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

Abstract

Occupational hand eczema is a frequent and often chronic disease and knowledge of the consequences of change of profession is sparse. To compare severity of hand eczema and health-related quality of life (HR-QoL) in patients who after 5 years were still in the same profession and those who were not. The study is a register-based cohort study including patients with recognized occupational hand eczema in Denmark in 2010 and 2011. Outcomes were eczema-related parameters and Dermatology Life Quality Index (DLQI) scores obtained from a follow-up questionnaire after 5 years. A total of 1496 participants were included in the study. More participants who changed profession or left the labour market reported complete healing of hand eczema at follow-up, compared with participants still in the same profession [odds ratio (OR) 1·62, 95% confidence interval (CI) 1·06-2·47 and OR 2·85, 95% CI 1·83-4·42, respectively], in addition to increased improvement at follow-up (OR 1·91, 95% CI 1·44-2·54 and OR 1·51, 95% CI 1·09-2·10, respectively). However, DLQI scores for participants who changed profession or left the labour market had increased at follow-up [incidence rate ratio (IRR) 1·12 (95% CI 0·98-1·28 and IRR 1·29, 95% CI 1·11-1·51, respectively]. The results from subgroup analyses of patients with irritant or allergic occupational hand eczema did not differ markedly. Change of work procedures was positively associated with improvement (OR 2·31, 95% CI 1·51-3·54), and did not markedly influence DLQI. Change of profession has a beneficial effect on eczema parameters, but a negative effect on HR-QoL, indicated by increased DLQI scores. 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.