Hand eczema in car mechanics

To estimate the prevalence of hand eczema, a questionnaire was distributed to 901 male car mechanics. Of the 801 persons who responded, 15% reported hand eczema on some occasion in the previous 12 months, and 57% admitted dry skin on the hands. In a 2nd part of the study, those who reported hand eczema were examined and patch tested with a standard series and a special "car mechanics' series". The most common diagnosis was irritant contact dermatitis, 55%, and 2nd was allergic contact dermatitis, 19%. 35/105 (33%) had a total of 51 positive patch test reactions, all to substances in the standard series, except for 2 persons who reacted to oxidized d-limonene. The most frequent reactions were to thimerosal (9%), nickel (8%) and colophony (5%). One plausible explanation for the high prevalence of nickel allergy was the common use of nickel-plated tools. 5 individuals had a history of contact urticaria, but scratch tests were negative. It was concluded that car mechanics are at high risk for contact dermatitis on the hands, irritant as well as allergic.