Outcome of job change in patients with occupational chromate dermatitis

Patients with allergic contact dermatitis due to dichromate are reputed to have a bad prognosis. Based on the Swiss Law on Accidents Insurance, the Swiss National Accidents Insurance Organization (SNAIO) may issue a declaration of medical inability (DMI) in cases of severe occupational dichromate dermatitis. With such a DMI, an employee is not allowed to perform any further work in contact with dichromate or cement. In this study, we reviewed medical records from 88 construction workers with DMI due to occupational dichromate dermatitis, between 1986 and 1989. Follow-up was performed by standardized questionnaire. 63 patients (72%) healed in the first few years after DMI. These patients mostly changed industry and strictly avoided all contact with cement or chromium salts. A few retired early. The outcome of our study is favorable in comparison to studies from other countries without the DMI mechanism. We conclude that strict allergen avoidance enforced by authorities, and financial support in the case of job change, are important factors in improving the prognosis in occupational dichromate dermatitis.