The association between wet work and hand eczema in the Dutch general population: Application of a job exposure matrix to the lifelines cohort study

Background: Studies on wet work and hand eczema (HE) frequently rely solely on self-reports, and do not take sex-specific associations into account.
Objectives: To assess the sex-specific association between wet work and moderate-to-very-severe HE, within the Dutch general population, by using a wet work-specific job exposure matrix (JEM). 
Methods: Within the Lifelines Cohort Study, participants with self-reported moderate-to-very-severe HE at worst in the past year were linked to data from the Danish wet work-specific JEM, a tool that links occupations with wet work indices (including duration and probability of glove use, wet hands and total wet work for at least two and four hours/day).
Results: In total, 56.978 (41.9%) participants were included. Among females, the multivariate binary logistic regression analyses showed significant associations between all facets of wet work and moderate-to-very-severe HE. No significant associations were found among males. 
Conclusions: This study is the first to use a wet work-specific JEM in a large population sample, which highlights sex-specific differences regarding wet work and HE. The contrasting sex-specific findings should be interpreted with caution, due to limitations inherent in using a JEM, and should be further explored with observational study designs, with a focus on duration, frequency and exposure type.