Challenges of using the Occupational Asthma-specific job exposure matrix to assess occupational exposure and hand eczema.
Brands Marjolein J MJ, Loman Laura L, Bültmann Ute U, Schuttelaar Marie L A MLA
General population-based studies addressing the association between occupational exposure to irritants and allergens and hand eczema (HE) are limited, or only focus on specific occupations using self-reported exposure data. To assess the association between occupational exposure to irritants and allergens and moderate-to-very severe HE, by using the Occupational Asthma-specific job exposure matrix (OasJEM) within the Dutch general population, and to address the applicability of this approach. Within the Lifelines Cohort Study, participants with moderate-to-very severe HE at worst in the past year vs. no HE in lifetime were identified based on self-reports. The OasJEM was used to link occupations with occupational exposure to irritants and sensitizers, relying on expert-based classification. In total, 56,978 (41.9%) participants were included. The multivariate binary logistic regression analyses showed associations between occupational exposure to irritants [Odds ratio (OR): 1.19 (95% CI: 1.06-1.33)], high molecular weight sensitizers [OR: 1.20 (95% CI: 1.06-1.36)], mites [OR: 1.41 (95% CI: 1.16-1.73)] and disinfectants and cleaning products [1.25 (95% CI: 1.11-1.42)], and moderate-to-very severe HE. While associations between several irritants and allergens and HE were found by applying the OasJEM, which may provide insights into occupational exposure patterns and highlight the general relevance of occupational exposure in relation to HE and its prevention, several methodological and conceptual challenges must be acknowledged. A JEM not specifically designed for HE, like the OasJEM, may not fully capture the complex interplay between occupational exposure and HE, particularly in reflecting direct skin contact, the primary exposure route relevant for HE. However, in the absence of widely available and reliable HE-specific exposure assessment tools, the use of non-HE-specific JEMs may be considered a pragmatic alternative, while acknowledging certain limitations. Future studies should focus on task-based and HE-specific exposure data, providing more accurate insights into occupational exposure and HE.