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Objective Albeit a pivotal risk for the development of hand eczema (HE), the exposure-response relationship between wet work and HE remains to be further investigated. Knowledge on exposure-response is important regarding preventive measures, medico-legal regulations and job-counseling. Recently, a job-exposure matrix (JEM) for wet work was developed, providing information on the likelihood of wet work. By combining the JEM with data on HE we aimed to investigate the relationship between extent of wet work and HE. Methods This study is a case-referent study including patients registered in the National Database of Contact Allergy, Denmark, and comprises data on sex, age, atopic dermatitis, HE, face eczema and patch testing results. Patients with HE served as cases and patients with facial eczema served as referents. Information on profession was retrieved from the DOC*X database in accordance with the DISCO-88 classification system. A wet-workspecific JEM provides - for each profession - an estimate for (i) the likelihood of wet work lasting ≥2 hours/day and (ii) the average number of hours of wet work per day. Results After two hours of wet hands and glove wear, the odds ratio (OR) was 3.49 and 3.19, respectively, for females and 2.41 and 1.82, respectively, for males. Females had a higher risk of HE than males with probability of wet hands <75% (OR 2.34, 95% CI 2.12-2.58 compared to males 1.68, 95% CI 1.22-2.31) and regarding glove wear at all exposure levels. Conclusion Our data confirms a close association between wet work and HE. Exposure lasting less than the current definition of wet work (having wet hands for ≥2 hours per day) may be of importance. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to create a job-exposure matrix (JEM) for wet work. A JEM is a tool used to assess exposure to potential health hazards in occupational epidemiological studies. It can be used when counselling concerning job change/job choice, as a medico-legal tool when recognizing diseases as occupational and when planning interventions regarding prevention of, in this case, occupational hand eczema. Methods: The study population was based on results from national surveys on working environment performed by the National Research Centre for the Working Environment in Denmark in 2000, 2005, and 2010 (National Research Centre for the Working Environment). We assessed responses on questions regarding wet hands, glove wear and total wet work. For the JEM a cutoff of 2 h total wet work/day was chosen as the exposure measurement. The proportion of responses of 2 h total wet work/day in each profession is illustrated as a number between 0 and 1 equal to 0–100% of the responses. Results: Total wet work was most frequent among cleaners (domestic, office, and hotel cleaning), butchers and fishmongers, cooks, beauticians (hairdressers, barbers, related work) and health care workers (home-based personal workers, dentists, dental assistants). Regarding differences between sexes we found that indifferent of age and profession, women had 78% higher odds of having wet work. Conclusion: We found that wet work as an exposure varies among professions depending on whether wet hands or glove wear is assessed. A JEM is a useful tool to assess the extent of the exposure, wet work, independent of prior perceptions of classical wet work professions. [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 Skin diseases are the most commonly recognized occupational diseases in Denmark, and occupational contact dermatitis (OCD) comprises ∼95% of all cases. Objectives To prevent occupational contact dermatitis, it is important to specifically identify exposures and work routines related to outbreak of the disease. The aim of this study was to give an overview of exposures for patients with occupational contact dermatitis in Denmark in 2010, and relate this to line of work and disease severity. Material and methods The study was a descriptive, register-based study including patients with recognized occupational contact dermatitis in Denmark in 2010. Data were obtained from the National Board of Industrial Injuries in Denmark, and comprised information about the skin disease as well as the occupation/industry of employment and exposures. Results One thousand five hundred and four patients, 1020 women and 484 men, were included in the study. Irritant contact dermatitis accounted for 70% of all cases; 68% of these were caused by wet work. Forty-six per cent of all patients were employed either in the healthcare sector, in cleaning, or as kitchen workers. Among contact allergies, the most common were to rubber additives from gloves and epoxy in patients employed in the windmill industry. Conclusion The data are important for planning preventive efforts in the future. The workers in the healthcare sector, kitchen workers and cleaners constitute almost half of all cases, and future preventive efforts should be directed at these occupations. [ABSTRACT FROM AUTHOR]

