| 1. |
- Albin, Maria, et al.
(författare)
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0253 Hairdressers are occupationally exposed to ortho- and meta- toluidine
- 2014
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 71 Suppl 1, s. 32-33
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Konferensbidrag (refereegranskat)abstract
- Hairdressing work is classified as carcinogenic based on excess risk for bladder cancer. We aimed at evaluating if current hairdressers are exposed to established/suspected bladder carcinogens (aromatic amines) and indicate possible sources of exposure.
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| 2. |
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| 3. |
- Carlsson, Annica, et al.
(författare)
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Scoring of hand eczema: good agreement between patients and dermatological staff
- 2011
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Ingår i: British Journal of Dermatology. - : Blackwell Publishing Ltd. - 0007-0963 .- 1365-2133. ; 165:1, s. 123-128
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Tidskriftsartikel (refereegranskat)abstract
- Background Assessment of hand eczema in a clinical study has been achieved using a scoring system which documents extent of eczema on different areas of the hand. Objectives To investigate whether the same scoring system could be used by patients to communicate current status of hand eczema. Methods In a study of 62 patients (36 women and 26 men, age range 1975 years), the patients own assessment was compared with the assessment by a dermatologist and a dermatological nurse. Standardized information was given to the patient and the form was filled in independently by the patient, the nurse and the dermatologist, during the patients visit to the clinic. Individual area scores were summed to a total score. Results The overall agreement was good, with an interclass correlation (ICC) of 0.61 between patient and dermatologist for the total score. The ICC between nurse and dermatologist was 0.78. Differences between observers were more pronounced for the more severe cases - those with higher numerical scores as assessed by the dermatologist. There was a tendency for women and for patients over the median age of 44 years to set a lower point score than the dermatologist. The concordance of observations from individual anatomical areas was higher for fingertips and nails and lower for the palm and dorsum of the hand. Conclusions Patients are able to report the extent of hand eczema with good accuracy. Self-assessment protocols for hand eczema may well have a place in the monitoring of hand eczema extent over time.
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| 4. |
- Josefson, Anna
(författare)
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Nickel allergy and hand eczema : epidemiological aspects
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Nickel allergy is the most prevalent contact allergy and has been discussed as a possible riskfactor for hand eczema. However, hand eczema is one of the most frequently occurring skindiseases and has multifactorial origin. The aim of this thesis was to study the association between nickel allergy and hand eczema in the general population. There are only a fewpopulation-based studies previously published, that include patch testing. In addition, this thesis aimed to evaluate methods to follow the prevalence of nickel allergy.The study cohort consisted of 908 women who had been patch tested for the occurrence of nickel allergy as schoolgirls. Twenty years later, they were invited to participate in a follow-up questionnaire study. The response rate was 81%. In total, 17.6% of respondents reported handeczema after the age of 15 years and there was no statistically significant difference in the occurrence of hand eczema between those who were nickel-positive and those who were nickel negativeas schoolgirls. To further investigate possible links, another study was performed,which included a second questionnaire, a clinical investigation and patch testing. All schoolgirls from the baseline study who were still living in the area as adults were invited to participate and the participation rate was 77%. Patch test showed 30.1% nickel-positive individuals.When all participants were included in the analysis, there was no statistically significant difference between nickel-positive and nickel-negative women regarding occurrence of hand eczema. The most important risk factor for hand eczema was childhood eczema. Adjusted prevalence proportion ratio (PPR) for hand eczema after age 15 in relation to nickel patch testresults was 1.03 (95% CI 0.71--1.50) and in relation to childhood eczema 3.68 (95% CI 2.45--5.54). When women with and without history of childhood eczema were analyzed separately, the hand eczema risk was doubled in nickel-positive women without history of childhood eczema. In conclusion, the risk of hand eczema in nickel-positive women may previously havebeen overestimated. Next, the validity of self-reported nickel allergy was investigated. In the established cohort; two questions regarding nickel allergy were compared with patch test results. The validity of self-reported nickel allergy was low, and the questions regarding nickel allergy overestimated the true prevalence of nickel allergy. The positive predictive values were 59% and 60%. Another method for estimating the prevalence of nickel allergy, namely self-patch testing, was validated in the last study. In total, 191 patients from three different dermatology departments participated. The validity of self-testing for nickel allergy was adequate, with sensitivity 72%and proportion of agreement 86%.
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| 5. |
- Josefson, Anna, et al.
(författare)
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Validation of Self-testing as a Method to Estimate the Prevalence of Nickel Allergy
- 2011
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 91:5, s. 526-530
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the validity of self-patch testing for nickel allergy, in order to determine a cost-effective method for surveillance of the prevalence of nickel allergy. Population-based study including patch testing is the most reliable method to study the prevalence of allergy, but it is expensive and has logistical problems. A total of 191 dermatology patients referred to patch testing were provided with a self-test package with written instructions. The self-test was applied on the arm by the patient, on the same day that the regular patch test was applied on the back. The patient evaluated the self-test before patch test reading at the clinic. Patch test at the dermatology clinic detected 46/191 (24%) nickel-positive individuals. The sensitivity of the self-test was 72% (95% confidence interval (Cl) 57-84), the specificity 91% (95% Cl 85-95), and the proportion of agreement 86% (95% CI 81-91). Thus, in the population studied, the validity of self-testing for nickel allergy was adequate.
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| 6. |
- Josefson, Anna, et al.
