Screened Out Before Takeoff: The First Study from Pakistan on Dermatological Disqualification of Gulf-Bound Workers
Dermatological Disqualification of Gulf-Bound Workers
DOI:
https://doi.org/10.66344/jpad.v36i3.3455Keywords:
expatriates, gulf, derma, public health, skin diseasesAbstract
Background High incidences of skin diseases affecting employability, quality of life, and medical fitness are seen in expatriate populations. Despite their importance, data on the prevalence and clinical profile of dermatological disorders in pre-departure medical examination is scarce.
Objective To assess the prevalence and spectrum of skin disorders among the potential expatriates, to study the influence of socio-demographic variables on the diagnosis, and to identify factors associated with being medically unfit for deployment.
Methods We conducted a cross-sectional analysis of 512 applicants during March–August, 2025 at Atlas Medical center plus Caring and curing center, Peshawar. Inclusion criteria covered only those who were intended for migration to Gulf States. Descriptive statistics were computed on SPSS (version 30) and Chi-square (χ²) tests were carried out at 95% confidence level to assess associations. Binary logistic regression was utilized to identify predictors for medically unfit to deploy.
Results Out of 512 candidates, a total of 17.3% (n=89) were unfit to deploy. The common conditions were Vitiligo (17.3%), Pityriasis versicolor (14.6%) and Psoriasis (10.1%). Chi-square test revealed a statistically significant association of diagnosis with occupation (P=.012), age group (P<.001) and residence (P=.010). In separate binary logistic regression models, severe disease (OR=3.210, 95% CI: 1.756–5.869) and chronic duration (>3 months) (OR=2.750, 95% CI: 1.632–4.634) independently predicted unfitness.
Conclusion The result highlights the burden of skin disorders among these potential expatriates. Targeted screening, early diagnosis and treatment, environmental health planning and education campaigns could maximize health gains in this population.
References
Williams, H. C. (1998). Epidemiology of skin disease. Rook’s Textbook of Dermatology,, 1-21.
Germain, N., Augustin, M., François, C., Legau, K., Bogoeva, N., Desroches, M., & Sommer, R. (2021). Stigma in visible skin diseases–a literature review and development of a conceptual model. Journal of the European Academy of Dermatology and Venereology, 35(7), 1493-1504.
Alswaidi, F. M., Memish, Z. A., Al-Hakeem, R. F., Atlam, S. A. (2013). Saudi Arabian expatriate worker fitness-screening programme: a review of 14 years of data. East Mediterr Health J, 19(7), 664-70.
Gulf health council. (2023). Regulations of medical examination of expatriates coming to GCC states for work or residence (6th edition). Wafid.
Abduljabbar, R. A. (2024). Vitiligo Causes and Treatment: A Review. Haya Saudi J Life Sci, 9(5), 149-157.
Bhatia, R., & Sharma, V. K. (2017). Occupational dermatoses: an Asian perspective. Indian Journal of Dermatology, Venereology and Leprology, 83, 525.
Boch, K., Langan, E. A., Kridin, K., Zillikens, D., Ludwig, R. J., & Bieber, K. (2021). Lichen planus. Frontiers in medicine, 8, 737813.
Gupta, A. K., Bluhm, R., & Summerbell, R. (2002). Pityriasis versicolor. Journal of the European Academy of Dermatology and Venereology, 16(1), 19-33.
Leung, A. K., Lam, J. M., Leong, K. F., & Hon, K. L. (2020). Tinea corporis: an updated review. Drugs in context, 9.
Kalavala, M., & Anstey, A. (2008). Introduction to Dermatology. Principles and Practice of Skin Toxicology, 221-243.
Simpson, E. L., Bruin-Weller, M., Flohr, C., Ardern-Jones, M. R., Barbarot, S., Deleuran, M., & Paller, A. S. (2017). When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council. Journal of the American Academy of Dermatology, 77(4), 623-633.
El-Ghannam, A. S., Shams, G. M., ABD ElRaouf, M. S., & Omar, G. H. (2024). Assessment of the prevalence of parasitic infestation of the skin. PREVALENCE OF PARASITIC INFESTATION OF THE SKIN. Journal of the Egyptian Society of Parasitology, 54(2), 267-276.
Jarrett P. Dermatological Conditions of the Foot and Leg. Neale's Disorders of the Foot and Ankle. 2020 Jan 1:58-88.
Diepgen, T. L. (2012). Occupational skin diseases. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 10(5), 297-315.
Lucas, R. M., McMichael, A. J., Armstrong, B. K., & Smith, W. T. (2008). Estimating the global disease burden due to ultraviolet radiation exposure. International journal of epidemiology, 37(3), 654-667.
Pathak, N., Patel, D., Alani, O., Belle, A., & Lipner, S. (2025). Burden of dermatologic diseases in Pakistan: Insights for global dermatology. Archives of Dermatological Research, 317(1).
Bhatia, R., & Sharma, V. K. (2017). Occupational dermatoses: an Asian perspective. Indian Journal of Dermatology, Venereology and Leprology, 83, 525.
Parisi, R., Iskandar, I. Y., Kontopantelis, E., Augustin, M., Griffiths, C. E., & Ashcroft, D. M. (2020). National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. bmj, 369.
Feldman, S. R., et al. (2021). Psoriasis prevalence and severity by expert elicitation. Dermatology and Therapy.
Karimkhani, C., Dellavalle, R. P., Coffeng, L. E., Flohr, C., Hay, R. J., Langan, S. M., ... & Naghavi, M. (2017). Global skin disease morbidity and mortality: an update from the global burden of disease study 2013. JAMA dermatology, 153(5), 406-412.
Li, F., Fan, D., Zhao, X., Song, M., Guo, Y., Li, H., Xu, Y., & Li, Z. (2025). Worldwide trends and future projections of fungal skin disease burden: A comprehensive analysis from the Global Burden of Diseases Study 2021
Sethi, S. (2021). Eczema (dermatitis). In Concise Dermatology (pp. 96-112). CRC Press.
Kimball, A. B., Jacobson, C., Weiss, S., Vreeland, M. G., & Wu, Y. (2005). The psychosocial burden of psoriasis. American journal of clinical dermatology, 6(6), 383-392.
Fernando, D. D., Mounsey, K. E., Bernigaud, C., Surve, N., Estrada Chávez, G. E., Hay, R. J., & Fischer, K. (2024). Scabies. Nature Reviews Disease Primers, 10(1), 74.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Urooj Amjad
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.
