Hand Eczema, Risk Factors and Microbial Skin Contamination in the Norwegian Waste Sorting Industry: A Cross-Sectional Study.

INTRODUCTION: Hand eczema, skin barrier function and skin microbial contamination among waste workers are underexplored. This study aims to assess: (1) the prevalence and risk factors of hand eczema, (2) the levels of transepidermal water loss (TEWL), and (3) skin microbial contamination in waste sorting workers. METHODS: Using the Nordic Occupational Skin Questionnaire-2002, data were collected from 69 waste sorting workers and 25 office personnel. TEWL was measured with a Tewameter (TM 300, Courage+ Khazaka Electronic, Köln). Microbial skin samples were collected from the left dorsal hand with sterile swabs (Copan, Italy) and cultured. Analyses included descriptive statistics and multivariate logistic regression. RESULTS: The hand eczema prevalence was 25% among waste workers and 40% in office personnel. The prevalence of hand eczema was significantly lower among exposed workers compared to controls (p = 0.012). TEWL and fungal concentrations were comparable across groups. Atopic dermatitis (AD) and nicotine use were significant predictors of HE. The prevalence of hand eczema experienced during the past week was significantly associated with elevated bacterial concentrations (p value = 0.05) in both groups. CONCLUSIONS: Waste sorting workers had up to 2.4 times higher prevalence of hand eczema compared with the general population, but a lower prevalence than office workers in the same industry. These findings may reflect a potential healthy worker effect. The potential role of bacterial concentrations in the occurrence of hand eczema warrants further investigation.