Health care services use by workers with work-related contact dermatitis.
BACKGROUND: There is little information in the literature regarding the use of health care services by workers with occupational contact dermatitis. OBJECTIVE: The objective of the study was to describe the use of health care services by workers with occupational contact dermatitis. METHODS: One hundred workers with hand dermatitis were enrolled and observed for 6 months after assessment at St. Michael's Hospital (Toronto, ON, Canada). Information was collected at the time of diagnosis and 6 months after the assessment. Questionnaires were administered to collect information about clinical presentation and the use of health services. RESULTS: A diagnosis of occupational contact dermatitis was made for 78 of the workers. By the time of assessment at the Occupational Health Clinic at St. Michael's Hospital, almost all of the workers had seen their family doctor for their skin problem, and 71% had seen a dermatologist. Although family doctors and dermatologists asked the workers to identify their occupation, they rarely asked about workplace exposures, and the physicians provided minimal advice about job change or modification on return to work. During the 6 months following diagnosis, 62% of the workers saw their family physicians in follow-up, but rarely was advice about job change or modification provided at these follow-up visits. CONCLUSIONS: This descriptive information suggests that there are gaps in health services for patients with work-related skin disease and that there is a need for refinement of the delivery of health services related to occupational disease. A redesign of the occupational health care delivery system to address these issues and an evaluation of new models seem appropriate.