Occupational Medicine 2016;66:82 doi:10.1093/occmed/kqv059
QUESTIONNAIRE REVIEW
The Nordic Occupational Skin Questionnaire a screening tool for large populations, while selfreported diagnosis can be used to determine a preliminary estimate of the prevalence [5]. However, in a Swedish study among 194 patients referred for hand eczema, self-reported diagnosis, ‘Do you have hand eczema?’, had 87% sensitivity and 79% specificity, while symptom-based questions had low sensitivity (32%) [6]. NOSQ-2002/SHORT uses self-report while the long version also has a section on symptoms. The validity of NOSQ self-reported hand eczema questions was compared with the gold standard of clinical examination in 502 hairdressing apprentices. A sensitivity of 70.3%, specificity 99.8%, positive predictive value 96.3% and negative predictive value 98.5% were found. However, self-reporting may be more likely to underestimate the true prevalence of hand eczema [7]. The NOSQ may be helpful when investigating workplace dermatitis outbreaks. Yassein Shamout and Anil Adisesh e-mail: [email protected]
References 1. Susitaival P, Flyvholm MA, Meding B et al. Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Dermatitis 2003;49:70–76. 2. Sala-Sastre N, Herdman M, Navarro L et al. [Occupational dermatoses. Cross-cultural adaptation of the Nordic Occupational Skin Questionnaire (NOSQ-2002) from English to Spanish and Catalan]. Actas Dermosifiliogr 2009;100:685–692. 3. Williams HC, Burney PG, Hay RJ et al. The U.K. Working Party’s Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis. Br J Dermatol 1994;131:383–396. 4. NOSQ 2002. National Research Centre for the Working Environment. http://www.arbejdsmiljoforskning.dk/en/publikationer/spoergeskemaer/nosq-2002 (29 June 2015, date last accessed). 5. Smit HA, Coenraads PJ, Lavrijsen AP, Nater JP. Evaluation of a self-administered questionnaire on hand dermatitis. Contact Dermatitis 1992;26:11–16. 6. Svensson A, Lindberg M, Meding B, Sundberg K, Stenberg B. Self-reported hand eczema: symptom-based reports do not increase the validity of diagnosis. Br J Dermatol 2002;147:281–284. 7. Bregnhøj A, Søsted H, Menné T, Johansen JD. Validation of self-reporting of hand eczema among Danish hairdressing apprentices. Contact Dermatitis 2011;65:146–150.
© The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: [email protected]
Downloaded from http://occmed.oxfordjournals.org/ at Queen's University on February 15, 2016
The Nordic Occupational Skin Questionnaire (NOSQ) was developed by a group of Nordic occupational dermatology researchers to survey work-related skin dermatoses and exposures to environmental factors. The questionnaire was created to provide a standardized method by which results across countries can be compared for epidemiological studies. The NOSQ-2002 was based on a collection of pre-existing tools: the Finnish Tuohilampi Questionnaire, the Danish Work Environment Cohort Study (DWECS), the Copenhagen Allergy Study of 1990 and 1998 and a Swedish study by Susitaival et al. [1]. The NOSQ addresses several issues not covered by previous questionnaires including items on environmental exposure, type of work, skin tests and occupational urticaria. The NOSQ was published in English in 2003, with later translations into Danish, Swedish, Finnish, Icelandic, Norwegian, Spanish and Catalan [2]. Short and long versions of NOSQ-2002 are designed for separate purposes. The 14-question shorter form (NOSQ2002/SHORT) is a 4-page questionnaire for screening and monitoring occupational skin diseases on hands and forearms. The NOSQ-2002/SHORT questions are included in the 57-question long version (NOSQ-2002/LONG), meant for occupational skin disease or hand eczema research. The NOSQ-2002/LONG is designed for a more detailed survey of hand and forearm dermatitis and identifying workplace or population risk factors. The questionnaire covers demographics, occupational history, atopic symptoms, self-reported hand or forearm eczema, exacerbating factors, consequences and life impact of dermatoses, self-reported contact urticaria on hands or forearms, skin symptoms, skin tests, exposures, protective glove use, general health and household size [1]. Atopic dermatitis is assessed with a UK-working party developed question (‘Have you had an itchy rash that has been coming and going?’) [3]. The Nordic Council of Ministers has the copyright to the NOSQ-2002, which can be downloaded from the website www.ami.dk/NOSQ and used freely but not for commercial purposes [4]. Two methods are used in questionnaire studies of eczema, a self-reported diagnosis of hand dermatitis or a symptom-based diagnosis [5]. In a Dutch study, 109 nurses referred for skin examination were enrolled to compare the validity of two types of diagnostic questionnaires: symptom-based and self-reported. The sensitivity and specificity of symptom-based diagnosis were 100 and 64%, while self-reported diagnosis were 65 and 93%. This suggests symptom-based diagnosis can be used as
