Prevalence Of Hand Dermatitis Research Articles

Cocos nucifera and glycerine afterwork moisturizers for secondary prevention of hand dermatitis among fabric worker: a randomized, double-blind, cross over trial

The use of skin barrier-enhancing topical medication is a favorable approach for the treatment of occupational hand dermatitis (OHD). Cocos nucifera or coconut oil is one of the best sources of lipid enriched with laurate acid, and glycerin is a well-known humectant that improves skin hydration. This study is aimed is to evaluate the effectiveness of C. nucifera and glycerin for secondary prevention of OHD among batik (Indonesian traditional fabric) workers. In a randomized, double-blind, crossover trial, the effect of glycerine–C. nucifera cream versus glycerin-only was considered with multiple afterwork applications of moisturizer over a 2-week period on batik workers with OHD. Assessment of trans-epidermal water loss (TEWL), skin capacitance, and a clinical assessment using the Hand Eczema Severity Index (HECSI) were carried out at day 0 and 14. The results show thirty-two batik dyeing and/or rinsing workers were enrolled in the study with mild to moderate OHD. Clinical improvement was demonstrated by 20% decrease in HECSI and TEWL, and 20% increase in skin capacitance. Both moisturizers were equally effective for the secondary prevention of OHD. As a conclusion, glycerine–C. nucifera and glycerin-only cream are equally effective for secondary prevention for OHD among batik worker to reduce the prevalence of hand dermatitis.

The prevalence of hand dermatitis among intensive care unit nurses.

Healthcare workers are at high risk of developing occupational hand dermatitis (HD) due to their frequent exposure to wet-work and use of gloves. Complaints of HD may interfere with work and cause loss of work productivity, or sick leave, and may have impact on job pleasure and performing daily activities. The prevalence of HD among intensive care unit (ICU) nurses is unknown. To investigate the point prevalence and the 1-year prevalence of HD among ICU nurses, and to determine the impact of HD on work and daily activities. A questionnaire-based cross-sectional study was performed among ICU nurses. Participants were recruited in the Amsterdam University Medical Centre. A symptom-based questionnaire was used to determine HD and atopic predisposition, and an additional questionnaire was used concerning the influence of HD. ICU nurses with an atopic predisposition or symptoms suiting HD were invited for the hand dermatitis consultation hour (HDCH). Data were analysed with logistic regression. A total of 184 ICU nurses were included. The point prevalence of HD was 9.8% (95% CI: 5.9-15.0) and the 1-year prevalence was 26.6% (95% CI: 20.4-33.6). Sick leave was reported by 0.5%. HD seemed to have more impact on job pleasure than on work productivity. The high prevalence rate of HD resulting from our study highlights the need for the prevention of occupational HD among healthcare workers.

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

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.

Hand dermatitis, Prevalence and Risk Factors among Healthcare Workers during the COVID-19

Background: Healthcare workers (HCWs) need to perform new preventive measures to protect themselves and patients against ongoing COVID-19 transmission, which can increase hand dermatitis (HD) among them. This study aims to investigate the prevalence of HD among HCWs and its possible risk factors in IRAN. Methods: A survey of 159 HCWS working in university hospitals was performed from August to September 2020 in a cross-sectional study. Research data were collected via standardized self-administered questionnaire. The history of HD was determined via standardized Nordic Occupational Skin Questionnaire (NOSQ-2002). Results: The prevalence of HD in the study population was 51.6%. A significant association was found between the prevalence of HD among HCWs and sex, age, working hours per week, and wearing gloves (P<0.05). Females had a 3.84 fold higher risk of HD than males (confidence interval (CI): 1.85-8). HCWs older than 40 and those who aged 30-39 had a 9.6 and 1.72 fold higher risk of HD than those aged 20-29 (CI: 2.6-35.7; CI: 0.87-3.4, respectively). Conclusion: Possible risk factors for developing HD among HCWs are female gender, age, wearing gloves, and fewer working hours per week. Preventive measures for HD are needed for HCWs, especially during the COVID-19 pandemic.

