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. 2022 Jan;95(1):35-65.
doi: 10.1007/s00420-021-01781-0. Epub 2021 Oct 19.

Causes of irritant contact dermatitis after occupational skin exposure: a systematic review

Gitte Jacobsen  1   2 , Kurt Rasmussen  3 , Anne Bregnhøj  4 , Marléne Isaksson  5 , Thomas L Diepgen #  6 , Ole Carstensen  3
Affiliations

Causes of irritant contact dermatitis after occupational skin exposure: a systematic review

Gitte Jacobsen et al. Int Arch Occup Environ Health. 2022 Jan.

Abstract

Purpose: Irritant contact dermatitis (ICD) is a major cause of occupational disease. The aim was to review the relation between exposure to occupational irritants and ICD and the prognosis of ICD.

Methods: Through a systematic search, 1516 titles were identified, and 48 studies were included in the systematic review.

Results: We found that the evidence for an association between ICD and occupational irritants was strong for wet work, moderate for detergents and non-alcoholic disinfectants, and strong for a combination. The highest quality studies provided limited evidence for an association with use of occlusive gloves without other exposures and moderate evidence with simultaneous exposure to other wet work irritants. The evidence for an association between minor ICD and exposure to metalworking fluids was moderate. Regarding mechanical exposures, the literature was scarce and the evidence limited. We found that the prognosis for complete healing of ICD is poor, but improves after decrease of exposure through change of occupation or work tasks. There was no substantial evidence for an influence of gender, age, or household exposures. Inclusion of atopic dermatitis in the analysis did not alter the risk of ICD. Studies were at risk of bias, mainly due to selection and misclassification of exposure and outcome. This may have attenuated the results.

Conclusion: This review reports strong evidence for an association between ICD and a combination of exposure to wet work and non-alcoholic disinfectants, moderate for metalworking fluids, limited for mechanical and glove exposure, and a strong evidence for a poor prognosis of ICD.

Keywords: Hand eczema; Irritant contact dermatitis; Occupational contact dermatitis; Prognosis; Skin exposure.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this review.

Figures

Fig. 1
Fig. 1
Flowchart of the inclusion of studies
See this image and copyright information in PMC

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