Incidence of work-related hand eczema during apprenticeship: first resultsof a prospective cohort study in the car industry

Data on the incidence and prevalence of occupational contact dermatitis (OC D) are scarce, and most of our knowledge about OCD is derived from clinical case reports or clinical studies of in- and out-patients. Therefore, we in vestigated in the epidemiological, prospective Audi cohort study (PACO stud y) the incidences of work-related hand eczema in different apprenticeships of Audi AG. In total, 2078 apprentices were investigated at the start of th eir apprenticeship and systematically followed up over a 3-year period. At the end of the study, information on 2042 (98.2% followup) apprentices was available. The I-year cumulative incidences of hand eczema were 9.2% (95%-c onfidence interval 7.8-10.7) in metalworkers, 8.8% (95%-CI 7.0-10.7) in oth er blue-collar workers, and 4.6% (95%-CI 2.3-8.1) in white-collar apprentic es. The 3-year cumulative incidences of hand eczema were 15.3% (95%-CI 13.6 -17.2) in metalworkers, 14.1% (95%-CI 11.8-16.5) in other blue-collar worke rs, and 6.9% (95%-CI 4.0-10.9) in white-collar apprentices. In females, the cumulative incidence of hand eczema was higher compared to men (1-year inc idence 10.1%, 95%-CI 7.7-13.0, versus 8.3%, 95%-CI 7.1-9.5; 3-year incidenc e 16.1%, 95%-CI 13.1-19.5 versus 13.6%. 95%-CI 12.2-15.2). In some occupati ons, like cooks, tool mechanics, milling cutters and varnishers, the incide nce of hand eczema was significantly increased. In those occupations, howev er, no job change was necessary, and no notifiable occupational contact der matitis occurred. The incidence was not uniformly distributed over the 3-ye ar period. Within the first 6 months, a particularly high rate of hand ecze ma occurred, which then declined and remained steady at a lower rate over t he 2nd and the 3rd years. The results of our study give important suggestio ns for preventive measures at the workplace and effective occupational pre- employment advices.