Hand eczema in metalworker trainees - an analysis of risk factors

The present study as part of PROMETES (Swiss Prospective Metal Worker Eczem a Study), was performed to examine risk factors for the development of occu pational hand dermatitis in metalworker trainees. Since this disease is ver y common, a high standard of preventive measures is necessary, especially f or persons with an endogenous disposition for the development of eczema, e. g., atopics. Within the cohort of 201 healthy young men, 47 (23%) showed at least mild signs of hand eczema at 1 point of the 2.5 year observation per iod. Various occupational and domestic exposures, skin protection behaviour , regeneration time, and smoking habits, as well as atopic disposition, wer e studied with regard to their influence on the skin condition of the metal worker trainees. By multivariate analysis, we determined 3 important risk f actors for the development of hand eczema in the cohort. (i) We showed once more the important influence of an atopic disposition as a major risk fact or for occupational contact dermatitis. (ii) Furthermore, the results sugge st that, apart from chemical irritants, mechanical factors should not be un derestimated in their role as irritants to the epidermal barrier. (iii) Add itionally, an insufficient amount of skin recovery time seems to support a cumulative sub-irritant effect on the skin, which may lead to irritant cont act dermatitis.