Exposure and work-related factors in subjects with hand eczema: Data from a cross-sectional questionnaire within the Lifelines Cohort Study

Background Hand eczema (HE) is the most frequently occurring occupational skin disease. However, studies on non-occupational wet exposure, occupations not considered as high-risk, and socioeconomic factors regarding HE are scarce. Objectives To investigate the association between HE and occupational and non-occupational wet exposure and work-related factors in the Dutch general population. Methods Within the Lifelines Cohort Study, participants with HE were identified by a digital, add-on questionnaire that included questions regarding exposure. Data on work-related and socioeconomic factors were collected from baseline. Results Overall, 57 046 participants (42.0%) were included. Occupational and non-occupational wet exposure were positively associated with HE in the past year (odds ratios (ORs) 1.35, [95% confidence interval (CI): 1.22-1.49] and 1.34, [95%CI: 1.17-1.53], respectively). Positive associations for high-risk occupations (OR 1.20, [95%CI: 1.06-1.36] for personal care workers in health services and OR 1.25, [95%CI: 1.06-1.48] for nursing and midwifery professionals), occupations not considered as high-risk (OR 1.19, [95%CI: 1.03-1.39] for legal, social and religious associate professionals) and higher levels of education were found (OR 1.17, [95%CI: 1.04-1.32] and OR 1.18, [95%CI: 1.04-1.34] for middle and high level, respectively). Conclusion Preventive strategies for HE should focus on avoidance of all wet exposure, regardless of origin. In addition, job tasks instead of job title should be taken into account. As previous results on the association between HE and socioeconomic factors differ, future research should focus on a uniform definition of socioeconomic status. Highlights Preventive strategies for hand eczema should focus on avoidance of all exposure to wet activities, regardless of origin. Job tasks instead of job title should be considered when counseling patients with hand eczema. Future research on the association between hand eczema and socioeconomic factors should focus on a uniform definition of socioeconomic status.