Dermatological Complaints of Contact Dermatitis During the COVID-19 Pandemic (2019-2021) Among Healthcare Workers of an Isfahan University-Affiliated Hospital, Iran

Background and aims: Using anti-septic and personal protective equipment (PPE) may cause contact dermatitis (CD) in hospital staff. During COVID-19, the team used PPE and hand washing more frequently. This study investigated the prevalence of CD and its related factors among hospital staff during the COVID-19 pandemic. Methods: Overall, 360 participants were selected by proportion sampling from an Isfahan University-affiliated hospital (Alzahra hospital) between 2019 and 2021. A checklist about demographic and workplace variables, skin signs, and symptoms was distributed to samples. We assessed associations between the frequencies of the worksite and cleaning product exposures and a symptom-based definition of CD among current hospital workers. Results: The prevalence of hand dermatitis in participants and their mean age were 84% and 35.7±8.6 years, respectively. In addition, the most reported symptoms were itching (147, 40%) and redness of the hand (141, 39%). Using gloves, especially latex and vinyl gloves, had a significant association with the incidence of CD (P<0.03). The frequency and time of hand washing had no significant relationship with dermatitis (P>0.05). Conclusion: Setting up preventive actions and managing this condition are better to be influential among the policies of hospital managers given the high prevalence of CD among hospital workers.

Investigating the Prevalence of Contact Dermatitis and its Related Factors Among Hospital Staff During the Outbreak of the COVID-19 Epidemic: A Cross-Sectional Study.

Background:Frequent hand washing and prolonged mask use during the Coronavirus disease (COVID-19) pandemic may cause contact dermatitis in hospital staffs. This study was conducted to investigate the prevalence of contact dermatitis and its related factors among hospital staff during the COVID-19 pandemic.Materials and Methods:The present cross-sectional study was conducted among the hospital personnel of Aligoudarz Shahid Valian Hospital, Lorestan, Iran, from March to June 2020. Sampling was performed using the complete enumeration method and 142 hospital staff (physicians, nurses, service personnel, nurses’ aides, secretaries, and laboratory and radiology experts) participated in the study. Data were collected using a 3-part questionnaire containing a demographic characteristics form, job information form, and the Nordic Occupational Skin Questionnaire (NOSQ). The obtained data were analyzed using descriptive statistics, Chi-square, and Spearman's correlation coefficient in SPSS.Results:The prevalence of hand dermatitis in participants was 88.02%, and facial dermatitis with the surgical mask was 71.83% and with n95 mask was 81.69%. The most-reported symptom was dryness of the hand. The most common symptom observed after prolonged use of surgical (55 Samples; 38.73%) and n95 masks (79 Samples; 55.63%) was redness. The frequency of hand washing (F = 8; p = 0.017) and the use of liquid soap (F = 4; p = 0.047) had a significant interrelation with the severity of dermatitis.Conclusions:Planning for preventive actions and management of the current situation should be a priority among the policies of hospital managers given the high prevalence of hand and face dermatitis among hospital staff.

Investigating hand dermatitis among nurses in Iran during the outbreak of COVID-19: Comparison of COVID and non-COVID wards

Background & Aim: Hand dermatitis is one of the occupational skin diseases among nurses. Due to the prevalence of COVID-19, nurses' exposure to disinfectant solutions has increased, which can increase the incidence of dermatitis among them. The purpose of this study was to determine the prevalence of hand dermatitis among nurses in COVID and non-COVID wards and its related factors during the outbreak of COVID-19 in Iran. Methods & Materials: This descriptive-correlational study was performed by available sampling on 287 nurses. Data were collected using a self-administered questionnaire on hand dermatitis. Data were analysed using SPSS software version 22. Results: The prevalence of hand dermatitis among COVID wards nurses was 65.7% and among non-COVID wards nurses was 36.2%. However, the logistic regression showed that Female gender (P= 0.001, odds ratio=3.19, CI=1.57-6.46), marital status (single) (P= 0.011, odds ratio=2.64, CI=1.25-5.57), age 31-40 (P=0.003, odds ratio=0.16, CI=0.06-0.55), COVID wards (P= 0.000, odds ratio=4.99, CI=2.36-10.59), Allergy history (P= 0.000, odds ratio=13.07, CI=6.12-27.95) increase the prevalence of hand dermatitis among nurses. Conclusion: Hand dermatitis is a serious problem among corona ward nurses. Therefore, timely identification and treatment of this injury can be very helpful. Nurses should receive adequate training and care for hand dermatitis.

