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Workplace
Original research
Exploration of associations between occupational exposures and current adult eczema
  1. Diego J Lopez1,
  2. Sheikh Alif2,3,4,
  3. Shyamali Dharmage1,5,
  4. Caroline J Lodge1,5,
  5. Dinh S Bui1,
  6. Nicole Le Moual6,
  7. Nilakshi T Waidyatillake1,
  8. John C Su5,7,
  9. Michael Abramson4,
  10. E Haydn Walters1,8,
  11. Garun S Hamilton9,10,
  12. Gayan Bowatte1,
  13. Bircan Erbas11,
  14. Geza Benke4,
  15. Jennifer Perret1,
  16. Adrian J Lowe1,5
  1. 1 Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  2. 2 School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Institute of health and wellbeing, Federation University Australia, Berwick, Victoria, Australia
  4. 4 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  5. 5 Murdoch Children’s Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
  6. 6 Équipe d’Épidémiologie Respiratoire Intégrative, Université Paris-Saclay, Villejuif, France
  7. 7 Department of Dermatology, Monash University, Clayton, Victoria, Australia
  8. 8 School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
  9. 9 Monash Lung, Sleep, Allergy and Immunology, Monash Health, Clayton, Victoria, Australia
  10. 10 School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
  11. 11 School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Shyamali Dharmage, Allergy and Lung health Unit, The University of Melbourne School of Population and Global Health, Melbourne, VIC 3052, Australia; s.dharmage{at}unimelb.edu.au

Abstract

Objectives There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults.

Methods A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at age 53. Their work history was collated with the occupational asthma-specific job exposure matrix to define ever-exposure and cumulative exposure unit-years since no eczema job exposure matrix is available. Eczema was determined using the report of flexural rash that was coming and going for at least 6 months in the last 12 months. Skin prick tests were used to further subgroup eczema and atopic eczema (AE) or non-AE (NAE). Logistic and multinomial regression models were used to investigate the associations.

Results Eczema prevalence was 9.1%. Current occupational exposure to animals (adjusted OR, aOR=3.06 (95% CI 1.43 to 6.58)), storage mites (aOR=2.96 (95% CI 1.38 to 6.34)) and endotoxin (aOR=1.95 (95% CI 1.04 to 3.64)) were associated with increased risk of current eczema. Furthermore, increased odds of NAE were associated with current exposure to animals (aOR=5.60 (95% CI 1.45 to 21.7)) and storage mites (aOR=5.63 (95% CI 1.45 to 21.9)). Current exposures to isocyanates (aOR=5.27 (95% CI 1.17 to 23.7)) and acrylates (aOR=8.41 (95% CI 1.60 to 44.3)) were associated with AE. There was no evidence of associations between cumulative exposures and eczema prevalence. Cumulative exposure to metalworking fluids (aOR=1.10 (95% CI 1.01 to 1.22)) was associated with NAE and acrylates (aOR=1.24 (95% CI 1.04 to 1.46)) with AE.

Conclusions In this exploratory assessment, multiple occupational exposures were associated with current eczema in middle-aged adults. Raising awareness and limiting these exposures during an individual’s productive working life will likely have various health benefits, including reducing eczema prevalence.

  • allergy and immunology
  • occupational health
  • dermatology

Data availability statement

Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from the Tasmanian Longitudinal Health Study, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors on reasonable request and with permission of Tasmanian Longitudinal Health Study. Data requests should be made at: https://tahs.com.au/data-request/.

https://doi.org/10.1136/oemed-2023-108950

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from the Tasmanian Longitudinal Health Study, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors on reasonable request and with permission of Tasmanian Longitudinal Health Study. Data requests should be made at: https://tahs.com.au/data-request/.

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    Footnotes

    • JP and AJL are joint senior authors.

    • Twitter @SheikhAlif

    • Contributors Conceptualisation, DJL, AJL and JP; Data curation, SD, CJL and GSH; Formal analysis, DJL, SA, SD, NTW, MA, GBo, GBe and AJL; Funding acquisition, SD and AJL; Investigation, GBe and AJL; Methodology, DJL, SA, SD, CJL, DSB, NLM, JCS, MA, GBo, BE, GBe, JP and AJL; Resources, GSH; Software, DJL; Supervision, JP and AJL; Visualisation, DJL; Writing–original draft, DJL; Writing–review and editing, SA, SD, CJL, DSB, NLM, NTW, JCS, MA, GSH, GBo, BE, GBe, JP and AJL. DJL is responsible for the overall content as guarantor and accepts full responsibility for the finished work.

    • Funding This work was supported by: National Health and Medical Research Council (NHMRC) of Australia (research grants 299901 and 1021275); the University of Melbourne, Clifford Craig Medical Research Trust of Tasmania; the Victorian, Queensland and Tasmanian Asthma Foundations; Royal Hobart Hospital; Helen MacPherson Smith Trust; GlaxoSmithKline and John L Hopper. DJL was supported by the University of Melbourne and Becas Carlos Antonio Lopez scholarship.

    • Disclaimer The funding agencies had no direct role in the conduct of the study, the collection, management, statistical analysis and interpretation of the data, preparation or approval of the manuscript.

    • Competing interests SD, CJL, MA, JP and AJL declare they have received research funds from GSK’s competitively awarded Investigator Sponsored Studies programme, for unrelated research. AJL, SD and MA have received grant funding from Sanofi Regeneron for unrelated research. SD has received funds from AZ for unrelated research. AJL has received donations of interventional product (EpiCeram) from Primus Pharmaceuticals for unrelated research. JCS has been a consultant/speaker/investigator for AbbVie, Amgen, Bioderma, Bristol Myers Squibb, Ego Pharmaceuticals, Eli-Lilly, Janssen, LEO Pharma, L’Oreal, Mayne, Novartis, Pfizer, Pierre-Fabre, and Sanofi. MA holds investigator-initiated grants for unrelated research from Pfizer, Boehringer-Ingelheim and Sanofi. MA has also undertaken an unrelated consultancy for Sanofi. MA has also received a speaker’s fee from GSK.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.