1
|
Armstrong A, Hahn-Pedersen J, Bartlett C, Glanville J, Thyssen JP. Economic Burden of Chronic Hand Eczema: A Review. Am J Clin Dermatol 2022; 23:287-300. [PMID: 35258783 PMCID: PMC9142418 DOI: 10.1007/s40257-021-00669-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 11/25/2022]
Abstract
There has been no extensive synthesis of studies evaluating the cost of chronic hand eczema (CHE). This review evaluated the societal costs, healthcare resource utilisation, missed work time and job loss due to CHE. MEDLINE and 16 other databases and websites were searched in October 2020 for studies meeting prespecified inclusion criteria. Studies conducted in Europe, Australia, New Zealand or the Americas were included. Two reviewers independently assessed titles and abstracts, and full-text papers published in English between 2000 and 2020, for relevance. Data extraction was carried out by one reviewer and checked by a second reviewer. All data were based on costs between 2001 and 2013 but have been inflated to 2020 prices and converted to US dollars and Euros. A total of 30 studies (reported in 33 publications) were included in the synthesis. Mean total societal costs per year per patient ranged from $2549 (€1813) to $10,883 (€7738). Pharmacological therapy was, on average, $28.34 (€20.15) per month in Italy and $36.49 (€25.94) per month for emollients in Switzerland. Yearly treatment costs were $599.05 (€425.92) for drugs, including topical corticosteroids, topical calcineurin inhibitors, other topical treatments and oral treatments, and $178.40 for emollients, in Germany. CHE was associated with hospitalisation costs ranging from $81.86 (€58.20) per patient per month (US) to $105.04 (€74.68) per patient per month (Italy) and $639.59 (€454.75) per year (Germany). Up to 57% of patients took sick leave and up to 25% reported job loss/job change due to CHE. This review confirms the significant cost burden of CHE. Given the paucity of studies estimating the monetary costs of absenteeism, presenteeism and job loss associated with CHE, current mean societal costs are likely underestimated. Uncontrolled disease may also lead to increased costs to patients and society.
Collapse
Affiliation(s)
- April Armstrong
- Department of Dermatology, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
| | | | - Chris Bartlett
- York Health Economics Consortium Ltd, York, YO10 5NQ, UK.
| | | | - Jacob P Thyssen
- Department of Dermatology Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Jacobsen G, Rasmussen K, Bregnhøj A, Isaksson M, Diepgen TL, Carstensen O. Causes of irritant contact dermatitis after occupational skin exposure: a systematic review. Int Arch Occup Environ Health 2022; 95:35-65. [PMID: 34665298 PMCID: PMC8755674 DOI: 10.1007/s00420-021-01781-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 07/11/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE Irritant contact dermatitis (ICD) is a major cause of occupational disease. The aim was to review the relation between exposure to occupational irritants and ICD and the prognosis of ICD. METHODS Through a systematic search, 1516 titles were identified, and 48 studies were included in the systematic review. RESULTS We found that the evidence for an association between ICD and occupational irritants was strong for wet work, moderate for detergents and non-alcoholic disinfectants, and strong for a combination. The highest quality studies provided limited evidence for an association with use of occlusive gloves without other exposures and moderate evidence with simultaneous exposure to other wet work irritants. The evidence for an association between minor ICD and exposure to metalworking fluids was moderate. Regarding mechanical exposures, the literature was scarce and the evidence limited. We found that the prognosis for complete healing of ICD is poor, but improves after decrease of exposure through change of occupation or work tasks. There was no substantial evidence for an influence of gender, age, or household exposures. Inclusion of atopic dermatitis in the analysis did not alter the risk of ICD. Studies were at risk of bias, mainly due to selection and misclassification of exposure and outcome. This may have attenuated the results. CONCLUSION This review reports strong evidence for an association between ICD and a combination of exposure to wet work and non-alcoholic disinfectants, moderate for metalworking fluids, limited for mechanical and glove exposure, and a strong evidence for a poor prognosis of ICD.
Collapse
Affiliation(s)
- Gitte Jacobsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark.
- Department of Occupational Medicine, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark.
| | - Kurt Rasmussen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Anne Bregnhøj
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Thomas L Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ole Carstensen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| |
Collapse
|
3
|
Havmose M, Thyssen JP, Zachariae C, Johansen JD. Long-term follow-up of hand eczema in hairdressers: a prospective cohort study of Danish hairdressers graduating from 1985 to 2007. J Eur Acad Dermatol Venereol 2021; 36:263-270. [PMID: 34747547 DOI: 10.1111/jdv.17794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Occupational hand eczema is common among hairdressers and implementing effective preventive measures requires a good understanding of the disease's epidemiology. OBJECTIVE To investigate the long-term development of hand eczema (HE) in hairdressers. METHODS A prospective cohort study of all hairdressers graduating from Danish hairdressing vocational schools from 1985 to 2007 was conducted. A self-administered questionnaire was sent in 2009 with follow-up in 2020. Data from the Danish labour market supplementary pension scheme provided information on yearly affiliation with the hairdressing trade. RESULTS The cumulative lifetime prevalence of HE increased from 42.3% at baseline to 45.2% at follow-up (odds ratio [OR], 1.1; 95% confidence interval [CI], 1.0-1.2). The incidence rate decreased from 42.8 cases/1000 person-years (95% CI, 40.8-44.8) at baseline to 3.4 cases/1000 person-years (95% CI, 2.5-4.6) within the follow-up period. HE onset occurred within 8 years of beginning an apprenticeship for >90% of cases and occurred within the apprenticeship period for 68% of cases. The risk factors associated with having had HE at baseline were a previous positive patch test (adjusted OR [aOR], 5.3; 95% CI, 4.2-6.6), a history of atopic dermatitis (aOR, 3.4; 95% CI, 2.9-4.0) and female sex (aOR, 1.8; 95% CI 1.4-2.3). The most important risk factors at follow-up were previous HE (aOR, 10.1; 95% CI, 7.3-13.8) and a positive patch test within the follow-up period (aOR, 4.5; 95% CI, 3.0-6.8). Among the hairdressers who had HE at baseline, 65.5% exhibited remission, whereas 34.6% had persistent and often severe HE at follow-up. Hairdressers with persistent HE were the subgroup of the study population most frequently affected by the risk factors identified for HE. CONCLUSIONS Primary prevention of HE should focus on hairdressing apprentices and fully trained hairdressers who have recently graduated. Approximately one-third of trained hairdressers develop persistent and often severe HE, emphasizing the need for early intervention.
Collapse
Affiliation(s)
- M Havmose
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - J P Thyssen
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - C Zachariae
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - J D Johansen
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| |
Collapse
|
4
|
Holness DL, Gomez P, Kudla I, Skotnicki S, DeKoven JG. Occupational contact dermatitis: Return to work using a multidisciplinary clinic model. Contact Dermatitis 2021; 85:686-692. [PMID: 34293189 DOI: 10.1111/cod.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/24/2021] [Accepted: 07/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Occupational contact dermatitis often results in work disruption. Return-to-work (RTW) is an important outcome. OBJECTIVE The objective of this study was to determine RTW outcomes and factors associated with such outcomes using a multidisciplinary clinic model. METHODS Chart abstraction was performed for 194 workers who received RTW assistance over a 6-year period. Elements abstracted included demographic and diagnostic information and information about the RTW program including principles, program components, barriers, and facilitators. RESULTS Of the 902 workers seen for dermatologic assessment, 194 received RTW assistance. At initial assessment, 37% were not working because of their skin disease, and at follow-up, 7% were not working because of their skin disease. The RTW plan components included a graduated or trial of RTW, specific recommendations for avoiding exposure, personal protective equipment, skin management, and ongoing skin monitoring. Principles associated with successful RTW included good communication and the availability of modified work and a worker adherence to the plan. Barriers included lack of modified work, unresponsive employers, and ongoing skin problems. CONCLUSIONS Specific approaches are important to identify if RTW is to be successful for workers with occupational contact dermatitis.