Background The incidence of occupational hand eczema is approximately 0.32 per 1,000 person years. The burden of the disease is high, as almost 60% has eczema-related sick leave during the first year after notification, and 15% are excluded from the workforce 12 years after disease onset. New treatments and prevention strategies are needed. Methods/design Trial design: The PREVEX trial is a randomised, parallel-group, superiority trial. Participants: All individuals from the Capital Region of Denmark and Region Zealand with a suspected occupational skin disorder notified to the National Board of Industrial Injuries between June 2012 and December 2013 are invited to participate in the trial. Inclusion criteria are: self-reported hand eczema and informed consent. Exclusion criteria are: age <18 years or >65 years; permanent exclusion from the workforce; inability to understand the Danish language; any serious medical condition; and lack of written informed consent. We plan to randomise 742 participants. Interventions: The experimental intervention is an educational course in skin-protective behaviour and written information about skin care related to their specific occupation. Also, a telephone hotline is available and a subgroup will be offered a work-place visit. The experimental and the control group have access to usual care and treatment. All participants are contacted every eighth week with questions regarding number of days with sick leave or other absence from work. 12 months after randomisation follow-up is completed. Objective: To assesses the effect of an educational course versus treatment as usual in participants with newly notified occupational hand eczema. Randomisation: Participants are centrally randomised according to a computer-generated allocation sequence with a varying block size concealed to investigators. Blinding: It is not possible to blind the participants and investigators, however, data obtained from registers, data entry, statistical analyses, and drawing of conclusions will be blinded. Outcomes: The three co-primary outcomes, assessed at 12 months, are: total number of selfreported days with sick leave; health-related quality of life; and subjective assessment of hand eczema severity. Explorative outcomes are: self-reported eczema-related sick leave, absence from work registered by the DREAM-register and by self-report, risk behaviour, knowledge of skin protection and performance management (self-efficacy; and self-evaluated ability to self-care). Discussion The PREVEX trial will be the first individually randomised trial to investigate the benefits and harms of group-based education in patients with newly notified occupational hand eczema. [ABSTRACT FROM AUTHOR]

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., (© 2024 Wiley Periodicals LLC.)

Per- and polyfluorinated alkyl substances (PFAS) are a group of man-made extremely persistent chemicals that have been spread worldwide since the 1950s due to their properties as effective water- and grease-repellent and heat- and temperature-resistant. They are associated with an increasing number of health effects including immune and hormonal disturbances and some types of cancer. We present a review of PFAS pollution in Denmark, the current human exposure, suspected health effects, and patient management in environmental medicine., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Background: Polychlorinated biphenyls (PCBs) are biopersistent chemicals classified as human carcinogens. This classification is primarily based on evidence on higher-chlorinated PCBs found in food. The carcinogenic potential of airborne lower-chlorinated PCBs remains largely unexplored., Objectives: We aimed to investigate cancer risk following residential exposure to airborne PCBs., Methods: Cancer risk was examined in the Health Effects of PCBs in Indoor Air (HESPAIR) cohort of 38,613 residents of two partly PCB-contaminated residential areas in Greater Copenhagen, identified by nationwide registries. PCB exposure was based on relocation dates and indoor air PCB measurements in subsets of apartments. Cancer diagnoses were extracted from the Danish Cancer Registry for the follow-up period of 1970-2018. We estimated adjusted hazard ratios with time-varying cumulative exposure and a 10-y lag using Cox regression., Results: Overall risk of cancer was not associated with PCB year , [hazard ratio (HR) for high-exposed vs. low-exposed = 0.98 ; 95% confidence interval (CI): 0.88, 1.09], but residents exposed to ≥ 3,000  ng / m 3 PCB × year had higher risk of liver cancer (HR = 2.81 ; 95% CI: 1.28, 6.15) and meningiomas (HR = 3.49 ; 95% CI: 1.84, 6.64), with indications of exposure-response relationships. Results were suggestive of a higher risk of pancreatic cancer (HR = 1.59 ; 95% CI: 0.95, 2.64) at the highest aggregated PCB level. For testis cancer, a higher risk was observed among residents exposed to 300 - 949   ng / m 3 PCB × year relative to residents exposed to < 300  ng / m 3 PCB × year (HR = 2.97 ; 95% CI: 1.41, 6.28), but the risk was not higher for residents exposed to ≥ 950  ng / m 3 PCB × year . Apart from this, the risk of specific cancers was similar across exposure groups., Discussion: In this, to our knowledge, first population-based cohort study of residential exposure to airborne PCBs, we found no association between exposure to PCBs in indoor air in private homes and the risk for most of the specific cancers. Higher risk of liver cancer and meningiomas were observed. https://doi.org/10.1289/EHP10605.

