Incidence Rate of Hand Eczema in Different Occupations: A Systematic Review and Meta-analysis
DOI:
https://doi.org/10.2340/actadv.v102.360Keywords:
hand eczema, epidemiology, occupation, incidenceAbstract
Hand eczema is a chronic disease that results in economic and psychosocial burdens. The aim of this study was to systematically review and assess the magnitude of the association between exposure related to occupations and the incidence rate of hand eczema. A systematic search in PubMed, EMBASE, CINAHL and Cochrane databases, from inception to September 2017, of full-text observational studies reporting incident cases of hand eczema during employment, and a supplementary search in PubMed to September 2020, were conducted. Among 2,417 screened abstracts, 15 studies fulfilled the inclusion criteria. Incidence rates were reported per 100 person-years. Based on the Newcastle-Ottawa Scale, 9 studies were good quality, 2 fair quality, and 4 poor quality. Hairdressers had a high incidence of hand eczema of 21.4 (95% confidence interval [CI] 15.3–27.4), as did nurses, 16.9 (95% CI 11.2–22.7), and metal workers, 12.4 (95% CI 3.5–21.3). Hairdressers were predominantly women, and metal worker were predominantly men. Office occupations had an incidence rate of hand eczema of 4.9 (95% CI 1.2–9.6). The high risk of hand eczema for hairdressers, nurses, and metal workers, should be considered by healthcare policymakers. Even occupations with low irritant profile, such as office workers, were at risk of developing hand eczema, and more occupations should be investigated regarding the related risk of developing hand eczema.
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Ruff SMD, Engebretsen KA, Zachariae C, Johansen JD, Silverberg JI, Egeberg A, et al. The association between atopic dermatitis and hand eczema: a systematic review and meta-analysis. Br J Dermatol 2018; 178: 879-888.
https://doi.org/10.1111/bjd.16147 DOI: https://doi.org/10.1111/bjd.16147
Funke U, Fartasch M, Diepgen TL. Incidence of work-related hand eczema during apprenticeship: first results of a prospective cohort study in the car industry. Contact Dermatitis 2001; 44: 166-172.
https://doi.org/10.1034/j.1600-0536.2001.044003166.x DOI: https://doi.org/10.1034/j.1600-0536.2001.044003166.x
Bolognia J, Schaffer JV, Cerroni L. Dermatology: Elsevier 2017, p. 274.
Nicholson PJ LD, English JS. Guidelines Development Group. Evidence-based guidelines for the prevention, identification and management of occupational contact dermatitis and urticaria. Contact Dermatitis 2010; 63: 177-186.
https://doi.org/10.1111/j.1600-0536.2010.01763.x
Diepgen TL, Andersen KE, Chosidow O, Coenraads PJ, Elsner P, English J, et al. Guidelines for diagnosis, prevention and treatment of hand eczema. J Dtsch Dermatol Ges 2015; 13: e1-e22.
https://doi.org/10.1111/ddg.12510_1 DOI: https://doi.org/10.1111/ddg.12510_1
Nicholson PJ, Llewellyn D, English JS. Evidence-based guidelines for the prevention, identification and management of occupational contact dermatitis and urticaria. Contact Dermatitis 2010; 63: 177-186.
https://doi.org/10.1111/j.1600-0536.2010.01763.x DOI: https://doi.org/10.1111/j.1600-0536.2010.01763.x
Smedley J. Concise guidance: diagnosis, management and prevention of occupational contact dermatitis. Clin Med 2010; 10: 487-490.
https://doi.org/10.7861/clinmedicine.10-5-487 DOI: https://doi.org/10.7861/clinmedicine.10-5-487
Lukacs J, Schliemann S, Elsner P. Association between smoking and hand dermatitis - a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2015; 29: 1280-1284.
https://doi.org/10.1111/jdv.12971 DOI: https://doi.org/10.1111/jdv.12971
Lund T, Petersen SB, Flachs EM, Ebbehoj NE, Bonde JP, Agner T. Risk of work-related hand eczema in relation to wet work exposure. Scand J Work Environ Health 2020; 46: 437-445.
