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Carriers of filaggrin gene (FLG) mutations avoid professional exposure to irritants in adulthood

Authors

  • Josefine Bandier,

    1. Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
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    • Equal responsibilities as first authors.
  • Katrine Ross-Hansen,

    Corresponding author
    1. Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
    • Correspondence: Katrine Ross-Hansen, Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Niels Andersens Vej 5, 2900 Hellerup, Denmark. Tel: +45 39777310; Fax: +45 39777118. E-mail: katrine.ross-hansen@regionh.dk

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    • Equal responsibilities as first authors.
  • Berit C. Carlsen,

    1. Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
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  • Torkil Menné,

    1. Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
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  • Allan Linneberg,

    1. Research Centre for Prevention and Health, Copenhagen University Hospital Glostrup, Glostrup, Denmark
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  • Steen Stender,

    1. Department of Clinical Biochemistry, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
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  • Pal B. Szecsi,

    1. Department of Clinical Biochemistry, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
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  • Michael Meldgaard,

    1. Department of Clinical Biochemistry, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
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  • Jacob P. Thyssen,

    1. Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
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  • Jeanne D. Johansen

    1. Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark
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  • Conflict of interest: The authors have declared no conflicts. Funding sources: the Danish board of Health, the Danish Environmental Protection Agency, the Copenhagen County Research Foundation, the Aase and Einar Danielsens Foundation, the Velux Foundation, ALK-Abelló A/S, Denmark, and the Danish Scientific Research Council. MEKOS Laboratories, Denmark kindly donated some of the TRUE tests.

Summary

Background

Loss-of-function mutations in the filaggrin gene (FLG) are associated with xerosis, atopic dermatitis, and early onset of hand eczema. Irritant exposure is a risk factor for occupational hand eczema, and FLG mutations increase the risk of occupational irritant contact dermatitis on the hands in hospital cohorts. It is unknown whether FLG mutations affect the level of irritant exposure.

Objectives

To evaluate whether exposure to occupational irritants was dependent on FLG mutations, atopic dermatitis, and age at hand eczema onset.

Methods

Randomly chosen Danish adults completed a questionnaire on general health and occupational exposures. Genotyping for FLG mutations (R501X, 2282del4, and R2447X) and patch testing were performed.

Results

Overall, 38.7% of subjects reported present or previous occupational exposure to irritants. Among individuals who reported hand eczema onset before entering their work life, 50.6% (45/89) of FLG non-mutation carriers became exposed to irritants, as compared with 28.6% (4/14) of heterozygous and 0% (0/6) of homozygous mutation carriers (p = 0.006). Avoidance was conspicuous among mutation carriers reporting childhood hand eczema and atopic dermatitis (odds ratio 0.08, 95% confidence interval 0.01–0.65).

Conclusions

Carriers of FLG mutations who have had hand eczema onset in childhood avoid occupational exposure to irritants; the association is most marked with homozygous mutation status combined with atopic dermatitis.

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