P54 Prevalence of skin changes in the cleaning industry

Background: In the cleaning industry, the hands are exposed to water and irritants, resulting in dry skin and hand eczema. The prevalence and severity of skin changes is unknown. Objectives: To quantify the prevalence and the severity of skin changes of the hands. To compare questionnaire‐based self‐reported signs of hand eczema (both current and at any occasion during the last 12 months), with skin changes revealed by clinical examination. Methods: A random sample of 231 employees in the cleaning industry participated in the study. Most of them were immigrants. They had to answer a (translated) questionnaire about signs of hand eczema. Then all of them were examined and the severity of hand eczema was graded by a scoring system1. In the comparison only objective subvariables (desquamation, erythema, fissures, infiltration, vesicles) were used. Results: Clinical examination of the hands detected desquamation in 38%; erythema in 29%; fissures in 24%; infiltration in 12%; vesicles in 4%. Severity scoring of hand eczema: one point in 21%; two points in 18%; three points in 9%; four points in 4%. Signs of hand eczema reported in the questionnaire based on the current situation: desquamation in 17%; erythema in 20%; fissures in 20%; infiltration in 10%; vesicles in 12%. Signs of hand eczema reported in the questionnaire based on any occasion during the last 12 months: desquamation in 18%; erythema in 17%; fissures in 22%; infiltration in 11%; vesicles in 15%. False negative self‐reporting by the questionnaire: desquamation in 26%; erythema in 18%; fissures in 14%; infiltration in 11%; vesicles in 3%. False positive self‐reporting by the questionnaire: desquamation in 5%; erythema in 10%; fissures in 10%; infiltration in 8%; vesicles in 11%. Conclusions: Desquamation and erythema were the most common signs both in clinical examination and in questionnaire. The self‐reported prevalence (both current and over the last 12 months) of erythema and desquamation is an underestimation of the true prevalence. Scoring hand eczema revealed that most of the employees scored one or two points; indicating that most of the clinical signs of hand eczema are minor. False negative self‐reporting by questionnaire was high; indicating that these minor symptoms of hand eczema were probably not recognized by the employees. False positive self‐reporting was also high; probably because they misunderstood the questions. This study illustrates the need for a consensus about the distinction between “minor skin damage” and “true eczema”.