Collapse
Affiliation(s)
- D Linn Holness
- Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.,MAP Centre for Urban Health Solutions, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Pilar Gomez
- Occupational Medicine Clinic, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Irena Kudla
- Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Occupational Medicine Clinic, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sandy Skotnicki
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Joel G DeKoven
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| |
Collapse
|
5
|
Holness DL. Occupational Dermatitis and Urticaria. Immunol Allergy Clin North Am 2021; 41:439-453. [PMID: 34225899 DOI: 10.1016/j.iac.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Occupational contact dermatitis is the most common occupational skin disease (OSD), and most of them are irritant in nature. There is less information available about contact urticaria than contact dermatitis. There are several strategies to prevent OSD, although workplace studies suggest there are gaps in their use in the workplace. Because early detection leads to improved outcomes, screening for dermatitis in industries such as health care would be useful. Both diagnosis and management involve 2 components: the actual disease diagnosis and medical treatment and the work-relatedness and management of the workplace to reduce exposures.
Collapse
Affiliation(s)
- Dorothy Linn Holness
- Department of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
| |
Collapse
|
6
|
Dietz JB, Menné T, Meyer HW, Viskum S, Flyvholm MA, Ahrensbøll-Friis U, John SM, Johansen JD. Degree of employment, sick leave, and costs following notification of occupational contact dermatitis-A register-based study. Contact Dermatitis 2020; 84:224-235. [PMID: 33058169 DOI: 10.1111/cod.13719] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Occupational contact dermatitis (OCD) is the most commonly recognized occupational disease in Denmark. OBJECTIVES To examine the impact of recognized OCD on degree of employment, sick leave, unemployment, and job change. METHODS Data on all recognized individuals with OCD notified in Denmark between 2010 and 2015 (n = 8940) were linked to information on social transfer payments in the years before and after notification. The number of weeks on unemployment benefits or sick leave and the degree of employment during the 2 years prior to notification was compared with the 2 years following notification. RESULTS The degree of employment decreased on average 8.9 work-hours/month, corresponding to an average annual loss of income per worker of approximately €1570. The average number of weeks that workers were receiving unemployment benefits and paid long-term sick leave rose by 2.5 and 3.4 weeks, respectively, corresponding to an average additional annual cost per worker of approximately €420 and €770, respectively. Longer case-processing time was significantly associated with lower degree of employment and higher levels of unemployment and sick leave. CONCLUSIONS OCD has a significant negative impact on employment and economics, thus highlighting the need for a national, strategic action plan for effective prevention of OCD.
Collapse
Affiliation(s)
- Jojo B Dietz
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Torkil Menné
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Harald W Meyer
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sven Viskum
- Unit of Social Medicine, Copenhagen University Hospital Frederiksberg, Frederiksberg, Denmark
| | - Mari-Ann Flyvholm
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ulrik Ahrensbøll-Friis
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Swen M John
- Department of Dermatology, Environmental Health and Health Theory, University of Osnabrück and Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| |
Collapse
|
7
|
Alyasin S, Nabavizadeh SH, Esmaeilzadeh H, Heydari ST, Mosavat SH, Parvizi MM, Hashemi SM, Hashempur MH. Efficacy of oral supplementation of whey protein in patients with contact dermatitis: A pilot randomized double-blind placebo-controlled clinical trial. Dermatol Ther 2020; 33:e14260. [PMID: 32876987 DOI: 10.1111/dth.14260] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/16/2020] [Accepted: 08/30/2020] [Indexed: 11/30/2022]
Abstract
Whey protein is a popular dietary product that has numerous health benefits such as immune modulation. In this study, we assessed efficacy of whey protein in management of patients with contact dermatitis (CD) through a double blind, randomized controlled clinical trial in Emam Reza clinic, Shiraz, Iran. Twenty-five patients in each group were randomly assigned to receive whey protein or placebo powder, 30 g in 200 mL warm water at fasting time for 4 weeks. Outcome measures were Dermatology Life Quality Index (DLQI) questionnaire and the Eczema Area and Severity Index (EASI) score. Furthermore, subjective total improvement (assessed by visual analogue scale) was set as the other primary outcome measure. A significant decrease was observed in the scores of EASI, DLQI, and subjective total improvement in the drug group after the intervention compared with the baseline. However, no changes were seen in the placebo group. Moreover, there was a significant reduction in the scores of EASI (P = .002) and subjective total improvement scores (P = .039) over the study period in the drug group compared with the placebo group. According to the results of this study, it seems that oral supplementation of whey protein could improve the symptoms of CD compared with placebo.
Collapse
Affiliation(s)
- Soheila Alyasin
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Seyed Taghi Heydari
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hamdollah Mosavat
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mahdi Parvizi
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | |
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW Occupation is an important contributing factor in the presentation of allergic disease in adults. This review article focuses on the contribution of occupation to the development and presentation of food allergies. RECENT FINDINGS A variety of occupations involve repeated transdermal and respiratory exposures to food-related allergens, which can result in sensitization. A sensitized individual can then manifest symptoms of food allergy after ingestion of the relevant food, even in a nonoccupational setting. Cooks and other food-processing workers bear increased risk for being sensitized to foods. Although any type of food can become a causal agent for this phenomenon, published cases of occupational food allergy concentrate on fish and seafood allergies among cooks and food-processing workers who come into direct contact with these foods. Latex-fruit syndrome is also a relatively common form of occupational food allergy among healthcare workers. Hand eczema has also been shown to be an important risk factor for occupational sensitization to food allergens. SUMMARY The association of occupation with food allergy in adults has been documented. Considering the under-recognized nature of this phenomenon, we should be aware in our clinical practice that a patient's occupation might be relevant to his or her food allergy.
Collapse
|
9
|
Elias M, Patel S, Schwartz RA, Lambert WC. The color of skin: red diseases of the skin, nails, and mucosa. Clin Dermatol 2019; 37:548-560. [PMID: 31896409 DOI: 10.1016/j.clindermatol.2019.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Red color is pervasive in local and systemic skin conditions. It is a color that often reflects variations of dermal blood flow and extends beyond the rubor and calor of inflammation. The pathophysiology of red skin involves remote and local chemical mediators that dilate arteriolar smooth muscle and increase blood flow to superficial vessels and capillary beds. Incident light hits hemoglobin, which preferentially absorbs light of shorter wavelengths, such as blue, and reflects warmer colors. Due to its pervasiveness and consistency, red color is a useful descriptive factor in helping narrow a differential diagnosis. Red skin disorders include a variety of conditions involving endocrine mediators, cardiovascular responses, and the disruption of the skin barrier. An understanding of the blood's role in these disorders equips clinicians to generate differential diagnoses through the lens of pathophysiology. Dermatologists can improve management by considering red skin as part of systemic disease rather than as an isolated incident.
Collapse
Affiliation(s)
- Marcus Elias
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Shreya Patel
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Robert A Schwartz
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - W Clark Lambert
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Pathology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
| |
Collapse
|
10
|
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on occupational contact dermatitis including gaps in knowledge and practice. Occupational contact dermatitis is the most common occupational skin disease. RECENT FINDINGS New sources of exposure for known allergens and new allergens are continually being reported. Through clinical databases and surveillance systems, effects of prevention efforts or introduction of new allergens or new uses of known allergens can be monitored. Though the diagnostic process is clear, there are delays in workers seeking care. As early detection and intervention improves outcomes, screening should be implemented. Gaps in primary prevention in the workplace are identified and should be addressed to reduce the burden of disease. Surveillance systems support the prevention mandate. Understanding limitations of our knowledge and identifying gaps in practice can lead to initiatives to address research and practice needs and improve prevention of occupational dermatoses.
