Determinants of epoxy allergy in the construction industry: a case-control study.

Background. Workers exposed to epoxy products are at risk of developing allergic contact dermatitis. Objectives. To compare workers throughout the German construction industry with and without skin allergy to epoxy resins, hardeners, and/or reactive diluents, and to investigate which determinants are related to the development of epoxy allergy. Methods. A questionnaire was completed by 179 epoxy allergy cases, and 151 epoxy workers as controls. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by the use of backwards stepwise logistic regression analysis. A multiple imputation approach was used to deal with missing data. Results. Epoxy allergy was associated with an unusually high level of exposure to epoxy products [OR 2.13 (95% CI: 1.01-4.51)], wearing short sleeves or short trousers [OR 2.38 (95% CI: 1.03-5.52)], and not always using the correct type of gloves [OR 2.12 (95% CI: 1.12-4.01)]. A monotonic increasing risk was found with increasing exposure hours per week [OR 1.72 (95% CI: 1.39-2.14)]. Not using skin cream was inversely associated with epoxy allergy [OR 0.22 (95% CI: 0.08-0.59)]. Years working with epoxy products were inversely associated with epoxy allergy [OR 0.41 (95% CI: 0.27-0.61) per 10-year increase], suggesting a healthy worker survivor effect. Conclusions. Occupational epoxy allergy may be prevented by improving occupational hygiene behaviour and personal protection.