Job change facilitates healing in a cohort of patients with occupational hand eczema. (1st July 2018)

• Record Type: Journal Article
• Authors: Carøe, T.K.; Ebbehøj, N.E.; Bonde, J.P.E.; Vejlstrup, S.G.; Agner, T.
• Is Part Of: British journal of dermatology. Volume 179:Number 1(2018)
• Page Start: 80
• Page End: 87
• Publication Date: 2018-07-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.16095
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Occupational hand eczema is a frequent and often chronic disease and knowledge of the consequences of change of profession is sparse. Objectives: To compare severity of hand eczema and health‐related quality of life (HR‐QoL) in patients who after 5 years were still in the same profession and those who were not. Methods: The study is a register‐based cohort study including patients with recognized occupational hand eczema in Denmark in 2010 and 2011. Outcomes were eczema‐related parameters and Dermatology Life Quality Index (DLQI) scores obtained from a follow‐up questionnaire after 5 years. Results: A total of 1496 participants were included in the study. More participants who changed profession or left the labour market reported complete healing of hand eczema at follow‐up, compared with participants still in the same profession [odds ratio (OR) 1·62, 95% confidence interval (CI) 1·06–2·47 and OR 2·85, 95% CI 1·83–4·42, respectively], in addition to increased improvement at follow‐up (OR 1·91, 95% CI 1·44–2·54 and OR 1·51, 95% CI 1·09–2·10, respectively). However, DLQI scores for participants who changed profession or left the labour market had increased at follow‐up [incidence rate ratio (IRR) 1·12 (95% CI 0·98–1·28 and IRR 1·29, 95% CI 1·11–1·51, respectively]. The results from subgroup analyses of patients with irritant or allergic occupational hand eczema did not differ markedly. Change of work procedures was positively associated with improvement (OR 2·31, 95% CI 1·51–3·54), and did not markedly influence DLQI. Conclusions: Change of profession has a beneficial effect on eczema parameters, but a negative effect on HR‐QoL, indicated by increased DLQI scores. Change of work procedures while staying in the same profession positively influenced improvement, with no marked influence on HR‐QoL, and should be considered as an alternative to job change.