseline, information on sex, age, occupation, wet work, AD and contact sensitization was collected. In 2015 participants received a questionnaire with questions about lifestyle factors, current occupation and healing of OHE. Results In total, 2703 patients received the questionnaire; 1491 responded to the question about healing of OHE and were included in the study. Altogether, 19·3% of patients reported complete healing at follow‐up. Current tobacco smoking and a high level of stress were factors inversely associated with healing of hand eczema (P < 0·001 and P = 0·030, respectively), while a high level of exercise was significantly related to healing of eczema (P = 0·011). Change of profession was a favourable prognostic factor, while age, sex, AD, contact sensitization and education did not significantly influence prognosis. Conclusions Traditionally important risk factors such as AD and contact sensitization had no marked influence on prognosis, while lifestyle factors were of major importance. Our findings indicate that risk factors may vary over time, allowing for new perspectives on prevention. What's already known about this topic? Occupational hand eczema has a relapsing course and a poor overall prognosis. Atopic dermatitis and contact sensitization have previously been reported as risk factors for a poor prognosis. What does this study add? The results indicate that lifestyle factors are of importance for the prognosis of occupational hand eczema. Traditionally reported risk factors such as atopic dermatitis and contact sensitization do not currently influence prognosis.

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Section: Discussionsupporting

confidence: 90%

Factors influencing prognosis for occupational hand eczema: new trends

et al. 2019

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“…The increased knowledge may have changed attitudes and improved protective behavior and thus reduced levels of exposure to skin hazards as observed in other studies . Wet work, particularly when exceeding 2 h/d, is a well‐known risk factor for work‐related HE . In the present study, the percentage of MWA reporting wet work ≥2 h/d increased significantly from T0 to T3 in the control group, whereas this rate was nearly unchanged in the intervention group.…”

Section: Discussionmentioning

confidence: 92%

Health education decreases incidence of hand eczema in metal work apprentices: Results of a controlled intervention study

et al. 2020

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Background: Metal work apprentices (MWAs) frequently develop work-related hand eczema (HE). Objectives: To evaluate the effect of health education on incidence of work-related HE in MWAs and to assess confounding factors. Materials/methods: In a prospective controlled intervention study, 131 MWAs received educational training on prevention of HE, whereas 172 MWAs and 118 office work apprentices served as controls. At baseline and during three yearly follow-ups, questionnaires were completed and hands were examined. Saliva samples were collected for assessment of filaggrin (FLG) null mutations and an explorative genome-wide association study (GWAS), and levels of various cytokines were assessed from stratum corneum samples.Results: The 2-year and 3-year incidence of HE in the metalwork control group was 20.9% and 32.6%, respectively, which was significantly higher than in the intervention group (odds ratio [OR] 2.63, 95% confidence interval [CI] 1.31 to 5.28, P < .01 and OR 3.47, 95% CI 1.88 to 6.40, P < .0001). The knowledge score was higher in unaffected MWAs (P < .05). Other factors significantly associated with developing

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“…40 While change of job was associated with improvement and healing of HE, it had a negative impact on QoL, 67 while for HE patients with wet work even minor changes in exposure were associated with healing and improvement with no negative influence on QoL. 68 Regarding influence on HR-QoL, HE is known to have a significantly negative impact, closely related to severity of the eczema, as well as to HE-related sick leave. 69 Women experience a greater burden to HR-QoL for milder HE than men, 69 and new data indicate that area of residence too has a modifying effect on HR-QoL, with a more negative impact on HR-QoL in metropolitan than in non-metropolitan areas.…”

Section: Risk Factors For Bad Prognosismentioning

confidence: 99%

“…78 A dose-dependent relationship exists between exposure and development of irritant HE, as for allergic HE. 68 Optimizing consultations for your HE patient The content of consultations for HE patients naturally depends on factors such as severity and duration of the eczema, the age of the patients and whether the eczema is work-related. Below is a review of some important elements that could be included.…”

Section: Consequences and Preventionmentioning

confidence: 99%

Hand eczema: epidemiology, prognosis and prevention

Agner

Elsner

2019

Acad Dermatol Venereol

114

103

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Hand eczema (HE) is a heterogeneous and often chronic disease located to the hands and wrist, and frequently associated with eczema on the feet. The aetiology is diverse, and the eczema may present with a variety of clinical symptoms. Acute and chronic stages appear; severity varies from mild to moderate and severe, and flares may be frequently recurrent or rare. The divergent aetiology and varied morphology of HE is sometimes tricky and may be challenging to the dermatologist. This review has focus on epidemiology, prognosis and prevention of HE, and intends to point towards some practical advice on how to diagnose, inform and guide HE patients.

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Hand eczema and wet work: dose–response relationship and effect of leaving the profession

Abstract: Leaving the profession has a positive effect on eczema; however, even minor changes in exposure to wet work were associated with healing and improvement. This information has implications with respect to advice given to patients with occupational hand eczema caused by wet work.

Cited by 35 publications

References 25 publications

Factors influencing prognosis for occupational hand eczema: new trends

Factors influencing prognosis for occupational hand eczema: new trends

Health education decreases incidence of hand eczema in metal work apprentices: Results of a controlled intervention study

Hand eczema: epidemiology, prognosis and prevention

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