Abstract
BackgroundHealth care workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to frequent exposure to ‘wet work’. Amongst HCWs, nurses are at highest risk, with an estimated point prevalence of HD ranging between 12 and 30%. The burden of disease is high with chronicity, sick leave, risk of unemployment and impaired quality of life. Despite evidence from the medical literature on the risk factors and the importance of skin care in the prevention of HD, in practice, compliance to skin care protocols are below 30%. New preventive strategies are obviously needed.Methods/designThis is a cluster randomized controlled trial, focusing on nurses performing wet work. In total, 20 wards are recruited to include 504 participating nurses in the study at baseline. The wards will be randomized to an intervention or a control group and followed up for 18 months.The intervention consists of the facilitation of creams being available at the wards combined with the continuous electronic monitoring of their consumption with regular feedback on skin care performance in teams of HCWs. Both the intervention and the control group receive basic education on skin protection (as ‘care as usual’). Every 6 months, participants of both groups will fill in the questionnaires regarding exposure to wet work and skin protective behavior. Furthermore, skin condition will be assessed and samples of the stratum corneum collected. The effect of the intervention will be measured by comparing the change in Hand Eczema Severity Index (HECSI score) from baseline to 12 months. The Natural Moisturizing Factor (NMF) levels, measured in the stratum corneum as an early biomarker of skin barrier damage, and the total consumption of creams per ward will be assessed as a secondary outcome.DiscussionThis trial will assess the clinical effectiveness of an intervention program to prevent hand dermatitis among health care workersTrial registrationNetherlands Trial Register (NTR), identification number NTR5564. Registered on 2 November 2015.
Highlights
Health care workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to frequent exposure to ‘wet work’
This trial will assess the clinical effectiveness of an intervention program to prevent hand dermatitis among health care workers
The overall purpose of the Healthy Hands Project is to change the behavior of HCWs towards hand care and make skin care part of the work culture
Summary
Health care workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to frequent exposure to ‘wet work’ [1]. Wet work, defined as unprotected exposure to humid environments/water; high frequency of hand-washing procedures or prolonged glove occlusion, is believed to cause irritant contact dermatitis in a variety of occupations [2]. Almost 60% of HCWs are reported to have eczemarelated sick leave during the first year after notification of the disease [6]. This makes the burden of disease high for affected individuals as well as in the socioeconomic context. The total annual costs for occupational skin diseases for medical care, absenteeism and disability pensions are estimated to be €98 million in The Netherlands [7]
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