title: Sustainability of interdisciplinary secondary prevention in patients with occupational hand eczema: a 5-year follow-up survey.
abstract: BACKGROUND
  Occupational hand eczema (OHE) is common in 'wet work' occupations. Thus, effective and sustainable prevention strategies are needed.
  
  
  OBJECTIVE
  To investigate the long-term effectiveness (sustainability) of an interdisciplinary secondary prevention programme.
  
  
  METHODS
  One hundred and thirty-four patients with OHE consecutively participated in an outpatient skin protection seminar comprising dermatological and educational interventions. Data were obtained at baseline (T0) and at 9 months (T1) and 5 years (T2) after participation. A cohort of 84 patients was available for analysis of the outcomes 'job continuation', 'skin condition', 'skin protection behaviour', and 'disease management'.
  
  
  RESULTS
  At T2, 71.4% of patients remained in their occupation. The prevalence and severity of self-reported OHE were significantly reduced as compared with T0 (p = 0.007, p = 0.002). Of the patients, 13.1% gave up work because of OHE at T2. The intervention was most successful in patients suffering from milder forms of OHE, and there was less success in patients with severe OHE. The results showed a significant reduction in the frequency of 'hand washing' (p = 0.003) but no measurable change in the use of skin care products (p = 1.000).
  
  
  CONCLUSIONS
  The intervention showed sustainable long-term effects. Early detection and reporting of OHE in the initial stages of the disease is of utmost importance for the effectiveness of secondary prevention. In cases of severe OHE, inpatient programmes may be indicated.
authors: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Sedanstraße 115, 49090 Osnabrück, Germany. awilke@uos.de
authors: Annika
authors: A
authors: Wilke
authors: Günther
authors: G
authors: Gediga
authors: Tanja
authors: T
authors: Schlesinger
authors: Swen M
authors: SM
authors: John
authors: Britta
authors: B
authors: Wulfhorst
mesh_terms: D000328:Adult; D000368:Aged; D009783:Dermatitis, Occupational / Q000517:prevention & control*; D004485:Eczema / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D017575:Gloves, Protective / Q000009:adverse effects; D006229:Hand Dermatoses / Q000517:prevention & control*; D006235:Hand Disinfection; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D055502:Secondary Prevention / Q000379:methods*; D017592:Skin Care / Q000706:statistics & numerical data