Reporting of self-reported hand eczema as an occupational disease in hospital cleaners: A cross-sectional questionnaire-based study

BACKGROUND: Hand eczema (HE) is a prevalent disease among professional cleaners.

OBJECTIVES: To investigate how often cleaners have their self-reported HE, induced or worsened by cleaners' occupational activities, reported as an occupational disease to the authorities in Denmark and to identify reasons for underreporting. In addition, consultation by physicians and treatment for HE among cleaners were also investigated.

METHODS: This cross-sectional questionnaire-based study included hospital cleaners at three different hospitals in Region Zealand, Denmark.

RESULTS: We included 224 out of 234 cleaners from three hospitals (response rate: 96%). The lifetime prevalence of self-reported HE with onset in adulthood was 18.3% (n = 41), with cleaners believing every case to be caused or exacerbated by their occupation. Only 9.7% (n = 4/41) of the cases were reported as an occupational disease to the authorities. The most common reasons for non-reporting were a lack of perceived seriousness of the disease (40.5%) and unawareness of the risk of self-reported HE being of occupational origin (32.4%). Remarkably, only 75.7% (n = 28/37) of workers with unreported cases had consulted a physician at some point. Additionally, among cleaners who self-reported HE attributed or aggravated by their occupation, but not officially reported as such, only 56.8% (n = 21/37) had ever used hand moisturisers, while less than 45% had ever used topical steroids or calcineurin inhibitors.

CONCLUSION: Our findings reveal substantial underreporting of self-reported HE, perceived to be induced or worsened by the cleaner's occupational activities, as an occupational disease to the authorities.