Occurrence and prognosis of hand eczema in the car industry: results from the PACO follow-up study (PACO II)

Background:  Only a few epidemiological studies on hand eczema (HE) in the metalworking industry have been conducted, and no study has attempted a long-term follow-up.
Objectives:  In the Prospective Audi Cohort (PACO) II follow-up study, we aimed to estimate burden and prognosis of HE in a car industry setting (follow-up > 10 years).
Patients/Methods:  Eligible participants were individuals who had been examined in the original PACO study (1990–1998) and had been followed through until the end of their apprenticeship ( n  = 1909). Participants were interviewed and underwent dermatological examination. An exposure assessment was carried out according to a pre-defined algorithm.
Results:  The follow-up rate was 78.3% (1494/1909). Mean follow-up time was 13.3 [standard deviation 1.3] years. The period prevalence of HE in the follow-up period was 21.0% [95% confidence interval (CI) 19.0–23.1%], yielding a cumulative incidence of 29.3% (95% CI 26.9–31.6%) in the entire study period. HE persisted after the end of apprenticeship in 40.0% (95% CI 33.3–46.7%) of subjects who had had HE during apprenticeship ( n  = 205). 18.0% (95% CI 15.9–20.1%) developed HE in the follow-up period ( n  = 1289).
Conclusions:  Around 30% of subjects were affected by HE at least once during the study period. HE persisted in 40% of the participants affected during apprenticeship.