The correlation between self-reported hand eczema and clinically based diagnosis in professional cleaners

Contact Dermatitis. 2024 Aug;91(2):104-111. doi: 10.1111/cod.14611. Epub 2024 Jun 6.

Abstract

Background: Most studies investigating the prevalence of hand eczema (HE) in professional cleaners use self-reported questionnaire-based data. However, no validation studies of self-reporting of HE among professional cleaners have previously been conducted.

Objectives: To investigate (1) the point prevalence of self-reported HE, (2) the point prevalence of HE estimated by physical examination of the hands and (3) the sensitivity and specificity of self-reporting of HE compared with the diagnosis based on physical examination among professional cleaners.

Methods: Professional cleaners at three different hospitals in Region Zealand were invited to fill out a questionnaire. The point prevalence of self-reported HE was estimated based on questions from the Nordic Occupational Skin Questionnaire. After completing the questionnaire, each cleaner underwent a physical examination of the hands by a dermatologist on the same day.

Results: In total, 234 cleaners were invited to participate in the study, and 224 (response rate = 96.0%) agreed to take part. Based on the self-reported questionnaires, 5.3% (n = 12) of the cleaners had current HE. Based on an examination by a physician, 19.2% (n = 43) of the cleaners had current HE. The sensitivity of self-reported HE was found to be 28.0%, while the specificity was found to be 100.0%. The positive predictive value was found to be 100.0%, while the negative predictive value was 85.0%.

Conclusion: The true point prevalence of HE among professional cleaners is underestimated when based on self-reporting.

Keywords: cleaning; contact allergy; dermatitis; sensitization.

MeSH terms

  • Adult
  • Dermatitis, Allergic Contact / diagnosis
  • Dermatitis, Allergic Contact / epidemiology
  • Dermatitis, Occupational* / diagnosis
  • Dermatitis, Occupational* / epidemiology
  • Eczema* / diagnosis
  • Eczema* / epidemiology
  • Female
  • Hand Dermatoses* / diagnosis
  • Hand Dermatoses* / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Physical Examination
  • Prevalence
  • Self Report*
  • Sensitivity and Specificity*
  • Surveys and Questionnaires