title: Associations between lifestyle factors and hand eczema severity: are tobacco smoking, obesity and stress significantly linked to eczema severity?
abstract: BACKGROUND
  It has been suggested that lifestyle factors such as smoking, overweight and stress may influence the prevalence and severity of hand eczema.
  
  
  OBJECTIVE
  To investigate the association between lifestyle factors and hand eczema severity in a cohort of patients with work-related hand eczema.
  
  
  METHODS
  Individuals with work-related hand eczema notified in the period between June 2012 and November 2013 were included in this questionnaire-based cross-sectional study. Participants responded to a questionnaire including questions on lifestyle factors, as well as a photographic guide for assessment of severity of hand eczema and questions on quality of life.
  
  
  RESULTS
  A total of 773 individuals (546 women and 227 men) responded to the questionnaire and were included in the study. A strong association was found between tobacco smoking and hand eczema severity (p = 0.003), whereas no significant association was found for body weight and stress. Other factors linked to severe eczema were male sex and older age (p = 0.04 and p = 0.01, respectively), and wet work (p = 0.08).
  
  
  CONCLUSIONS
  The data from the present study strongly support an association between smoking and hand eczema severity. However, owing to the cross-sectional design of the study, no conclusion on causation can be drawn.
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400, Copenhagen, Denmark.|Department of Dermatology, Bispebjerg University Hospital, 2400, Copenhagen, Denmark.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Sørensen
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400, Copenhagen, Denmark.
authors.forename: Maja H
authors.initials: MH
authors.lastname: Fisker
authors.affiliation: Department of Dermatology, Bispebjerg University Hospital, 2400, Copenhagen, Denmark.
authors.forename: Tove
authors.initials: T
authors.lastname: Agner
authors.affiliation: Department of Dermatology, Bispebjerg University Hospital, 2400, Copenhagen, Denmark.
authors.forename: Kim K B
authors.initials: KK
authors.lastname: Clemmensen
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400, Copenhagen, Denmark.
authors.forename: Niels E
authors.initials: NE
authors.lastname: Ebbehøj
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004485:Eczema / Q000453:epidemiology*; D005260:Female; D006229:Hand Dermatoses / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: hand eczema; lifestyle factors; quality of life; severity; tobacco smoking; work-related