Smit H A, van Rijssen A, Vandenbroucke J P, Coenraads P J
Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands.
Scand J Work Environ Health. 1994 Apr;20(2):113-21. doi: 10.5271/sjweh.1423.
The role of atopic constitution, contact sensitization, transepidermal water loss, and dry skin in the development of hand dermatitis was investigated in a prospective study of 74 apprentice hairdressers and 111 apprentice nurses.
Base-line measurements included a questionnaire on personal characteristics and anamnestic information, examination of hand skin, measurements of transepidermal water loss, patch tests, and prick tests. The condition of the hands, previous exposure, and transepidermal water loss were followed at intervals of four to six weeks. Cox proportional hazard models were used in the statistical analysis.
The average incidence rate of hand dermatitis was 32.8 cases per 100 person-years for the hairdressers and 14.5 cases per 100 person-years for the nurses. The rate ratio of having a dry versus normal skin type was 7.3 for the hairdressers [95% confidence interval (95% CI) 2.2-24.3] and 1.7 for the nurses (95% CI 0.5-6.4). Apprentice nurses with a history of (atopic) mucosal symptoms had a 3.4-fold increased incidence rate of hand dermatitis (95% CI 1.05-11.2). The rate ratio of mucosal atopy for the apprentice hairdressers was 2.2 (95% CI 0.7-6.7). Graphic display of the results suggested an increased risk of hand dermatitis among the apprentice hairdressers with transepidermal water loss on the hand greater than 15 g.m-2.h, but the relative risk of increased transepidermal water loss was not statistically significant.
The most important endogenous risk factors for hand dermatitis among the apprentice hairdressers and nurses were the presence of dry skin and a history of mucosal atopy. No relationship between increased transepidermal water loss and the risk of hand dermatitis was observed.
在一项针对74名美发学徒和111名实习护士的前瞻性研究中，调查特应性体质、接触致敏、经表皮水分流失和皮肤干燥在手部皮炎发生中的作用。
基线测量包括一份关于个人特征和既往史信息的问卷、手部皮肤检查、经表皮水分流失测量、斑贴试验和点刺试验。每隔四至六周对手部状况、既往接触情况和经表皮水分流失进行随访。统计分析采用Cox比例风险模型。
美发学徒手部皮炎的平均发病率为每100人年32.8例，实习护士为每100人年14.5例。干性皮肤与正常皮肤类型的发病率比值，美发学徒为7.3[95%置信区间(95%CI)2.2 - 24.3]，实习护士为1.7(95%CI 0.5 - 6.4)。有(特应性)黏膜症状病史的实习护士手部皮炎发病率增加3.4倍(95%CI 1.05 - 11.2)。美发学徒黏膜特应性的发病率比值为2.2(95%CI 0.7 - 6.7)。结果的图表显示，手部经表皮水分流失大于15 g·m⁻²·h的美发学徒发生手部皮炎的风险增加，但经表皮水分流失增加的相对风险无统计学意义。
美发学徒和实习护士手部皮炎最重要的内源性危险因素是皮肤干燥和黏膜特应性病史。未观察到经表皮水分流失增加与手部皮炎风险之间的关系。
