Occurrence and prognosis of hand eczema in the car industry: results from the PACO follow-up study (PACO II).

BACKGROUND

Only a few epidemiological studies on hand eczema (HE) in the metalworking industry have been conducted, and no study has attempted a long-term follow-up.

OBJECTIVES

In the Prospective Audi Cohort (PACO) II follow-up study, we aimed to estimate burden and prognosis of HE in a car industry setting (follow-up > 10 years).

PATIENTS/METHODS: Eligible participants were individuals who had been examined in the original PACO study (1990-1998) and had been followed through until the end of their apprenticeship (n = 1909). Participants were interviewed and underwent dermatological examination. An exposure assessment was carried out according to a pre-defined algorithm.

RESULTS

The follow-up rate was 78.3% (1494/1909). Mean follow-up time was 13.3 [standard deviation 1.3] years. The period prevalence of HE in the follow-up period was 21.0% [95% confidence interval (CI) 19.0-23.1%], yielding a cumulative incidence of 29.3% (95% CI 26.9-31.6%) in the entire study period. HE persisted after the end of apprenticeship in 40.0% (95% CI 33.3-46.7%) of subjects who had had HE during apprenticeship (n = 205). 18.0% (95% CI 15.9-20.1%) developed HE in the follow-up period (n = 1289).

CONCLUSIONS

Around 30% of subjects were affected by HE at least once during the study period. HE persisted in 40% of the participants affected during apprenticeship.