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Epidemiology and Burden of Occupational Skin Diseases

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Handbook of Occupational Dermatoses

Part of the book series: Updates in Clinical Dermatology ((UCD))

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Abstract

Occupational skin diseases (OSD) belong to the most common occupational diseases worldwide. However, there are clear indications for underdiagnosing and underreporting and thus, the magnitude of the problem is underestimated. The two most frequent OSD are occupational contact dermatitis (OCD) due to exposure to irritants and/or allergens and non-melanoma skin cancer (NMSC) arising from occupational exposure to solar ultraviolet (UV) radiation. OCD is more frequent in females and usually starts early after entering the profession. Irritant contact dermatitis is more common than allergic contact dermatitis. High-risk occupations include hairdressers, healthcare workers, metalworkers, cleaners or construction workers. NMSC due to occupational exposure to solar UV radiation affects outdoor workers who are primarily men. Due to a long latency period, NMSC usually occurs in older, often already retired individuals. Both OSDs show a chronic course and cause substantial impairments in health-related quality of life. As OCD affects primarily younger age groups, it is associated with work absenteeism, job loss and job change and thus, with a high economic burden for the society mainly related to indirect costs. In patients with NMSC, direct costs caused by treatment are usually higher than indirect costs.

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References

  1. Mahler V, Aalto-Korte K, Alfonso JH, Bakker JG, Bauer A, Bensefa-Colas L, et al. Occupational skin diseases: actual state analysis of patient management pathways in 28 European countries. J Eur Acad Dermatol Venereol. 2017;31(Suppl 4):12–30.

    Article  PubMed  Google Scholar 

  2. Smit HA, Burdorf A, Coenraads PJ. Prevalence of hand dermatitis in different occupations. Int J Epidemiol. 1993;22(2):288–93.

    Article  CAS  PubMed  Google Scholar 

  3. Diepgen TL. Occupational skin-disease data in Europe. Int Arch Occup Environ Health. 2003;76(5):331–8.

    Article  PubMed  Google Scholar 

  4. Dickel H, Bruckner T, Bernhard-Klimt C, Koch T, Scheidt R, Diepgen TL. Surveillance scheme for occupational skin disease in the Saarland, FRG. First report from BKH-S. Contact Dermatitis. 2002;46(4):197–206.

    Article  CAS  PubMed  Google Scholar 

  5. Turner S, Carder M, van Tongeren M, McNamee R, Lines S, Hussey L, et al. The incidence of occupational skin disease as reported to the health and occupation reporting (THOR) network between 2002 and 2005. Br J Dermatol. 2007;157(4):713–22.

    Article  CAS  PubMed  Google Scholar 

  6. Herloch V, Elsner P. The (new) occupational disease no. 5101: “severe or recurrent skin diseases”. J Dtsch Dermatol Ges. 2021;19(5):720–41. https://doi.org/10.1111/ddg.14537.

    Article  PubMed  Google Scholar 

  7. Dietz JB, Menne T, Meyer HW, Viskum S, Flyvholm MA, Ahrensboll-Friis U, et al. Degree of employment, sick leave, and costs following notification of occupational contact dermatitis-a register-based study. Contact Dermatitis. 2021;84(4):224–35. https://doi.org/10.1111/cod.13719.

    Article  PubMed  Google Scholar 

  8. Kanerva L, Jolanki R, Toikkanen J, Tarvainen K, Estlander T. Statistics on occupational dermatoses in Finland. Curr Probl Dermatol. 1995;23:28–40. https://doi.org/10.1159/000424295.

    Article  CAS  PubMed  Google Scholar 

  9. Keegel T, Moyle M, Dharmage S, Frowen K, Nixon R. The epidemiology of occupational contact dermatitis (1990–2007): a systematic review. Int J Dermatol. 2009;48(6):571–8.

    Article  PubMed  Google Scholar 

  10. Dickel H, Kuss O, Blesius CR, Schmidt A, Diepgen TL. Occupational skin diseases in northern Bavaria between 1990 and 1999: a population-based study. Br J Dermatol. 2001;145(3):453–62.

    Article  CAS  PubMed  Google Scholar 

  11. Skoet R, Olsen J, Mathiesen B, Iversen L, Johansen JD, Agner T. A survey of occupational hand eczema in Denmark. Contact Dermatitis. 2004;51(4):159–66.

    Article  PubMed  Google Scholar 

  12. Quaade AS, Simonsen AB, Halling AS, Thyssen JP, Johansen JD. Prevalence, incidence, and severity of hand eczema in the general population - a systematic review and meta-analysis. Contact Dermatitis. 2021;84(6):361–74. https://doi.org/10.1111/cod.13804.

