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Techasatian L, Thaowandee W, Chaiyarit J, Uppala R, Sitthikarnkha P, Paibool W, Charoenwat B, Wongmast P, Laoaroon N, Suphakunpinyo C, Kiatchoosakun P, Kosalaraksa P. Hand Hygiene Habits and Prevalence of Hand Eczema During the COVID-19 Pandemic. J Prim Care Community Health 2021; 12:21501327211018013. [PMID: 34009056 PMCID: PMC8138294 DOI: 10.1177/21501327211018013] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: This study aimed to explore the prevalence of and possible risk factors for
hand eczema with respect to the dissemination of information about new hand
hygiene habits to protect against ongoing COVID-19 cross-transmission. The
authors conducted a survey among health care workers (HCWs) and non-HCW
populations in Khon Kaen, Thailand. Results: A total of 805 participants participated. The prevalence of hand eczema in
the study population was 20.87%. There were several risk factors, including
working as a HCW, having a history of previous hand eczema, having
underlying atopic dermatitis, wearing gloves in everyday life, and washing
hands frequently (more than 10 times/day). Hand hygiene with alcohol-based
products was shown to be a risk factor for hand eczema, (OR (95% CI) 1.86
(1.03-3.35), P = .04). Conclusion: In terms of hand eczema prevention, we suggest that the use of alcohol-based
products should be discontinued if other handwashing methods are available.
The following factors increase the risk of hand eczema: being a HCW, having
previous hand eczema, and having underlying atopic dermatitis. Proper
strategies in terms of hand eczema prevention should be addressed,
especially in this group, since we need to continue performing hand hygiene
during the ongoing COVID-19 pandemic.
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The Utility of a Questionnaire Proposal as an Analytic Diagnostic Tool in Healthcare Providers Occupational Hand Eczema. JOURNAL OF INTERDISCIPLINARY MEDICINE 2020. [DOI: 10.2478/jim-2020-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
The aim of this study was to estimate the prevalence of self-reported work-related and occupational hand eczema, as well as associated risk factors in hospitals and out-patient clinics in Romania. A standardized questionnaire was addressed to health professionals from different medical fields. Out of 245 healthcare providers who completed the survey, 235 were women (95.9%), and 243 were working more than 8 hours/day in hospitals (99.18%). Hand eczema was self-reported and documented in almost one third of the nurses (33.49%), the most frequently involved trigger factor being powdered latex gloves. A total of 207 (84.48%) individuals denied any present or past allergic diseases. Only one nurse declared that severe hand eczema was the cause of losing her job at the hospital. Exposure assessment is essential for the diagnosis of work-related or occupational skin diseases.
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Diepgen TL, Andersen KE, Chosidow O, Coenraads PJ, Elsner P, English J, Fartasch M, Gimenez-Arnau A, Nixon R, Sasseville D, Agner T. Guidelines for diagnosis, prevention and treatment of hand eczema. J Dtsch Dermatol Ges 2015; 13:e1-22. [PMID: 25763418 DOI: 10.1111/ddg.12510_1] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). In addition to the evidence- and consensus-based recommendation on the treatment of HE, the guidelines cover mainly consensus-based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non-pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long-term treatment beyond six weeks only when necessary and under careful me-dical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed.The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wis-senschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medi-cal Societies in Germany).No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest.
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Fronteira I, Ferrinho P. Do nurses have a different physical health profile? A systematic review of experimental and observational studies on nurses' physical health. J Clin Nurs 2011; 20:2404-24. [PMID: 21752130 DOI: 10.1111/j.1365-2702.2011.03721.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM To review the evidence on nurses' health systematically. BACKGROUND Nurses are one of the most important resources of a health system. They are subjected to biological, socio-economic, cultural and health system factors that determine their health. Although mental and physical health problems seem to prevail among nurses, literature is often contradictory. The literature on health styles, health behaviours and self perceived health of nurses is also unclear. DESIGN Systematic review of experimental and observational studies on nurses' health. METHODS Forty-three databases searched. 2692 references identified as of potential interest; 187 studies included. Only the results from studies on physical health are presented. No meta-analysis was possible. The Scottish Intercollegiate Guidelines Network system was used to rate evidence. RESULTS Nurses were at greater risk of musculoskeletal injuries and more prone to blood-borne pathogens infections than other health care workers. They were at greater risk of breast cancer than other female health care workers. Nurses in hospitals were more at risk of tuberculosis. They did not have excess risk of cancer in general, Hodgkin's disease, stomach, colon, rectum, pancreatic, ovary, kidney, brain or thyroid cancer or of lymphosarcoma. They have a higher prevalence of occupational allergies than clerical workers. DISCUSSION Nurses suffer more from musculoskeletal disorders which is consistent with the nature of nursing work. They are at greater risk of acquiring tuberculosis, particularly if they work in pulmonary, medicine or Human Immunodeficiency Virus wards which might be due to repeated contact with infected patients. Nurses are also more prone to blood-borne pathogens infections which might be explained by exposure while working. The proneness to occupational allergies can be explained by exposure to a series of chemical agents. RELEVANCE TO CLINICAL PRACTICE Without sound knowledge on nurses' health and it is not possible to develop specific occupational health programmes.
