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Objectives: To update and extend the examination of cancer incidence in a cohort of Danish firefighters, now adding 7 years of follow‐up and 2766 additional firefighters. The primary focus was directed toward cancer sites that recently contributed to the hazard evaluation conducted by the International Agency for Research on Cancer (IARC). Methods: The updated cohort consisted of 11,827 male Danish firefighters who were followed up for cancer from 1968 to 2021. Cohort cancer morbidity was compared with a working population reference group, and standardized incidence ratios (SIR) were used for estimation of relative risks, along with 95% confidence intervals (95% CI). Results: Among full‐time firefighters, SIR of skin melanoma was 1.30 (95% CI: 1.02–1.66), and SIR = 1.37 (95% CI: 1.02–1.85) for over 5 years of employment. Slightly positive associations were also observed for cancer of the urinary bladder (SIR = 1.16; 95% CI: 0.93–1.45), prostate (SIR = 1.11; 95% CI: 0.97–1.28), and testis (SIR = 1.11; 95% CI: 0.75–1.63). Conclusions: This updated study provides evidence indicating an elevated risk of skin melanoma in firefighters. Consistent with IARC's evaluation, we also identified positive associations for urinary bladder, prostate, and testis cancer. In contrast, our findings did not suggest an increased risk of colon cancer, non‐Hodgkin lymphoma, and mesothelioma. The latter may be due to small numbers in our still relatively young cohort. Continuous follow‐up for cancer in firefighters is warranted, including assessment of influence from surveillance bias. [ABSTRACT FROM AUTHOR]

Background: The accuracy of self‐reported hand eczema (HE) is currently unclear, and it is unknown how well self‐reported signs and symptoms of skin lesions that indicate HE correlate with self‐reported HE. Objectives: To correlate self‐reported signs and symptoms of skin lesions on the hands with self‐reported HE, to assess the sensitivity and specificity, and to suggest a definition for HE. Method: Seven hundred ninety‐five (47.8%) of 1663 invited healthcare workers completed a digital questionnaire, and were asked to report if they experienced HE or any of the following skin signs/symptoms in past 11 months: scaling, erythema, fissures, vesicles, dryness, itch, stinging. Results: HE during the past 11 months was reported by 11.9%. Of these, 91.4% reported at least one skin sign versus 32.3% of those without self‐reported HE. The highest sensitivity and specificity were found for erythema (77.4% and 78.2%, respectively) and itch (78.5% and 78.6%, respectively), both separately and combined. The combination of ≥2 signs (erythema, scaling, fissures and vesicles) and itch, reached a sensitivity of 52.7% and specificity of 93.9%. Conclusion: The marked difference between self‐reported HE and signs/symptoms highlights the importance of differentiating between data based on self‐reported HE and signs/symptoms. As a first step towards diagnostic HE criteria, ≥2 signs combined with itch could be considered, but clinical studies are needed to verify the precision. [ABSTRACT FROM AUTHOR]

Background: Hand eczema (HE) is common in health care workers (HCWs). During the last decade, new recommendations have supported increased use of alcohol‐based hand rub (ABHR) to partially replace hand washings to lower the prevalence of HE. However, newer data on this recommendation is lacking. Objectives: To assess current 1‐year prevalence of HE in HCWs, to investigate exposure, and the extent of subjective discomfort to hand washings and ABHR. Methods: A digital questionnaire was sent to 4876 HCWs from April to May 2020. Results: Of 2125 respondents (1779 women, 346 men), 14.7% reported HE within the last year. In total, 9.1% reported >20 hand washings per shift and 76.0% reported ABHR use >20 times per shift. HE was significantly associated with hand washings (adjusted odds ratio [OR] 1.73 [95% confidence interval [CI] 1.26‐2.36]) and glove use on wet skin (adjusted OR 1.99 [95% CI 1.27‐3.12]). Subjective discomfort to ABHR was reported significantly more often than to hand washings (P <.001) and significantly more often in HCWs with HE than in those without HE (P <.001). Conclusions: The current 1‐year HE prevalence in HCWs of 14.7% was lower than in previously reported Scandinavian data. HE was related to frequent hand washings, as previously reported, and to glove use on wet skin, which is a possible risk factor for HE that should be further explored. [ABSTRACT FROM AUTHOR]

