Interdisciplinary and multiprofessional outpatient secondary individual prevention of work-related skin diseases in the metalworking industry: 1-year follow-up of a patient cohort.

Content Provider	Europe PMC
Author	Wilke, Annika Gediga, Günther Goergens, Andreas Hansen, Andreas Hübner, Anja John, Swen Malte Nordheider, Kathrin Rocholl, Marc Weddeling, Sabine Wulfhorst, Britta Nashan, Dorothée
Abstract	BackgroundIn Germany, work-related skin diseases are predominant within the spectrum of reported occupational diseases. Metal workers are among the high-risk professions. Offering effective prevention programs to affected patients is of utmost importance to avoid deterioration of the disease and job loss. We conducted a 1-year follow-up in patients who participated in a multidisciplinary, complex outpatient prevention program representing a standard procedure of patient care by the respective statutory accident insurance.MethodsThe multi-component prevention program consists of multiprofessional individual patient counseling, a structured skin protection seminar in a group, as well as workplace visits and on-site counseling in terms of appropriate skin protection (e.g. gloves). An observational study with a 1-year follow-up and four measurements (T1-T4, longitudinal pre/post-test design) including dermatological examinations and standardized written questionnaires was conducted between 2013 and 2016 to assess changes over time regarding job loss and disease severity.ResultsData from 94 patients (87 male, mean age: 45.4 years) were included in the analysis. One year after the skin protection seminar (T4), 83 patients (88.3%) remained in their original professional metalworking activity and four patients (4.3%) had given up their profession because of their skin disease. At baseline (T1), irritant contact dermatitis of the hands was the most frequent diagnosis (80.7%). Methods for self-reported disease severity showed good correlation with the clinical gold standard at T1 and T2 (dermatological examination with the Osnabrück Hand Eczema Severity Index / OHSI), and a significant decrease of the self-reported disease severity was found over time from T1 to T4 (p < 0.001). Further results indicate an improved self-perceived disease control and an overall satisfaction with the prevention program.ConclusionsThe results of this observational study demonstrate that the comprehensive prevention program positively influences the course of work-related skin diseases, increases the possibility to continue working in a “high-risk” profession and improves the disease management of metal workers. In the long term, the prevention program may lead to cost savings by preventing high therapy costs or professional retraining.Electronic supplementary materialThe online version of this article (10.1186/s12895-018-0080-2) contains supplementary material, which is available to authorized users.
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Journal	BMC Dermatology [BMC Dermatol]
Volume Number	18
DOI	10.1186/s12895-018-0080-2
PubMed Central reference number	PMC6292163
Issue Number	1
PubMed reference number	30541516
e-ISSN	14715945
Language	English
Publisher	BioMed Central
Publisher Date	2018-12-12
Publisher Place	London
Access Restriction	Open
Rights License	Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. © The Author(s). 2018
Subject Keyword	Occupational contact dermatitis Hand eczema Prevention Metalworking industry Patient education Occupational health Skin protection Patient care Follow-up Interdisciplinary
Content Type	Text
Resource Type	Article
Subject	Dermatology