Prevalence of Occupational Contact Dermatitis and its related Factors among Surgical Technologists in Five Educational Centers of Mazandaran University of Medical Sciences

Introduction: Occupational skin diseases and hand contact dermatitis specifically are among the most common occupational diseases among the healthcare workers. Since surgical technologists have contact with allergens and irritant substances are more susceptible to hand contact dermatitis. Thus, the aim of this study was to evaluate the prevalence of occupational hand contact dermatitis and effective factors among surgical technologists in five educational centers affiliated to Mazandaran University of Medical Sciences.
 Methods: The present cross-sectional study was conducted over 125 surgical technologists working in the hospitals affiliated with Mazandaran University of Medical Sciences who were selected via census sampling. Later, 97 participants who met the inclusion criteria were investigated. Data were collected by Nordic Occupational Skin questionnaire (NOSQ-2002) through interview and analyzed by SPSS software version 23.
 Results: The findings indicated that 68% of the examined technologists were female and 57.7% were over 37 years old. The prevalence of hand dermatitis was 45.4% (44 people). The highest prevalence was observed at the back of hands (24.7%) and between fingers (17.5%). Contact hand dermatitis had a significant correlation with the participants’ gender (p = 0.002), work experience (p = 0.028), and frequency of hand washes (p = 0.021). Moreover, having a history of eczema and allergy (P-Value≤ 0.01) was significantly effective in increasing hand contact dermatitis.
 Conclusion: The prevalence of hand contact dermatitis is high among surgical technologists. Therefore, hospital managers are required to plan for preventive measures and control the current situation. Furthermore, future researchers are recommended to carry out more studies on allergic dermatitis.

Prevalence of Dermatitis and Superficial Fungal Infection of the Hands in Seafood Workers: An Investigation from Food Markets in Ningbo, China.

ObjectiveSeafood workers have high risks of hand skin diseases. The purpose of this survey is to study the prevalence of occupational hand skin diseases in this population.MethodsFrom March 2018 to October 2018, seafood workers in two food markets in Ningbo, China were investigated. Fungal microscopy and cultures from lesions on the hands and nails were performed. A community-based investigation of hand skin diseases was performed as a control group.ResultsOne handred and eleven of 135 (82.2%) seafood workers in two food markets in Ningbo were taken into the investigation. The prevalence of hand dermatitis was 50.5% (56/111) in seafood workers, which is significantly higher than that of the control group (7.43%, p<0.001). It was found that the incidence of superficial fungal infection of the hands in seafood workers was much higher than that in community residents (26.1% vs 2.7%, p<0.001). Without wearing waterproof gloves, longer working time per day, longer history of seafood work increased the risk of hand dermatitis, instead of candidial infection of the hands and nails.ConclusionHand skin diseases are highly prevalent in seafood workers in Ningbo, a city in eastern China. This public health problem should be addressed in this population.

A behaviour change package to prevent hand dermatitis in nurses working in the National Health Service: results of a cluster randomized controlled trial.

SummaryBackgroundOccupational hand dermatitis poses a serious risk for nurses.ObjectivesTo evaluate the clinical and cost‐effectiveness of a complex intervention in reducing the prevalence of hand dermatitis in nursesMethodsThis was a cluster randomized controlled trial conducted at 35 hospital trusts, health boards or universities in the UK. Participants were (i) first‐year student nurses with a history of atopic conditions or (ii) intensive care unit (ICU) nurses. Participants at intervention sites received access to a behavioural change programme plus moisturizing creams. Participants at control sites received usual care. The primary outcome was the change of prevalent dermatitis at follow‐up (adjusted for baseline dermatitis) in the intervention vs. the control group. Randomization was blinded to everyone bar the trials unit to ensure allocation concealment. The trial was registered on the ISRCTN registry: ISRCTN53303171.ResultsFourteen sites were allocated to the intervention arm and 21 to the control arm. In total 2040 (69·5%) nurses consented to participate and were included in the intention‐to‐treat analysis. The baseline questionnaire was completed by 1727 (84·7%) participants. Overall, 789 (91·6%) ICU nurses and 938 (84·0%) student nurses returned completed questionnaires. Of these, 994 (57·6%) had photographs taken at baseline and follow‐up (12–15 months). When adjusted for baseline prevalence of dermatitis and follow‐up interval, the odds ratios (95% confidence intervals) for hand dermatitis at follow‐up in the intervention group relative to the controls were 0·72 (0·33–1·55) and 0·62 (0·35–1·10) for student and ICU nurses, respectively. No harms were reported.ConclusionsThere was insufficient evidence to conclude whether our intervention was effective in reducing hand dermatitis in our populations. Linked Comment: Brans. Br J Dermatol 2020; 183:411–412.

Screening for hand dermatitis in healthcare workers: Comparing workplace screening with dermatologist photo screening.