Collapse
Affiliation(s)
- Dorothy Linn Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, Toronto, Canada. .,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada. .,MAP Centre for Urban Health Solutions, St Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada.
| |
Collapse
|
11
|
Olesen CM, Agner T, Ebbehøj NE, Carøe TK. Factors influencing prognosis for occupational hand eczema: new trends. Br J Dermatol 2019; 181:1280-1286. [PMID: 30851194 DOI: 10.1111/bjd.17870] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2019] [Indexed: 12/26/2022]
Abstract
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.
Collapse
Affiliation(s)
- C M Olesen
- Departments of Dermatology, Bispebjerg University Hospital, Copenhagen, 2400, Denmark
| | - T Agner
- Departments of Dermatology, Bispebjerg University Hospital, Copenhagen, 2400, Denmark
| | - N E Ebbehøj
- Departments of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, 2400, Denmark
| | - T K Carøe
- Departments of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, 2400, Denmark
| |
Collapse
|
12
|
Nichol K, Copes R, Kersey K, Eriksson J, Holness DL. Screening for hand dermatitis in healthcare workers: Comparing workplace screening with dermatologist photo screening. Contact Dermatitis 2019; 80:374-381. [DOI: 10.1111/cod.13231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/31/2018] [Accepted: 01/21/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Kathryn Nichol
- Collaborative Academic PracticeUniversity Health Network Toronto Ontario Canada
- Dalla Lana School of Public HealthUniversity of Toronto Toronto Ontario Canada
- Centre for Research Expertise in Occupational Disease Toronto Ontario Canada
| | - Ray Copes
- Dalla Lana School of Public HealthUniversity of Toronto Toronto Ontario Canada
- Environmental and Occupational HealthPublic Health Ontario Toronto Ontario Canada
| | - Karon Kersey
- Occupational Health and SafetyUniversity Health Network Toronto Ontario Canada
| | - Jonas Eriksson
- Collaborative Academic PracticeUniversity Health Network Toronto Ontario Canada
| | - Dorothy L. Holness
- Dalla Lana School of Public HealthUniversity of Toronto Toronto Ontario Canada
- Centre for Research Expertise in Occupational Disease Toronto Ontario Canada
- Division of Occupational Medicine, Department of MedicineUniversity of Toronto Toronto Ontario Canada
- Division of Occupational MedicineSt Michael's Hospital Toronto Ontario Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge InstituteSt Michael's Hospital Toronto Ontario Canada
| |
Collapse
|
13
|
Effect of Patch Testing on the Course of Allergic Contact Dermatitis and Prognostic Factors That Influence Outcomes. Dermatitis 2019; 30:135-141. [DOI: 10.1097/der.0000000000000452] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
14
|
Cazzaniga S, Ballmer-Weber BK, Gräni N, Spring P, Bircher A, Anliker M, Sonntag AK, Piletta P, Huber C, Diepgen TL, Apfelbacher C, Naldi L, Borradori L, Simon D. Chronic hand eczema: A prospective analysis of the Swiss CARPE registry focusing on factors associated with clinical and quality of life improvement. Contact Dermatitis 2018; 79:136-148. [DOI: 10.1111/cod.13041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/09/2018] [Accepted: 05/03/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Simone Cazzaniga
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
- Centro Studio, Italian Group for Epidemiological Research in Dermatology (GISED); Bergamo Italy
- Graduate School for Cellular and Biomedical Sciences; University of Bern; Bern Switzerland
| | - Barbara K. Ballmer-Weber
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
- Faculty of Medicine; University of Zurich; Zurich Switzerland
- Allergy Unit, Clinic of Dermatology and Allergology; Cantonal Hospital St Gallen; St. Gallen Switzerland
| | - Nora Gräni
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - Philippe Spring
- Department of Dermatology; University Hospital of Lausanne CHUV; Lausanne Switzerland
| | - Andreas Bircher
- Department of Dermatology; University Hospital Basel; Basel Switzerland
| | - Mark Anliker
- Clinic of Dermatology and Allergology; Cantonal Hospital St Gallen; St Gallen Switzerland
- Hautärzte am Graben; Winterthur Switzerland
| | | | - Pierre Piletta
- Department of Dermatology; Geneva University Hospitals (HUG); Geneva Switzerland
| | - Caroline Huber
- Department of Dermatology; Geneva University Hospitals (HUG); Geneva Switzerland
- Dermatology Office; Versoix Switzerland
| | - Thomas L. Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University Hospital, Ruprecht Karls University; Heidelberg Germany
| | - Christian Apfelbacher
- Institute of Epidemiology and Preventive Medicine; University of Regensburg; Regensburg Germany
| | - Luigi Naldi
- Centro Studio, Italian Group for Epidemiological Research in Dermatology (GISED); Bergamo Italy
- Department of Dermatology; San Bortolo Hospital; Vicenza Italy
| | - Luca Borradori
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
| | - Dagmar Simon
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
| |
Collapse
|
15
|
Nichol K, McKay SM, Ruco A, Holness DL. Testing the Hand Dermatitis Screening Tool in the Home Health Care Sector. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2018. [DOI: 10.1177/1084822318780012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Workers exposed to wet work are at an increased risk for occupational contact dermatitis and may benefit from screening to detect early disease. The objective of this study was to assess the prevalence of hand dermatitis in home care workers, identify factors that influence presence of disease, and explore feasibility and importance of workplace screening in the home care sector. Following institutional ethics approval, nurses, personal support workers, and rehab therapists at one large home care provider in Ontario, Canada, self-screened for hand dermatitis using the Hand Dermatitis Screening Tool and accompanying photo guide and completed a short feasibility evaluation. Of the 220 participants, 18% had a positive screen for hand dermatitis and 77% reported exposure to wet work. In all, 93% of participants reported using the tool took less than 2 minutes and 84% reported screening for hand dermatitis is important. In conclusion, prevalence of hand dermatitis in home care workers is higher than reported in the general population. Workplace screening for hand dermatitis was deemed important, and the tool was feasible to use in the home care sector.
Collapse
Affiliation(s)
- K. Nichol
- VHA Home HealthCare, Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
| | - S. M. McKay
- VHA Home HealthCare, Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada
| | - A. Ruco
- VHA Home HealthCare, Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada
- St. Michael’s Hospital, Toronto, Ontario, Canada
| | - D. L. Holness
- University of Toronto, Ontario, Canada
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
- St. Michael’s Hospital, Toronto, Ontario, Canada
| |
Collapse
|
16
|
Minami T, Fukutomi Y, Sekiya K, Akasawa A, Taniguchi M. Hand eczema as a risk factor for food allergy among occupational kitchen workers. Allergol Int 2018; 67:217-224. [PMID: 28874315 DOI: 10.1016/j.alit.2017.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/27/2017] [Accepted: 08/03/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND An increasing number of studies in children is highlighting the importance of transdermal routes of exposure to food allergens through damaged skin in the pathogenesis of food allergies. However, data on this in adults are limited. A few case-series studies has documented development of food allergy among kitchen workers with hand eczema after direct contact exposure to foods. METHODS To explore the significance of hand eczema as a risk factor for food allergies in adults at the epidemiological level, we performed a cross-sectional web-based questionnaire survey on kitchen workers whose exposures were classed as occupational (cooks and food handlers, n = 1592) or non-occupational (housewives, n = 1915). Logistic regression was used to explore the association between the presence/severity of hand eczema and the risk of food allergy after adjustment for potential confounders. RESULTS Current hand eczema and current diagnosed food allergy were more common among occupational kitchen workers (OKW) than among non-occupational kitchen workers (NOKW) (32.3%-vs-29.9% and 9.9%-vs-3.8%, respectively). Current hand eczema was significantly associated with increased risk of current diagnosed food allergy in OKW (adjusted odds ratio 2.4, 95% CI 1.6-3.7). Those with more severe hand eczema were more likely to suffer from allergic symptoms for foods, and diagnosed food allergy. CONCLUSIONS This study illustrates a significant public health problem in the adult population, documenting a major impact of hand eczema on the ongoing adult food allergy epidemic.
