title: Tertiary individual prevention of occupational skin diseases: a decade's experience with recalcitrant occupational dermatitis.
abstract: OBJECTIVE
  If employees are threatened to loose their job due to a severe occupational skin disease (OSD), intensive interdisciplinary measures of tertiary individual prevention (TIP) are required. TIP comprises 2-3-weeks in-patient treatment plus intensive health-pedagogic counseling, and consecutive 3-weeks out-patient treatment by the local dermatologists. Each patient (pt) will stay off work for a total of usually 6 weeks to allow full barrier-recovery.
  
  
  METHODS
  All 1,486 TIP-pts from various high-risk-professions, treated in our institution in the period 1994-2003, were followed up 1 year after the TIP by a standardised questionnaire, which was returned by 1,164 (78%) pts.
  
  
  RESULTS
  Seven hundred and sixty-four (66%) of the responding 1,164 TIP-pts had successfully remained in their (risk-)professions. It could be demonstrated that to remain in the workplace was dependent on the individual motivation to use skin protection (P < 0.001), the provision of skin protection by the employer (P < 0.001), (higher) age of pt (P < 0.001) and the duration of continued out-patient-treatment by the local dermatologist (P < 0.001). However, there were no significant differences concerning the likelihood of successful job-continuation in the various high-risk-professions, e.g. hairdressers, nurses, metal-workers, food handlers, construction-workers.
  
  
  CONCLUSIONS
  The obtained data from TIP reveal remarkable pertinent options for interdisciplinary pt-management in severe OSD in all risk-professions.
authors.affiliation: Department of Dermatology, Faculty of Human Sciences, University of Osnabrueck, Osnabrueck, Germany. cskudlik@uos.de
authors.forename: C
authors.initials: C
authors.lastname: Skudlik
authors.forename: B
authors.initials: B
authors.lastname: Wulfhorst
authors.forename: G
authors.initials: G
authors.lastname: Gediga
authors.forename: M
authors.initials: M
authors.lastname: Bock
authors.forename: H
authors.initials: H
authors.lastname: Allmers
authors.forename: S M
authors.initials: SM
authors.lastname: John
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D009783:Dermatitis, Occupational / Q000517:prevention & control* / Q000628:therapy*; D004651:Employment; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055512:Tertiary Prevention / Q000379:methods*; D055815:Young Adult