Healthcare workers are at increased risk for occupational contact dermatitis, owing to wet work exposure. Early detection and management improves outcomes. Although several diagnostic tools are available, none is appropriate for rapid screening. To assess the validity and feasibility of the Hand Dermatitis Screening Tool in the acute healthcare sector. Screening of 508 employees at three hospitals in Ontario, Canada was performed with the Hand Dermatitis Screening Tool either by an occupational health nurse (N = 225) or by self-administration (N = 283). Two occupational dermatologists rated photographs of participants' hands. Of the participants, 30.5% screened positive for hand dermatitis. A positive screen was associated with wet work, history of eczema, dermatitis, or other rash, and currently having a rash. Ninety-four per cent of participants reported that using the tool took <2 minutes, 99% indicated that the tool was easy to use, and 86% stated that workplace screening was very important. Workplace and dermatologist photo screening showed fair agreement. The prevalence of hand dermatitis and identified risk factors were consistent with the literature. These findings, along with positive feasibility results, support further testing of the tool despite only fair agreement between workplace and dermatologist screening.

Occupational hand dermatitis in car repair workers.

IntroductionExposure to used gasoline engine oils during oil change and other automobile repair services is common for many mechanics, electrical technicians, and other car service workers. We aimed to determine the prevalence of hand dermatitis in car repair workers with different specialty and actual dermal exposure hazards in the workplace.MethodsWe examined the dermal problems in 153 male car repair workers and compared it to 140 office workers. Exposed and control groups were administered a Nordic Occupational Skin Questionnaire. Dermal exposure score also was calculated.ResultsThe prevalence of hand dermatitis in car repair workers (19.0%) was significantly higher than office worker (7.9%) [OR: 2.74, (95% CI = 1.31, 5.73)] and also higher than general population. Prevalence of atopic dermatitis was significantly higher in exposed group that had hand dermatitis compared with those who had no hand dermatitis (P < 0.001). The highest hand dermatitis as well as actual dermal exposure was observed in the mechanics and transmission technician respectively.ConclusionCar repair workers have an elevated prevalence of hand dermatitis in comparison with office workers. The most important risk factors for hand dermatitis among car repair workers are atopic dermatitis and the next the level of skin exposure to potential skin hazards.

Hand dermatitis among patients visited the Dermatology Clinic of Al-Sadder Teaching Hospital,MisanProvince

Abstract&#x0D; Hand dermatitis is a common dermatosis which a polymorphic inflammatory reaction pattern that involving the skin layers (epidermis and dermis). There are a lot of factors that causing hand dermatitis with clinically wide range of manifestations. Females is at increasing risk of the hand dermatitis development.. The study aim is to determine the prevalence and the important common factors that affect the hand dermatitis&#x0D; Patients and methods: A cross- sectional study including a total number of patients with generalized eczema in the body were 840.The number of the patients had hand eczema were 240. study was carried out during the period from 1st of January 2016 to 1st of November 2016.&#x0D; Results: In our study there were certain risk factors affected the patients presented with hand dermatitis were identified.. The results in study showed that(17.5%) had positive family history of hand dermatitis, (30%) had positive history of atopy and negative drug history had(77.5%). Patients with bilateral hands involvement (82.5% ) and the highest percentage in female at or older than 40years old(35.48% ).The highest percentage was among males in the (30-39 and above 40 years) age group with 44.44% for each group. Hand dermatitis more common in house wife then in building worker and nurse with married females have higher percentage 74% than non marriedones 26%. &#x0D; Conclusion : Hand dermatitis prevalence was higher in female patients at age of 20 to 29 years with one third of them had history of atopy, especially in house wives with excessive exposure to daily cleaning topical chemicals.

Testing the Hand Dermatitis Screening Tool in the Home Health Care Sector

Workers exposed to wet work are at an increased risk for occupational contact dermatitis and may benefit from screening to detect early disease. The objective of this study was to assess the prevalence of hand dermatitis in home care workers, identify factors that influence presence of disease, and explore feasibility and importance of workplace screening in the home care sector. Following institutional ethics approval, nurses, personal support workers, and rehab therapists at one large home care provider in Ontario, Canada, self-screened for hand dermatitis using the Hand Dermatitis Screening Tool and accompanying photo guide and completed a short feasibility evaluation. Of the 220 participants, 18% had a positive screen for hand dermatitis and 77% reported exposure to wet work. In all, 93% of participants reported using the tool took less than 2 minutes and 84% reported screening for hand dermatitis is important. In conclusion, prevalence of hand dermatitis in home care workers is higher than reported in the general population. Workplace screening for hand dermatitis was deemed important, and the tool was feasible to use in the home care sector.

