Hand eczema (HE) is positively associated with occupational and nonoccupational wet exposure within the past year, according to study findings published in Contact Dermatitis.

Researchers sought to evaluate the association between HE and occupational and nonoccupational wet exposure and work-related and socioeconomic factors among the general population living in the Northern Netherlands.

The findings are based on a cross-sectional add-on study within the Lifelines Cohort study, a multi-disciplinary, prospective, population-based cohort study that assessed health and health-related behaviors of 167,729 persons.

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From February 6, 2020, to March 2, 2020, the investigators sent a self-administrable digital add-on questionnaire regarding dermatologic diseases to 135,950 participants aged 18 years or older, of whom 58,198 participants responded (42.8%). Of this group, 57,046 participants (mean age, 55.8 ± 12.2 years; 60.3% women) responded to the question regarding the lifetime prevalence of HE and were included in the analysis.

Occupational wet exposure was determined according to 3 questions regarding hand exposure on an average working day: hours of direct contact with water, fluids, and/or moist products; hours of wearing gloves that are impermeable to fluids; and frequency of hand washing.

Nonoccupational wet exposure was defined as: activities in which individuals have to immerse their hands in liquids for more than 2 hours daily, or wear (occlusive) gloves for more than 2 hours daily, or wash their hands more than 20 times a day. Nonoccupational wet exposure was also defined as: a combination of 2 of the following: activities in which individuals have to immerse their hands in liquids for 1 to 2 hours daily, wear (occlusive) gloves for 1 to 2 hours daily, or wash their hands 10 to 20 times a day.

Participants had a lifetime prevalence of HE of 15.0% (95% CI [14.7-15.3]) and the 1-year prevalence was 7.3% (95% CI [7.1-7.5]). Univariate analysis revealed a positive association between HE within the past year and occupational wet exposure and nonoccupational wet exposure (odds ratio [OR] 1.73; 95% CI, 1.61-1.87; and OR 1.56; 95% CI, 1.42-1.71, respectively). After adjustment in 2 models, the positive association with HE was still evident (model 2: OR 1.35; 95% CI, 1.22-1.49 and OR 1.34; 95% CI, 1.17-1.53, respectively).

After adjustment for age and sex, a positive association was found between HE in the past year and the nursing and midwifery professional occupational groups (OR 1.25; 95% CI, 1.06-1.48), legal, social, and religious associate professionals (OR 1.19; 95% CI, 1.03-1.39), and personal care workers in health services (OR 1.20; 95% CI, 1.06-1.36).

Univariate analyses and both adjusted models found no significant association between socioeconomic status and HE in the past year (model 2: OR 1.05; 95% CI, 0.95-1.15 and OR 1.02; 95% CI, 0.83-1.25 for middle and high socioeconomic status, respectively).

Among several study limitations, the cross-sectional data regarding HE were insufficient to determine causality between HE and socioeconomic and work-related factors, and the data could have changed from baseline to the add-on study. Also, data regarding the variables of interest were self-reported, and the presence of selection bias cannot be ruled out completely.

“Specific factors contributing to occupational wet exposure included direct contact with fluids, use of gloves, and frequency of hand washing,” stated the researchers. “Specific factors for nonoccupational wet exposure included use of gloves and frequency of hand washing. Apart from a positive association between HE and certain high-risk occupations, a positive association was found for occupations not considered as high-risk occupations as well.”

Disclosure: This study was financially supported by Novartis. One of the study authors declared affiliations with pharmaceutical companies. Please see the original reference for a full list of disclosures.


Brands MJ, Loman L, Schuttelaar MLA. Exposure and work-related factors in subjects with hand eczema: data from a cross-sectional questionnaire within the Lifelines Cohort study. Contact Dermatitis. Published online February 4, 2022. doi:10.1111/cod.14066