(författare)
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Validation of self-testing as a method to estimate the prevalence of nickel allergy
- 2011
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Ingår i: Acta Dermato-Venereologica. - : Society for Publication of Acta Dermato-Venereologica. - 0001-5555 .- 1651-2057. ; 91:5, s. 526-530
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Tidskriftsartikel (refereegranskat)abstract
- Background: Valid epidemiological tools are required for surveillance of the prevalence of contact allergy. Population based studies including patch testing is the most reliable method, but implies heavy expenses and logistical problems. Clinical data are not representative for the general population and questionnaires concerning contact allergy have a low validity. Self-testing might be a useful method but it has to be validated and evaluated.Objectives: To investigate the validity of self-patch testing for nickel allergy. Methods: Patients from three dermatology clinics were included consecutively when referred to patch testing. In total, 191 patients participated and they were provided with a self-test package including written instructions. The self-test was applied on the arm by the patient, on the same day as the patch test was applied on the back, in the clinic. The patient evaluated the self-test before the patch test reading at the clinic.Results: Patch test at dermatology clinic (‘gold standard’) gave 46/191 (24%) nickel-positive individuals. The sensitivity of the self-test was 72% (95% CI 57–84), the specificity was 91% (95% CI 85–95) and the proportion of agreement was 86% (95% CI 81–91).Conclusions: The validity of self-testing for nickel allergy was adequate in the studied population. To determine whether self-testing is a useful tool for measuring the prevalence of nickel allergy in the general population further studies will be needed.
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| 7. |
- Josefson, Anna, et al.
(författare)
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Validity of self-reported nickel allergy
- 2010
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Ingår i: Contact Dermatitis. - Oxford : Wiley. - 0105-1873 .- 1600-0536. ; 62:5, s. 289-293
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Tidskriftsartikel (refereegranskat)abstract
- Background: To estimate the prevalence of nickel allergy, self-reports are sometimes used in epidemiological studies. Self-reports are practical and may facilitate estimation of prevalence provided that the questions are validated.Objectives: To investigate the validity of self-reported nickel allergy.Methods: Three hundred and sixty-nine women, aged 30–40 years, from the general population participated in the study. The participants answered a questionnaire before a clinical examination and patch testing. The two questions being validated were ‘Are you sensitive/hypersensitive/allergic to nickel?’ and ‘Do you get a rash from metal buttons, jewellery or other metal items that come in direct contact with your skin?’Results: Patch test showed nickel-positive reaction in 30% of the subjects. Self-reported prevalence of nickel allergy as indicated by the two respective questions was 40% and 35%. Positive predictive values for the two questions were 59% (95% CI 50–67) and 60% (95% CI 51–69). History of childhood eczema was over-represented among women with ‘false-positive’ self-reported nickel allergy (P = 0.008). Self-reported hand eczema or ‘high wet exposure’ did not influence the validity.Conclusions: The validity of self-reported nickel allergy is low. The questions regarding nickel allergy overestimate the true prevalence of nickel allergy.
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| 8. |
- Lindberg, Magnus, 1952-, et al.
(författare)
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Hand eczema and health-related quality of life : a comparison of EQ-5D and the Dermatology Life Quality Index (DLQI) in relation to the hand eczema extent score (HEES)
- 2013
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Ingår i: Contact Dermatitis. - Hoboken, USA : Wiley-Blackwell. - 0105-1873 .- 1600-0536. ; 69:3, s. 138-143
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health-related quality of life (HRQoL) is associated with the extent and severity of hand eczema. We still lack a consensus about which HRQoL instrument to use as the standard, and how to measure the extent and severity of hand eczema.Objectives: To compare the Dermatology Life Quality Index (DLQI) with EQ-5D (a standardized instrument for use as a measure of health outcome), and to evaluate how the Hand Eczema Extent Score (HEES) relates to these instruments.Methods: Ninety-three patients (61 females) were included. The HEES was recorded by a dermatologist, and the DLQI and EQ-5D by the patients. The results were analysed with factor analysis and non-parametric statistics.Results: The DLQI and EQ-5D showed decreased HRQoL. Using factor analysis, we could not establish an association between the DLQI and EQ-5D. There were, however, correlations between the DLQI and the HEES (0.31), the EQ(index) and the HEES (-0.32), the DLQI and the EQ(VAS) (-0.62), and the DLQI and the EQ(index) (-0.67) (the EQ(VAS) and the EQ(index) are calculated from EQ-5D).Conclusions: We could not link factors in the DLQI to EQ-5D, which has previously been done for SF-36 (Short Form 36). On the basis of this, we cannot recommend EQ-5D over SF-36 for hand eczema studies. The DLQI correlates with the EQ(VAS) and the EQ(index), and can probably be used as an approximation for EQ-5D. Our findings with the HEES are interesting, as it can be used by patients.
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| 9. |
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| 10. |
- Meding, Birgitta, et al.
(författare)
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Handeksem - en folksjukdom som påverkar livskvalitet och arbetsförmåga : önskvärt med tidigare behandling och bättre uppföljning
- 2013
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 110:4, s. 145-148
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Årsprevalensen av handeksem är 10 procent hos vuxna, och handeksem är vanligare hos kvinnor.Handeksem påverkar livskvaliteten funktionellt och mentalt.Handeksem medför konsekvenser i både privatlivet och arbetslivet.Handeksem får socioekonomiska konsekvenser i form av arbetsbyten, sjukvårdskonsumtion, sjukskrivning och produktionsbortfall.Prognosen för handeksem är i dag dålig.Behandlingen av handeksem omfattar lokalbehandling, systemisk behandling och fysikalisk ljusbehandling.Behov finns av flera kontrollerade, randomiserade och jämförande behandlingsstudier.Behov finns av ökad kunskap om och förståelse av tidiga insatser och bättre uppföljning och information till patienterna.
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