Adisesh A, Meyer J D, Cherry N M
Occupational Disease Intelligence Network, Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK.
Contact Dermatitis. 2002 May;46(5):273-9. doi: 10.1034/j.1600-0536.2002.460505.x.
The consequences of a diagnosis of occupational contact dermatitis (OCD) were investigated using cases available from the voluntary surveillance scheme, EPIDERM. Cases of OCD reported from November 1994 to September 1995 were identified and sampled to give at least 100 cases of allergic, irritant and mixed OCD reported by consultant dermatologists (344 cases) and occupational physicians (377 cases). A questionnaire was sent to the reporting physician to elicit further information. 512 completed questionnaires were returned, of which 510 were eligible for analysis. Among cases reported by dermatologists (n = 286) and occupational physicians (n = 224), 7% (6.3%) had been unemployed and 16.8% (20.1%) had taken sick leave. 3 factors independently predicted time off work in a logistic regression analysis: age OR = 1.25 (95% CI, 1.05-1.49), allergic dermatitis OR = 1.77 (95% CI, 1.13-2.79) and medicolegal assessment OR = 4.42 (95% CI, 2.20-8.89). Overall, 15.7% did not improve clinically between the first and last visit. Those who did not improve had been exposed to the agent for longer (mean 7.6 years) than those who did (5.3 years) (p = 0.09). In patients <or= 45 years, those reported to be atopic failed to improve (25.4%) more often than those not atopic (13.4%) (p = 0.04). The substantial numbers (21%) with time off work and with persistent dermatitis suggest that OCD continues to have a significant impact on workers and their employers.
利用自愿监测计划EPIDERM中的现有病例，对职业性接触性皮炎（OCD）诊断的后果进行了调查。确定并抽取了1994年11月至1995年9月报告的OCD病例，以获得皮肤科顾问医生（344例）和职业医生（377例）报告的至少100例过敏性、刺激性和混合性OCD病例。向报告医生发送了一份问卷，以获取更多信息。共返回512份完整问卷，其中510份符合分析条件。在皮肤科医生报告的病例（n = 286）和职业医生报告的病例（n = 224）中，7%（6.3%）曾失业，16.8%（20.1%）请过病假。在逻辑回归分析中，有3个因素独立预测了缺勤时间：年龄OR = 1.25（95%CI，1.05 - 1.49），过敏性皮炎OR = 1.77（95%CI，1.13 - 2.79），法医学评估OR = 4.42（95%CI，2.20 - 8.89）。总体而言，15.7%的患者在首次就诊和末次就诊之间临床症状未改善。未改善的患者接触该致病因子的时间（平均7.6年）比改善的患者（5.3年）更长（p = 0.09）。在年龄≤45岁的患者中，报告为特应性体质的患者未改善的比例（25.4%）高于非特应性体质的患者（（13.4%）（p = 0.04）。大量（21%）患者缺勤且皮炎持续存在，这表明职业性接触性皮炎继续对工人及其雇主产生重大影响。
