1. Department of Clinical Social Medicine, Center of Occupational and Environmental Dermatology, University Hospital of Heidelberg, Germany
2. ^*Department of Occupational Medicine, Bavarian Health and Safety Executive, Nuremberg, Germany

Correspondence: Prof. Thomas Diepgen, University Hospital of Heidelberg, Department of Clinical Social Medicine, Thibautstr. 3, D-69115 Heidelberg, Germany; Email: thomas_diepgen@med.uni-heidelberg.de

¹Parts of the work have been presented before in an oral presentation at the 4th International Meeting on Epidemiology and Prevention of Skin Diseases and the 7th Annual Scientific Meeting of the International Dermato-Epidemiology Association at the 20th World Congress of Dermatology in Paris in June 2002 and in a poster presentation at the XXIX Annual Meeting of the Arbeitsgemeinschaft Dermatologische Forschung in Berlin in February 2002.

Received 23 July 2002; Revised 31 December 2002; Accepted 11 February 2003; Published online 30 June 2003.

Abstract

Present evidence convincingly indicates that workers with occupational skin disease are more frequently affected by atopic skin diathesis than the general working population. Population-based studies estimating the impact of atopic skin diathesis on occupational skin disease in various occupations have not been reported to date. We analyzed data of all initial reports of occupational skin diseases recorded in the register of occupational skin diseases in northern Bavaria, Germany, from 1990 to 1999. The main outcome measure was the attributable risk of atopic skin diathesis on occupational skin disease within 24 occupational groups that are most hazardous to the skin. Of the 5285 registered cases, 3730 had a confirmed occupational causation. Among these, 1366 workers (37%) presented an atopic skin diathesis. Assuming a prevalence of atopic skin diathesis of 20% in the total population, we found that 21.6% (95% confidence interval 19.4; 23.7) of occupational skin disease cases within 24 occupational groups may be ascribed to this endogenous risk factor. The attributable risk of atopic skin diathesis helped to explain a large proportion of occupational skin diseases. Empirical evidence supports the importance of surveying atopic skin diathesis as part of an occupational skin disease prevention strategy.