Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
Department of Occupational and Environmental Medicine, University of Copenhagen, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
Br J Dermatol. 2018 Jul;179(1):80-87. doi: 10.1111/bjd.16095. Epub 2018 Mar 13.
Occupational hand eczema is a frequent and often chronic disease and knowledge of the consequences of change of profession is sparse.
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.
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.
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.
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.
职业性手部湿疹是一种常见且常为慢性疾病，人们对其职业改变后果的认知较为匮乏。
比较职业性手部湿疹患者在经历 5 年后仍从事原职业与改行后对疾病严重程度和健康相关生活质量（HR-QoL）的影响。
本研究为基于注册的队列研究，纳入了丹麦于 2010 年和 2011 年确诊的职业性手部湿疹患者。通过随访问卷调查，获取 5 年后的湿疹相关参数和皮肤病生活质量指数（DLQI）评分。
共纳入 1496 名参与者。与仍从事原职业的参与者相比，改行或离开劳动力市场的参与者报告手部湿疹在随访时完全愈合的比例更高[比值比（OR）1.62，95%置信区间（CI）1.06-2.47 和 OR 2.85，95% CI 1.83-4.42]，且随访时改善程度更高[OR 1.91，95% CI 1.44-2.54 和 OR 1.51，95% CI 1.09-2.10]。然而，改行或离开劳动力市场的参与者的 DLQI 评分在随访时增加[发病率比（IRR）1.12（95% CI 0.98-1.28 和 IRR 1.29，95% CI 1.11-1.51]。亚组分析显示，刺激性或变应性职业性手部湿疹患者的结果差异不显著。改变工作程序与改善显著相关（OR 2.31，95% CI 1.51-3.54），且对 DLQI 影响不大。
改行对湿疹参数有积极影响，但对 HR-QoL 有负面影响，表现为 DLQI 评分增加。改行与改行的同时改变工作程序对改善有积极影响，对 HR-QoL 影响不大，应作为改变职业的替代方案。