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Affiliation(s)
- Inês Fronteira
- Health Systems Unit, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Lisboa, Portugal.
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Ibler KS, Agner T, Hansen JL, Gluud C. The Hand Eczema Trial (HET): Design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema. BMC DERMATOLOGY 2010; 10:8. [PMID: 20807407 PMCID: PMC2939593 DOI: 10.1186/1471-5945-10-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Accepted: 08/31/2010] [Indexed: 11/10/2022]
Abstract
Background Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema. Methods/Design We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index); self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life. Trial registration The trial is registered in ClinicalTrials.Gov, NCT01012453.
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Won JU. Health Effects of Chemicals used in hospitals among Healthcare Workers. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2010. [DOI: 10.5124/jkma.2010.53.6.474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jong Uk Won
- Department of Preventive Medicine, Yonsei University College of Medicine and Institute for Occupational Health, Korea
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Lampel HP, Patel N, Boyse K, O'Brien SH, Zirwas MJ. Prevalence of hand dermatitis in inpatient nurses at a United States hospital. Dermatitis 2008; 18:140-2. [PMID: 17725920 DOI: 10.2310/6620.2007.06024] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Hand dermatitis is a significant problem among inpatient nurses. Accurate population-based data on the prevalence and risk factors for hand dermatitis in this group are lacking. OBJECTIVE To determine the prevalence of hand dermatitis in inpatient nurses at a US hospital. METHODS Each nursing unit in a single hospital was visited twice by a single physician. All nurses working at the time of each visit were questioned and examined. No nurses were enrolled twice. RESULTS Fifty-five percent (92 of 167) of the nurses had hand dermatitis. Among intensive care unit (ICU) nurses, the prevalence was 65% (35 of 54); among non-ICU nurses, the prevalence was 50% (57 of 113). In nurses with self-reported atopic dermatitis, the prevalence was 71% (12 of 17); in nurses without self-reported atopic dermatitis, it was 53% (80 of 150). Data collection on variables such as hand hygiene and glove use relied on subject recall and was considered unreliable. There was a low prevalence of atopic patients. CONCLUSIONS Hand dermatitis affects over 50% of inpatient nurses. Hand dermatitis appears to be more common in the ICU setting and in nurses with a self-reported history of atopy.
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Affiliation(s)
- Heather P Lampel
- Department of Dermatology, University of Pittsburgh Medical Center, PA, USA
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Abstract
Occupational skin diseases are frequent in the healthcare sector. The objective of this study was to obtain baseline data on hand eczema and risk factors for hand eczema in an unselected hospital population. A questionnaire study on hand eczema and risk factors for hand eczema was performed among hospital employees at a middle-size Danish hospital. A total of 1909 employees from all job groups and all departments were included. Response rate was 65.3%. The overall frequency of self-reported hand eczema within the past 12 months was 23%. Divided into job groups, the frequencies varied from 8% to 32% and were significantly higher among assistant nurses (32%), nurses (30%), and nursing aids (27%). For the individual departments, the hand eczema frequencies varied from 7% to 50%, with the highest frequencies reported at medical and surgical wards. Occupational risk factors for hand eczema such as use of protective gloves and hand washing were significantly more frequent among respondents with hand eczema within the past year, which suggests a potential for prevention through workplace interventions. In conclusion, high frequencies of hand eczema were observed among assistant nurses, nurses, and nursing aids. Hand eczema was more frequent among women and in the younger age groups.
