Long term evaluation of the cohorts in the research project "Rehabilitation of occupational skin diseases - Optimisation and quality assurance of inpatient management" (ROQ)

Status:

completed 07/2015

Aims:

This project "Medical-Occupational Rehabilitation Procedure Skin – optimizing and quality assurance of inpatient-management" (ROQ) conducted about 5 years (1 January 2011 to 31 July 2015) was designed to further follow-up the DGUV multicenter study for tertiary individual prevention concept (TIP).The aim of ROQ II was to analyse if the promising results from ROQ are sustainable, in particular, regarding the parameters: - job continuation, - course of the dermatoses, including therapeutic intervention and severity of remaining skin lesions - effect on life quality of the affected workers.

Activities/Methods:

Prospective cohort study (5-year-follow-up); German multicentre study (five centres: University of Osnabrück, University of Heidelberg, iDerm/Trauma-Hospital Hamburg, Occupational diseases centre Bad Reichenhall, Occupational diseases centre Falkenstein, in cooperation with training- and education centres of the BGW).

Results:

The most important results and conclusions from ROQ II are: ROQ II was successfully implemented in all 5 participating study centers, the follow-up of the cohort could be conducted in a high epidemiological quality (80%). 75.5 % of all participants (n = 1,294) available for the 5-year follow-up reported to be working. Only 3.9 % of the participants had discontinued employment since the last follow up investigation (three years after admission to TIP) because of the occupational skin disease. Over the complete observation period of the ROQ-Project job discontinuation of the original occupation occurred in 37.7 % of patients; however, this was due to a dermatosis only in 26.6 % of all patients, at the 5-year follow-up 9.4 % were still unemployed. On the occasion of the 5-year follow-up (T7) 674 participants (52.1 %) reported on telephone interview recent skin lesions; 324 of these followed the invitation for a consecutive dermatological consultation. In these meticulous consultations it turned out that the claimed skin lesions only in 255 patients were caused occupationally. In comparison to the 3-year follow-up a further reduction of severity was observed and a trend towards a further optimized therapy, including reduction of topical corticosteroid use. Furthermore, there was a high participant motivation detected to practice the knowledge on skin protection gained through TIP. Accordingly, the average annual sick leave could be further reduced. At the 5-year follow-up a comparison of employed patients with unemployed patients showed a significant difference regarding the skin related quality of life, even though clinical severity was equal in both groups. For methodological reasons including the different study design, quality of life outcomes were not comparable between ROQ II and ROQ. The results from ROQ II strongly support the current practice of German social accident insurance bodies which offer TIP in the framework of the so-called "Procedure Skin" ("Verfahren Haut") as routine patient care measure for affected employees with severe dermatoses at their workplaces.

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