    Article  PubMed  Google Scholar 

  13. Nichol K, Copes R, Kersey K, Eriksson J, Holness DL. Screening for hand dermatitis in healthcare workers: comparing workplace screening with dermatologist photo screening. Contact Dermatitis. 2019;80(6):374–81. https://doi.org/10.1111/cod.13231.

    Article  PubMed  Google Scholar 

  14. Campion KM. A survey of occupational skin disease in UK health care workers. Occup Med (Lond). 2015;65(1):29–31. https://doi.org/10.1093/occmed/kqu170.

    Article  CAS  PubMed  Google Scholar 

  15. Aalto-Korte K, Koskela K, Pesonen M. 12-year data on skin diseases in the Finnish register of occupational diseases II: risk occupations with special reference to allergic contact dermatitis. Contact Dermatitis. 2020;82(6):343–9. https://doi.org/10.1111/cod.13510.

    Article  PubMed  Google Scholar 

  16. Cahill JL, Williams JD, Matheson MC, Palmer AM, Burgess JA, Dharmage SC, et al. Occupational skin disease in Victoria, Australia. Australas J Dermatol. 2016;57(2):108–14. https://doi.org/10.1111/ajd.12375.

    Article  PubMed  Google Scholar 

  17. Aalto-Korte K, Koskela K, Pesonen M. 12-year data on dermatologic cases in the Finnish register of occupational diseases I: distribution of different diagnoses and main causes of allergic contact dermatitis. Contact Dermatitis. 2020;82(6):337–42. https://doi.org/10.1111/cod.13488.

    Article  CAS  PubMed  Google Scholar 

  18. Pesonen M, Jolanki R, Larese Filon F, Wilkinson M, Krecisz B, Kiec-Swierczynska M, et al. Patch test results of the European baseline series among patients with occupational contact dermatitis across Europe - analyses of the European surveillance system on contact allergy network, 2002–2010. Contact Dermatitis. 2015;72(3):154–63.

    Article  CAS  PubMed  Google Scholar 

  19. Caroe TK, Ebbehoj N, Agner T. A survey of exposures related to recognized occupational contact dermatitis in Denmark in 2010. Contact Dermatitis. 2014;70(1):56–62. https://doi.org/10.1111/cod.12134.

    Article  PubMed  Google Scholar 

  20. Bensefa-Colas L, Telle-Lamberton M, Paris C, Faye S, Stocks SJ, Luc A, et al. Occupational allergic contact dermatitis and major allergens in France: temporal trends for the period 2001–2010. Br J Dermatol. 2014;171(6):1375–85.

    Article  CAS  PubMed  Google Scholar 

  21. Hogan DJ, Dannaker CJ, Maibach HI. The prognosis of contact dermatitis. J Am Acad Dermatol. 1990;23(2 Pt 1):300–7.

    Article  CAS  PubMed  Google Scholar 

  22. Mälkonen T, Alanko K, Jolanki R, Luukkonen R, Aalto-Korte K, Lauerma A, et al. Long-term follow-up study of occupational hand eczema. Br J Dermatol. 2010;163(5):999–1006.

    Article  PubMed  Google Scholar 

  23. Olesen CM, Agner T, Ebbehoj NE, Caroe TK. Factors influencing prognosis for occupational hand eczema: new trends. Br J Dermatol. 2019;181(6):1280–6. https://doi.org/10.1111/bjd.17870.

    Article  CAS  PubMed  Google Scholar 

  24. Meding B, Swanbeck G. Consequences of having hand eczema. Contact Dermatitis. 1990;23(1):6–14.

    Article  CAS  PubMed  Google Scholar 

  25. Holness DL, Beaton D, Harniman E, DeKoven J, Skotnicki S, Nixon R, et al. Hand and upper extremity function in workers with hand dermatitis. Dermatitis. 2013;24(3):131–6. https://doi.org/10.1097/DER.0b013e3182910416.

    Article  PubMed  Google Scholar 

  26. Nicholson PJ, Llewellyn D, English JS. Evidence-based guidelines for the prevention, identification and management of occupational contact dermatitis and urticaria. Contact Dermatitis. 2010;63(4):177–86.

    Article  PubMed  Google Scholar 

  27. Cvetkovski RS, Zachariae R, Jensen H, Olsen J, Johansen JD, Agner T. Quality of life and depression in a population of occupational hand eczema patients. Contact Dermatitis. 2006;54(2):106–11.

    Article  PubMed  Google Scholar 

  28. Matterne U, Apfelbacher CJ, Soder S, Diepgen TL, Weisshaar E. Health-related quality of life in health care workers with work-related skin diseases. Contact Dermatitis. 2009;61(3):145–51.