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Affiliation(s)
- Mari-Ann Flyvholm
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark.
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Weisshaar E, Radulescu M, Soder S, Apfelbacher CJ, Bock M, Grundmann JU, Albrecht U, Diepgen TL. Secondary individual prevention of occupational skin diseases in health care workers, cleaners and kitchen employees: aims, experiences and descriptive results. Int Arch Occup Environ Health 2006; 80:477-84. [PMID: 17091305 DOI: 10.1007/s00420-006-0154-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 09/21/2006] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants' attitudes towards health) and medical aims (e.g. optimising diagnostic procedures, complementing individual therapy). METHODS Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient's history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. RESULTS In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. CONCLUSIONS There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions.
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Affiliation(s)
- Elke Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital of Heidelberg, Thibautstrasse 3, 69115 Heidelberg, Germany.
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Weisshaar E, Radulescu M, Bock M, Albrecht U, Diepgen TL. Educational and dermatological aspects of secondary individual prevention in healthcare workers. Contact Dermatitis 2006; 54:254-60. [PMID: 16689809 DOI: 10.1111/j.0105-1873.2006.00811.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Healthcare workers (HCW) have an increased risk of suffering from occupational skin diseases (OSDs). Therefore, we established special prevention and skin protection courses for HCW. Medical aims are to optimize diagnostic procedures and individual therapy, educational aims are to improve individual skin protection/skin care habits of the patient and also to influence the participants' attitudes towards health. Participants are patients that have been suspected to suffer from an OSD and are insured with the German Accident Prevention Insurance Association for Health Care Workers (BGW). Teaching units mainly focus on the texture and functioning of the skin, general aspects of OSDs, general information concerning skin protection, instructions about the correct use of skin cleansing and skin protection products. Besides, every participant is clinically examined by a dermatologist and a precise patient's history is obtained. Individually adapted skin protection strategies are developed. Patients can ask the dermatologist questions in confidence. 504 patients (mean age: 36.9 years, SD = 11.7) participated in the skin protection courses. 94.6% (n = 477) suffered from hand eczema frequently caused by a mixture of atopic, irritant and allergic contact dermatitis, but irritant contact dermatitis was the most frequent diagnosis (55.4%, n = 279). The participants rated the course as good to excellent. Health education and advisory services in occupational dermatology are still fragmentary. Prevention of OSD and maintenance of health through education are important complementary measures for dermatological care. In the future, similar educational programmes should be offered for employees of other professions with an increased risk for OSD.
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Affiliation(s)
- Elke Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital of Heidelberg, Heidelberg, Germany.
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Abstract
With almost 65 million women in the workforce, their representation in various occupational sectors is crucial, as is their health and safety. Female-dominated occupations in health care and cosmetology along with their potential cutaneous exposures are reviewed. Proper evaluation and management are necessary to minimize the disability that can result from these illnesses.
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Affiliation(s)
- Antoine Amado
- Department of Dermatology, Desk A-61, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Weisshaar E, Radulescu M, Bock M, Albrecht U, Zimmermann E, Diepgen TL. [Skin protection and skin disease prevention courses for secondary prevention in health care workers: first results after two years of implementation]. J Dtsch Dermatol Ges 2006; 3:33-8. [PMID: 16353747 DOI: 10.1046/j.1439-0353.2005.04798.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Healthcare workers have an increased risk of occupational dermatoses. In January 2002, the Department of Social Medicine, Occupational and Environmental Dermatology of the University of Heidelberg started organizing special prevention courses for this group of employees in cooperation with the Accident Prevention & Insurance Association for Health Care Workers (BGW). The major aims are to improve individual skin protection and skin care habits, as well as to optimize diagnostic procedures and therapy. PATIENTS AND METHODS The two-day course has up to 14 participants. Teaching units mainly focus on skin structure and function, general aspects of occupational skin diseases, general information concerning skin protection and practical exercises emphasizing the correct use of skin cleansing and skin protection products. Additionally, every participant undergoes a dermatological examination including a detailed history and skin inspection. Individual skin protection strategies are developed, and the participants are provided with the opportunity to ask the dermatologist questions in confidence. RESULTS Most of the 355 participants have been female (87.3%) with a mean age of 36.9 years. 95% had hand eczema, predominantly dyshidrotic morphology. In many cases, there was a mixture of atopic, irritant and allergic contact dermatitis but irritant contact dermatitis was most common (43%). Atopy was present in 68% of the patients. The participants rated the course as good to excellent. Other benefits are the exchange of experience between patients working in the same or similar occupations and transfer of the new knowledge to colleagues, family and friends. CONCLUSIONS Examinations and advisory services in occupational dermatology are still fragmentary. Skin barrier creams and moisturizers are not sufficiently utilized in daily practice. In the future, similar courses should be offered for employees in other professions with an increased risk of occupational skin diseases.
