title: The Hand Eczema Trial (HET): Design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema.
abstract: BACKGROUND
  Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema.
  
  
  METHODS
  We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index); self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life.
  
  
  BACKGROUND
  The trial is registered in ClinicalTrials.Gov, NCT01012453.
authors.affiliation: Department of Dermatology, Roskilde Hospital, Roskilde, Denmark. kristinaibler@hotmail.com
authors.forename: Kristina Sophie
authors.initials: KS
authors.lastname: Ibler
authors.forename: Tove
authors.initials: T
authors.lastname: Agner
authors.forename: Jane Lindschou
authors.initials: JL
authors.lastname: Hansen
authors.forename: Christian
authors.initials: C
authors.lastname: Gluud
mesh_terms: D003376:Counseling / Q000706:statistics & numerical data; D004485:Eczema / Q000145:classification / Q000453:epidemiology / Q000517:prevention & control; D006229:Hand Dermatoses / Q000145:classification / Q000453:epidemiology / Q000517:prevention & control; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D009784:Occupational Diseases / Q000145:classification / Q000453:epidemiology / Q000517:prevention & control; D011788:Quality of Life; D012107:Research Design; D018582:Sick Leave / Q000706:statistics & numerical data; D014478:Unemployment / Q000706:statistics & numerical data
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