Work-related skin disease is common and usually presents as hand eczema. From the Occupational Injury Information System in Sweden, as well as from registers of industrial injuries in other countries, it is evident that females report skin disease more often than males. Epidemiological studies of hand eczema also show that women are more often affected than men, in particular young women. The most common type of hand eczema is irritant contact dermatitis, which is often caused by wet work. Many female-dominated occupations involve extensive wet work, e.g., hairdressing, catering, cleaning and health-care work. These occupations are also high-risk occupations for hand eczema. Experimental studies of skin irritation have not confirmed differences between the sexes; thus, the higher prevalence of irritant contact dermatitis among females is most likely due to exposure, occupational and non-occupational. Nickel allergy is the most common contact allergy, which is most frequent in young females, and in 30-40% results over time in hand eczema. Hand eczema has an impact on quality of life and females seem to report a higher degree of discomfort than males. To achieve the optimal effect of preventive efforts regarding occupational skin disease, the focus for prevention should aim at reducing wet exposure.Key words: females; differences between the sexes; hand eczema; high-risk occupation; males; occupational skin disease; prevalence; prevention; risk factor; wet work. C Munksgaard, 2000.
Accepted for publication 28 March 2000Skin disease caused or worsened by factors in the working environment is one of the most commonly occurring work-related illnesses. The predominant condition is hand eczema, since in many jobs the skin on the hands is subjected to damage caused by contact with skin irritants and allergens. Unequivocal reports in industrial injury registers, epidemiological studies and clinical records indicate that women are affected far more than men. However, differences between the sexes with regard to work-related skin disease have never been studied to any great extent. A summary of a number of dermatological textbooks was drawn up in 1996 at