Prognosis and work absence due to occupational contact dermatitis

Abstract

The consequences of a diagnosis of occupational contact dermatitis (OCD) were investigated using cases available from the voluntary surveillance scheme, EPIDERM. Cases of OCD reported from November 1994 to September 1995 were identified and sampled to give at least 100 cases of allergic, irritant and mixed OCD reported by consultant dermatologists (344 cases) and occupational physicians (377 cases). A questionnaire was sent to the reporting physician to elicit further information. 512 completed questionnaires were returned, of which 510 were eligible for analysis. Among cases reported by dermatologists (n = 286) and occupational physicians (n = 224), 7% (6.3%) had been unemployed and 16.8% (20.1%) had taken sick leave. 3 factors independently predicted time off work in a logistic regression analysis: age OR = 1.25 (95% CI, 1.05-1.49), allergic dermatitis OR = 1.77 (95% CI, 1.13-2.79) and medicolegal assessment OR = 4.42 (95% CI, 2.20-8.89). Overall, 15.7% did not improve clinically between the first and last visit. Those who did not improve had been exposed to the agent for longer (mean 7.6 years) than those who did (5.3 years) (p = 0.09). In patients <or= 45 years, those reported to be atopic failed to improve (25.4%) more often than those not atopic (13.4%) (p = 0.04). The substantial numbers (21%) with time off work and with persistent dermatitis suggest that OCD continues to have a significant impact on workers and their employers.

Occupational contact dermatitis: Etiology, prevalence, and resultant impairment/disability

“…87 Overall, chronic cumulative ICD typically has a worse prognosis than ACD or acute ICD. 12,88,89 Although gender 82 and age 12,82 do not appear to be related to chronicity of symptoms, older workers tend to spend more time away from work because of their skin disease. 82 In addition to age, workers with ACD or pending medicolegal claims spend more time away from the workplace because of OCD.…”

“…However, more recent reviews suggest that response rates have significantly improved; 78% to 84% of patients with OCD, when appropriately managed, recover without impairment. 12,82 It has been suggested that the improved prognosis of OCD may relate to enhanced diagnostic procedures, more accurate identification of irritants and allergens, and increased preventive efforts, especially worker education. 83 Factors that have been associated with a worse prognosis for OCD include ACD to nickel or chromium, 84 chronicity of the dermatitis, 81,85 treatment delay, 71 a history of AD, 7,74,75 and a poor understanding by the worker of his or her disease.…”

Prognosis of Occupational Hand Eczema

“…3 For patients with high or medium socioeconomic status, there were no reports of taking prolonged sick leave or loss of job at all. This tendency is in accordance with earlier studies among dentists in Sweden, 47,48 and the results indicate that lower socioeconomic status is an important risk factor for prolonged sick leave and loss of job.…”

“…We also could not corroborate earlier findings that patients with ACD have a higher risk of prolonged sick leave. 3,30,42 Occupational CU appeared to be associated with a high risk of prolonged sick leave, which may be related to strict hygiene regulations in food-related occupations but was most likely due to chance. We found no association between sex and prolonged sick leave, which supports earlier findings.…”

Occupational Contact Dermatitis in 10,582 French Patients Reported between 2004 and 2007: A Descriptive Study

“…Moreover, 52% of hand dermatitis cases are caused by occupational exposure [4]. Evolving chronicity has been reported in nearly half of OCD cases, with concomitant physical and psychological consequences [5,6], as well as a significant impact on social relations, daily life and work activities [7,8,9]. Indeed, OCD causes a decrease in the quality of life comparable to that reported for generalised eczema and psoriasis [10].…”