Occupational Contact Dermatitis in Italy: Bridging the Gap Between Estimated Incidence and Official Reporting Data

Background/Objectives: Occupational Contact Dermatitis (OCD) is one of the most common occupational diseases and represents a substantial clinical and socioeconomic burden. Despite its high prevalence, OCD is frequently underrecognised and underreported, limiting the effectiveness of occupational health surveillance and preventive strategies. This study aimed to investigate the extent of OCD underreporting in Italy by comparing official reporting data with incidence estimates derived from epidemiological data available in the scientific literature. Methods: Official data on dermatitis and eczema cases reported to the Italian National Institute for Insurance against Accidents at Work (INAIL) between 2020 and 2024 were analysed and compared with incidence estimates obtained through a systematic literature search of epidemiological studies, surveillance systems, and cohort studies conducted in high-risk occupational groups with available specific incidence data in the scientific literature, such as healthcare workers, construction workers, and hairdressers. Results: INAIL data showed an average of approximately 182 reported OCD cases per year during the study period. However, the estimates we calculated suggested a substantially higher disease burden, with an annual estimate ranging from 1439 cases to 21,412 cases. This implies that, depending on the incidence source used, only 0.8% to 12.7% of the expected cases are notified. Conclusions: OCD appears to be substantially underreported in Italy. Underrecognition of its occupational origin, the low severity often attributed to symptoms, and the limits of current surveillance systems likely contribute. Better occupational health surveillance, greater awareness among clinicians and workers, and simpler reporting procedures would improve case recognition and help prevent progression to chronic disease.