BACKGROUND: We describe long-term work participation of patients with carpal tunnel syndrome (CTS) referred to Danish departments of occupational medicine and compare to patients with contact dermatitis. METHODS: One thousand seven hundred and sixty CTS-patients were included in this register-based nationwide longitudinal follow-up study and compared to 3158 contact dermatitis patients. We extracted register data on public benefits 5 years before and after assessment at a department of occupational medicine between 2000 and 2013. We defined a work participation score (WPS) as weeks where the patient was working divided by number of potential work weeks per year, dichotomized into low and high at the 75 RESULTS: Before assessment, both CTS and contact dermatitis patients had high work participation. In the follow-up period work participation decreased permanently for both patient groups. Comparing women with CTS to women with contact dermatitis, odds ratios (OR) of low WPS were 2.56 (2.11-3.11) and 1.68 (1.38-2.05) one and 5 years after assessment. For men, OR of low WPS were 2.01 (95% CI, 1.67-2.44) and 1.27 (95% CI, 1.04-1.56). ORs of receiving permanent health-related public benefits during follow-up were 2.10 (95% CI, 1.56-2.83) for men and 1.97 (95% CI, 1.54-2.54) for women with CTS compared to those with contact dermatitis. CONCLUSIONS: Patients referred to Danish departments of occupational medicine due to CTS have increased risk of reduced long-term work participation and of receiving permanent health-related public benefits compared to patients referred due to contact dermatitis.