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In the construction industry, a relatively high hand eczema prevalence can be expected due to exposure to irritating and allergenic agents.As part of a regular program of voluntary medical examinations, a questionnaire including items on health symptoms and working circumstances is administered to construction industry personnel. We studied 152,200 male workers (response rate 52%). Associations between possible risk factors and self-reported skin symptoms and skin hypersensitivity were assessed using log-binomial regression analysis.Prevalence of skin symptoms on the hands was 25.4% among construction workers, 14.6% among office personnel. Nuisance due to dust exposure was the most important work-related determinant for skin symptoms [Prevalence Ratio (PR) 1.59, 95% confidence interval (CI): 1.55–1.63]. Cross-sectional findings were supported by longitudinal analyses in a study population subset.Skin symptoms are common among construction workers. Nuisance due to dust exposure was associated with higher prevalences of skin symptoms. Am. J. Ind. Med. 57:660–668, 2014. © 2014 Wiley Periodicals, Inc.