https://doi.org/10.5271/sjweh.3876 DOI: https://doi.org/10.5271/sjweh.3876
Meding B LG, Alderling M, Wrangsjö K, Anveden Berglind I. Is skin exposure to water mainly occupational or nonoccupational? A population-based study. Br J Dermatol 2013; 168: 1281-1286.
https://doi.org/10.1111/bjd.12275 DOI: https://doi.org/10.1111/bjd.12275
Boer Md, Ketel WGv, Bruynzeel DP. Dermatoses in metal workers. II. Allergic contact dermatitis. Contact Dermatitis 1989; 20: 280-286.
https://doi.org/10.1111/j.1600-0536.1989.tb03146.x DOI: https://doi.org/10.1111/j.1600-0536.1989.tb03146.x
Diepgen TL, Agner T, Aberer W, Berth-Jones J, Cambazard F, Elsner P, et al. Management of chronic hand eczema. Contact Dermatitis 2007; 57: 203-110.
https://doi.org/10.1111/j.1600-0536.2007.01179.x DOI: https://doi.org/10.1111/j.1600-0536.2007.01179.x
Elston DM, Ahmed DD, Watsky KL, Schwarzenberger K. Hand dermatitis. J Am Acad Dermatol 2002; 47: 291-299.
https://doi.org/10.1067/mjd.2002.122757 DOI: https://doi.org/10.1067/mjd.2002.122757
Behroozy A, Keegel TG. Wet-work exposure: a main risk factor for occupational hand dermatitis. Saf Health Work 2014; 5: 175-180.
https://doi.org/10.1016/j.shaw.2014.08.001 DOI: https://doi.org/10.1016/j.shaw.2014.08.001
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000; 283: 2008-2012.
https://doi.org/10.1001/jama.283.15.2008 DOI: https://doi.org/10.1001/jama.283.15.2008
LaMorte WW. Measures of disease frequency: relationship of incidence rate to cumulative incidence risk. Boston: Boston University School of Public Health; 2012. [accessed April 2020] Available from: http://sphweb.bumc.bu.edu/otlt/MPH-Modules/EP/EP713_DiseaseFrequency/EP713_DiseaseFrequency5.html#headingtaglink_1.
Goldstein ND. Measures of frequency and risk. In: Improving population health using electronic health records, methods for data management and epidemiological analysis. First edition edn. Routledge Taylor and Francis Group, Boca Raton; 2017.
Chalmers JR, Thomas KS, Apfelbacher C, Williams HC, Prinsen CA, Spuls PI, et al. Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative). Br J Dermatol 2018; 178: e332-e341.
Valentine JC, Pigott TD, Rothstein HR. How many studies do you need? A primer on statistical power for meta-analysis. J Educ Behav Stat 2010; 35: 215-247.
https://doi.org/10.3102/1076998609346961 DOI: https://doi.org/10.3102/1076998609346961
Borenstein M. Common mistakes in meta-analysis and how to avoid them. First edn. Biostat Inc. New Jersey USA 2019.
Smit HA, van Rijssen A, Vandenbroucke JP, Coenraads PJ. Susceptibility to and incidence of hand dermatitis in a cohort of apprentice hairdressers and nurses. Scand J Work Environ Health 1994; 20: 113-121.
https://doi.org/10.5271/sjweh.1423 DOI: https://doi.org/10.5271/sjweh.1423
Brisman J, Meding B, Jarvholm B. Occurrence of self reported hand eczema in Swedish bakers. Occup Environ Med 1998; 55: 750-754.
https://doi.org/10.1136/oem.55.11.750 DOI: https://doi.org/10.1136/oem.55.11.750
Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Prevalence and incidence of hand dermatitis in hairdressing apprentices: results of the POSH study. Prevention of occupational skin disease in hairdressers. Int Arch Occup Environ Health 1998; 71: 487-492.
https://doi.org/10.1007/s004200050310 DOI: https://doi.org/10.1007/s004200050310
Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Hand eczema in a prospectively-followed cohort of office-workers. Contact Dermatitis 1998; 38: 83-89.
Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Hand dermatitis in a prospectively-followed cohort of hairdressing apprentices: final results of the POSH study. Prevention of occupational skin disease in hairdressers. Contact Dermatitis 1999; 41: 280-286.
https://doi.org/10.1111/j.1600-0536.1999.tb06162.x DOI: https://doi.org/10.1111/j.1600-0536.1999.tb06162.x
Berndt U, Hinnen U, Iliev D, Elsner P. Hand eczema in metalworker trainees - an analysis of risk factors. Contact Dermatitis 2000; 43: 327-332.
https://doi.org/10.1034/j.1600-0536.2000.043006327.x DOI: https://doi.org/10.1034/j.1600-0536.2000.043006327.x
John SM, Uter W, Schwanitz HJ. Relevance of multiparametric skin bioengineering in a prospectively-followed cohort of junior hairdressers. Contact Dermatitis 2000; 43: 161-168.
https://doi.org/10.1034/j.1600-0536.2000.043003161.x DOI: https://doi.org/10.1034/j.1600-0536.2000.043003161.x
Lind ML, Albin M, Brisman J, Kronholm Diab K, Lillienberg L, Mikoczy Z, et al. Incidence of hand eczema in female Swedish hairdressers. Occup Environ Med 2007; 64: 191-195.
https://doi.org/10.1136/oem.2005.026211 DOI: https://doi.org/10.1136/oem.2005.026211
Visser MJ, Verberk MM, van Dijk FJ, Bakker JG, Bos JD, Kezic S. Wet work and hand eczema in apprentice nurses; part I of a prospective cohort study. Contact Dermatitis 2014; 70: 44-55.
https://doi.org/10.1111/cod.12131 DOI: https://doi.org/10.1111/cod.12131
Steengaard SS, Bregnhoj A, Johansen JD. Hand eczema among hairdressing apprentices in Denmark following a nationwide prospective intervention programme: 6-year follow-up. Contact Dermatitis 2016; 75: 32-40.
https://doi.org/10.1111/cod.12588 DOI: https://doi.org/10.1111/cod.12588
Foss-Skiftesvik MH, Winther L, Johnsen CR, Zachariae C, Johansen JD. Incidence of skin and respiratory diseases among Danish hairdressing apprentices. Contact Dermatitis 2017; 76: 160-166.
https://doi.org/10.1111/cod.12744 DOI: https://doi.org/10.1111/cod.12744
Smit HA, Coenraads PJ. A retrospective cohort study on the incidence of hand dermatitis in nurses. Int Arch Occup Environ Health 1993; 64: 541-544.
https://doi.org/10.1007/BF00517697 DOI: https://doi.org/10.1007/BF00517697
Schmid K, Broding HC, Uter W, Drexler H. Transepidermal water loss and incidence of hand dermatitis in a prospectively followed cohort of apprentice nurses. Contact Dermatitis 2005; 52: 247-253.
https://doi.org/10.1111/j.0105-1873.2005.00557.x DOI: https://doi.org/10.1111/j.0105-1873.2005.00557.x
Reich A, Wilke A, Gediga G, Baurecht H, Rodriguez E, Jakasa I, et al. Health education decreases incidence of hand eczema in metal work apprentices: results of a controlled intervention study. Contact Dermatitis 2020; 82: 350-360.
https://doi.org/10.1111/cod.13502 DOI: https://doi.org/10.1111/cod.13502
Hornstein OP, Bäurle G, Kienlein Kletschka B. Prospektivstudie zur Bedeutung konstitutioneller Parameter für die Ekzemgenese im Friseur-und Baugewerbe. Deramotsen 1985; 33: 43-49.
Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Risk factors for hand dermatitis in hairdressing apprentices: results of the POSH study. Dermatosen in Beruf und Umwelt 1998; 46: 151-158.
Rothman KJ, Greenland S. Modern epidemiology. Second edn. Lippincott Williams and Wilkins, Philadelphia; 1998.
Fletcher R, Fletcher SW, Fetcher GS. Clinical epidemiology: the essentials. Fifth edition. Lippincott Williams and Wilkins; 2014.
Borenstein M. Common mistakes in meta-analysis and how to avoid them. First edition. Biostat Inc.; 2019.
Meding B, Barregard L. Validity of self-reports of hand eczema. Contact Dermatitis 2001; 45: 99-103.
https://doi.org/10.1034/j.1600-0536.2001.045002099.x DOI: https://doi.org/10.1034/j.1600-0536.2001.045002099.x
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