Job change facilitates healing in a cohort of patients with occupational hand eczema

Abstract

Background

Occupational hand eczema is a frequent and often chronic disease and knowledge of the consequences of change of profession is sparse.

Objectives

To compare severity of hand eczema and health related QoL HR-QoL in patients who after 5 years were still in the same profession and those who were not.

Methods

The study is a register-based cohort study including patients with recognised occupational hand eczema in Denmark in 2010 and 2011. Outcomes were eczema related parameters and Dermatology Life Quality Index (DLQI) obtained from a follow-up questionnaire after 5 years.

Results

A total of 1496 participants were included in the study. More participants who changed or ended profession reported complete healing of hand eczema at follow up, compared to participants still in the same profession (OR=1.62 (1.06-2.47) and OR=2.85 (1.83-4.42), respectively), as well as increased improvement at follow-up (OR=1.91(1.44-2.54) and OR=1.51(1.09-2.10), respectively), while DLQI for participants who changed or ended profession was increased at follow up, (Incidence Rate Ratio (IRR)= 1.12 (0.98-1.28) and IRR= 1.29 (1.11-1.51), respectively). Subgroup analyses of patients with irritant or allergic occupational hand eczema did not differ markedly from this result. Change of work procedures was positively associated with improvement (OR=2.31(1.51-3.54)), and did not markedly influence DLQI.

Conclusion

Change of profession has a beneficial effect on eczema parameters, but a negative effect on HR-QoL, indicated by increased DLQI. 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.

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