Differential effects of a tertiary individual prevention programme for patients with occupational skin disease depending on diagnosis.
BACKGROUND
Occupational skin disease (OSD) is common. Tertiary individual prevention programmes (TIP) aim at helping individuals with refractory OSD to remain active in the workforce. Evidence exists that these interventions improve skin protection behaviour related cognitions. However, it is not clear whether these effects generalize to all types of OSD.


OBJECTIVE
To evaluate whether effects on socio-cognitive determinants of skin protection behaviour vary between patients with work related atopic dermatitis (AD) and other work related skin diseases.


METHODS
A total of 14 inpatients with work related AD and 87 inpatients with other work related skin diseases completed measures on socio-cognitive determinants of skin protection behaviour before and after a 3-week inpatient TIP. Mixed model analyses, using maximum-likelihood estimation tested whether there were differential effects of the intervention on socio-cognitive determinants of skin protection behaviour.


RESULTS
Although patients with AD reported more favourable cognitions towards skin protection behaviour than patients with other skin diseases at admission, these cognitions deteriorated or remained on the same level. Patients with other forms of OSD on the other hand developed more favourable cognitions during the intervention.


CONCLUSIONS
Professionals working in the field of OSD should not cease to assist AD patients in achieving optimal skin protection behaviour. Tertiary individual prevention measures may need to pay more attention to the needs of individuals with an occupationally relevant AD. This may contribute to their being able to remain active in the workforce. The alternative would entail regular sick leave, poorer quality of life and economic hardship for the AD patient.
Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Heidelberg, Germany. uwe.matterne@med.uni-heidelberg.de
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Matterne
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Diepgen
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Weisshaar
D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis / Q000517:prevention & control*; D012871:Skin Diseases / Q000175:diagnosis / Q000517:prevention & control*