In these data, we identified groups of professional cleaning workers at elevated risk of hand
dermatitis. Our results extend previous findings from epidemiological research into skin
symptoms in cleaning workers (6-8) by reporting elevated risk among users of products
known to affect the respiratory tract and skin (1,15,16), providing evidence of increased risk
with increasing frequency of use, and generating increasing adjusted risk estimates for
workers performing a variety of tasks or using multiple products.
In addition to occupational risk factors, individual susceptibility factors such as atopy also
play a role in the prevalence of hand dermatitis. In our data, hand dermatitis was reported
among 39% more respondents with than without a self-reported history of eczema or other
skin allergy. Although our data collection was not designed to distinguish allergic from
irritant dermatitis, the cleaning-related exposures we identify here should be considered risk
factors for both. Indeed, the adjusted PR generated for current cleaning overall was similar
to those generated when the data were stratified by self-reported history of eczema or other
skin allergy (history: PR: 1.61; no history: PR: 1.57). These estimates and stratified
estimates for particular worksites and cleaning products (not shown) do not provide
sufficient evidence of effect modification by atopic status; improved information about
atopy and a larger sample size would have allowed us to more thoroughly explore this
potential effect modification. Nonetheless, any interventions aimed at reducing these
exposures will likely reduce the burden of hand dermatitis among atopic and non-atopic
individuals.