Prevention Of Irritant Contact Dermatitis Research Articles

Prevention of Irritant Contact Dermatitis Due to Hand Hygiene in The Era of COVID 19 Pandemic

Irritant contact dermatitis (ICD) is an inflammatory epidermal disorder associated with physical or immunological provocation that results in impaired skin barrier. The prevalence of ICD is found to be 17-30% in healthcare workers compared to general population. The first-line management strategies of ICD is based on prevention. Intensive hand cleansing is one of the causes of ICD. Hand hygiene is general term that refers to any action of hand cleansing. Hand hygiene practices include hand washing and hand rubbing with antiseptics. Hand hygiene is the most effective preventive measure in preventing infection control, especially in the era of coronavirus (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since December 2019. This disease is transmitted through inhalation or contact with infected droplets. Prevention and mitigation actions are key in controlling infection.

The Efficacy to Prevent Irritant Hand Eczema: an Overview of the Interventional Procedures

Interventional procedures to prevent hand eczema (HE), comprising educational programs, are widely used for primary, secondary, and tertiary prevention of irritant contact dermatitis on the hands. This review gives an overview of randomized controlled trials (RCTs) addressing the efficacy of interventional procedures and educational programs in HE prevention. RCTs on HE prevention differ with respect to form and implementation of interventions, populations, and follow-up times. Overall, the education has focused on use of moisturizers, gloves, and substitution of hand washes with alcohol-based hand rubs. Regarding outcome measures, the effect of interventions on prevalence (i.e., primary prevention) has been inconclusive. Meanwhile, educational programs aiming at HE patients (secondary prevention) had a positive effect on behavior in four out of five RCTs and a decrease in HE severity in four out of six RCTs (one with group-based and three with individual-based education). Positive effect on knowledge and on health-related quality of life was only found in few studies. Overall, preventive educational programs are useful. Along with intensified, individual-based educations rather than group-based education, a shorter follow-up time seems to influence outcome measures positively. Future studies should investigate the long-term benefit from repeated educational sessions to maintain the positive benefits.

The three moments of skin cream application: an evidence‐based proposal for use of skin creams in the prevention of irritant contact dermatitis in the workplace

Contact dermatitis is one of the most common occupational diseases, with serious impact on quality of life, lost days at work and a condition that may be chronically relapsing. Regular prophylactic skin cream application is widely acknowledged to be an effective prevention strategy against occupational contact dermatitis; however, compliance rates remain low. To present a simple programme for skin cream application in the workplace with focus on implementation to drive down the rate of occupational irritant contact dermatitis, an expert panel of eight international dermatologists combined personal experience with extensive literature review. The recommendations are based on clinical experience as supported by evidence‐based data from interventional studies. The authors identified three moments for skin cream application in the work place: (i) before starting a work period; (ii) after washing hands; and (iii) after work. Affecting behaviour change requires systematic communications, monitoring and reporting, which is proposed through Kotter's principles of organizational change management. Measurement tools are provided in the appendix. Interventional data based on application of this proposal is required to demonstrate its effectiveness.

Prevention of Irritant Contact Dermatitis among Health Care Workers by Using Evidence-Based Hand Hygiene Practices: A Review

Irritant contact dermatitis is often found on the hands of healthcare workers and is generally caused by frequent hand washing, gloves, aggressive disinfectants or detergents. Alcohols have only a marginal irritation potential, although they may cause a burning sensation on pre-irritated skin. A burning sensation when using alcohols therefore, suggests that the skin barrier is already damaged. Two options for hand hygiene are generally available in clinical practice: (1) hand washing with some type of soap and water or (2) hand disinfection with alcohol-based hand rubs. Most clinical situations require the use of an alcohol-based hand rub for decontamination, which is especially useful for reducing the nosocomial transmission of various infectious agents. Washing one's hands should be the exception, to be performed only when they are visibly soiled or contaminated with proteinaceous material, or visibly soiled with blood or other body fluids. The overall compliance rate in hand hygiene is around 50%, which is far too low. In addition, healthcare workers quite often wash their hands with soap and water, when they should use an alcohol-based hand rub. This not only adds to the degree of skin irritation, but is also potentially dangerous for patients, due to the low efficacy of hand washing when compared to hand disinfection with alcohol rubs. Adhering to evidence-based hand hygiene protocols and following international guidelines on hand hygiene practices therefore, can help prevent irritant contact dermatitis among healthcare workers.

