Exploration of associations between occupational exposures and current adult eczema

Diego J. Lopez; Sheikh Alif; Shyamali Dharmage; Caroline J. Lodge; Dinh S. Bui; Nicole Le Moual; Nilakshi T. Waidyatillake; John C. Su; Michael Abramson; E. Haydn Walters; Garun S. Hamilton; Gayan Bowatte; Bircan Erbas; Geza Benke; Jennifer Perret; Adrian J. Lowe

doi:10.1136/oemed-2023-108950

Exploration of associations between occupational exposures and current adult eczema

Diego J. Lopez, Sheikh Alif, Shyamali Dharmage, Caroline J. Lodge, Dinh S. Bui, Nicole Le Moual, Nilakshi T. Waidyatillake, John C. Su, Michael Abramson, E. Haydn Walters, Garun S. Hamilton, Gayan Bowatte, Bircan Erbas, Geza Benke, Jennifer Perret, Adrian J. Lowe

Research output: Contribution to journal › Article › Research › peer-review

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Abstract

Objectives There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults. Methods A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at age 53. Their work history was collated with the occupational asthma-specific job exposure matrix to define ever-exposure and cumulative exposure unit-years since no eczema job exposure matrix is available. Eczema was determined using the report of flexural rash that was coming and going for at least 6 months in the last 12 months. Skin prick tests were used to further subgroup eczema and atopic eczema (AE) or non-AE (NAE). Logistic and multinomial regression models were used to investigate the associations. Results Eczema prevalence was 9.1%. Current occupational exposure to animals (adjusted OR, aOR=3.06 (95% CI 1.43 to 6.58)), storage mites (aOR=2.96 (95% CI 1.38 to 6.34)) and endotoxin (aOR=1.95 (95% CI 1.04 to 3.64)) were associated with increased risk of current eczema. Furthermore, increased odds of NAE were associated with current exposure to animals (aOR=5.60 (95% CI 1.45 to 21.7)) and storage mites (aOR=5.63 (95% CI 1.45 to 21.9)). Current exposures to isocyanates (aOR=5.27 (95% CI 1.17 to 23.7)) and acrylates (aOR=8.41 (95% CI 1.60 to 44.3)) were associated with AE. There was no evidence of associations between cumulative exposures and eczema prevalence. Cumulative exposure to metalworking fluids (aOR=1.10 (95% CI 1.01 to 1.22)) was associated with NAE and acrylates (aOR=1.24 (95% CI 1.04 to 1.46)) with AE. Conclusions In this exploratory assessment, multiple occupational exposures were associated with current eczema in middle-aged adults. Raising awareness and limiting these exposures during an individual's productive working life will likely have various health benefits, including reducing eczema prevalence.

Original language	English
Pages (from-to)	564-571
Number of pages	8
Journal	Occupational and Environmental Medicine
Volume	80
Issue number	10
DOIs	https://doi.org/10.1136/oemed-2023-108950
Publication status	Published - Oct 2023

Keywords

allergy and immunology
dermatology
occupational health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/oemed-2023-108950

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Lopez, D. J., Alif, S., Dharmage, S., Lodge, C. J., Bui, D. S., Le Moual, N., Waidyatillake, N. T., Su, J. C., Abramson, M., Walters, E. H., Hamilton, G. S., Bowatte, G., Erbas, B., Benke, G., Perret, J., & Lowe, A. J. (2023). Exploration of associations between occupational exposures and current adult eczema. Occupational and Environmental Medicine, 80(10), 564-571. https://doi.org/10.1136/oemed-2023-108950

@article{8498e1ceaf244bef9dfae76928bb7a1d,

title = "Exploration of associations between occupational exposures and current adult eczema",

abstract = "Objectives There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults. Methods A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at age 53. Their work history was collated with the occupational asthma-specific job exposure matrix to define ever-exposure and cumulative exposure unit-years since no eczema job exposure matrix is available. Eczema was determined using the report of flexural rash that was coming and going for at least 6 months in the last 12 months. Skin prick tests were used to further subgroup eczema and atopic eczema (AE) or non-AE (NAE). Logistic and multinomial regression models were used to investigate the associations. Results Eczema prevalence was 9.1%. Current occupational exposure to animals (adjusted OR, aOR=3.06 (95% CI 1.43 to 6.58)), storage mites (aOR=2.96 (95% CI 1.38 to 6.34)) and endotoxin (aOR=1.95 (95% CI 1.04 to 3.64)) were associated with increased risk of current eczema. Furthermore, increased odds of NAE were associated with current exposure to animals (aOR=5.60 (95% CI 1.45 to 21.7)) and storage mites (aOR=5.63 (95% CI 1.45 to 21.9)). Current exposures to isocyanates (aOR=5.27 (95% CI 1.17 to 23.7)) and acrylates (aOR=8.41 (95% CI 1.60 to 44.3)) were associated with AE. There was no evidence of associations between cumulative exposures and eczema prevalence. Cumulative exposure to metalworking fluids (aOR=1.10 (95% CI 1.01 to 1.22)) was associated with NAE and acrylates (aOR=1.24 (95% CI 1.04 to 1.46)) with AE. Conclusions In this exploratory assessment, multiple occupational exposures were associated with current eczema in middle-aged adults. Raising awareness and limiting these exposures during an individual's productive working life will likely have various health benefits, including reducing eczema prevalence.",

