title: Severe occupational hand eczema, job stress and cumulative sickness absence.
abstract: BACKGROUND
  Stress is known to activate or exacerbate dermatoses, but the relationships between chronic stress, job-related stress and sickness absence among occupational hand eczema (OHE) patients are inadequately understood.
  
  
  OBJECTIVE
  To see whether chronic stress or burnout symptoms were associated with cumulative sickness absence in patients with OHE and to determine which factors predicted sickness absence in a model including measures of job-related and chronic stress.
  
  
  METHODS
  We investigated correlations of these factors in employed adult inpatients with a history of sickness absence due to OHE in a retrospective cross-sectional explorative study, which assessed chronic stress (Trier Inventory for the Assessment of Chronic Stress), burnout (Shirom Melamed Burnout Measure), clinical symptom severity (Osnabrück Hand Eczema Severity Index), perceived symptom severity, demographic characteristics and cumulative days of sickness absence.
  
  
  RESULTS
  The study group consisted of 122 patients. OHE symptoms were not more severe among patients experiencing greater stress and burnout. Women reported higher levels of chronic stress on some measures. Cumulative days of sickness absence correlated with individual dimensions of job-related stress and, in multiple regression analysis, with an overall measure of chronic stress.
  
  
  CONCLUSIONS
  Chronic stress is an additional factor predicting cumulative sickness absence among severely affected OHE patients. Other relevant factors for this study sample included the 'cognitive weariness' subscale of the Shirom Melamed Burnout Measure and the physical component summary score of the SF-36, a measure of health-related life quality. Prevention and rehabilitation should take job stress into consideration in multidisciplinary treatment strategies for severely affected OHE patients.
authors.affiliation: Institute for Innovative Rehabilitation, Hospital Management and Stress Medicine (IREHA) of the Lielje Gruppe, Loehne, Germany, d.boehm@uglielje.de.
authors.forename: D
authors.initials: D
authors.lastname: Böhm
authors.affiliation: Institute for Innovative Rehabilitation, Hospital Management and Stress Medicine (IREHA) of the Lielje Gruppe, Loehne, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Stock Gissendanner
authors.affiliation: Department of Allergology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Finkeldey
authors.affiliation: Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrueck, Lower Saxony Institute for Occupational Dermatology (NIB), Osnabrueck, Germany.
authors.forename: S M
authors.initials: SM
authors.lastname: John
authors.affiliation: Clinic for Dermatology, Allergology, and Venerology, Hanover Medical School, Hanover, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Werfel
authors.affiliation: Department of Clinical Social Medicine, Center of Health System Research, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany.
authors.forename: T L
authors.initials: TL
authors.lastname: Diepgen
authors.affiliation: Department of Allergology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Breuer
mesh_terms: D000041:Absenteeism; D000328:Adult; D002055:Burnout, Professional; D003430:Cross-Sectional Studies; D009783:Dermatitis, Occupational; D004485:Eczema; D005260:Female; D006225:Hand; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018582:Sick Leave; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
keywords: Burnout; job stress; occupational hand eczema; sickness absence.