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BACKGROUND: Hand eczema risk factors are potentially associated with lifestyle, and changes in lifestyle may influence the prevalence of this condition.

OBJECTIVES: To report potential lifestyle risk factors and their association with hand eczema.

PATIENTS/MATERIALS/METHODS: Cross-sectional questionnaire survey and standard patch test among Swedish upper secondary school children. The participation rate was 81% (6095/7543) for the questionnaire and 59% (4439/7543) for the test.

RESULTS: Girls reported piercing (84% versus 18%), tattooing (6% versus 3%), smoking (24% versus 16%) and vegetarianism (21% versus 7%) significantly more often than boys. Girls had significantly more hand eczema (7% versus 4%) than boys. Besides female sex (OR 2.0), allergic rhinitis (OR 1.8), flexural eczema (OR 4.5), and positive nickel test (OR 1.7) were significant risk factors in multivariate analysis. Piercing entailed a decreased risk (OR 0.6). Other lifestyle practices had no association with hand eczema. Vegetarian diet and dental braces which potentially increase oral nickel exposure were not associated with hand eczema prevalence in nickel sensitized individuals.

CONCLUSIONS: The studied lifestyle practices were more prevalent in girls. Smoking, tattooing, and diet were not associated with the occurrence of hand eczema.