keywords = "allergy and immunology, dermatology, occupational health",

author = "Lopez, {Diego J.} and Sheikh Alif and Shyamali Dharmage and Lodge, {Caroline J.} and Bui, {Dinh S.} and {Le Moual}, Nicole and Waidyatillake, {Nilakshi T.} and Su, {John C.} and Michael Abramson and Walters, {E. Haydn} and Hamilton, {Garun S.} and Gayan Bowatte and Bircan Erbas and Geza Benke and Jennifer Perret and Lowe, {Adrian J.}",

note = "Funding Information: SD, CJL, MA, JP and AJL declare they have received research funds from GSK{\textquoteright}s competitively awarded Investigator Sponsored Studies programme, for unrelated research. AJL, SD and MA have received grant funding from Sanofi Regeneron for unrelated research. SD has received funds from AZ for unrelated research. AJL has received donations of interventional product (EpiCeram) from Primus Pharmaceuticals for unrelated research. JCS has been a consultant/speaker/investigator for AbbVie, Amgen, Bioderma, Bristol Myers Squibb, Ego Pharmaceuticals, Eli-Lilly, Janssen, LEO Pharma, L{\textquoteright}Oreal, Mayne, Novartis, Pfizer, Pierre-Fabre, and Sanofi. MA holds investigator-initiated grants for unrelated research from Pfizer, Boehringer-Ingelheim and Sanofi. MA has also undertaken an unrelated consultancy for Sanofi. MA has also received a speaker{\textquoteright}s fee from GSK. Funding Information: This work was supported by: National Health and Medical Research Council (NHMRC) of Australia (research grants 299901 and 1021275); the University of Melbourne, Clifford Craig Medical Research Trust of Tasmania; the Victorian, Queensland and Tasmanian Asthma Foundations; Royal Hobart Hospital; Helen MacPherson Smith Trust; GlaxoSmithKline and John L Hopper. DJL was supported by the University of Melbourne and Becas Carlos Antonio Lopez scholarship. Funding Information: We acknowledge TAHS staff that contributed to collection and entry of data. Likewise, the founders of the TAHS. DJL was supported by the University of Melbourne and Becas Carlos Antonio Lopez scholarship. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2023",

month = oct,

doi = "10.1136/oemed-2023-108950",

language = "English",

volume = "80",

pages = "564--571",

journal = "Occupational and Environmental Medicine",

issn = "1351-0711",

publisher = "BMJ",

number = "10",

}

Lopez, DJ, Alif, S, Dharmage, S, Lodge, CJ, Bui, DS, Le Moual, N, Waidyatillake, NT, Su, JC , Abramson, M, Walters, EH, Hamilton, GS, Bowatte, G, Erbas, B, Benke, G, Perret, J & Lowe, AJ 2023, 'Exploration of associations between occupational exposures and current adult eczema', Occupational and Environmental Medicine, vol. 80, no. 10, pp. 564-571. https://doi.org/10.1136/oemed-2023-108950

TY - JOUR

T1 - Exploration of associations between occupational exposures and current adult eczema

AU - Lopez, Diego J.

AU - Alif, Sheikh

AU - Dharmage, Shyamali

AU - Lodge, Caroline J.

AU - Bui, Dinh S.

AU - Le Moual, Nicole

AU - Waidyatillake, Nilakshi T.

AU - Su, John C.

AU - Abramson, Michael

AU - Walters, E. Haydn

AU - Hamilton, Garun S.

AU - Bowatte, Gayan

AU - Erbas, Bircan

AU - Benke, Geza

AU - Perret, Jennifer

AU - Lowe, Adrian J.

