๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
EPIDEMIOLOGY
In a UK household survey, a rate of occupational dermatosis of 15/10โ000 for those who had ever been employed demonstrates the high frequency of affected individuals; in comparison, a rate of 5.1/10โ000 has been reported by physicians in Denmark and Finland, where occupational disease is notifiable. Of the most common physical illnesses due to occupation, skin diseases (23%) rank second, after musculoskeletal disorders (45%). In the US in 2010 it was estimated that for private industry, the annual cost of occupational skin disease due to lost productivity, medical care, and disability payments was US3550 and the period of disability was 24 days. More recently, the German statutory health insurance companies estimated the cost of hand eczema to be โฌ9000 per case with an annual cost of โฌ2128.
Based upon classification systems such as the International Standard Classification of Occupations (ISCO), the distribution of occupational skin disease reported by industry varies with the specialty of the physician (Fig. 16.1). The difference in incidence of neoplasia, as reported by dermatologists compared to occupational physicians, reflects the delay between exposure and development of disease and the fact that the majority of workers have left employment when the cancer develops. Differences in reporting also reflect the distribution of occupational health departments in industry: vehicle assembly, glass, and ceramic workers as well as scientific technicians are often seen by occupational physicians, whereas hairdressers, for example, are seen primarily by dermatologists. Over the past decade, there has been a consistent
S. Mark Wilkinson and Faheem Latheef
decline in the reported incidence of occupational dermatoses both in the US and in Europe.
Fig. 16.1 Relative frequency of reported occupational skin disease highlighting differences by medical specialty.Courtesy The Health and Occupation Research (THOR) network of the Centre for Occupational and Environmental Health (COEH) of the University of Manchester, UK.