Determinants of current hand eczema: results from case-control studies nested in the PACO follow-up study (PACO II)

Hand eczema is often a result of the interplay of exogenous and endogenous risk factors. Epidemiological studies demonstrating the interrelationship between these factors are lacking.

To analyse risk factors associated with current hand eczema and current irritant hand eczema in two case-control studies nested in a long-term follow-up study in the car industry.

Eligible participants were individuals who had been followed until the end of their apprenticeship in the original cohort study (1990-1998, N = 1909). Participants were interviewed and underwent dermatological examination. Two case-control studies were nested within the cohort, one using current hand eczema cases (n = 110) and one using current irritant hand eczema cases (n = 57). Multivariable modelling was performed.

The only significant finding was a positive association of atopic skin diathesis with hand eczema in both studies. Wet work >or=2 hr/day was positively related to current irritant hand eczema. Age and having an office job were inversely related to hand eczema.

Atopic skin diathesis was the most important determinant of hand eczema. Constitution seems to play a dominant role compared with environmental and occupational hazards in a setting where skin protection measures are well established.