Collapse
|
17
|
Carøe T, Ebbehøj N, Bonde J, Vejlstrup S, Agner T. Job change facilitates healing in a cohort of patients with occupational hand eczema. Br J Dermatol 2018; 179:80-87. [DOI: 10.1111/bjd.16095] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2017] [Indexed: 11/27/2022]
Affiliation(s)
- T.K. Carøe
- Department of Dermatology; University of Copenhagen; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen Denmark
| | - N.E. Ebbehøj
- Department of Occupational and Environmental Medicine; University of Copenhagen; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen Denmark
| | - J.P.E. Bonde
- Department of Occupational and Environmental Medicine; University of Copenhagen; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen Denmark
| | - S.G. Vejlstrup
- Department of Occupational and Environmental Medicine; University of Copenhagen; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen Denmark
| | - T. Agner
- Department of Dermatology; University of Copenhagen; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen Denmark
| |
Collapse
|
18
|
Graversgaard C, Agner T, Jemec GBE, Thomsen SF, Ibler KS. A long-term follow-up study of the Hand Eczema Trial (HET): a randomized clinical trial of a secondary preventive programme introduced to Danish healthcare workers. Contact Dermatitis 2018; 78:329-334. [DOI: 10.1111/cod.12964] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 12/16/2017] [Indexed: 11/27/2022]
Affiliation(s)
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital; 2400 Copenhagen Denmark
- Department of Biomedical Sciences; University of Copenhagen; 2200 Copenhagen Denmark
| | - Gregor B. E. Jemec
- Department of Dermatology; Zealand University Hospital; 4000 Roskilde Denmark
- Department of Biomedical Sciences; University of Copenhagen; 2200 Copenhagen Denmark
| | - Simon F. Thomsen
- Department of Dermatology; Bispebjerg Hospital; 2400 Copenhagen Denmark
- Department of Biomedical Sciences; University of Copenhagen; 2200 Copenhagen Denmark
| | - Kristina S. Ibler
- Department of Dermatology; Zealand University Hospital; 4000 Roskilde Denmark
| |
Collapse
|
19
|
Cazzaniga S, Apfelbacher C, Diepgen T, Ofenloch R, Weisshaar E, Molin S, Bauer A, Mahler V, Elsner P, Schmitt J, Ballmer‐Weber B, Spring P, Naldi L, Borradori L, Simon D. Patterns of chronic hand eczema: a semantic map analysis of the
CARPE
registry data. Br J Dermatol 2017; 178:229-237. [DOI: 10.1111/bjd.15660] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 11/30/2022]
Affiliation(s)
- S. Cazzaniga
- Department of Dermatology, Inselspital Bern University Hospital Bern Switzerland
- Centro Studi GISED Bergamo Italy
| | - C. Apfelbacher
- Institute of Epidemiology and Preventive Medicine University of Regensburg Regensburg Germany
| | - T. Diepgen
- Department of Clinical Social Medicine Occupational and Environmental Dermatology University Hospital Ruprecht Karls University Heidelberg Germany
| | - R.F. Ofenloch
- Department of Clinical Social Medicine Occupational and Environmental Dermatology University Hospital Ruprecht Karls University Heidelberg Germany
| | - E. Weisshaar
- Department of Clinical Social Medicine Occupational and Environmental Dermatology University Hospital Ruprecht Karls University Heidelberg Germany
| | - S. Molin
- Department of Dermatology and Allergy Ludwig Maximilian University Munich Germany
| | - A. Bauer
- Department of Dermatology University Hospital Carl Gustav Carus Technical University Dresden Dresden Germany
| | - V. Mahler
- Department of Dermatology University Hospital of Erlangen Friedrich Alexander University Erlangen‐Nuremberg Erlangen Germany
| | - P. Elsner
- Department of Dermatology and Dermatological Allergy Friedrich Schiller University Jena Jena Germany
| | - J. Schmitt
- Centre for Evidence‐based Healthcare Medical Faculty Carl Gustav Carus Technical University Dresden Dresden Germany
| | - B.K. Ballmer‐Weber
- Allergy Unit Department of Dermatology University Hospital Zürich Zurich Switzerland
| | - P. Spring
- Department of Dermatology University Hospital of Lausanne CHUV Lausanne Switzerland
| | - L. Naldi
- Centro Studi GISED Bergamo Italy
- Department of Dermatology Papa Giovanni XXIII Hospital Bergamo Italy
| | - L. Borradori
- Department of Dermatology, Inselspital Bern University Hospital Bern Switzerland
| | - D. Simon
- Department of Dermatology, Inselspital Bern University Hospital Bern Switzerland
| | | |
Collapse
|
20
|
Nørreslet LB, Ebbehøj NE, Ellekilde Bonde JP, Thomsen SF, Agner T. The impact of atopic dermatitis on work life - a systematic review. J Eur Acad Dermatol Venereol 2017; 32:23-38. [PMID: 28833648 DOI: 10.1111/jdv.14523] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 07/25/2017] [Indexed: 12/21/2022]
Abstract
Atopic dermatitis (AD) has considerable multidimensional personal and societal costs. However, the extend to which the patient's work life is affected due to AD is more sparsely described in the literature. The objective of this review was to examine the impact on work life for patients with AD, with a specific focus on choice of education and occupation, sick leave, social compensations and change of job due to AD. A systematic literature search was performed in PubMed, EMBASE and Web og Science up to 7 February 2017 for articles on the impact on work life for patients with AD. Results were summarized taking several measures of study quality into account. The search identified twenty-three articles, whereof five studies assessed the influence of AD on educational or job choice, without any consistent conslusion, while eight of nine studies with respect to sick leave and two on disability pensions found AD to have a negative impact. Studies of change or loss of job and AD showed more diverse results, as not all studies documented a negative effect of AD on work life. Atopic dermatitis imposes a burden extending beyond personal, emotional and financial costs. This review strongly implies that AD affects sick leave, and though not fully clarified, possible also job choice, change or loss of job and even disability pensions for the more severe cases.
