Occupational skin diseases are among the most frequent work‐related diseases in industrialized countries. Good occupational skin disease statistics exist in few countries. Questionnaire studies are needed to get more data on the epidemiology of occupational skin diseases. The Nordic Occupational Skin Questionnaire Group has developed a new questionnaire tool – Nordic Occupational Skin Questionnaire (NOSQ‐2002) – for surveys on work‐related skin disease and exposures to environmental factors. The 2 NOSQ‐2002 questionnaires have been compiled by using existing questionnaires and experience. NOSQ‐2002/SHORT is a ready‐to‐use 4‐page questionnaire for screening and monitoring occupational skin diseases, e.g. in a population or workplace. All the questions in the short questionnaire (NOSQ‐2002/SHORT) are included in the long version, NOSQ‐2002/LONG, which contains a pool of questions to be chosen according to research needs and tailored to specific populations. The NOSQ‐2002 report includes, in addition to the questionnaires, a comprehensive manual for researchers on planning and conducting a questionnaire survey on hand eczema and relevant exposures. NOSQ‐2002 questionnaires have been compiled in English and translated into Danish, Swedish, Finnish and Icelandic. The use of NOSQ‐2002 will benefit research on occupational skin diseases by providing more standardized data, which can be compared between studies and countries.

Hand eczema is the most frequent occupational skin disease. Our aim was to study changes in its prevalence in Swedish adults. Cross-sectional studies were performed in 1983 and 1996. Random samples from the population of Gothenburg, Sweden, aged 20-65 y, were drawn from the population register. Data were collected with a postal questionnaire, which was identical in the two studies. The response rate was 83.5% (16,708 out of 20,000) in 1983 and 73.9% (2218 out of 3000) in 1996. The reported 1 y prevalence of hand eczema decreased from 11.8% in 1983 to 9.7% in 1996 (p < 0.01), a large difference being found in the youngest age group. Reported childhood eczema increased from 10.4% to 12.4%, however (p < 0.01). Of those with childhood eczema 27.9% and 25.2% reported hand eczema, compared to 10.0% and 7.5% among those without childhood eczema. In total 76.8% were gainfully employed in 1983 and 68.3% in 1996 (p < 0.001). In 1983 23.0% were employed in "high-risk" occupations for hand eczema compared to 19.4% in 1996 (p < 0.001). Even though the increase in childhood eczema was largest in the youngest group, there was a large decrease in the prevalence of hand eczema in that age group among both sexes. The study indicates that the prevalence of hand eczema in Swedish adults had decreased between 1983 and 1996 despite an increasing prevalence of childhood eczema. Secular changes in reporting hand eczema and childhood eczema may explain some of the changes, but a decreased occupational exposure to skin irritants is a probable cause, implying that occupational factors may be important predictors of hand eczema.

The occurrence of hand eczema in an industrial city was studied. Questionnaires were sent to 20,000 individuals aged 20-65 years, randomly selected from the population register of the city. After two reminders, a response rate of 83% was obtained. Analysis of the drop-outs did not indicate that the presence of hand eczema was an important selection factor for response to the questionnaire. Those subjects considering themselves to have had hand eczema within the previous 12 months were invited to a dermatological examination to verify the diagnosis and for further investigation. Seventy-one per cent accepted the invitation. Analysis of drop-outs showed that willingness to attend the dermatological examination was to some extent dependent on the severity of the hand eczema. It was found that almost 11% considered themselves to have had hand eczema at some time during the previous 12-month period; approximately two thirds were women. Five point four per cent had had hand eczema at a particular point in time (prevalence) and 2% had had continuous problems with hand eczema during the previous year.

This study demonstrates a variable and poor long-term prognosis for hand eczema in the general population. One-third sought medical care during follow-up, while the vast majority with ongoing hand eczema experienced negative psychosocial consequences. For about 5%, the hand eczema gave far-reaching consequences including long sick-leave periods, sick pension and changes of occupation.