Background: Sickness absence in hand eczema patients has been associated with stress rather than disease severity, indicating that personal aspects regarding hand eczema should be investigated further. Objectives: To examine whether patient education vs treatment as usual can influence behaviour and knowledge regarding skin protection and care, as well as personal resources, in patients with occupational hand eczema. Methods: PREVEX is an individually randomized clinical trial investigating the 1‐year effects of a simple, low‐cost group‐counselling programme vs treatment as usual for patients with notified occupational hand eczema. Exploratory outcomes were behaviour, knowledge, self‐efficacy, and self‐evaluated skin care ability. Results: In total, 1668 patients with notified occupational skin disease were invited to participate, of whom 769 were randomized and 756 were analysed: intervention group (n = 376) vs control group (n = 380). Behaviour was improved and the knowledge score increased in the intervention group as compared with the control group (respectively: estimate 0.08; 95%CI: 0.02‐0.19; P = .01; and estimate 0.49; 95%CI: 0.28‐0.70; P < .001). Self‐efficacy was lower in the intervention group as compared with the control group (estimate −0.78; 95%CI: −1.25 to −0.30; P = .001). No difference was found regarding skin care abilities. Conclusions: The intervention had a positive influence on 1‐year behaviour and knowledge, but was insufficient to result in long‐term positive changes in personal resources regarding dealing with hand eczema. [ABSTRACT FROM AUTHOR]

Background Hairdressers are at risk of developing occupational contact dermatitis because of their intense contact with wet work in combination with chemicals. Objectives To perform an analysis of a cohort study of hairdressers with occupational contact dermatitis recognized in the period 2006-2011, focusing on individual and environmental factors associated with the disease. Methods The study was a descriptive, register-based survey including all hairdressers with recognized occupational contact dermatitis in Denmark in the period January 2006 to September 2011. Data were obtained from the Danish National Board of Industrial Injuries. Results The study comprised 381 patients (373 women and 8 men). The median age was 25 years, 64.8% were apprentices, and 35.2% were fully trained hairdressers. The prevalence of atopic dermatitis was 36.0%, and was significantly higher among apprentices than among fully trained hairdressers (44.9% and 19.4%, respectively) ( p < 0.001). Of the patients, 48.3% had their dermatitis recognized as occupational irritant contact dermatitis, 46.7% had their dermatitis recognized as as occupational allergic contact dermatitis or combined allergic and irritant contact dermatitis, and 5.0% were recognized as having occupational contact urticaria. Conclusion The low median age, the high percentages of atopic dermatitis in apprentices and the fact that more apprentices than fully trained hairdressers had recognized occupational contact dermatitis underlines the importance of early prevention. [ABSTRACT FROM AUTHOR]

Background: Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness.Case Report: Four of seven staff members in an emergency department became acutely ill with nonspecific symptoms. After uneventful observation they were discharged, but symptoms worsened at reassembly for debriefing. Poisoning with hydrogen sulfide was suspected, and the victims were transferred by helicopter for hyperbaric oxygen (HBO) treatment. During the following 9 days, 14 possible poisoning victims were identified, 6 of whom were transferred for HBO. After hospital stays with repeated HBO treatment and examinations without identification of significant physical disease, the majority of the 10 HBO-treated victims remained symptomatic, some on prolonged sick leave. The ward was closed for several weeks during comprehensive but negative investigations for toxic chemicals. Clinical data and lack of indication of chemical exposure, together with an attack pattern with only some individuals becoming ill in a shared environment, suggest MPI. Iatrogenic influence from dramatic intervention was probably a strong driving force in the outbreak. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Awareness of MPI may prevent unnecessary and potentially harmful treatment as well as improve health care resilience, particularly with respect to preparedness. Outbreaks of illness in a group of symptomatic victims without indication of significant physical disease should be managed by observation and limited intervention. [ABSTRACT FROM AUTHOR]