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Affiliation(s)
- Elke Weisshaar
- Abteilung Klinische Sozialmedizin, Berufs- und Umweltdermatologie, Universitätsklinikum Heidelberg.
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Scott A, Egner W, Gawkrodger DJ, Hatton PV, Sherriff M, van Noort R, Yeoman C, Grummitt J. The national survey of adverse reactions to dental materials in the UK: a preliminary study by the UK Adverse Reactions Reporting Project. Br Dent J 2004; 196:471-7; discussion 465. [PMID: 15105862 DOI: 10.1038/sj.bdj.4811176] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2002] [Accepted: 07/01/2003] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Dental treatment involves the use of a wide range of materials. Many of the dental materials or their components pose a potential risk to the patient and member of the dental team. Pre-market biocompatibility testing cannot guarantee absolute safety, making monitoring of materials likely to cause an adverse reaction essential. The prevalence of adverse reactions to dental materials amongst dental patients and staff has not been systematically monitored in the UK. This project aims to develop a systematic approach to the evaluation and monitoring of the extent and severity of adverse reactions to dental materials in the UK. METHOD Through the distribution of reporting forms to dental surgeries and laboratories in the UK, the ARRP has received 1,075 complete reports relating to adverse reactions seen or experienced by dental staff and patients. RESULTS The main findings were that different materials cause adverse reactions to different groups of people. The largest proportion of patient related adverse reactions were reported to be due to metals (n = 175). These were mainly amalgam associated oral lichenoid reactions (n = 124). Dental technicians reported acrylic resin as the causal factor of hand dermatitis in 61% (44 out of a total 72) of cases reported. Finally, dental surgery staff reported gloves as causing hand dermatitis in 75% of cases (398 out of a total 531). CONCLUSIONS Different dental materials affect different person groups depending on their exposure to the material. Dental staff are most at risk from an adverse reaction to latex gloves, whereas most reported reactions for patients were due to metals. For dental technicians the biggest danger of an adverse reaction was from acrylic resins. There is a need to continue to raise the awareness among dental professionals of the existence of the Adverse Reactions Reporting Project so as to overcome problems of under-reporting.
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Affiliation(s)
- A Scott
- Department of Adult Dental Care, University of Sheffield, Sheffield S10 2TA
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Scott A, Gawkrodger DJ, Yeoman C, Egner W, van Noort R, Hatton PV, Grummitt J. Adverse reactions to protective gloves used in the dental profession: experience of the UK Adverse Reaction Reporting Project. Br Dent J 2003; 195:686-90. [PMID: 14718955 DOI: 10.1038/sj.bdj.4810821] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2002] [Accepted: 03/31/2003] [Indexed: 11/09/2022]
Abstract
The Adverse Reaction Reporting Project (ARRP) was set up to measure the extent and severity of adverse reactions to dental materials in the UK. Further analysis into the use of protective gloves has been carried out to establish the degree to which gloves are having a deleterious effect on the dental profession. In addition the survey aimed to establish the techniques used to manage adverse reactions and their effectiveness. In a 23-month period, 369 reports were received concerning adverse reactions to protective gloves used in dental practices. Reporters were contacted for further information, and a 92% response rate was achieved. The 330 reports analysed showed dentists to be the largest group to report adverse reactions, whilst dental technicians reported the fewest. The referral rate for staff and patients was similar with a third of adverse reactions being referred (n=110) to a specialist for diagnosis. A confirmed diagnosis was received in 65% of referred cases (n=72), but the symptoms reported suggested a larger degree of Type I reactions occurring than diagnosed. The use of non-powdered gloves appeared to be favoured over powdered gloves in 42% of glove changes, and nitrile gloves were used as an alternative to latex in 39% of changes. In conclusion, the results from this survey showed that wearing gloves in dental practices in the UK caused a range of adverse reactions. In 79% (n=330) of cases reported and analysed, these reactions were readily resolved or improved by self-medication, prescribed medication and/or changing to a different type of protective glove.