Collapse
Affiliation(s)
- L B Nørreslet
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - N E Ebbehøj
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - J P Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - S F Thomsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Agner
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
21
|
Johnston G, Exton L, Mohd Mustapa M, Slack J, Coulson I, English J, Bourke J, McHenry P, Gibbon K, Buckley D, Leslie T, Mallon E, Wakelin S, Ungureanu S, Hunasehally R, Cork M, Natkunarajah J, Worsnop F, Chiang N, Donnelly J, Saunders C, Brain A, Exton LS. British Association of Dermatologists’ guidelines for the management of contact dermatitis 2017. Br J Dermatol 2017; 176:317-329. [DOI: 10.1111/bjd.15239] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 12/18/2022]
Affiliation(s)
- G.A. Johnston
- Department of Dermatology University Hospitals of Leicester NHS Trust Infirmary Square Leicester LE1 5WW U.K
| | - L.S. Exton
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
| | - M.F. Mohd Mustapa
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
| | - J.A. Slack
- Department of Dermatology University Hospitals of Leicester NHS Trust Infirmary Square Leicester LE1 5WW U.K
| | - I.H. Coulson
- Department of Dermatology Burnley General Hospital Casterton Avenue Burnley BB10 2PQ U.K
| | | | - J.F. Bourke
- Department of Dermatology South Infirmary Victoria University Hospital Old Blackrock Road Cork City Ireland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Josefson A, Berg M, Gånemo A, Hallander A, Hindsén-Stenström M, Meding B, Svensson Å, Lindberg M. Methodological aspects of assessing hand eczema: comparison of two tools and three different categories of evaluators. Br J Dermatol 2016; 176:1373-1375. [PMID: 28012170 DOI: 10.1111/bjd.15265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Josefson
- Department of Dermatology, Faculty of Medicine, Örebro University, SE-701 85, Örebro, Sweden
| | - M Berg
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - A Gånemo
- Department of Dermatology, Institute of Clinical Research in Malmö, Lund University, Malmö, Sweden
| | - A Hallander
- Department of Dermatology, Faculty of Medicine, Örebro University, SE-701 85, Örebro, Sweden
| | - M Hindsén-Stenström
- Department of Dermatology, Institute of Clinical Research in Malmö, Lund University, Malmö, Sweden
| | - B Meding
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Å Svensson
- Department of Dermatology, Institute of Clinical Research in Malmö, Lund University, Malmö, Sweden
| | - M Lindberg
- Department of Dermatology, Faculty of Medicine, Örebro University, SE-701 85, Örebro, Sweden
| |
Collapse
|
23
|
Politiek K, Oosterhaven JAF, Vermeulen KM, Schuttelaar MLA. Systematic review of cost-of-illness studies in hand eczema. Contact Dermatitis 2016; 75:67-76. [DOI: 10.1111/cod.12590] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Klaziena Politiek
- Department of Dermatology; University Medical Centre Groningen, University of Groningen; 9700 RB Groningen The Netherlands
| | - Jart A. F. Oosterhaven
- Department of Dermatology; University Medical Centre Groningen, University of Groningen; 9700 RB Groningen The Netherlands
| | - Karin M. Vermeulen
- Department of Epidemiology; University Medical Centre Groningen, University of Groningen; 9700 RB Groningen The Netherlands
| | - Marie-Louise A. Schuttelaar
- Department of Dermatology; University Medical Centre Groningen, University of Groningen; 9700 RB Groningen The Netherlands
| |
Collapse
|
24
|
Braun R, Dotterud LK. Occupational skin diseases from 1997 to 2004 at the Department of Dermatology, University Hospital of Northern Norway (UNN): an investigation into the course and treatment of occupational skin disease 10-15 years after first consultations with a dermatologist. Int J Circumpolar Health 2016; 75:30100. [PMID: 27172061 PMCID: PMC4864832 DOI: 10.3402/ijch.v75.30100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/01/2016] [Accepted: 03/07/2016] [Indexed: 11/21/2022] Open
Abstract
Objectives We investigate the impact of occupational skin disease consultations among outpatients at the Dermatological Department, University Hospital, Northern Norway. Study design From 1997 until 2004, 386 patients with occupational skin disease were examined and given advice on skin care, skin disease treatment, skin protection in further work, and on the legal rights of patients with this disease. Ten to fifteen years later, we wanted to look at these patients in terms of their work situation, the current status of their disease, the help they received from the labour offices, and their subjective quality of life. Material and methods In the autumn of 2011 until the spring of 2012, a number of the patients examined in the period from 1997 to 2004 were selected and sent a questionnaire, which they were asked to answer and return, regarding their work situation and the progress and current status of their occupational disease. Results A total of 153 (77%) patients answered the questionnaire; 71% of these patients were still in work, and further 15% had old-age retired, 13% were working until then; 16% had retired early because of disability; 54% had changed jobs because of their occupational skin disease; 86% of the patients indicated that the skin disease had improved since our previous investigation. Conclusions Our investigation into patients with occupational skin disease documented that the majority of patients who had received professional dermatological consultation and intervention offers were still in the labour market and had good control of their skin disease 10–15 years later. We discovered that 71% of the patients were still employed. 13% had remained in work until they became old age pensioners. Only 16% dropped out of work because of disability. These high percentages may indicate that our intervention has contributed positively to patients’ work conditions and the course of their skin disease.
Collapse
Affiliation(s)
- Rosemarie Braun
- Department of Dermatology, University Hospital, Tromsø, Norway; @unn.no
| | | |
Collapse
|
25
|
Brok L, Clemmensen KKB, Carøe TK, Ebbehøj NE, Agner T. Occupational allergic contact dermatitis in a 2-year follow-up study: how well does the patient remember the result of patch testing? Contact Dermatitis 2016; 75:41-7. [PMID: 27102974 DOI: 10.1111/cod.12560] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/15/2016] [Accepted: 01/23/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patch testing is mandatory for diagnosing contact dermatitis. It is, however, crucial that patients understand and remember the result of the test. OBJECTIVES The aim of our study was to evaluate the impact of patch testing with respect to patients' ability to remember patch test results and the results of natural rubber latex protein allergy after 2 years. METHODS One hundred and ninety-nine patients diagnosed with relevant occupational epoxy or rubber chemical contact allergy, or allergy to natural rubber latex protein, were invited to participate in a questionnaire study about their knowledge of contact allergies after 2 years. RESULTS The response rate was 75%. Of the respondents, 13% did not remember their occupational contact allergy to rubber chemicals or epoxy. Ability to remember was not significantly influenced by sex or Dermatology Life Quality Index, but was decreased by age >60 years (p < 0.01). Of patients with an additional contact allergy, <36% remembered this correctly. Of patients allergic to natural rubber latex proteins, 50% remembered this correctly. CONCLUSIONS The impact of patch testing depends on the patients' ability to understand and remember the results of the test. Attention should be drawn to the importance of this, and patients with increased need for information should be identified.
Collapse
Affiliation(s)
- Line Brok
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, 2400, Copenhagen, Denmark
| | - Kim K B Clemmensen
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, 2400, Copenhagen, Denmark
| | - Tanja K Carøe
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, 2400, Copenhagen, Denmark
| | - Niels E Ebbehøj
- Department of Occupational and Environmental Medicine, University of Copenhagen, Bispebjerg Hospital, 2400, Copenhagen, Denmark
| | - Tove Agner
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, 2400, Copenhagen, Denmark
| |
Collapse
|
26
|
Fonacier L, Bernstein DI, Pacheco K, Holness DL, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles S, Wallace D. Contact dermatitis: a practice parameter-update 2015. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 3:S1-39. [PMID: 25965350 DOI: 10.1016/j.jaip.2015.02.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 01/08/2023]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, which represents the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Contact Dermatitis: A Practice Parameter-Update 2015." This is a complete and comprehensive document at the current time. The medical environment is changing and not all recommendations will be appropriate or applicable to all patients. Because this document incorporated the efforts of many participants, no single individual, including members serving on the Joint Task Force, are authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information or interpretation of this practice parameter by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by the pharmaceutical industry in drug development or promotion. Previously published practice parameters of the Joint Task Force on Practice Parameters for Allergy & Immunology are available at http://www.JCAAI.org or http://www.allergyparameters.org.