QUESTIONNAIRE REVIEW
The Nordic Occupational Skin Questionnaire a screening tool for large populations, while selfreported diagnosis can be used to determine a preliminary estimate of the prevalence [5]. However, in a Swedish study among 194 patients referred for hand eczema, self-reported diagnosis, ‘Do you have hand eczema?’, had 87% sensitivity and 79% specificity, while symptom-based questions had low sensitivity (32%) [6]. NOSQ-2002/SHORT uses self-report while the long version also has a section on symptoms. The validity of NOSQ self-reported hand eczema questions was compared with the gold standard of clinical examination in 502 hairdressing apprentices. A sensitivity of 70.3%, specificity 99.8%, positive predictive value 96.3% and negative predictive value 98.5% were found. However, self-reporting may be more likely to underestimate the true prevalence of hand eczema [7]. The NOSQ may be helpful when investigating workplace dermatitis outbreaks. Yassein Shamout and Anil Adisesh e-mail: [email protected]
References 1. Susitaival P, Flyvholm MA, Meding B et al. Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Dermatitis 2003;49:70–76. 2. Sala-Sastre N, Herdman M, Navarro L et al. [Occupational dermatoses. Cross-cultural adaptation of the Nordic Occupational Skin Questionnaire (NOSQ-2002) from English to Spanish and Catalan]. Actas Dermosifiliogr 2009;100:685–692. 3. Williams HC, Burney PG, Hay RJ et al. The U.K. Working Party’s Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis. Br J Dermatol 1994;131:383–396. 4. NOSQ 2002. National Research Centre for the Working Environment. http://www.arbejdsmiljoforskning.dk/en/publikationer/spoergeskemaer/nosq-2002 (29 June 2015, date last accessed). 5. Smit HA, Coenraads PJ, Lavrijsen AP, Nater JP. Evaluation of a self-administered questionnaire on hand dermatitis. Contact Dermatitis 1992;26:11–16. 6. Svensson A, Lindberg M, Meding B, Sundberg K, Stenberg B. Self-reported hand eczema: symptom-based reports do not increase the validity of diagnosis. Br J Dermatol 2002;147:281–284. 7. Bregnhøj A, Søsted H, Menné T, Johansen JD. Validation of self-reporting of hand eczema among Danish hairdressing apprentices. Contact Dermatitis 2011;65:146–150.
© The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: [email protected]
Downloaded from http://occmed.oxfordjournals.org/ at Queen's University on February 15, 2016
The Nordic Occupational Skin Questionnaire (NOSQ) was developed by a group of Nordic occupational dermatology researchers to survey work-related skin dermatoses and exposures to environmental factors. The questionnaire was created to provide a standardized method by which results across countries can be compared for epidemiological studies. The NOSQ-2002 was based on a collection of pre-existing tools: the Finnish Tuohilampi Questionnaire, the Danish Work Environment Cohort Study (DWECS), the Copenhagen Allergy Study of 1990 and 1998 and a Swedish study by Susitaival et al. [1]. The NOSQ addresses several issues not covered by previous questionnaires including items on environmental exposure, type of work, skin tests and occupational urticaria. The NOSQ was published in English in 2003, with later translations into Danish, Swedish, Finnish, Icelandic, Norwegian, Spanish and Catalan [2]. Short and long versions of NOSQ-2002 are designed for separate purposes. The 14-question shorter form (NOSQ2002/SHORT) is a 4-page questionnaire for screening and monitoring occupational skin diseases on hands and forearms. The NOSQ-2002/SHORT questions are included in the 57-question long version (NOSQ-2002/LONG), meant for occupational skin disease or hand eczema research. The NOSQ-2002/LONG is designed for a more detailed survey of hand and forearm dermatitis and identifying workplace or population risk factors. The questionnaire covers demographics, occupational history, atopic symptoms, self-reported hand or forearm eczema, exacerbating factors, consequences and life impact of dermatoses, self-reported contact urticaria on hands or forearms, skin symptoms, skin tests, exposures, protective glove use, general health and household size [1]. Atopic dermatitis is assessed with a UK-working party developed question (‘Have you had an itchy rash that has been coming and going?’) [3]. The Nordic Council of Ministers has the copyright to the NOSQ-2002, which can be downloaded from the website www.ami.dk/NOSQ and used freely but not for commercial purposes [4]. Two methods are used in questionnaire studies of eczema, a self-reported diagnosis of hand dermatitis or a symptom-based diagnosis [5]. In a Dutch study, 109 nurses referred for skin examination were enrolled to compare the validity of two types of diagnostic questionnaires: symptom-based and self-reported. The sensitivity and specificity of symptom-based diagnosis were 100 and 64%, while self-reported diagnosis were 65 and 93%. This suggests symptom-based diagnosis can be used as