The Prevalence of Hand Dermatitis in Nurses: A Narrative Review Highlighting the Importance of Prevention

The Prevalence of Hand Dermatitis in Nurses: A Narrative Review Highlighting the Importance of Prevention

The effectiveness of a skin care program for the prevention of contact dermatitis in health care workers (the Healthy Hands Project): study protocol for a cluster randomized controlled trial

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.

Recent advances in the management of hand dermatitis: Does alitretinoin work?

Hand dermatitis can cause significant morbidity. It is not only pruritic, painful, and adversely affects manual dexterity, but it is also very visible, resulting in a substantial psychosocial and physical impact. The prevalence of hand dermatitis in the general population is 5% to 10%, and it appears to be twice as common in women than in men. Certain occupations predispose workers to hand dermatitis, especially those that require frequent hand washing or exposure to particular substances such as solvents. Hand dermatitis has a significant economic effect on society, and the socioeconomic and psychologic effect for the individual can be catastrophic. The need for effective management of this condition is, therefore, quite clear; however, historically hand dermatitis is difficult to treat. This contribution reviews the various types of hand dermatitis and how best to manage them and examines the role which the recently introduced drug alitretinoin now plays in managing this clinically challenging condition.

Hand dermatitis among veterinarians from Queensland, Australia

Although hand dermatitis (HD) represents a frequent occupational issue for many health professionals, little is known about the prevalence and distribution of HD among veterinarians, particularly in Australia. We utilized a previously validated questionnaire survey to examine a cross-section of veterinarians from Queensland, Australia, to determine the prevalence of HD and its associated factors. We conducted a questionnaire-based survey of HD, which was mailed to 1094 veterinarians registered with the Veterinary Surgeons Board of Queensland during 2006 (64.0% response rate). The overall prevalence rate of HD during this study was 15.9%. HD prevalence was significantly higher in those with current allergic disease (P < 0.001), among female veterinarians (P < 0.001), and those reporting latex allergy in the past 12 months (P < 0.001). Overall, this study suggests that HD may be more prevalent among veterinarians in Queensland than among their counterparts studied elsewhere. Veterinary practices may need to consider making non-latex gloves available or avoiding latex products wherever possible, particularly for their female staff. The importance of HD to the veterinary profession is predicted to increase as females begin to make up a greater proportion of registered veterinarians as result of a demographic shift.

Workplace Hazards Among Australian Dental Students

Workplace Hazards Among Australian Dental Students

Nurses’ perceptions of the benefits and adverse effects of hand disinfection: alcohol-based hand rubs vs. hygienic handwashing: a multicentre questionnaire study with additional patch testing by the German Contact Dermatitis Research Group

Nurses have a high risk of developing hand eczema due to hand disinfection procedures. To investigate the perception of nurses regarding the adverse effects of hand washing (HW) and alcoholic disinfection (ADI), and to obtain data on the prevalence of hand dermatitis and sensitization to alcohols and alcohol-based hand rubs (ABHRs). A self-administered questionnaire survey, carried out as a pilot study (PS), followed by a modified multicentre study (MC) in five hospitals. Patch tests to ethanol (80%), 1-propanol (60%), 2-propanol (70%) and ABHRs were performed in a subsample. The majority (PS 60.1%; MC 69.5%) of nurses considered ADI to be more damaging than HW. Mostly, ADI and HW were suspected to have irritant effects (ADI 79.2%/52.1%; HW 65.5%/36.2%) compared with an allergenic potential (ADI 10.4%/5.8%; HW 7.8%/3.9%). The prevalence of hand dermatitis in the MC was 13.4% by self-diagnosis and 22.4% by symptom-based questions. In 50 tested individuals no sensitization and only two irritant reactions to alcohols and three single-positive reactions to ABHRs were observed, none of the latter related to alcohols. Although ADI is known to cause less skin irritation than HW, nurses perceive ADI as more damaging, resulting in: (i) a low compliance with ADI and (ii) a higher prevalence of hand dermatitis because the more deleterious HW is preferred. This may result in an increase in occupational disease and nosocomial infections. Educational programmes should promote ADI as a procedure with good efficiency and skin tolerability to reduce the prevalence of hand eczema in nurses and to enhance compliance with hand hygiene standards.