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Incidence of hand eczema in female Swedish hairdressers
  1. Marie-Louise Lind1,
  2. Maria Albin3,
  3. Jonas Brisman4,
  4. Kerstin Kronholm Diab3,
  5. Linnéa Lillienberg4,
  6. Zoli Mikoczy3,
  7. Jörn Nielsen3,
  8. Lars Rylander3,
  9. Kjell Torén4,
  10. Birgitta Meding2
  1. 1Occupational and Environmental Dermatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
  2. 2National Institute for Working Life, Stockholm, Sweden
  3. 3Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden
  4. 4Department of Occupational and Environmental Medicine, Sahlgrenska Academy and University Hospital, Göteborg, Sweden
  1. Correspondence to:
 MrsM-L Lind
 National Institute for Working Life, SE-113 91 Stockholm, Sweden; marie-louise.lind{at}niwl.se

Abstract

Objective: To estimate the occurrence of hand eczema in hairdressers in Sweden.

Methods: The occurrence of hand eczema was estimated in a Swedish longitudinal retrospective cohort study including all female graduates from vocational schools for hairdressers from 1970 to 1995. A stratified sample from the general population acted as controls. A self-administered questionnaire including questions on the occurrence of hand eczema, skin atopy, working periods and number of hair treatments performed per week was sent to the participants. Incidence rate ratios (IRRs) of hand eczema were estimated.

Results: The incidence rate of hand eczema in hairdressers was 23.8 cases/1000 person-years, whereas in hairdressers who were aged <25 years it was 37.1/1000 person-years. The corresponding IRR for hairdressers compared with controls was 2.5 (95% confidence interval (CI) 2.2 to 2.8), and that for younger hairdressers was 3.1 (95% CI 2.6 to 3.5). The mean age at onset of hand eczema was 21.6 years for hairdressers and 21.2 years for controls. The 1-year prevalence of hand eczema was 18.0% for hairdressers and 12.1% for controls. A large number of hair treatments involving exposure to skin irritants and sensitisers were reported. The incidence rate of hand eczema was higher among individuals with a history of childhood eczema, both for hairdressers and for controls, giving an (age-adjusted) IRR of 1.9 and 2.2, respectively. The attributable fraction of hand eczema from skin atopy was 9.6%. A synergistic effect of skin atopy and hairdressing was found on the occurrence of hand eczema. The relative excess risk due to interaction was 1.21 (95% CI 0.21 to 2.21; p = 0.01).

Conclusion: Hairdressers are highly exposed to skin-damaging substances. The self-reported incidence of hand eczema was substantially higher in female hairdressers than in controls from the general population and than that found previously in register-based studies. For many individuals, onset of hand eczema occurs early in life. Only about 10% of the hand eczema cases among hairdressers would be prevented if no one with skin atopy entered the trade.

  • IRR, incidence rate ratio
  • RERI, relative excess risk due to interaction

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Footnotes

  • Published Online First 19 October 2006

  • Competing interests: None declared.

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