Uter W, Pfahlberg A, Gefeller O, Schwanitz H J
University of Osnabrück, Department of Dermatology, Environmental Medicine and Health Theory, Germany.
Int Arch Occup Environ Health. 1998 Oct;71(7):487-92. doi: 10.1007/s004200050310.
Occupational skin changes in hairdressers are very common. Morbidity, however, has not yet been quantified precisely.
A cohort of 2,352 hairdressing apprentices (of the 2,570 invited to participate, i.e., 91.5% response) was prospectively followed for the duration of their vocational training (3 years) by three examinations. Three waves (years) were recruited in 1992, 1993, and 1994 from 15 vocational training schools in northwestern Germany.
The point prevalence of (mostly slight) irritant skin changes of the hands increased from 35.4% in the initial examination to 47.5% in the intermediate examination and to 55.1% in the final examination. Given a more conservative definition of a case of "hand dermatitis," these estimates were 12.9%, 23.5%, and 23.9%, respectively. Altogether, 34.3 and 15.2 cases of "skin changes (any degree)" and "hand dermatitis," respectively, in 100 person-years were observed during the study period. The incidence rate, i.e., the number of newly diseased study participants in relation to the person-time at risk contributed, decreased in the course of the study. The proportion of dropouts until final follow-up was 51.8%.
The present results appear to lie in a range with those found in other, much smaller cohort studies. However, comparison of the results is hampered either by the lack of a clear definition or by a different definition of "person-time at risk" or "a case of hand dermatitis." As compared with an external control group of office apprentices, the incidence was several times higher in hairdressing apprentices, which points to the high risk for skin damage in this occupation.
美发师的职业性皮肤改变非常常见。然而，发病率尚未得到精确量化。
对2352名美发学徒（受邀参与的2570名中的一部分，即91.5%的回应率）在其职业培训期间（3年）进行了三次检查的前瞻性随访。1992年、1993年和1994年从德国西北部的15所职业培训学校招募了三个批次（年份）的学员。
手部（大多为轻度）刺激性皮肤改变的时点患病率从初次检查时的35.4%增至中期检查时的47.5%，并在末次检查时达到55.1%。对于“手部皮炎”病例采用更保守的定义，这些估计值分别为12.9%、23.5%和23.9%。在研究期间，每100人年分别观察到34.3例“（任何程度的）皮肤改变”和15.2例“手部皮炎”。发病率，即新发病的研究参与者数量与贡献的危险人时相关，在研究过程中有所下降。直至末次随访时的失访比例为51.8%。
目前的结果似乎与其他规模小得多的队列研究结果处于同一范围。然而，由于缺乏明确的定义或“危险人时”或“手部皮炎病例”的不同定义，结果的比较受到阻碍。与办公室学徒的外部对照组相比，美发学徒中的发病率高出数倍，这表明该职业中皮肤受损的风险很高。
