"In this population-based study, all atopic diseases, not only atopic dermatitis, were found as individual risk factors for HE. In addition, female gender, obesity and mold exposure increased the risk of HE," lead study author Marjut Koskelo, MD, and her colleagues at the University of Oulu in Finland write in Contact Dermatitis.
"Parental allergy was also a risk factor of offspring's HE. Moderate or high physical activity as well as owning a dog appeared as protective factors of HE. No association was found between other lifestyle factors and HE," they add.
Hand eczema is one of the most common skin disorders and is the most common occupational skin disease, the authors write. Many risk factors, including atopic dermatitis, are known to be linked with HE, but whether various other factors might also be linked has not been well studied.
The research team investigated the link between HE and atopic diseases, parental factors, environmental factors (exposure to mold, keeping animals), and lifestyle factors (physical activity, obesity, tobacco and alcohol use).
They analyzed data of people who took part in the Northern Finland Birth Cohort 1966 Study. The data, collected since 1965, includes details about 12,055 mothers in northern Finland who were expected to deliver babies in 1966, and their 12,058 live-born children. The children have been followed over the years with questionnaires and clinical examinations, and their parents have been followed by national registers and medical reports.
For the 46-year follow-up, 6830 respondents aged 45 to 46 years, roughly half of them women, completed a 132-question form covering physical health, lifestyle, environmental factors, socioeconomic status, and history of hand eczema and other atopic diseases.
In the statistical analysis, the researchers adjusted for atopic dermatitis, asthma, allergic rhinoconjunctivitis, education level, body mass index (BMI), maternal BMI, parental allergy, physical activity, living on a farm, and mold exposure and symptoms.
Of the 900 respondents who reported having had HE: 592 (65.8%) were women and 308 (34.2%) were men (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.49 - 2.0).
Various Factors Linked With Hand Eczema Risk
The authors found that:
Atopic diseases and HE were linked: atopic dermatitis (adjusted odds ratio [aOR], 9.66; 95% CI, 8.03 - 11.66), asthma (aOR, 1.38; 95% CI, 1.12 - 1.71), and allergic rhinoconjunctivitis (aOR, 1.28; 95% CI, 1.04 - 1.56). Sex did not affect the link between atopic diseases and HE
Respondents who reported visible mold or mold odor in their apartment had higher risk for HE than those without a history of mold exposure (OR, 1.32; 95% CI, 1.07 - 1.61)
Obesity was linked with HE (OR, 3.44; 95% CI, 1.05 - 22.8), but smoking status, alcohol intake, and education level were not statistically significant risk factors for HE
Participants who reported moderate or high physical activity had lower risk for HE (OR, 0.78; 95% CI, 0.64 - 0.94; and OR, 0.56; 95% CI, 0.33 - 0.91, respectively) than those who were less active
Parental allergy increased risk for HE (OR, 1.98; 95% CI, 1.70 - 2.30); as maternal age, BMI, and menarche age increased, so did the risk for the child's HE, but the increases were not statistically significant; and no significant links were found between maternal tobacco smoking, parental asthma, birth weight, parity, gestational age, and HE
Dog owners had less risk for HE than people without a dog (OR, 0.83; 95% CI, 0.71 - 0.97); links between cat or farm animal owners and HE were not significant
"There is a strong association between hand eczema and atopic diseases," Maya Jonas, MD, a clinical assistant professor of dermatology at The Ohio State University Wexner Medical Center in Columbus, Ohio, told Medscape Medical News in an email.
"When evaluating patients with hand eczema, it is important to ask if they have a history of atopic dermatitis, asthma, or allergic rhinitis," said Jonas, who was not involved in the study.
Elma Baron, MD, professor and director, Skin Study Center, Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio, was surprised by the inverse link between physical activity and HE.
"What struck me as interesting is the inverse association between hand eczema and physical activity, that greater physical activity will decrease the risk for hand eczema," she said in a phone interview. "It's an interesting finding that's worth exploring.
"Dermatologists have also speculated about the association with the female gender, because women are more likely to be in situations that involve frequent hand washing or in occupations, such as hairdressing, that involve known irritants and allergens," added Baron, who also was not involved in the study.
The main weakness, she noted, is the reliance on self-reported diagnosis. "Hand eczema is a common condition, but the etiologies of reported hand eczema may vary."
"Being cognizant of these associations can help us prescribe appropriate medications and advise patients about how they can avoid exposures that will aggravate their condition," Baron advised.
The authors recommend further related studies.
The authors, Jonas, and Baron report no relevant financial relationships. The study was not funded.
Contact Dermatitis. Published online August 18, 2022. Full text.
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Cite this: Many Factors Linked With Higher, Lower Risk for Hand Eczema - Medscape - Sep 07, 2022.