title: Occurrence and prognosis of hand eczema in the car industry: results from the PACO follow-up study (PACO II).
abstract: 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.
  
  
  OBJECTIVE
  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).
  
  
  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.
authors.affiliation: Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Thibautstr. 3, 69115 Heidelberg, Germany.
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Apfelbacher
authors.forename: Magda
authors.initials: M
authors.lastname: Radulescu
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Diepgen
authors.forename: Ulrich
authors.initials: U
authors.lastname: Funke
mesh_terms: D000328:Adult; D001336:Automobiles; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006229:Hand Dermatoses / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007221:Industry; D007407:Interviews as Topic; D008297:Male; D008669:Metallurgy; D016273:Occupational Exposure / Q000009:adverse effects; D015995:Prevalence; D011379:Prognosis; D011795:Surveys and Questionnaires