Open Access Research article

Are skin disorders related to work strain in hospital workers? A cross-sectional study

Nicola Magnavita1*, Marko Elovainio23, Tarja Heponiemi2, Anna M Magnavita4 and Antonio Bergamaschi1

Author Affiliations

1 Institute of Occupational Medicine, Universita Cattolica del Sacro Cuore, Roma, Italy

2 National Institute for Health and Welfare, Helsinki, Finland

3 University College London, London, UK

4 Dermatology Department, John Paul II Hospital, Lamezia Terme, Italy

For all author emails, please log on.

BMC Public Health 2011, 11:600  doi:10.1186/1471-2458-11-600

Published: 28 July 2011



To evaluate whether occupational stress factors (high demands, low control, low social support, strain, and iso-strain) are associated with skin disorders in hospital workers and whether psychological problems, such as anxiety and depression, act as potential mechanisms through which occupational stress factors are associated with skin disorders.


1,744 hospital workers were invited to answer a questionnaire concerning the occurrence of skin disorders and psychosocial factors at work. The abbreviated Italian version of the Demand/Control model (Karasek) was used to assess perceived work strain, while the Goldberg scales were used to assess anxiety and depression. Analyses were adjusted for age, gender, occupation, latex glove use and history of atopy.


Of the participants, 25% reported hand dermatitis in the previous 12 months and 35% had been affected by skin disorders in other parts of the body. High job demands (OR = 1.09 CI95% 1.05-1.14), low social support (OR = 0.90, CI95% 0.87-0.93), high strain (OR = 1.54 CI95% 1.20-1.98) and high iso-strain (1.66 CI95% 1.27-2.19) were all associated with a higher prevalence of reported hand skin disorders. Both depression (OR = 2.50 CI95% 1.99-3.14) and anxiety (OR = 2.29 CI95% 1.81-2.89) were associated with higher risk of hand skin disorders. The same pattern was observed for dermatological complaints in other parts of the body. Only a slight reduction in the association between occupational stress variables and skin disorders was observed after including depression and anxiety in the model.


Job stress plays a significant role in triggering skin disorders among hospital workers and psychological problems do not appear to be the mechanism behind this association. Occupational health education and training should focus on reducing job demands and occupational stress in order to prevent skin problems among hospital workers.

hospital workers; skin disorders; occupational stress factors; psychological problems; anxiety; depression; demand; control; social support; strain; isostrain