Collapse
|
27
|
Cazzaniga S, Ballmer-Weber B, Gräni N, Spring P, Bircher A, Anliker M, Sonntag A, Piletta P, Huber C, Borradori L, Diepgen T, Apfelbacher C, Simon D. Medical, psychological and socio-economic implications of chronic hand eczema: a cross-sectional study. J Eur Acad Dermatol Venereol 2015; 30:628-37. [DOI: 10.1111/jdv.13479] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/07/2015] [Indexed: 11/28/2022]
Affiliation(s)
- S. Cazzaniga
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
- Centro Studi GISED; Bergamo Italy
| | - B.K. Ballmer-Weber
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - N. Gräni
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - P. Spring
- Department of Dermatology; University Hospital of Lausanne CHUV; Lausanne Switzerland
| | - A. Bircher
- Department of Dermatology; University Hospital Basel; Basel Switzerland
| | - M. Anliker
- Department of Dermatology; Cantonal Hospital St. Gallen; St. Gallen Switzerland
| | - A.K. Sonntag
- Department of Dermatology; Cantonal Hospital Aarau; Aarau Switzerland
| | - P. Piletta
- Department of Dermatology; Geneva University Hospitals (HUG); Geneva Switzerland
| | - C. Huber
- Department of Dermatology; Geneva University Hospitals (HUG); Geneva Switzerland
| | - L. Borradori
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
| | - T. Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University Hospital; Ruprecht Karls University; Heidelberg Germany
| | - C. Apfelbacher
- Institute of Epidemiology and Preventive Medicine; University of Regensburg; Regensburg Germany
| | - D. Simon
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
| |
Collapse
|
28
|
Abstract
BACKGROUND The length of time between onset of symptoms and definitive diagnosis is associated with outcomes in contact dermatitis (CD). Understanding the health care experience of patients with CD could identify areas for improvement. OBJECTIVE The objective of the study was to describe the health care experience of individuals being patch tested and the barriers and facilitators to their seeking care. METHODS One hundred forty-nine patients completed a survey containing information on types of health care providers seen, length of wait times, and barriers and facilitators to seeking care. RESULTS Sixty-six percent were first assessed by their family physicians. Forty-five percent waited more than 3 months before seeing a health care provider. Common reasons for delay included thinking their symptoms (1) would get better, (2) were not serious enough, or (3) were not limiting their ability to work or carry out other activities. Most patients waited less than 3 months for dermatological assessment and for patch test consultation after referral. CONCLUSIONS Patients with possible CD spend considerable time in the health care system before they undergo definitive assessment. Understanding the reasons for not seeking care may be useful for promoting earlier evaluation and intervention to result in better outcomes.
Collapse
|
29
|
Breuer K, John S, Finkeldey F, Boehm D, Skudlik C, Wulfhorst B, Dwinger C, Werfel T, Diepgen T, Schmid-Ott G. Tertiary individual prevention improves mental health in patients with severe occupational hand eczema. J Eur Acad Dermatol Venereol 2015; 29:1724-31. [DOI: 10.1111/jdv.12975] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 12/19/2014] [Indexed: 11/30/2022]
Affiliation(s)
- K. Breuer
- Department of Allergology and Occupational Dermatology; Dermatologikum Hamburg; Hamburg Germany
| | - S.M. John
- Department of Dermatology, Environmental Medicine, Health Theory; University of Osnabrueck; Osnabrueck Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck; Dermatologic Centre; Trauma Hospital; Hamburg Germany
| | - F. Finkeldey
- Department of Dermatology; Elbe-Klinikum Buxtehude; Buxtehude Germany
| | - D. Boehm
- Institute for Innovative Rehabilitation; Hospital Management and Distress Medicine (IREHA); Lielje Group; Löhne Germany
| | - C. Skudlik
- Department of Dermatology, Environmental Medicine, Health Theory; University of Osnabrueck; Osnabrueck Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck; Dermatologic Centre; Trauma Hospital; Hamburg Germany
| | - B. Wulfhorst
- Department of Dermatology, Environmental Medicine, Health Theory; University of Osnabrueck; Osnabrueck Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck; Dermatologic Centre; Trauma Hospital; Hamburg Germany
| | - C. Dwinger
- Department of Psychology; Employers' Liability Insurance Association Hospital for Accidents; Hamburg Germany
| | - T. Werfel
- Division of Immunodermatology and Allergy Research; Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - T.L. Diepgen
- Department of Clinical Social Medicine; Center of Health System Research, Occupational and Environmental Dermatology; University of Heidelberg; Heidelberg Germany
| | - G. Schmid-Ott
- Institute for Innovative Rehabilitation; Hospital Management and Distress Medicine (IREHA); Lielje Group; Löhne Germany
- Department of Psychosomatic Medicine; Berolina Clinic; Löhne Germany
| |
Collapse
|
30
|
Scalone L, Cortesi P, Mantovani L, Belisari A, Ayala F, Fortina A, Bonamonte D, Borroni G, Cannavò S, Guarneri F, Cristaudo A, De Pità O, Gallo R, Girolomoni G, Gola M, Lisi P, Pigatto P, Satta R, Giannetti A. Clinical epidemiology of hand eczema in patients accessing dermatological reference centres: results from Italy. Br J Dermatol 2014; 172:187-95. [DOI: 10.1111/bjd.13220] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 11/27/2022]
Affiliation(s)
- L. Scalone
- Research Centre on Public Health (CESP); University of Milan-Bicocca; Villa Serena Via Pergolesi 33 I-20052 Monza Italy
- CHARTA Foundation; Milan Italy
| | - P.A. Cortesi
- Research Centre on Public Health (CESP); University of Milan-Bicocca; Villa Serena Via Pergolesi 33 I-20052 Monza Italy
- CHARTA Foundation; Milan Italy
| | - L.G. Mantovani
- CHARTA Foundation; Milan Italy
- Faculty of Pharmacy; University of Naples Federico II; Naples Italy
| | | | - F. Ayala
- Department of Dermatology; University of Naples Federico II; Naples Italy
| | - A.B. Fortina
- Pediatric Dermatology Unit; Department of Medicine; University of Padova; Padova Italy
| | - D. Bonamonte
- Department of Biomedical Science and Human Oncology; Unit of Dermatology; University of Bari ‘Aldo Moro’; Bari Italy
| | - G. Borroni
- Clinical-Surgical, Diagnostic and Pediatric Science; Dermatology Unit; University of Pavia; Fondazione IRCCS Policlinico San Matteo; Pavia Italy
| | - S.P. Cannavò
- Department of Clinical and Experimental Medicine-Unit of Dermatology; University of Messina; Messina Italy
| | - F. Guarneri
- Department of Clinical and Experimental Medicine-Unit of Dermatology; University of Messina; Messina Italy
| | - A. Cristaudo
- Department of Allergological and Occupational Dermatology; San Gallicano Dermatologic Institute, IRCCS; Rome Italy
| | - O. De Pità
- Laboratory of Immunology; Istituto Dermopatico dell'Immacolata (IDI)-IRCCS; Rome Italy
| | - R. Gallo
- Section of Dermatology; DISSAL - Department of Health Sciences; University of Genoa; Genoa Italy
| | - G. Girolomoni
- Department of Medicine; Section of Dermatology and Venereology; University of Verona; Verona Italy
| | - M. Gola
- Allergological and Occupational Dermatology Unit; Department of Critical Care Medicine and Surgery; University of Florence; Florence Italy
| | - P. Lisi
- Department of Medical and Surgical Specialities and Public Health; Section of Clinical, Allergological and Venereological Dermatology; University of Perugia; Perugia Italy
| | - P.D. Pigatto
- Department of Biomedical Science for Health IRCCS Galeazzi Hospital; University of Milan; Milan Italy
| | - R. Satta
- Institute of Dermatology; University of Sassari; Sassari Italy
| | - A. Giannetti
- Division of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | | |
Collapse
|
31
|
Petersen A, Johansen J, Hald M. Hand eczema - prognosis and consequences: a 7-year follow-up study. Br J Dermatol 2014; 171:1428-33. [DOI: 10.1111/bjd.13371] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A.H. Petersen
- National Allergy Research Centre; Copenhagen University Hospital Gentofte; Kildegaardsvej 28 DK-2900 Hellerup Denmark
| | - J.D. Johansen
- National Allergy Research Centre; Copenhagen University Hospital Gentofte; Kildegaardsvej 28 DK-2900 Hellerup Denmark
| | - M. Hald
- Department of Dermato-Allergology; Copenhagen University Hospital Gentofte; Kildegaardsvej 28 DK-2900 Hellerup Denmark
| |
Collapse
|
32
|
Basketter D, Kimber I. Consideration of criteria required for assignment of a (skin) sensitiser a substance of very high concern (SVHC) under the REACH regulation. Regul Toxicol Pharmacol 2014; 69:524-8. [PMID: 24893346 DOI: 10.1016/j.yrtph.2014.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 05/22/2014] [Accepted: 05/23/2014] [Indexed: 11/27/2022]
Abstract
The identification, characterisation, risk assessment and risk management of materials that cause allergic sensitisation is an important requirement for human health protection. It has been proposed that for some chemical and protein allergens, and in particular for those that cause sensitisation of the respiratory tract (associated with occupational asthma), it may be appropriate to regard them as Substances of Very High Concern (SVHC) under the provisions of REACH (Registration, Evaluation, Authorisation and restriction of CHemicals). We have argued previously that categorisation of sensitising agents as SVHC should be used only in exceptional circumstances. In the present article, the subject of SVHC is addressed from another perspective. Here the information that would be required to provide a compelling case for categorisation of a skin sensitising substance as a SVHC is considered. Three skin sensitising chemicals have been identified to serve as working examples. These are chromate, a potent contact allergen, and the skin sensitisers formaldehyde and isoeugenol. The key criterion influencing the decision regarding a skin sensitiser being categorised as SVHC is the extent to which impacts on the quality of life are reversible. Consequently, SVHC categorisation for skin sensitising chemicals should be used only in exceptional circumstances.
