Atopy, occupation and domestic work as risk factors for hand eczema in hospital workers.

By means of a multivariate regression analysis, we have studied the importance of atopy, "wet" and "dry" occupations, and domestic work as risk factors for hand eczema. Hand eczema was identified by questionnaire. The studied cohort consisted of 2452 newly employed hospital workers with a median follow-up time of 20 months. Of the total cohort studied, 86% were female. The total occurrence of hand eczema in the 4 occupational groups studied were: nursing staff 41%, kitchen workers/cleaners 37%, office workers 25% and caretakers/craftsmen 17%. Atopic dermatitis increased the odds of developing hand eczema by 3 times in wet as well as in dry work. Subjects with atopic dermatitis developed a more severe hand eczema than subjects with atopic mucosal symptoms and non-atopics. Wet hospital work increased the odds by a factor of 2 compared to dry office work. 2 anamnestically available parameters of domestic work, namely "nursing of children younger than 4 years" and "absence of dish-washing machine" were found to significantly increase the risk of developing hand eczema. Wet work in combination with unfavourable domestic factors increased the odds by a factor of 4. The caretakers/craftsmen group, which was dominated by men, showed the lowest figure for hand eczema.