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., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: Due to the long lag-time for health outcomes, historical asbestos exposure measurements are valuable to support assessments of associated occupational health effects, and also to assess time trends and effects of preventive measures., Methods: Different sources of stored data were collated, assessed and refined to create a harmonized database on historical asbestos fibre concentrations measured in specific work tasks and different industries. The final database contains 9236 asbestos measurements from Danish workplaces collected from 1971 to 1997., Results: The geometric mean of asbestos concentrations in different occupations and tasks ranged from 0.003 to 35 fibres cm -3 . Highest concentrations were registered during handling of asbestos products in the construction services during the period 1981-1997. Although all the measured asbestos exposures without the use of respiratory equipment by the worker in the period of 1971-1997 exceeded the current 8-h time-weighted average exposure limit of 0.1 fibres cm -3 , the majority of samples collected in the earlier period of 1971 to 1980 did not exceed the exposure limit of 2 fibres cm -3 , which was in place at the time. All exposure data obtained from 1980 and onwards were found to be one seventh of the mean fibre concentrations in the previous measurement period. The impact of time shows a clear exponentially decreasing trend-line., Conclusions: Despite limitations in coverage of different occupations and tasks associated with the inventoried historical asbestos measurements, the data are helpful to identify specific work scenarios within an industry, where relatively high asbestos exposure levels may still occur or have occurred from 1971 to 1997.

Air force ground crew personnel are potentially exposed to fuels and lubricants, as raw materials, vapours and combustion exhaust emissions, during operation and maintenance of aircrafts. This study investigated exposure levels and biomarkers of effects for employees at a Danish air force military base. We enrolled self-reported healthy and non-smoking employees (n = 79) and grouped them by exposure based on job function, considered to be potentially exposed (aircraft engineers, crew chiefs, fuel operators and munition specialists) or as reference group with minimal occupational exposure (avionics and office workers). We measured exposure levels to polycyclic aromatic hydrocarbons (PAHs) and organophosphate esters (OPEs) by silicone bands and skin wipes (PAHs only) as well as urinary excretion of PAH metabolites (OH-PAHs). Additionally, we assessed exposure levels of ultrafine particles (UFPs) in the breathing zone for specific job functions. As biomarkers of effect, we assessed lung function, plasma levels of acute phase inflammatory markers, and genetic damage levels in peripheral blood cells. Exposure levels of total PAHs, OPEs and OH-PAHs did not differ between exposure groups or job functions, with low correlations between PAHs in different matrices. Among the measured job functions, the UFP levels were higher for the crew chiefs. The exposure level of the PAH fluorene was significantly higher for the exposed group than the reference group (15.9 ± 23.7 ng/g per 24 h vs 5.28 ± 7.87 ng/g per 24 h, p = 0.007), as was the OPE triphenyl phosphate (305 ± 606 vs 19.7 ± 33.8 ng/g per 24 h, p = 0.011). The OPE tris(1,3-dichlor-2-propyl)phosphate had a higher mean in the exposed group (60.7 ± 135 ng/g per 24 h) compared to the reference group (8.89 ± 15.7 ng/g per 24 h) but did not reach significance. No evidence of effects for biomarkers of systemic inflammation, genetic damage or lung function was found. Overall, our biomonitoring study show limited evidence of occupational exposure of air force ground crew personnel to UFPs, PAHs and OPEs. Furthermore, the OH-PAHs and the assessed biomarkers of early biological effects did not differ between exposed and reference groups., (© 2021. The Author(s).)

Human health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was - 32 g (95% CI-79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose-response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy., (© 2021. The Author(s).)