Collapse
Affiliation(s)
- David Basketter
- DABMEB Consultancy Ltd., Sharnbrook, Bedfordshire MK44 1PR, UK.
| | - Ian Kimber
- Faculty of Life Sciences, University of Manchester, Manchester M13 9PT, UK
| |
Collapse
|
33
|
|
34
|
Corti MA, Stirnimann R, Borradori L, Simon D. Effects of Systematic Patient Education in Skin Care and Protection in a Hand Eczema Clinic. Dermatology 2014; 228:220-4. [DOI: 10.1159/000357523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 11/21/2013] [Indexed: 11/19/2022] Open
|
35
|
Diepgen TL, Scheidt R, Weisshaar E, John SM, Hieke K. Cost of illness from occupational hand eczema in Germany. Contact Dermatitis 2014; 69:99-106. [PMID: 23869729 DOI: 10.1111/cod.12038] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is little knowledge about the costs of occupational hand eczema. OBJECTIVES To estimate the societal costs of patients with occupational hand eczema in Germany. METHODS Resource use during the past year, disease severity and quality of life [Dermatology Life Quality Index (DLQI)] were gathered for patients with occupational hand eczema before they entered a special rehabilitation programme. Costs were calculated from the societal perspective. The analysis focused on all patients and the severity groups no signs/mild (group A) and moderate to severe (group B). RESULTS One hundred and fifty-one patients were analysed, with a mean age of 44.9~years and a mean DLQI score of 10.9; 64.9% were male. Sickness absence was recorded for 62.9% of all patients (76.4~days on average in the last 12~months). Annual societal costs were €8799 per patient. Indirect costs represented 70% of total costs. Quality of life (DLQI) was statistically different across both severity groups (group A, 7.9; group B, 12.9), but direct treatment costs were not (€2705 versus €2610, respectively). There was a trend towards higher indirect costs in patients in severity group B (group A, €5120; group B, €6796). CONCLUSION The annual societal costs of patients with occupational hand eczema in this study are high, and similar to those for severe psoriasis and atopic dermatitis.
Collapse
Affiliation(s)
- Thomas L Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, 69115 Heidelberg, Germany.
| | | | | | | | | |
Collapse
|
36
|
|
37
|
Lindberg M, Bingefors K, Meding B, Berg M. Hand eczema and health-related quality of life; a comparison of EQ-5D and the Dermatology Life Quality Index (DLQI) in relation to the hand eczema extent score (HEES). Contact Dermatitis 2013; 69:138-43. [DOI: 10.1111/cod.12067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/15/2013] [Accepted: 01/16/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - Kerstin Bingefors
- Department of Pharmacy; Uppsala University; SE-751 05; Uppsala; Sweden
| | | | | |
Collapse
|
38
|
van der Meer EWC, Boot CRL, van der Gulden JWJ, Jungbauer FHW, Coenraads PJ, Anema JR. Hand eczema among healthcare professionals in the Netherlands: prevalence, absenteeism, and presenteeism. Contact Dermatitis 2013; 69:164-71. [DOI: 10.1111/cod.12099] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/18/2013] [Accepted: 04/04/2013] [Indexed: 01/28/2023]
Affiliation(s)
- Esther W. C. van der Meer
- Department of Public and Occupational Health; EMGO Institute for Health and Care Research, VU University Medical Centre; Amsterdam; 1081 BT; The Netherlands
| | | | - Joost W. J. van der Gulden
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health; Radboud University Nijmegen Medical Centre; Nijmegen; 6500 HB; The Netherlands
| | - Frank H. W. Jungbauer
- Department of Public and Occupational Health; Groningen University Medical Centre; Groningen; 9700 RB; The Netherlands
| | - Pieter Jan Coenraads
- Department of Dermatology; University Medical Centre Groningen, University of Groningen; Groningen; 9700 RB; The Netherlands
| | | |
Collapse
|
39
|
Vester L, Thyssen JP, Menné T, Johansen JD. Consequences of occupational food-related hand dermatoses with a focus on protein contact dermatitis. Contact Dermatitis 2012; 67:328-33. [PMID: 22624860 DOI: 10.1111/j.1600-0536.2012.02101.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Protein contact dermatitis is a frequent disorder among hand eczema patients who have occupational food contact. Knowledge about the consequences of having protein contact dermatitis is lacking. OBJECTIVES To investigate the consequences of having occupational skin disease on the hands resulting from food handling, with a focus on protein contact dermatitis. MATERIAL AND METHODS One hundred and seventy-eight patients who were identified as having skin disease related to occupational food exposure and who answered a questionnaire concerning the consequences of their skin disease were included in the study. The patients were consecutively examined at Gentofte Hospital, Denmark between 2001 and 2010. RESULTS Seventy-five per cent of patients with protein contact dermatitis had to wear gloves at work, and 62.5% reported sick leave lasting for >3 weeks, as compared with 60.2% and 30%, respectively, of the patients with other occupational food-related hand dermatoses (p = 0.02). Sixty-two per cent and 43%, respectively, had to change job because of skin problems (p = 0.02). Atopic dermatitis was equally common in the two groups. CONCLUSION We found that the patients with protein contact dermatitis experienced more severe and frequent consequences than patients with other food-related hand dermatoses.