    Article  PubMed  Google Scholar 

  29. Chernyshov PV, John SM, Tomas-Aragones L, Goncalo M, Svensson A, Bewley A, et al. Quality of life measurement in occupational skin diseases. Position paper of the European academy of dermatology and venereology task forces on quality of life and patient oriented outcomes and occupational skin disease. J Eur Acad Dermatol Venereol. 2020;34(9):1924–31. https://doi.org/10.1111/jdv.16742.

    Article  CAS  PubMed  Google Scholar 

  30. Boehm D, Schmid-Ott G, Finkeldey F, John SM, Dwinger C, Werfel T, et al. Anxiety, depression and impaired health-related quality of life in patients with occupational hand eczema. Contact Dermatitis. 2012;67(4):184–92.

    Article  PubMed  Google Scholar 

  31. Diepgen TL, Scheidt R, Weisshaar E, John SM, Hieke K. Cost of illness from occupational hand eczema in Germany. Contact Dermatitis. 2013;69(2):99–106.

    Article  PubMed  Google Scholar 

  32. Meding B, Lantto R, Lindahl G, Wrangsjo K, Bengtsson B. Occupational skin disease in Sweden—a 12-year follow-up. Contact Dermatitis. 2005;53(6):308–13.

    Article  CAS  PubMed  Google Scholar 

  33. Cvetkovski RS, Rothman KJ, Olsen J, Mathiesen B, Iversen L, Johansen JD, et al. Relation between diagnoses on severity, sick leave and loss of job among patients with occupational hand eczema. Br J Dermatol. 2005;152(1):93–8.

    Article  CAS  PubMed  Google Scholar 

  34. Caroe TK, Ebbehoj NE, Bonde JP, Agner T. Occupational hand eczema and/or contact urticaria: factors associated with change of profession or not remaining in the workforce. Contact Dermatitis. 2018;78(1):55–63. https://doi.org/10.1111/cod.12869.

    Article  PubMed  Google Scholar 

  35. Lysdal SH, Sosted H, Andersen KE, Johansen JD. Hand eczema in hairdressers: a Danish register-based study of the prevalence of hand eczema and its career consequences. Contact Dermatitis. 2011;65(3):151–8.

    Article  PubMed  Google Scholar 

  36. Diepgen TL. Occupational skin diseases. J Dtsch Dermatol Ges. 2012;10(5):297–313; quiz 4–5.

    PubMed  Google Scholar 

  37. Andrees V, John SM, Nienhaus A, Skudlik C, Brans R, Augustin M, et al. Economic evaluation of a tertiary prevention program for occupational skin diseases in Germany. Contact Dermatitis. 2020;82(6):361–9. https://doi.org/10.1111/cod.13506.

    Article  PubMed  Google Scholar 

  38. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, et al. Global, regional, and National Cancer Incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study. JAMA Oncol. 2019;5(12):1749–68. https://doi.org/10.1001/jamaoncol.2019.2996.

    Article  PubMed Central  Google Scholar 

  39. Alam M, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med. 2001;344(13):975–83. https://doi.org/10.1056/NEJM200103293441306.

    Article  CAS  PubMed  Google Scholar 

  40. Surdu S. Non-melanoma skin cancer: occupational risk from UV light and arsenic exposure. Rev Environ Health. 2014;29(3):255–64. https://doi.org/10.1515/reveh-2014-0040.

    Article  CAS  PubMed  Google Scholar 

  41. Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012;166(5):1069–80. https://doi.org/10.1111/j.1365-2133.2012.10830.x.

    Article  CAS  PubMed  Google Scholar 

  42. Saladi RN, Persaud AN. The causes of skin cancer: a comprehensive review. Drugs Today (Barc). 2005;41(1):37–53. https://doi.org/10.1358/dot.2005.41.1.875777.

    Article  CAS  PubMed  Google Scholar 

  43. Loney T, Paulo MS, Modenese A, Gobba F, Tenkate T, Whiteman DC, et al. Global evidence on occupational sun exposure and keratinocyte cancers: a systematic review. Br J Dermatol. 2021;184(2):208–18. https://doi.org/10.1111/bjd.19152.

    Article  CAS  PubMed  Google Scholar 

  44. Modenese A, Korpinen L, Gobba F. Solar radiation exposure and outdoor work: an underestimated occupational risk. Int J Environ Res Public Health. 2018;15(10):2063. https://doi.org/10.3390/ijerph15102063.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Trakatelli M, Barkitzi K, Apap C, Majewski S, De Vries E, group E. Skin cancer risk in outdoor workers: a European multicenter case-control study. J Eur Acad Dermatol Venereol. 2016;30(Suppl 3):5–11. https://doi.org/10.1111/jdv.13603.