Background: Concerns have been raised that a chronic course of hand eczema (HE) could be fostered by a lack of efficient treatment at an early stage., Objectives: First, to assess the prevalence of systemic treatment in patients with chronic occupational HE (OHE) and relate this to demographic data, HE severity, and atopic dermatitis (AD). Second, to explore the use of complementary and alternative medicine (CAM) in the same population., Methods: Baseline data were obtained from a registry-based study including patients with recognized OHE in a 2-year period in Denmark, comprising a total of 2703 workers. A follow-up questionnaire after 4 to 5 years included questions on disease severity and treatments., Results: A total of 1565 participants responded to the questionnaire, and of these 1203 had ongoing HE at follow-up and were included in the study. In total, 10.0% had received systemic therapy, whereas this share was 13.3% in those with self-reported moderate-to-severe HE. Age >35 years, previous or current AD, and severe eczema were factors related to use of systemic treatment. Use of CAM was reported by 6.2% of the study population., Conclusions: We suggest that chronicity of HE may be perpetuated by the lack of efficient treatment., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective Prolonged seated immobility during long-distance flights is related to an increased risk of venous thromboembolism (VTE), but little, if anything, is known about the risk related to sedentary work. The objective of this paper was to examine the risk of VTE according to sitting posture at work. Methods This prospective study includes a total of 78 936 participants from the Copenhagen City Heart Study and the Copenhagen General Population Study, all without previous thromboembolic events and aged <65 years. An assessment of the number of hours spent in sitting position at work was assigned each participant at baseline using a job exposure matrix. VTE was identified through national patient registries. Survival analyses were performed to determine the risk of VTE according to sedentary position at work with adjustment for a range of known determinants including lifestyle and coagulation factors. Results During the follow-up period of 582 411 person years (mean follow-up, 7.4 years) 911 participants experienced their first VTE event. Multivariable adjusted analyses showed no difference in risk of VTE between occupational sitting ≥6.5 hours/day and occupational sitting ≤3.5 hours/day (hazard ratio 1.11, 95% confidence interval 0.92-1.34). Conclusion This study does not support the hypothesis that sedentary work is a risk factor for VTE in the general population. Whether certain occupations with particularly high exposure to immobilized sitting positions are associated with thromboembolic events is not addressed.

Purpose: Wet work is the most important exposure leading to occupational hand eczema; however, the prevalence and character of wet work in various wet work professions remain not fully covered. Self-reported data are widely used in studies of wet work although the validity of these remains uncertain. The objective of the present study is to provide information on validity of self-reported wet work exposure in different professions by comparing work place observations with self-reported data., Methods: 114 workers from 15 various wet work professions were observed. The observations covered duration and frequency of wet work activities. The observed population as well as a non-observed population from each work place were given a questionnaire covering the same wet work activities., Results: Correspondence analysis between self-reported and observed wet work showed that misclassification was larger regarding duration than frequency. 29.2% overestimated and 23.9% underestimated total wet work with more than 2 h/day. Professions with high wet work prevalence overestimated duration of wet work activities, but underestimated frequency. Females overestimated frequency, but not duration. The observed group (45%) significantly more often, than the non-observed group (32%), reported having more than 2 h of wet work/day (OR 2.8, 95% CI 1.6-4.9). Sensitivity and specificity of the questionnaire regarding total wet work in the observed population showed 51% sensitivity and 59% specificity., Conclusion: Over- and underestimation of wet work were found to be equally distributed. The correspondence analyses illustrate a noticeable misclassification between the estimations and the observations on all wet work variables, but largest for total wet work.

