Effectiveness of secondary prevention in metalworkers with work-related skin diseases and comparison with participants of a tertiary prevention program: a prospective cohort study.

BACKGROUND In Germany, a multi-step approach has been established to prevent work-related skin diseases (WRSD). OBJECTIVES To evaluate the effect of a secondary individual prevention program (SIP) in metalworkers with WRSD and to compare their characteristics with participants of a tertiary individual prevention program (TIP). PATIENTS AND METHODS In a prospective cohort study, metalworkers with WRSD of the hands participating either in the SIP (n=114) or in the TIP (n=83) were recruited. At baseline and at the respective follow-up 8-12 weeks after the SIP or at dismissal from the TIP (3-4 weeks later), questionnaires were completed and the severity of WRSD assessed. Saliva samples were collected for assessment of filaggrin (FLG) mutations and an explorative genome-wide association study (GWAS). RESULTS 93 (81.6%) SIP patients attended the follow-up. Disease severity was significantly reduced, while knowledge and protective behavior were significantly improved compared to baseline. Significant differences between SIP and TIP patients were found regarding duration and severity of symptoms, work absenteeism, tobacco smoking and presence of atopic dermatitis, but not regarding FLG mutations and by GWAS. CONCLUSIONS The SIP was effective in metalworkers with WRSD. Individual factors may influence the course of the disease and the need for the TIP. This article is protected by copyright. All rights reserved.