Is occupational irritant contact dermatitis predictable by cutaneous bioengineering methods? Results of the Swiss Metalworkers' Eczema Study (PROMETES)

Background: Since identification of subjects with high eczema risk by scree ning tests is desirable, different skin bioengineering methods were studied for their validity as predictive measures for the development of hand ecze ma. Methods: 205 metalworker trainees were followed up over 2.5 years from the beginning of their apprenticeship to observe the occurrence of hand ecz ema. Within the first weeks of their training they underwent a number of no ninvasive biophysical tests. Transepidermal water loss, skin moisture and s kin roughness were measured, and irritation tests with dimethyl sulfoxide ( DMSO), sodium hydroxide (NaOH) and sodium lauryl sulfate were conducted. Se nsitivity, specificity and predictive values of the performed tests and tes t combinations were calculated. Results: None of the observed single biophy sical methods can be considered a valid screening test. Conclusion: A combi nation of short irritation tests (DMSO and NaOH tests) and the measurement of skin moisture, however, allows to identify individuals at high risk for hand dermatitis with a high sensitivity, though low specificity.