Objective: Firefighters are exposed to numerous respiratory hazards, but large studies on the risk of pulmonary disease are scarce. The objective of this study was to examine incidence of asthma and chronic obstructive pulmonary disease (COPD) in a nationwide cohort of Danish firefighters., Methods: We used individual historical employment records on 11 968 Danish male firefighters primarily supplied by trade unions and fire agencies. Furthermore, we used the Supplementary Pension Fund Register to form an occupational reference group consisting of military employees. Information on respiratory incidence was retrieved from the nationwide Danish National Patient Registry. Age and calendar time standardised incidence ratio (SIR) and Poisson regression analyses (incidence rate ratio) were used for estimation of risks, including 95% CIs., Results: Compared with military employees, the overall age and calendar-time adjusted risk for asthma was significantly increased among full-time firefighters (SIR=1.58, 95% CI 1.32 to 1.88), but not among part-time/volunteer firefighters. Full-time firefighters' risk for asthma did not vary by duration of employment. No consistent evidence of an increased risk for chronic obstructive pulmonary disease was detected., Conclusion: Danish firefighters have an increased risk of asthma, but the causes, whether occupational or not, remain to be established., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: Firefighters are exposed to multiple cardiovascular hazards, but few epidemiological studies have addressed their cardiovascular morbidity. The objective of this study was therefore to examine the incidence of cardiovascular diseases (CVD) in Danish firefighters., Methods: We used individual historical employment records on 11.691 male Danish firefighters supplied by trade unions and fire agencies. The Supplementary Pension Fund Register was used to establish two occupational reference groups (a random sample from the male employed population and military employees). Information on CVD incidence was retrieved from the nationwide Danish National Patient Registry. SIRs and Poisson regression analyses (incidence rate ratio) were used for estimation of risks, including 95% CIs., Results: In comparison with the population sample, the age-adjusted and calendar time-adjusted SIR for all CVDs combined was increased in firefighters (SIR=1.10, 95% CI 1.05 to 1.15). The risk was also elevated for the most frequent outcomes, including angina pectoris (SIR=1.16, 95% CI 1.08 to 1.24), acute myocardial infarction (SIR=1.16, 95% CI 1.06 to 1.26), chronic ischaemic heart disease (SIR=1.15, 95% CI 1.06 to 1.24) and atrial fibrillation/flutter (SIR=1.25, 95% CI 1.14 to 1.36). This analysis showed the most elevated SIRs for CVD in full-time firefighters compared with part-time/volunteer firefighters. Both types of firefighters employed <15 years had an increased risk of CVD. Similar risk patterns appeared in comparisons with the military. Internal analysis supported external findings., Conclusion: The risk of overall CVD, including the most frequent subtypes was modestly increased in Danish firefighters and was most elevated in full-time firefighters compared with other male employees., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Skin disorders accounted for one third of all recognised occupational diseases in Denmark in 2010. Wet work is a risk factor for the development of occupational hand eczema. The consequences of occupational hand eczema include sick leave, loss of job and impaired quality of life., Objectives: The aim of the present study was to investigate exposures related to cleaning and the effect of an evidence-based educational intervention on the prevention of hand eczema among hospital cleaners., Patients/materials/methods: The intervention consisted of a 1 hr course in hand protective behaviour. All full-time cleaners working at Bispebjerg Hospital in January 2013 were invited to participate. The outcome measures were self-reported skin behaviour, exposures, knowledge of skin protection and hand eczema severity index (HECSI)., Results: One hundred and five cleaners were invited to participate, of these 86 (82%) were included. At follow-up after 3 months there was a shift towards fewer daily hand washings and hand disinfections (p < 0.001 and p = 0.001 respectively). The number of correct answers to the knowledge questions rose from 6.3 to 7.3 (p = 0.006). The mean HECSI score decreased from 2.8 to 1.8 at follow-up (p = 0.002)., Conclusions: Data indicates a positive effect of a low-cost on-site educational intervention for hospital cleaners., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The incidence of occupational hand eczema is approximately 0.32 per 1,000 person years. The burden of the disease is high, as almost 60% has eczema-related sick leave during the first year after notification, and 15% are excluded from the workforce 12 years after disease onset. New treatments and prevention strategies are needed., Trial Design: The PREVEX trial is a randomised, parallel-group, superiority trial., Participants: All individuals from the Capital Region of Denmark and Region Zealand with a suspected occupational skin disorder notified to the National Board of Industrial Injuries between June 2012 and December 2013 are invited to participate in the trial. Inclusion criteria are: self-reported hand eczema and informed consent. Exclusion criteria are: age <18 years or >65 years; permanent exclusion from the workforce; inability to understand the Danish language; any serious medical condition; and lack of written informed consent. We plan to randomise 742 participants., Interventions: The experimental intervention is an educational course in skin-protective behaviour and written information about skin care related to the participants' specific occupation. Also, a telephone hotline is available and a subgroup will be offered a work-place visit. The experimental and the control group have access to usual care and treatment. All participants are contacted every eighth week with questions regarding number of days with sick leave or other absence from work. 12 months after randomisation follow-up is completed., Objective: To assesses the effect of an educational course versus treatment as usual in participants with newly notified occupational hand eczema. Randomisation: PARTICIPANTS are centrally randomised according to a computer-generated allocation sequence with a varying block size concealed to investigators. Blinding: It is not possible to blind the participants and investigators, however, data obtained from registers, data entry, statistical analyses, and drawing of conclusions will be blinded., Outcomes: The three co-primary outcomes, assessed at 12 months, are: total number of self-reported days with sick leave; health-related quality of life; and subjective assessment of hand eczema severity. Explorative outcomes are: self-reported eczema-related sick leave, absence from work registered by the DREAM-register and by self-report, risk behaviour, knowledge of skin protection and performance management (self-efficacy; and self-evaluated ability to self-care)., Discussion: The PREVEX trial will be the first individually randomised trial to investigate the benefits and harms of group-based education in patients with newly notified occupational hand eczema., Trial Registration: ClinicalTrials.gov Identifier: NCT01899287.

