Occurrence
Different countries have different systems for
registering industrial injuries, and different rules
regarding which illnesses are covered by industrial
injury insurance. In the Swedish system, musculoskeletal
conditions have been approved as industrial
injuries on a relatively broad basis, and these
conditions are predominant in Swedish industrial
injury statistics, skin diseases being the 2nd most
commonly recorded condition (4). Reports are
registered by the Occupational Injury Information
System with the National Board of Occupational
Safety and Health. A compilation has been made
of all reported cases of occupational skin disease
in Sweden in 1980–92 (5). This indicates that the
number of reported cases of skin disease per 1000
paid employees during the whole period was higher
for women than for men, and 2¿ the number of
cases were reported in the 16–24 age group compared
with other age groups (Fig. 1). Young
women therefore constitute a clear risk group for
work-related skin disease. In a report regarding
Danish industrial injury statistics for the years
1984–91, 2/3 of eczema sufferers were women (6).
Figures taken from other countries also indicate a
clear over-representation among women (7–9).
Epidemiological studies of hand eczema also
show that women are more often affected than
men. During the 1980s, the occurrence of hand eczema
in Gothenburg was studied using a postal
survey of 20 000 randomly selected people of
working age 20 to 65 years (3). The diagnoses were
verified by clinical examination. The reported 1-
year prevalence for women was 15%, and for men
9%. It also became clear that young women were
most affected, with a 1-year prevalence of 19% in
the 20–30 age group (Fig. 2). The results indicated
2¿ the prevalence of hand eczema compared to a
similar study conducted during the 1960s (10).
Very limited information is available in the dermatological
literature on the incidence rates of
hand eczema, but several epidemiological studies
are under way in which this illness occurrence parameter
is being used. A current Swedish surveybased
study on hand eczema in bakers and randomly selected population controls has found an
incidence rate of hand eczema among women of
11.3 cases/1000 person-years, compared to 4.4
cases among men, in the population controls,
which involves a relative risk of 2.6