Skin protection programmes.

Educational programmes, including evidence-based recommendations on skin protection (skin protection programmes), have been proposed for the prevention of irritant contact dermatitis in occupations with a high frequency of this disease. Recent intervention studies directed at wet-work employees showed a positive influence on wet-work behaviour and on clinical skin symptoms. The structure and implementation of skin protection programmes are discussed.

Efficacy of a New Class of Perfluoropolyethers in the Prevention of Irritant Contact Dermatitis

Perfluoropolyethers (Fomblin HC products) are chemical non-reactive polymers with special physico-chemical properties that recently showed promise as protective preparations in the prevention of irritant contact dermatitis. We evaluated the efficacy of a new class of perfluoropolyethers (perfluoropolyether phosphate, Fomblin HC/P2) in the prevention of experimentally induced cumulative irritant contact dermatitis if applied prior to irritation. A panel of 20 healthy volunteers was tested with a repetitive irritation test using 4 standard irritants (sodium lauryl sulphate of highest purity, sodium hydroxide, lactic acid and toluene) in a randomized double-blind study. Application sites were assessed clinically and by the use of bioengineering techniques (transepidermal water loss and chromametry). Three gel preparations each containing 5% perfluoropolyether phosphate showed significant efficacy against irritation due to sodium lauryl sulphate and sodium hydroxide, while one test preparation containing 2% showed inferior benefit, indicating a dose-related effect. Preparations containing perfluoropolyether phosphates can be recommended for workplaces with water-soluble irritants. Further studies under real workplace conditions are indicated.

Perfluoropolyethers in the Prevention of Irritant Contact Dermatitis

Background: Perfluoropolyethers (PFPEs) are non-reactive perfluorinated (no hydrogen atoms) liquid polymers that showed promise as ingredients of protective preparations in occupational dermatology. Objective: The aim of this study was to investigate if oil-in-water (o/w) emulsions containing 0.5, 1.0, 2.0 and 4.0% PFPEs (molecular weight 6,250 D) prevent epidermal barrier disruption induced by a repetitive irritation test (RIT). Methods: PFPE-containing o/w emulsions and the emulsion base alone were evaluated against a set of 4 irritants [10% sodium lauryl sulphate (SLS), 0.5% sodium hydroxide (NaOH), 15% lactic acid (LA), and undiluted toluene (TOL)] in the RIT. Ten subjects were tested on the paravertebral skin of the mid-back. Irritation was assessed by visual scoring, transepidermal water loss (TEWL) and colorimetry. Results: Both the emulsion base and all PFPE-containing preparations significantly suppressed irritation by SLS and NaOH. Against LA and TOL, only the 4% PFPE-containing preparation was significant as assessed by TEWL. Conclusion: A 4% PFPE-containing o/w emulsion significantly inhibits irritation due to a wide spectrum of hydrophilic and lipophilic irritants. o/w emulsions with lower concentrations of PFPE are also effective against SLS and NaOH, but this is also true for the cream base alone. Therefore, further studies are necessary to evaluate if a minimum of 4% PFPE in the base provides additional benefit.

Reproducibility of a non-invasive skin irritancy test in a cohort of metalworker trainees.

The identification of subjects with increased susceptibility to irritants may play an important rôle in the prevention of irritant contact dermatitis. A short and quick method of non-invasive testing for assessing irritant sensitivity was developed by Wilhelm and coworkers in 1990, based on the alkali resistance test of Burckhardt. In order to determine the reproducibility of this screening method, 204 healthy metalworker trainees were tested 2 x according to Wilhelm within an interval of 6 months. No statistically-significant correlation could be shown, indicating that the reproducibility of this screening method is low. Therefore, we propose applying not just a single test for the assessment of skin irritability, but a series of tests, in order to improve the reliability of this kind of testing.

An immunohistochemical study on mild skin irritation induced by a single application of a low-molarity sodium dodecyl sulfate solution: keys to the prevention of irritant contact dermatitis.

An immunohistochemical study on mild skin irritation induced by a single application of a low-molarity sodium dodecyl sulfate solution: keys to the prevention of irritant contact dermatitis.