Introduction: Skin cancer may, in some cases, be caused by occupational exposures. The aim of this study was to investigate the prevalence of and exposures leading to occupationally induced skin cancers in Denmark during a ten-year period., Material and Methods: The study is a descriptive, register-based study comprising all patients with recognized occupational malignant and premalignant skin conditions in Denmark in the 01/01 2000-31/12 2009 period. Data were obtained from The National Board of Industrial Injuries and comprise information about diagnosis, occupational and domestic exposure, anatomic localization, occupation, degree of permanent disability, age and sex., Results: A total of 36 patients were recognized as occupational skin cancer cases. The mean age was 61 years (44-75 years), 31 men and five women. The most frequent diagnosis was basal cell carcinoma followed by squamous cell carcinoma. No cases of malignant melanoma were recognized. The primary risk factor for development of occupational skin cancer was ultraviolet (UV) exposure during outdoor working., Conclusion: Data based on recognized cases of occupational skin cancer during a ten-year period in Denmark show that non-melanoma skin cancer was the most frequent diagnosis, while the primary risk factor was UV radiation in outdoor occupations. A total of 36 cases were reported over a period of ten years, and underreporting may be suspected. The purpose of the present study was to raise the awareness of occupational skin cancer, and on the basis of existing data to contribute to criteria for the diagnosis of occupational skin cancer., Funding: not relevant., Trial Registration: not relevant.

Twenty-four congeners of polychlorinated biphenyls (PCBs) were measured in 83 air samples and 20 elastic sealants samples of apartments with PCB-containing sealants. In addition, PCBs were measured in 21 air samples from reference apartments located in an uncontaminated section of the same estate. The PCB(tot) levels in the air of the contaminated section were 168-3843 ng m(-3) (mean: 1030 ng m(-3)), while the mean levels in the reference apartments were 6.03 ng m(-3). The sum of the 24 measured PCB congeners in sealants from the contaminated section was 187-221680 mg kg(-1). Principal component analysis revealed four groups among the sealant samples with different congener compositions, only two of which were clearly similar to known PCB mixtures, while two were not. Significant correlations and intercorrelations were observed between the lower chlorinated congeners in air and sealant, e.g. for PCB 28(air) and 28(seal) (p=0.04) and for PCB 28(air) and 52(air), 52(seal). However, no correlation was observed between the lower chlorinated congeners and the sums of PCB (∑PCB(6) or ∑PCB(24)) or the higher chlorinated congeners. Analysis of air concentrations in relation to questionnaire data indicated that the indoor air levels could be reduced by increased cleaning and airing frequencies., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: To investigate the interaction of smoking and history of long-term occupational exposure to organic solvents on the prevalence of chronic bronchitis (CB) among middle aged and elderly men., Methods: A questionnaire on health, lifestyle, and working conditions, and a clinical examination including measurements of height, weight, and peak-flow. Self-reported occupational solvent exposure for 5 years or more was compared to never exposed. Three thousand two hundred eight men aged 63 +/- 10 years were included., Results: Four hundred sixty one men had CB (14.4%). Current smoking and the interaction of smoking and long-term occupational exposure to organic solvents (> 5 years) were the factors most strongly associated with prevalence of CB. In the solvent exposed group odds ratio for CB was 7.0 (95% confidence interval [CI]: 3.4 to 14.5) comparing current smokers with non-smokers against only 3.7 (95% CI: 2.8 to 4.8) in the nonexposed group, also after control for potential confounders. Among nonsmokers only, long-term exposure to organic solvents was not associated with an increased prevalence of CB., Conclusion: Current or previous occupational exposure to organic solvents doubles the smoking related risk of CB, probably due to an additional irritative effect in the alveolar and bronchial mucosa.

Essential oils are used widespread by the Danish population. In Denmark a severe case of poisoning from anis oil has occurred.

The occurrence of non-specific low back pain (LBP) in 14-16-year-old adolescents has almost reached the level in adults. Among other things, the ranges of reported prevalences are wide, owing to the use of various outcome measures, questionnaire terminology, and differences in age and gender. A review of the literature points out some important possible risk factors for LBP: minimal physical activity, intensive sports, genetics, psychosocial factors, smoking and leisure-time activities with a high physical impact. However, the causal relations are not clear, and the morbidity related to non-specific LBP in adolescents has not yet been elucidated. Few intervention studies have been published, and the means of prevention have not yet been found. Research in LBP in adolescents deserves a high priority in the future to provide evidence for a relevant prevention strategy.