ABSTRACT
I. Introduction 20
II. Study Design 21
III. Prevalence of Hand Eczema 22
IV. Types of Hand Eczema 22
V. Occupation and Hand Eczema 24
VI. Consequences of Having Hand Eczema 25
VII. Severity of Hand Eczema 25
VIII. Hand Eczema and Atopy 26
IX. Predictive Factors for Hand Eczema 27
X. Comments 27
References 27
I. INTRODUCTION
Hand eczema is a common cause of medical consultation for skin disease. It is also the most important occupational skin disease. There are several reports on the prevalence of hand eczema, in particular from the Scandinavian countries. Agrup1 reported the prevalence to be 2 to 3% in the general population of mainly rural parts of south Sweden in the mid-1960s. In a Finnish population selected for studying nickel allergy from 1976 to 1977, Peltonen2 found the prevalence of hand eczema to be 4%. Menné et al.3 in 1982 reported a cumulative incidence of 22% in Danish women. In Tromsö, Norway, the 1-year period prevalence of allergic hand eczema was estimated to be 8.9% by Kavli and Förde4 in 1984. In
the Netherlands, the 3-year period prevalence was reported to be 6 to 7% in two samples of the general population.5,6 In Swedish upper secondary school pupils the 1-year period prevalence of self-reported hand eczema was 10% in 1998.7
To estimate with sufficient precision the distribution of a disease and its consequences, it is desirable to obtain information from the general population. This is also of value for allocating health care resources and planning preventive measures. To estimate the occurrence and importance of hand eczema in the general population of a large industrial city (Gothenburg, Sweden) an epidemiologic study was performed from 1983 to 1984.8-13
II. STUDY DESIGN
In Sweden, population registers are kept by the County Administrations. From the 1982 register of Gothenburg a random sample of 20,000 individuals, aged 20 to 65 years, was drawn. These individuals received a mailed questionnaire asking about the occurrence of hand eczema on some
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occasion in the previous 12 months, atopy history, occupation, and occupational exposure. Answers were obtained from 83% (16,584 subjects). Those who reported hand eczema were invited to a dermatological examination including patch testing with a standard series and, when appropriate, with complementary
FIGURE 2.1 Number of hand eczema patients in relation to age and sex.
