Occupational Irritant Hand Dermatitis Research Articles

Improving Recovery of Irritant Hand Dermatitis in Healthcare Workers With Workplace Interventions During the COVID-19 Pandemic.

Introduction:Occupational hand dermatitis is common among healthcare workers, with increased incidence during the COVID-19 pandemic. Irritant contact dermatitis accounts for the majority of occupational hand dermatitis and is largely due to frequent contact with hand hygiene products. Long-term prognosis of occupational contact dermatitis is often very poor. This study aims to identify and implement suitable workplace interventions to aid in the recovery of occupational irritant hand dermatitis among healthcare workers during the COVID-19 pandemic.MethodsA quality improvement (QI) project was performed in a tertiary hospital using the Plan-Do-Study-Act model. Healthcare workers seen at the Occupational Dermatology Clinic from March 2020 to May 2021 for the first time for likely occupational irritant dermatitis were targeted for the project. Four workplace interventions were implemented: (a) substitute current alcohol-based hand rub (ABHR) with a different, gentler ABHR, (b) alternate ABHR with gentle hand wash products, (c) temporary job modification with less clinical work (d) switch latex gloves to nitrile gloves. The improvement was assessed after 2 months of workplace intervention using a visual analogue scale, based on changes seen on photographs taken at the baseline and monthly review. The target improvement was set at 70% after 2 months of workplace interventions.ResultsA total of 21 participants were included in the QI project. All participants were found to have significant improvement in their hand condition. The estimated mean reduction of signs and symptoms was 80% in comparison to their baseline hand condition before intervention.ConclusionWorkplace interventions such as substituting irritant hand hygiene products with gentler alternatives and temporary reduction in clinical duties may be useful in improving the recovery rate of irritant hand dermatitis among healthcare workers. Areas with high hand hygiene workload or high incidences of hand dermatitis may opt to implement systemic workplace changes.

From the Cochrane Library: Interventions for Preventing Occupational Irritant Hand Dermatitis.

From the Cochrane Library: Interventions for Preventing Occupational Irritant Hand Dermatitis.

Is there randomized controlled trial evidence to support the use of interventions for preventing occupational irritant hand dermatitis (OIHD)?

Is there randomized controlled trial evidence to support the use of interventions for preventing occupational irritant hand dermatitis (OIHD)?

Effectiveness of interventions for preventing occupational irritant hand dermatitis: a quantitative systematic review.

The aim of this review was to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed here) in preventing occupational irritant hand dermatitis (OIHD) in wet workers, comparing each intervention to an alternative intervention or to usual care (workers' regular skin care regimen). The most significant occupational skin problem potentially encountered in wet work occupations is occupational dermatitis. When the skin comes into contact with hazardous substances at work, this can cause occupational dermatitis. Substances which may cause occupational dermatitis include cleaning products, organic solvents, metalworking fluids, cement, flour, adhesives, other chemicals and even certain plants. Occupational skin disease has adverse effects on quality of life and the long term prognosis for skin health is poor unless workplace exposures are addressed. To date, no systematic review has been undertaken to determine the effectiveness of interventions for the primary prevention of OIHD in wet workers. The review included any workers from healthcare (e.g. nurses, doctors and allied health professionals) and also people in different wet work occupations (e.g. hairdressers, florists, catering workers, metal workers) at similar risk of OIHD. Studies that assessed the following interventions in the primary prevention of OIHD in wet workers at the workplace and at home (before and after work) were included:Types of studies considered were experimental study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, and before and after studies. Primary outcome measures were OIHD incidence, and secondary outcome measures were product evaluation and change of occupation because of OIHD versus staying in the occupation. Published and unpublished literature in the English language was sought between 2004 and 2017. The databases searched included: COCHRANE CENTRAL, MEDLINE, CINAHL, AMED and Embase. The search for unpublished studies included: Google Scholar, Open DOAR and Robert Gordon University's thesis database, "OPEN AIR". There were no studies located that met the inclusion requirements of this review. There is currently no evidence available to determine the effectiveness of interventions to prevent OIHD amongst wet workers that met this review's inclusion criteria.

Interventions for preventing occupational irritant hand dermatitis.

Interventions for preventing occupational irritant hand dermatitis.

Hand hygiene compliance and irritant dermatitis: a juxtaposition of healthcare issues

Reduction and prevention of health care-associated infections is a worldwide priority with emphasis on increasing hand hygiene compliance. Repetitive exposure to hand hygiene products and procedures is a significant factor in the development of occupational irritant hand dermatitis. Compliance has been difficult to achieve often due to skin irritation. The introduction of alcohol hand rubs has positively influenced compliance but rates remain lower than required. Genetic and environmental factors to the frequency and severity of irritant contact dermatitis have been identified. Because of the skin's role in innate immunity, maintenance of epidermal integrity is a key strategy for reducing health care-associated infections. In this review, we examine the interdependence of the two issues and the challenges of simultaneously accomplishing both goals. We emphasize research conducted among healthcare workers in their clinical settings. The factors that influence skin integrity and the challenges in meeting both goals simultaneously are explored. Cosmetic scientists have played key roles in the development of improved skin care products, and the issues present an excellent opportunity for them to provide potentially life-saving contributions to health care.