Collapse
Affiliation(s)
- Lotte Vester
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, 2900 Hellerup, Denmark
| | | | | | | |
Collapse
|
40
|
Lysdal SH, Johansen JD, Flyvholm MA, Søsted H. A quantification of occupational skin exposures and the use of protective gloves among hairdressers in Denmark. Contact Dermatitis 2012; 66:323-34. [DOI: 10.1111/j.1600-0536.2012.02050.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
41
|
Boehm D, Schmid-Ott G, Finkeldey F, John SM, Dwinger C, Werfel T, Diepgen TL, Breuer K. Anxiety, depression and impaired health-related quality of life in patients with occupational hand eczema. Contact Dermatitis 2012; 67:184-92. [PMID: 22564098 DOI: 10.1111/j.1600-0536.2012.02062.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Occupational hand eczema is one of the most frequent occupational diseases. Few data about the prevalence of mental comorbidities are available. Objectives. We aimed to investigate the prevalence of anxiety, depression symptoms, the impairment of health-related quality of life (HRQoL) and their correlates in patients with occupational hand eczema. PATIENTS AND METHODS A test battery consisting of the German versions of the Hospital Anxiety and Depression Scale, the Dermatology Life Quality Index (DLQI) as a specific instrument and the Short Form Health Survey-36 (SF-36) as a generic instrument for HRQoL was applied in 122 patients. The severity of hand eczema was assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). RESULTS Twenty per cent of patients had a positive anxiety score, and 14% had a positive depression score. Higher anxiety levels, a greater impairment in the SF-36 mental component summary score and a higher DLQI category score for symptoms and feelings was detected in females than in males. The OHSI correlated with the impairment in HRQoL, and an association of severe hand eczema with symptoms of anxiety and depression was found in males. CONCLUSIONS We found a high prevalence of anxiety and depression in our study population of patients with occupational hand eczema. Preventive measures should consider the psychosocial implications of occupational hand eczema.
Collapse
Affiliation(s)
- Dana Boehm
- Institute for Innovative Rehabilitation, Hospital Management and Distress Medicine (IREHA), Lielje Group, 32584 Löhne, Germany
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Hannu T, Suuronen K, Aalto-Korte K, Alanko K, Luukkonen R, Järvelä M, Jolanki R, Jaakkola MS. Occupational respiratory and skin diseases among Finnish machinists: findings of a large clinical study. Int Arch Occup Environ Health 2012; 86:189-97. [PMID: 22422009 DOI: 10.1007/s00420-012-0754-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 02/28/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE Machinists are exposed to many sensitizing and irritant substances, but no previous study has assessed the occurrence of clinically verified occupational diseases in an unselected large workforce of machinists. Our aim was to study the occurrence of clinically verified occupational respiratory and skin diseases cross-sectionally in a large sample of machinists in southern Finland. METHODS A computer-assisted telephone interview on occupational exposures and health was carried out in a sample of 961 machining workers from 64 metalworking companies. Of these, 757 (79%) answered the interview. A total of 245 subjects reported work-related respiratory or skin symptoms and were invited to clinical examinations; 138 of these underwent a clinical interview and examination by an occupational health physician. On the basis of this examination, 32 subjects were further examined at the Finnish Institute of Occupational Health (FIOH) for occupational skin or respiratory diseases. RESULTS One case of occupational asthma (OA) and seven cases of occupational dermatoses (OD) were diagnosed, giving a prevalence of 0.13% (95% CI 0-0.39) for OA, and 0.92% (95% CI 0.24-1.16) for OD. The OA was induced by the patient's own MWF. Additional five cases of newly diagnosed non-occupational asthma (0.79%, 95% CI = 0.16-1.42) were detected. No cases of occupational rhinitis or COPD were diagnosed. The dermatoses diagnoses consisted of four cases of allergic contact dermatitis and three cases of irritant contact dermatitis. The most common causes of the ODs were MWFs. CONCLUSION This large clinical study of machinists representing metalworking in South Finland showed a prevalence of 0.13% of OA and 0.92% of OD. This relatively low occurrence of occupational diseases may reflect the strict Finnish criteria for the diagnosis of these occupational diseases and the relatively good level of occupational hygiene in machining workshops in Finland. Reported respiratory and skin symptoms were common, and these milder conditions may be linked to irritant rather than sensitizing exposures.
Collapse
Affiliation(s)
- Timo Hannu
- Occupational Medicine Team, Finnish Institute of Occupational Health, Helsinki, Finland
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Mirabelli MC, Vizcaya D, Martí Margarit A, Antó JM, Arjona L, Barreiro E, Orriols R, Gimenez-Arnau A, Zock JP. Occupational risk factors for hand dermatitis among professional cleaners in Spain. Contact Dermatitis 2012; 66:188-96. [PMID: 22268785 DOI: 10.1111/j.1600-0536.2011.02023.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dermatitis is an important health outcome for workers whose jobs put them in contact with irritants or sensitizing agents. OBJECTIVES We conducted an analysis of data from the Epidemiological Study on the Risk of Asthma in Cleaning Workers 2 (EPIASLI2) to assess worksites and cleaning products as risk factors for hand dermatitis among professional cleaning workers. MATERIALS/METHODS We distributed 4993 questionnaires to employees of 37 cleaning companies, and used data from 818 (16%) respondents who provided information about skin symptoms and cleaning-related exposures. We assessed associations between the frequencies of worksite and cleaning product exposures and a symptom-based definition of hand dermatitis among current cleaning workers (n = 693) and a comparison population (n = 125). RESULTS Hand dermatitis was reported by 28% of current cleaning workers, versus 18% of the comparison population, and was associated with cleaning outdoor areas and schools, and the use of hydrochloric acid [prevalence ratio (PR) 1.92, 95% confidence interval (CI) 1.22-3.02] and dust mop products (PR 1.75, 95% CI 1.11-2.75). CONCLUSIONS Professional cleaning workers may not be sufficiently protected from cutaneous disease at work. Future research should further investigate the roles of multiple product exposures and personal protective equipment.
Collapse
Affiliation(s)
- Maria C Mirabelli
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Skudlik C, Weisshaar E, Scheidt R, Elsner P, Wulfhorst B, Schönfeld M, John SM, Diepgen TL. First results from the multicentre study Rehabilitation of Occupational Skin Diseases - Optimization and Quality Assurance of Inpatient Management (ROQ). Contact Dermatitis 2011; 66:140-7. [DOI: 10.1111/j.1600-0536.2011.01991.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
45
|
Baumeister T, Uter W, Weistenhöfer W, Drexler H, Kütting B. On the lookout for precursor lesions: where does dry skin end and slight hand eczema begin? Contact Dermatitis 2011; 66:63-71. [DOI: 10.1111/j.1600-0536.2011.01969.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
46
|
Lysdal SH, Søsted H, Andersen KE, Johansen JD. Hand eczema in hairdressers: a Danish register-based study of the prevalence of hand eczema and its career consequences. Contact Dermatitis 2011; 65:151-8. [PMID: 21692809 DOI: 10.1111/j.1600-0536.2011.01935.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Susan Hovmand Lysdal
- Department of Dermato-Allergology, Research Centre for Hairdressers and Beauticians, Copenhagen University Hospital Gentofte, DK-2900 Gentofte, Denmark.
| | | | | | | |
Collapse
|
47
|
A review of the impact of occupational contact dermatitis on quality of life. J Allergy (Cairo) 2011; 2011:964509. [PMID: 21603173 PMCID: PMC3095907 DOI: 10.1155/2011/964509] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/19/2011] [Indexed: 11/17/2022] Open
Abstract
Occupational contact dermatitis (OCD) is the most common occupational skin disease in many countries. We reviewed the current evidence on how OCD impacts on quality of life (QoL). The three commonly used QoL questionnaires in OCD were the Short-Form Health Survey (SF-36), the Dermatology Life Quality Index (DLQI), and the Skindex. Despite the availability of a variety of validated QoL instruments, none of them is specific to OCD or entirely adequate in capturing the impact of OCD on QoL. Nonetheless, the results of this paper do suggest a significant impact. Use of QoL measures in clinical settings will provide patients with an opportunity to express their concerns and assist clinicians to evaluate the effectiveness of management beyond the clinical outcomes. This paper also highlights the lack of a disease-specific QOL instrument and the importance of developing a validated measure to assess QOL in OCD, enabling comparison across countries and occupational groups.
Collapse
|
48
|
Research Snippets. J Invest Dermatol 2010. [DOI: 10.1038/jid.2010.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|