Hand eczema-related presenteeism and sickness absence: A cross-sectional population-based study

Background: Hand eczema (HE) is a common skin disease with far-reaching personal and socio-economic consequences. To date, HE-related presenteeism has never been assessed within the general population. Studies on HE-related absenteeism within the general population are limited as well.
Aims: To assess the prevalence of both HE-related presenteeism and absenteeism, and factors associated with HE-related presenteeism, within the general population.
Methods: Within the Lifelines Cohort Study, participants with HE between 18 and 65 years old were identified by a questionnaire including questions regarding HE-related presenteeism and absenteeism, and clinical characteristics. Socio-demographic factors were collected between 2006 and 2019. 
Results: Overall, 3.718 participants were included. HE-related presenteeism was reported by 3% (n=102) of the total study population, and by 20% (n=59) of the participants with severe to very severe HE. HE-related absenteeism was reported by 1% (n=21) and 6% (n=18), respectively. Binary logistic regression analyses, adjusted for age and sex, showed statistically significant associations between HE-related presenteeism and lower educational attainment, an income of less than €2500 per month, chronic HE, moderate and severe to very severe HE (compared to a mild HE), atopic dermatitis and occupational wet exposure.
Conclusions: In contrast to the low prevalence of HE-related absenteeism, a high prevalence of HE-related presenteeism was found, especially in participants with severe to very severe HE. Future studies should focus on the longitudinal association between HE-related presenteeism and the clinical course of the disease, as HE-related presenteeism might aggravate HE symptoms and may negatively influence the course of the disease.