Interventions for preventing occupational irritant hand dermatitis: a summarised Cochrane review

Clinical and Experimental DermatologyVolume 36, Issue 2 p. 229-230 Interventions for preventing occupational irritant hand dermatitis: a summarised Cochrane review First published: 16 February 2011 https://doi.org/10.1111/j.1365-2230.2011.04029.x This is a summary of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2010, Issue 6 Citation: Bauer A, Schmitt J, Bennett C, Coenraads PJ, Elsner P, English J, Williams HC. Interventions for preventing occupational irritant hand dermatitis. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD004414. DOI: 10.1002/14651858.CD004414.pub2 Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume36, Issue2March 2011Pages 229-230 RelatedInformation

Insufficient evidence to determine the effectiveness of measures to prevent occupational irritant hand dermatitis

Commentary on: A Bauer, J Schmitt, C Bennett, et al.. Interventions for preventing occupational irritant hand dermatitis. Cochrane Database Syst Rev2010;6:CD004414.

The lactic acid stinging test predicts susceptibility to cumulative irritation caused by two lipophilic irritants*

Skin exposure to lipophilic irritants at workplaces is a risk factor for the development of occupational irritant hand dermatitis. Suitable lipophilic model irritants to be used in repeated irritation studies in volunteers are needed to gain a better understanding of the chemical-dependent mechanisms of skin irritation. To investigate acute and cumulative irritation elicited by two new lipophilic model irritants, octane (CAS No. 111-65-9) and cumene (CAS No. 98-82-8), in stingers as compared with non-stingers. Short-time occlusive and repetitive occlusive irritation patch tests were performed over 5 days with octane and cumene in two groups of healthy volunteers (n = 15 each) who were classified as stingers and non-stingers according to a preceding lactic acid stinging test. Acute and cumulative irritation was quantified using clinical assessments and bioengineering methods (laser Doppler flowmetry, transepidermal water loss, capacitance measurements, and skin colour reflectance). Significantly stronger cumulative irritation was observed in stingers than in non-stingers for both irritants (visual scoring, stratum corneum hydration, and skin colour reflectance). The preliminary results suggest the existence of a distinct sub-population with increased susceptibility to cumulative irritation induced by lipophilic irritants that can be identified by the lactic acid stinging test.

Interventions for preventing occupational irritant hand dermatitis

Occupational irritant hand dermatitis (OIHD) is an important cause of discomfort in the working population. Different preventive measures are in place but it is not clear how effective these are. To assess the effect of interventions for preventing OIHD in healthy people who work in occupations where the skin is at risk of damage. In May 2010, we searched the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLlNE and EMBASE. Conference proceedings, and ongoing trials registers were also searched. Randomised controlled trials (RCTs) studying the effectiveness of barrier creams, moisturisers, gloves, complex educational interventions, and other interventions for the prevention of OIHD. Two authors independently assessed the trials and extracted data. Four RCTs involving 894 participants from different occupations were included. The primary outcome was numbers of new cases.One large RCT of 708 print and dye workers compared 2 barrier creams (containing silicone or hydrocarbon) versus no intervention. Fewer workers using barrier creams developed OIHD than those who did not (39.9% versus 45%, (OR 0.75, 95% CI 0.53 to 1.07. P = 0.11) but this was not statistically significant.In 1 RCT of 54 metal workers less developed OIHD when using an after work emollient or a barrier cream compared to no intervention. There was no statistical difference between the groups at different times of follow-up.One RCT of 111 cleaners and kitchen workers compared a moisturiser (Locobase) versus no intervention using a cross-over design. While using the moisturiser no participant developed OIHD. During the control period with no skin treatment, 19 (20.4%) out of 93 participants developed OIHD.One RCT of 21 hairdressers compared a barrier cream containing aluminium chlorohydrate (Excipial protect) versus its vehicle. No participant developed OIHD while the products were used.Only limited side-effects such as transient itching, stinging, and dryness were reported for the interventions. Although the findings of this review were generally positive, no statistical significance was reached. We conclude that at present there is insufficient evidence for the effectiveness of most of the interventions used in the primary prevention of OIHD. This does not mean that current measures are necessarily ineffective, as the limited studies to date have been rather small and of poor quality. Larger well designed RCTs are now needed in different workplaces to establish the effectiveness of various preventative strategies.

Hand dermatitis in a prospectively-followed cohort of hairdressing apprentices: final results of the POSH study. Prevention of occupational skin disease in hairdressers.

The incidence of hand dermatitis is high in the hairdressing trade; the individual disease burden is substantial, as are the costs of treatment, workers compensation and retraining programs. To evaluate the risk of developing occupational irritant hand dermatitis associated with several potential risk factors, namely constitution (atopy) and occupational exposure, an observational prospective population-based cohort study set in vocational training schools in northwest Germany, recruiting 2352 hairdressing apprentices, was performed. Unprotected wet work of more than 2 h per day is the major significant risk factor; low ambient absolute humidity is equally associated with a significantly increased risk. Compared to the youngest age group, risk diminishes with increasing age. Constitutional risk factors are difficult to evaluate because of selective dropout of atopic participants. For primary prevention, a population approach, improving working conditions and skin protection for all exposed, appears to be the most beneficial.