Hand eczema in US employees: a retrospective observational study of workers' compensation and medical claims

This research quantified the impact of hand eczema (HE) on US employees.

Retrospective observational analysis of real-world data from >500 large, self-insured employers from 2010 through 2024. The database includes detailed workers' compensation (WC) claims: eligibility, duration (days claims were open), medical costs, salary replacement, and absence days. The protocol included employees with medical claims (ICD-10s [L20.x, L23.x, L24.x, L25.x, L30.x] or ICD-9 = 691.x) and WC claims suggestive of HE based on body-parts and nature of injury. The analysis quantified HE-related WC claims: incidence, work loss, costs, and duration. HE-related WC incidence and average cost/claim were reported by industry. Costs inflation-adjusted to December 2024.

The analysis identified 1,937 WC claims with study body-part and nature of injury codes, >48,000 employees with medical claims for the study ICD codes. 226 employees met the study criteria and had 6.1 HE-related WC claims/100,000 eligible person-years. Their 226 closed WC claims remained open for a mean of 343 days (SD = 616; median = 121) and cost a mean of $10,197 per claim (SD=$45,172; median=$477), including $4,535 in WC medical costs, $3,992 in salary-replacement costs, and $1,670 in other WC costs. Lost work time occurred in 11.5% (n = 26) of cases, with a mean duration of 277 days (SD = 680; median = 51). HE-related WC incidence was highest in manufacturing (11.2/100,000 person-years) and retail trade (10.5/100,000 person-years). Manufacturing had the highest average cost per claim ($29,587; SD=$94,790) and "healthcare and social assistance" had the highest average lost work time.

HE-related WC claims were associated with significant lost work time and costs. Costs approached $30,000 per claim among those in the manufacturing industry. These findings underscore the severe burden of occupational HE and the need for early diagnosis and treatment to limit disability.