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Int Arch Occup Environ Health. 2008 Aug;81(8):1059-64. doi: 10.1007/s00420-008-0300-x. Epub 2008 Feb 1.

Tertiary individual prevention of occupational skin diseases: a decade's experience with recalcitrant occupational dermatitis.

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  • 1Department of Dermatology, Faculty of Human Sciences, University of Osnabrueck, Osnabrueck, Germany. cskudlik@uos.de



If employees are threatened to loose their job due to a severe occupational skin disease (OSD), intensive interdisciplinary measures of tertiary individual prevention (TIP) are required. TIP comprises 2-3-weeks in-patient treatment plus intensive health-pedagogic counseling, and consecutive 3-weeks out-patient treatment by the local dermatologists. Each patient (pt) will stay off work for a total of usually 6 weeks to allow full barrier-recovery.


All 1,486 TIP-pts from various high-risk-professions, treated in our institution in the period 1994-2003, were followed up 1 year after the TIP by a standardised questionnaire, which was returned by 1,164 (78%) pts.


Seven hundred and sixty-four (66%) of the responding 1,164 TIP-pts had successfully remained in their (risk-)professions. It could be demonstrated that to remain in the workplace was dependent on the individual motivation to use skin protection (P < 0.001), the provision of skin protection by the employer (P < 0.001), (higher) age of pt (P < 0.001) and the duration of continued out-patient-treatment by the local dermatologist (P < 0.001). However, there were no significant differences concerning the likelihood of successful job-continuation in the various high-risk-professions, e.g. hairdressers, nurses, metal-workers, food handlers, construction-workers.


The obtained data from TIP reveal remarkable pertinent options for interdisciplinary pt-management in severe OSD in all risk-professions.

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