Incidence Rate of Hand Eczema in Different Occupations: A Systematic Review and Meta-analysis

Abstract

Hand eczema is a chronic disease that results in economic and psychosocial burdens. The aim of this study was to systematically review and assess the magnitude of the association between exposure related to occupations and the incidence rate of hand eczema. A systematic search in PubMed, EMBASE, CINAHL and Cochrane databases, from inception to September 2017, of full-text observational studies reporting incident cases of hand eczema during employment, and a supplementary search in PubMed to September 2020, were conducted. Among 2,417 screened abstracts, 15 studies fulfilled the inclusion criteria. Incidence rates were reported per 100 person-years. Based on the Newcastle-Ottawa Scale, 9 studies were good quality, 2 fair quality, and 4 poor quality. Hairdressers had a high incidence of hand eczema of 21.4 (95% confidence interval [CI] 15.3-27.4), as did nurses, 16.9 (95% CI 11.2-22.7), and metal workers, 12.4 (95% CI 3.5-21.3). Hairdressers were predominantly women, and metal worker were predominantly men. Office occupations had an incidence rate of hand eczema of 4.9 (95% CI 1.2-9.6). The high risk of hand eczema for hairdressers, nurses, and metal workers, should be considered by healthcare policymakers. Even occupations with low irritant profile, such as office workers, were at risk of developing hand eczema, and more occupations should be investigated regarding the related risk of developing hand eczema.

Fig. 1

Flow chart of the study inclusion process.

Fig. 2

Forest plot of mixed-effects meta-analysis of the incidence rates of hairdressers reported in 100 per-son-years grouped by study quality according to Newcastle-Ottawa Scale (high quality corresponds to ≥7 and poor quality ≤3).

Fig. 3

Forest plot of random-effects meta-analysis of the incidence rate of nurses reported in 100 person-years.

Fig. 4

Forest plot of mixed-effects meta-analysis of the incidence rate of metal workers reported in 100 person-years grouped by one and 3 years in occupation.

Fig. 5

Forest plot of mixed-effects meta-analysis of the incidence rate of office workers reported in 100 person-years grouped by one and 3 years in occupation.