Background Occupational hand eczema (OHE) is common in hairdressers, and many leave the trade because of the disease. However, the exact impact of OHE on career length is unknown.
Objective To assess the effect of OHE on career length and risk factors associated with leaving the trade because of OHE in hairdressers followed-up for up to 35 years.
Methods A prospective cohort study of Danish hairdressers graduating between 1985 and 2007 (n=5219) was performed. A questionnaire was sent in 2009 and 2020. The Danish Labor Marked Supplementary Pension Scheme provided information on affiliation to the hairdressing profession. Career length was assessed by Kaplan-Meier analyses.
Results The median survival time was 12.0 (95% CI 11.0 to 13.0) years in graduates with OHE and 14.0 (95% CI 12.6 to 15.4) years in graduates without OHE (p<0.001). Graduates with a frequency of hand eczema (HE) of ‘once’, ‘several times’ and ‘almost all the time’ had a median survival time of 20.0 (95% CI 14.6 to 25.4), 12.0 (95% CI 10.7 to 13.3) and 7.0 (95% CI 5.6 to 8.4) years, respectively. Graduates with OHE that left the trade (partly) because of HE constituted 11.7% of the study population. Factors associated with leaving the trade because of HE included a history of atopic dermatitis (adjusted OR (aOR) 2.2 (95% CI 1.2 to 4.0), a history of a positive patch test (aOR 5.1 (95% CI 2.3 to 11.0) and allergy to hair dyes (aOR 9.4 (95% CI 3.4 to 25.6).
Conclusion Career length is reduced in hairdressers with OHE, especially if frequently relapsing or caused by contact allergy, for example, to hair dyes.
- Dermatitis, Contact
- Occupational Health
Data availability statement
Data are available upon reasonable request from the National Allergy Research Centre, Denmark. Data consist of de-identified questionnaire data and career length estimates based on ATP data.
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Contributors MH: writing original draft, formal analysis and conceptualisation (support), guarantor. JPT: critical review and editing. CZ: critical review and editing. WU: critical review and editing. JDJ: critical review and editing and conceptualisation.
Funding This study was funded by an unrestricted grant from the Danish Hairdressers and Beauticians Union (grant number: not applicable).
Competing interests MH has no competing interest. JPT has received consulting fees from Coloplast and honoraria from Pfizer, AbbVie, Regeneron, Sanofi-Genzyme, LEO, Lilly, Almirall and has participated on a Data Safety Monitoring Board or Advisory Board for Pfizer, AbbVie, Regeneron, Sanofi-Genzyme, LEO, Lilly, Almirall, Arena, Aslan. CZ has received consulting fees from Jansen Cilag, Novartis and Leo Pharma and is a board member of the European Academy of Dermatology and Venereology. WU has a grant agreement for providing data management and analysis in the EFISS project of the IDEA/IFRA project group, has received travel reimbursement for attending IDEA project meeting in Munich August 2019 and is an external expert for the ‘Scientific Committee on Consumer Safety’ (SCCS) of the EU. JDJ has received grants from National Environmental Protection Agency and Leo Foundation, received an honorarium for lecture at The Yearly Meeting of Spanish Dermatologist, is head of Cosmetic Council and advisor to the Danish Minister of Environment (unpaid), President Elect in European Society of Contact Dermatitis (unpaid) and editor-in-chief for the journal Contact Dermatitis.
Provenance and peer review Not commissioned; externally peer reviewed.
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