    Article  PubMed  Google Scholar 

  46. Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, et al. Occupational UV-exposure is a major risk factor for basal cell carcinoma: results of the population-based case-control study FB-181. J Occup Environ Med. 2018;60(1):36–43. https://doi.org/10.1097/JOM.0000000000001217.

    Article  PubMed  Google Scholar 

  47. Bauer A, Haufe E, Heinrich L, Seidler A, Schulze HJ, Elsner P, et al. Basal cell carcinoma risk and solar UV exposure in occupationally relevant anatomic sites: do histological subtype, tumor localization and Fitzpatrick phototype play a role? A population-based case-control study. J Occup Med Toxicol. 2020;15:28. https://doi.org/10.1186/s12995-020-00279-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, et al. Is ultraviolet exposure acquired at work the most important risk factor for cutaneous squamous cell carcinoma? Results of the population-based case-control study FB-181. Br J Dermatol. 2018;178(2):462–72. https://doi.org/10.1111/bjd.15906.

    Article  CAS  PubMed  Google Scholar 

  49. Alfonso JH, Martinsen JI, Weiderpass E, Pukkala E, Kjaerheim K, Tryggvadottir L, et al. Occupation and cutaneous melanoma: a 45-year historical cohort study of 14.9 million people in five Nordic countries. Br J Dermatol. 2021;184(4):672–80. https://doi.org/10.1111/bjd.19379.

    Article  CAS  PubMed  Google Scholar 

  50. Mofidi A, Tompa E, Spencer J, Kalcevich C, Peters CE, Kim J, et al. The economic burden of occupational non-melanoma skin cancer due to solar radiation. J Occup Environ Hyg. 2018;15(6):481–91. https://doi.org/10.1080/15459624.2018.1447118.

    Article  PubMed  Google Scholar 

  51. John SM, Garbe C, French LE, Takala J, Yared W, Cardone A, et al. Improved protection of outdoor workers from solar ultraviolet radiation: position statement. J Eur Acad Dermatol Venereol. 2021;35(6):1278–84. https://doi.org/10.1111/jdv.17011.

    Article  CAS  PubMed  Google Scholar 

  52. Ulrich C, Salavastru C, Agner T, Bauer A, Brans R, Crepy MN, et al. The European status quo in legal recognition and patient-care services of occupational skin cancer. J Eur Acad Dermatol Venereol. 2016;30(Suppl 3):46–51. https://doi.org/10.1111/jdv.13609.

    Article  PubMed  Google Scholar 

  53. Caroe TK, Ebbehoj NE, Wulf HC, Agner T. Occupational skin cancer may be underreported. Dan Med J. 2013;60(5):A4624.

    PubMed  Google Scholar 

  54. Philipp-Dormston WG, Muller K, Novak B, Stromer K, Termeer C, Hammann U, et al. Patient-reported health outcomes in patients with non-melanoma skin cancer and actinic keratosis: results from a large-scale observational study analysing effects of diagnoses and disease progression. J Eur Acad Dermatol Venereol. 2018;32(7):1138–46. https://doi.org/10.1111/jdv.14703.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Gaulin C, Sebaratnam DF, Fernandez-Penas P. Quality of life in non-melanoma skin cancer. Australas J Dermatol. 2015;56(1):70–6. https://doi.org/10.1111/ajd.12205.

    Article  PubMed  Google Scholar 

  56. Guy GP Jr, Machlin SR, Ekwueme DU, Yabroff KR. Prevalence and costs of skin cancer treatment in the U.S., 2002–2006 and 2007–2011. Am J Prev Med. 2015;48(2):183–7. https://doi.org/10.1016/j.amepre.2014.08.036.

    Article  PubMed  Google Scholar 

  57. Fransen M, Karahalios A, Sharma N, English DR, Giles GG, Sinclair RD. Non-melanoma skin cancer in Australia. Med J Aust. 2012;197(10):565–8. https://doi.org/10.5694/mja12.10654.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany

    Richard Brans

  2. Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany

    Richard Brans

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Editors and Affiliations

  1. Department of Dermatology, Universitat Autònoma and Universitat Pompeu Fabra de Barcelona, Barcelona, Spain

    Ana M. Giménez-Arnau

  2. Department of Dermatology, UCSF Medical Center, San Francisco, CA, USA

    Howard I. Maibach

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Brans, R. (2023). Epidemiology and Burden of Occupational Skin Diseases. In: Giménez-Arnau, A.M., Maibach, H.I. (eds) Handbook of Occupational Dermatoses. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-031-22727-1_2

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