In addition to current hand eczema, cleaners were also more than twice as likely to report having current (i.e. within the last three months) itchy weals (or urticaria) on their hands, wrists or forearms (11% versus 5.3%; aOR=2.37, p<0.05) compared to the reference group. They were also more than three times as likely to have itchy weals after the age of 18 (not statistically significant) and to see a doctor as an adult for itchy weals (8.9% versus 2.1%; aOR=3.59, p<0.05). For itchy weals we found that 8% developed symptoms after they started their job as a cleaner. Thus, approximately 75% of all current symptoms of itchy weals in cleaners were new-onset symptoms.Almost one in four cleaners (24.2%) reported skin symptoms due to the use of gloves and 12% had changed glove type or stopped using gloves due to skin symptoms, compared to 6.8% and 1.8% in the reference group respectively (OR=3.87 and 6.78, p<0.01).For all areas of the hand/arm that are likely to be exposed to water and cleaning agents (back of hand, top forearm and volar forearm) we found elevated trans-epidermal water loss (signalling deteriorated skin barrier function) in cleaners compared to the reference group. Measurements of the upper arm, which is typically not exposed, showed no difference between cleaners and the reference group, suggesting that the difference in TEWL measured for the other part of the hand/arm were work-related.
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