gms | German Medical Science

Introduction/background: There are few epidemiological studies on hand dermatitis (HD) in the metalworking industry and no study has attempted a long-term follow-up. It is the aim of the Prospective Audi Cohort Follow Up Study (PACO II) to estimate burden, prognosis and risk of HD in a car industry setting with a long term follow-up perspective (>10 years).

Material and methods: Eligible participants were individuals who had been examined in the context of the original PACO study (1990-1998) and had been followed through until the end of their apprenticeship (N=1909). All participants were interviewed and underwent dermatological examination. An exposure assessment was carried out according to a pre-defined algorithm. 11.6% of the healthy individuals were included as controls. Those eligible participants who no longer worked at the AUDI company, or were unable to come to the study site (i.e. were on maternity leave) were contacted by telephone.

Results: The follow up rate was 78.3% (1495/1909). Mean follow up time was 13.2 years. The period prevalence of HD in the follow up period was 19.7(95% CI 17.7-21.8)%, the cumulative incidence in the entire study period was 28.4 (95% CI 26.1-30.7)%. Allergic contact dermatitis played a negligible role. There was no substantial difference when estimates as obtained from telephone interviews were compared to those obtained by medical interviews. While HD incidences were significantly different in different occupational groups (metalworkers, white collar workers, other blue collar workers) during apprenticeship, this was not true in the long run.

Discussion/Conclusions: The burden of HD in the car industry is considerable. In a long term perspective, an endogeneous predisposition seemed to be more important compared to occupational hazards, as reflected by similar long term incidences in different work environments. The pronounced role of skin atopy may account for this finding.