Job change facilitates healing in a cohort of patients with occupational hand eczema

TY - JOUR

T1 - Job change facilitates healing in a cohort of patients with occupational hand eczema

AU - Carøe, T. K.

AU - Ebbehøj, N. E.

AU - Bonde, J. P. E.

AU - Vejlstrup, S. G.

AU - Agner, T

N1 - This article is protected by copyright. All rights reserved.

PY - 2018/7

Y1 - 2018/7

N2 - 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.

AB - 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.

KW - Journal Article

U2 - 10.1111/bjd.16095

DO - 10.1111/bjd.16095

M3 - Journal article

C2 - 29078013

SN - 0007-0963

VL - 179

SP - 80

EP - 87

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 1

ER -