Article Text
Abstract
Objectives Contact dermatitis is widely present among construction workers. The risk of developing occupational contact dermatitis among this group is probably related to occupational exposure to chemicals. In addition, frequency of glove use and exposure to water during hand washing may also influence the prevalence of hand eczema. The aim of this project was to validate questionnaire items on hand dirtiness and glove use by comparing with direct workplace observations.
Methods A cross-sectional study was conducted at 13 different construction sites in the Netherlands. The questionnaire covered general information such as age, gender, occupation and specific questions regarding hand conditions, glove use, glove types, glove replacement, frequency of hand washing and possible symptoms of hand eczema during the last 12 months.
Data of 177 participants (95% response rate) were analysed. Agreement between observation and questionnaire was assessed by calculating Cohen’s kappa. In addition, the sensitivity and specificity were determined. Multivariate analysis was conducted to assess the association between hand eczema and workplace determinants.
Results Observation of hand dirtiness, glove use and glove types were found to agree well with questionnaires, with kappa’s of 0.75, 0.61 and 0.88 respectively. The 1-year prevalence of hand eczema was 45.8%. Multivariate logistic regression analysis with hand eczema as dependent variable showed a statistically significant correlation with ‘hand cream use’ (PR 2.4 (95% CI: 1.6 to 3.8)) and ‘hand washing efforts’ (PR 1.5 (95% CI: 1.1 to 2.0)). There was also a significant positive association between hand eczema and ‘hand dirtiness’ and ‘glove use’.
Conclusions There is a strong correlation found between direct observations and questionnaire. Therefore, it is reasonable to consider that these questionnaire items are suitable to be used in future epidemiological studies. Hand eczema was often reported and was positively associated with potential determinants of exposure asked for in the questionnaire.