Rehabilitation program combats occupational skin disease

By Helen Albert, Senior medwireNews Reporter

Results from a German study suggest that a 6-10 week rehabilitation program set up to help people overcome severe occupational skin disease (OSD) continues to have significant benefits for participants 1 year after discharge.

The researchers, led by Elke Weisshaar (University of Heidelberg, Germany), found that 1617 individuals who participated in the tertiary individual prevention (TIP) rehabilitation program had significantly reduced OSD severity, use of topical corticosteroids, and number of days absent from work because of OSD.

Quality of life (QoL) was also significantly improved by the intervention, and 87.4% of the participants had returned to work and remained part of the workforce at 1 year.

"OSD is the most common occupational disease in industrial countries, and is associated with substantial reductions in QoL, negative prognosis, and a considerable socio-economic burden," write Weisshaar and team in Contact Dermatitis.

To combat the problems posed by OSD, the TIP rehabilitation system was set up in Germany. It consists of a 3-week inpatient phase, during which patients undergo dermatologic and allergy assessment and treatment, as well as education and counseling. Second, a 3-week post-inpatient phase, during which patients remain absent from work with a view to establishing compete remission from their disease. And finally, a follow-up phase when the patients have returned to work, which lasted a maximum of 4 weeks in this study.

Weisshaar and colleagues evaluated whether the positive effects of the TIP program seen at 4 weeks after return to work remained at 1 year.

Of 1788 patients who had follow-up recorded at 4 weeks, 1617 also had follow-up data at 1 year.

Severity of OSD decreased significantly from a score of 2.88 at admission to 2.13 at 1 year. Similarly, patient scores on the Osnabrueck Hand Eczema Severity Index were significantly reduced from 6.35 at admission to 3.34 at 1 year.

Topical corticosteroids were being used by 88.8% of the participants at admission, but use had declined to 42.8% at 1 year. In addition, the average number of days absent from work decreased significantly by over 50% from a mean of 29.58 days at admission to 14.04 days at 1 year.

Finally, QoL, as measured by the Dermatology Life Quality Index and the Life Quality Index Occupational Dermatoses, improved from scores of 10.21 and 18.04, respectively, at admission to scores of 5.45 and 13.21 at 1 year.

While the researchers acknowledge that a randomized controlled trial "would have been desirable," they conclude that their results support the long-term efficacy of the TIP program for people with severe OSD.

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