Prevalence of Hand Eczema Owing to Hand Hygiene Practices among Healthcare Workers Managing COVID-19 Patients: A Cross-sectional Study Haryana, India

Abstract

Introduction: Healthcare Workers (HCWs) have borne the major brunt of the Coronavirus Disease-2019 (COVID-19) pandemic, being at the forefront. With the disease being enigmatic and no proven treatment or vaccine available during the initial stages, personal protection in general, and hand hygiene, in particular, have been the mainstays for protection against the disease, exposing HCWs to more wet work. Wet work exposure is considered a major risk factor for the occurrence of Hand Eczema (HE). Aim: To estimate the prevalence of hand dermatitis and ascertain the risk factors among HCWs exposed to wet work while caring for COVID-19 patients. Materials and Methods: A cross-sectional study was conducted among HCWs managing COVID-19 patients in a dedicated COVID-19 hospital from July to December 2020. The diagnosis of HE was based on medical history and clinical examination. Clinical features like itching, redness, scaling, clustered papulovesicles, hyperkeratosis, or fissuring largely confined to the hands, with none or only minor involvement of other areas, were used in diagnosing HE. An association of various wet work exposures with HE among study participants was analysed. Categorical variables were analysed using the Chi-square test, and a p-value <0.05 was considered statistically significant. Results: A total of 390 HCWs, of which 203 (52.1%) were females, participated in the study. The majority, i.e., 329 (84.4%) of participants, were in the age range of 21-35 years. A total of 244 (62.6%) HCWs were performing duties for 30-40 hours per week. Among all 390 HCWs studied, 102 (26.2%) were found to have features of HE. High frequency of alcoholic hand disinfectant use (>20 times daily) was significantly associated with the occurrence of HE. Similarly, the high frequency of hand washing with soap at work (>20 times) significantly increased the risk of developing HE. A prior history of atopic diathesis was found to be a significant risk factor for fresh episodes of HE. Conclusion: The present study concludes that intensive hand hygiene during the prevailing COVID-19 pandemic leads to the occurrence of HE among HCWs.