Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.
Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany.
Contact Dermatitis. 2020 Jun;82(6):350-360. doi: 10.1111/cod.13502. Epub 2020 Mar 18.
Metal work apprentices (MWAs) frequently develop work-related hand eczema (HE).
To evaluate the effect of health education on incidence of work-related HE in MWAs and to assess confounding factors.
MATERIALS/METHODS: In a prospective controlled intervention study, 131 MWAs received educational training on prevention of HE, whereas 172 MWAs and 118 office work apprentices served as controls. At baseline and during three yearly follow-ups, questionnaires were completed and hands were examined. Saliva samples were collected for assessment of filaggrin (FLG) null mutations and an explorative genome-wide association study (GWAS), and levels of various cytokines were assessed from stratum corneum samples.
The 2-year and 3-year incidence of HE in the metalwork control group was 20.9% and 32.6%, respectively, which was significantly higher than in the intervention group (odds ratio [OR] 2.63, 95% confidence interval [CI] 1.31 to 5.28, P < .01 and OR 3.47, 95% CI 1.88 to 6.40, P < .0001). The knowledge score was higher in unaffected MWAs (P < .05). Other factors significantly associated with developing HE in MWAs were smoking cigarettes (P < .01) and FLG mutations (P < .001). No significant associations were found regarding epidermal cytokine levels and GWAS.
Health education is effective in primary prevention of HE in MWAs. Individual factors should be considered in targeted counseling.
金属加工学徒（MWAs）经常出现与工作相关的手部湿疹（HE）。
评估健康教育对 MWAs 工作相关 HE 发生率的影响，并评估混杂因素。
材料/方法：在一项前瞻性对照干预研究中，131 名 MWAs 接受了预防 HE 的教育培训，而 172 名 MWAs 和 118 名办公室学徒作为对照。在基线和 3 年随访期间，完成了问卷调查并检查了手部情况。收集唾液样本以评估丝聚蛋白（FLG）缺失突变和探索性全基因组关联研究（GWAS），并从角质层样本中评估各种细胞因子的水平。
金属加工对照组的 2 年和 3 年 HE 发生率分别为 20.9%和 32.6%，显著高于干预组（比值比 [OR] 2.63，95%置信区间 [CI] 1.31 至 5.28，P < 0.01 和 OR 3.47，95% CI 1.88 至 6.40，P < 0.0001）。未患 HE 的 MWAs 的知识得分更高（P < 0.05）。与 MWAs 发生 HE 相关的其他因素还有吸烟（P < 0.01）和 FLG 突变（P < 0.001）。表皮细胞因子水平和 GWAS 与 HE 无显著相关性。
健康教育对 MWAs 工作相关 HE 的一级预防有效。在有针对性的咨询中，应考虑个体因素。
