The size of this problem has been underestimated in the past but, both in the UK and the USA, dermatitis is the second most common occupational disordera second only to musculoskeletal injuries. In the UK, it is most common in younger women (Fig. 7.11), and then is often associated with wet work. The incidence in men rises with age, and in older workers it is often caused by contact with cutting oils. Table 7.4 lists the types of work particularly associated with high rates of contact dermatitis in the UK. The hands are affected in 80–90% of cases. Often several factors (constitutional, irritant and allergic) have combined to cause this, and a change of job does not always lead to a cure, particularly in long-established cases. In one large series, hand dermatitis was most common in caterers, metal workers, hairdressers, health care workers and mechanics.