Work‐related hand eczema in atopics

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Abstract
Individuals (549) with severe (group 1) and 406 with moderate (group 2) atopic dermatitis in childhood, 222 with respiratory allergy but no atopic dermatitis in childhood (group 3) and 199 without personal or family atopy (group 4) were studied as to occupational health symptoms due to hand eczema. In groups 1, 2 and 4, there was a slightly significant difference (P < 0.05) between the frequency of hand eczema in individuals with and without occupational exposure to chemicals, water, soil or wear (friction). Despite no such work, 55% in group 1 and 44% in group 2 had developed hand eczema. About 1/4 of the atopics in extreme risk occupations, such as ladies'' hairdressers and nursing assistants, had not developed hand eczema. Altogether, 9% in groups 1 and 2 and 3% in group 4 had changed their jobs due to hand eczema, the majority from work with to work without exposure to chemicals, water, soil or wear. Social factors had usually contributed to the change. The healing rate after taking up a new occupation was 15% in group 1, 36% in group 2 and 67% (4 of 6) in group 4. The majority of the patients whose eczema had not healed had improved in their new occupations. Medical reasons for change of occupation should be carefully weighed against social reasons.