N1 - Funding Information: SD, CJL, MA, JP and AJL declare they have received research funds from GSK’s competitively awarded Investigator Sponsored Studies programme, for unrelated research. AJL, SD and MA have received grant funding from Sanofi Regeneron for unrelated research. SD has received funds from AZ for unrelated research. AJL has received donations of interventional product (EpiCeram) from Primus Pharmaceuticals for unrelated research. JCS has been a consultant/speaker/investigator for AbbVie, Amgen, Bioderma, Bristol Myers Squibb, Ego Pharmaceuticals, Eli-Lilly, Janssen, LEO Pharma, L’Oreal, Mayne, Novartis, Pfizer, Pierre-Fabre, and Sanofi. MA holds investigator-initiated grants for unrelated research from Pfizer, Boehringer-Ingelheim and Sanofi. MA has also undertaken an unrelated consultancy for Sanofi. MA has also received a speaker’s fee from GSK. Funding Information: This work was supported by: National Health and Medical Research Council (NHMRC) of Australia (research grants 299901 and 1021275); the University of Melbourne, Clifford Craig Medical Research Trust of Tasmania; the Victorian, Queensland and Tasmanian Asthma Foundations; Royal Hobart Hospital; Helen MacPherson Smith Trust; GlaxoSmithKline and John L Hopper. DJL was supported by the University of Melbourne and Becas Carlos Antonio Lopez scholarship. Funding Information: We acknowledge TAHS staff that contributed to collection and entry of data. Likewise, the founders of the TAHS. DJL was supported by the University of Melbourne and Becas Carlos Antonio Lopez scholarship. Publisher Copyright: © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2023/10

Y1 - 2023/10

N2 - Objectives There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults. Methods A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at age 53. Their work history was collated with the occupational asthma-specific job exposure matrix to define ever-exposure and cumulative exposure unit-years since no eczema job exposure matrix is available. Eczema was determined using the report of flexural rash that was coming and going for at least 6 months in the last 12 months. Skin prick tests were used to further subgroup eczema and atopic eczema (AE) or non-AE (NAE). Logistic and multinomial regression models were used to investigate the associations. Results Eczema prevalence was 9.1%. Current occupational exposure to animals (adjusted OR, aOR=3.06 (95% CI 1.43 to 6.58)), storage mites (aOR=2.96 (95% CI 1.38 to 6.34)) and endotoxin (aOR=1.95 (95% CI 1.04 to 3.64)) were associated with increased risk of current eczema. Furthermore, increased odds of NAE were associated with current exposure to animals (aOR=5.60 (95% CI 1.45 to 21.7)) and storage mites (aOR=5.63 (95% CI 1.45 to 21.9)). Current exposures to isocyanates (aOR=5.27 (95% CI 1.17 to 23.7)) and acrylates (aOR=8.41 (95% CI 1.60 to 44.3)) were associated with AE. There was no evidence of associations between cumulative exposures and eczema prevalence. Cumulative exposure to metalworking fluids (aOR=1.10 (95% CI 1.01 to 1.22)) was associated with NAE and acrylates (aOR=1.24 (95% CI 1.04 to 1.46)) with AE. Conclusions In this exploratory assessment, multiple occupational exposures were associated with current eczema in middle-aged adults. Raising awareness and limiting these exposures during an individual's productive working life will likely have various health benefits, including reducing eczema prevalence.

AB - Objectives There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults. Methods A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at age 53. Their work history was collated with the occupational asthma-specific job exposure matrix to define ever-exposure and cumulative exposure unit-years since no eczema job exposure matrix is available. Eczema was determined using the report of flexural rash that was coming and going for at least 6 months in the last 12 months. Skin prick tests were used to further subgroup eczema and atopic eczema (AE) or non-AE (NAE). Logistic and multinomial regression models were used to investigate the associations. Results Eczema prevalence was 9.1%. Current occupational exposure to animals (adjusted OR, aOR=3.06 (95% CI 1.43 to 6.58)), storage mites (aOR=2.96 (95% CI 1.38 to 6.34)) and endotoxin (aOR=1.95 (95% CI 1.04 to 3.64)) were associated with increased risk of current eczema. Furthermore, increased odds of NAE were associated with current exposure to animals (aOR=5.60 (95% CI 1.45 to 21.7)) and storage mites (aOR=5.63 (95% CI 1.45 to 21.9)). Current exposures to isocyanates (aOR=5.27 (95% CI 1.17 to 23.7)) and acrylates (aOR=8.41 (95% CI 1.60 to 44.3)) were associated with AE. There was no evidence of associations between cumulative exposures and eczema prevalence. Cumulative exposure to metalworking fluids (aOR=1.10 (95% CI 1.01 to 1.22)) was associated with NAE and acrylates (aOR=1.24 (95% CI 1.04 to 1.46)) with AE. Conclusions In this exploratory assessment, multiple occupational exposures were associated with current eczema in middle-aged adults. Raising awareness and limiting these exposures during an individual's productive working life will likely have various health benefits, including reducing eczema prevalence.

KW - allergy and immunology

KW - dermatology

KW - occupational health

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U2 - 10.1136/oemed-2023-108950

DO - 10.1136/oemed-2023-108950

M3 - Article

C2 - 37797979

AN - SCOPUS:85175260198

SN - 1351-0711

VL - 80

SP - 564

EP - 571

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

IS - 10

ER -

Exploration of associations between occupational exposures and current adult eczema

Abstract

Keywords

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