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Association between eczema and increased fracture and bone or joint injury in adults: a US population-based study
Nitin Garg1, Jonathan I Silverberg2
1Department of Dermatology, Northwestern University, Chicago, Illinois.
Importance:
Adults with eczema have multiple risk factors for accidental injury. However, little is known about the risk of injury in adult patients with eczema.
Objective:
To determine whether adult eczema is associated with an increased risk of injury.
Design, Setting, And Participants:
A prospective questionnaire-based study using the 2012 National Health Interview Survey among a nationally representative sample of 34 500 adults aged 18 to 85 years with a history of eczema in the past 12 months.
Main Outcomes And Measures:
History of fracture and bone or joint injury (FBJI) and other injury causing limitation.
Results:
The prevalences of eczema and any injury causing limitation were 7.2% (95% CI, 6.9%-7.6%) and 2.0% (95% CI, 1.9%-2.2%), respectively. An FBJI causing limitation was reported by 1.5% (95% CI, 1.3%-1.7%), while other types of injury causing limitation occurred in 0.6% (95% CI, 0.5%-0.7%). Adults with eczema had higher odds of any injury causing limitation (survey logistic regression adjusted odds ratio [aOR], 1.44; 95% CI, 1.07-1.94), particularly FBJI (aOR, 1.67; 95% CI, 1.21-2.33), in models controlling for sociodemographics, asthma, hay fever, food allergies, and psychiatric and behavioral disorders. The prevalence of FBJI causing limitation increased gradually with age, peaking at 50 to 69 years and decreasing thereafter. Significant interactions were observed between eczema and fatigue or sleep symptoms, such that adults with eczema and fatigue (aOR, 1.59; 95% CI, 1.16-2.19), daytime sleepiness (aOR, 1.81; 95% CI, 1.28-2.55), or insomnia (aOR, 1.74; 95% CI, 1.28-2.37) had higher rates of FBJI compared with those with sleep symptoms and no eczema. Adults with both eczema and psychiatric and behavioral disorders (aOR, 2.15; 95% CI, 1.57-2.93) had higher rates of FBJI compared with those with eczema (aOR, 1.39; 95% CI, 1.19-1.61) or psychiatric and behavioral disorders (aOR, 1.58; 95% CI, 1.36-1.83) alone.
Conclusions And Relevance:
The results of this study suggest that eczema in adulthood is a previously unrecognized risk factor for fracture and other injury causing limitation. Future studies are needed to confirm these associations. The findings may warrant the development of preventive measures for injury risk reduction in adult patients with eczema.