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Affiliation(s)
- A Scott
- Department of Adult Dental Care, University of Sheffield, Sheffield
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Abstract
The prevalence of reactions against natural rubber latex (NRL) is thought to be increasing in both the general public and healthcare workers. These can vary from mild benign skin reactions to bronchospasm, anaphylactic shock, and death. Difficulties exist for ophthalmic departments wishing to establish protocols in providing 'latex-free environments' for patients undergoing cataract surgery. Currently no legislation exists regarding the labelling of NRL-containing products in the United Kingdom with information on a product's NRL content provided by the manufacturer on a voluntary basis only. It is hoped this review article will act as a basic guide in the management of NRL-sensitive patients undergoing cataract surgery in the United Kingdom.
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Affiliation(s)
- D Cheung
- Birmingham and Midland Eye Centre, City Hospital NHS Trust, UK.
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Dickel H, Bruckner T, Bernhard-Klimt C, Koch T, Scheidt R, Diepgen TL. Surveillance scheme for occupational skin disease in the Saarland, FRG. First report from BKH-S. Contact Dermatitis 2002; 46:197-206. [PMID: 12081697 DOI: 10.1034/j.1600-0536.2002.460403.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Occupational skin disease (OSD) is a significant public health concern. To keep OSDs under surveillance, a register of OSDs (BKH-S) was implemented in 1999 in the Saarland, FRG. We conducted a population-based register study to analyse all initial reports of OSDs reported to the BKH-S. 336 cases were prospectively assessed from July 1999 to June 2001. In 78% (n = 263) of the cases an occupational cause for the skin disease was stated, 91% (n = 240) of which fell within 16 occupational groups. This is equivalent to 6.8 cases per 10,000 workers per year within these occupational groups. Notably, young age groups (median age 35 years) were affected with a female predominance. The most frequent final diagnosis was irritant contact dermatitis (75%) followed by allergic contact dermatitis (34%) and atopic dermatitis (19%). The overall prevalence of occupationally relevant delayed-type reactors was 21% and of immediate-type reactors 17%. Work-related delayed-type sensitizations to potassium dichromate (n = 8) and immediate-type sensitizations to natural rubber latex (n = 11) were the most frequently observed. Questionnaire results showed frequent occupational skin contact with wet work (59%), detergents (48%), and disinfectants (38%). The second valid surveillance scheme for OSD in the FRG has been introduced and can be made available for further analysis.
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Affiliation(s)
- H Dickel
- Department of Clinical Social Medicine, Centre of Occupational and Environmental Dermatology, University Hospital of Heidelberg, Heidelberg, Germany
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Hebert AA, Warken KA, Cherill R. Pimecrolimus cream 1%: a new development in nonsteroid topical treatment of inflammatory skin diseases. SEMINARS IN CUTANEOUS MEDICINE AND SURGERY 2001; 20:260-7. [PMID: 11770913 DOI: 10.1053/sder.2001.29062] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Atopic dermatitis (AD) is one of a family of inflammatory skin diseases (psoriasis, irritant contact dermatitis, and allergic contact dermatitis). Dermal inflammation and production of proinflammatory cytokines by activated T cells is a prominent and defining characteristic in all of these conditions. Corticosteroids, though effective and potent immunosuppressants, are associated with a number of systemic and local adverse effects. The ascomycin derivative pimecrolimus (formerly ASM 981) is a nonsteroid with topical anti-inflammatory activity. Pimecrolimus cream 1% is minimally absorbed into the circulation; thus, it has a low bioavailability-reducing the risk for systemic adverse effects. The efficacy and safety of pimecrolimus cream 1% has been well shown in diverse patient populations with inflammatory skin diseases in several well-controlled trials. Significant and rapid amelioration of the signs and symptoms of AD was established in 3 studies lasting 6 weeks each, evaluating 589 pediatric patients. In a 1-year study, pimecrolimus was applied at the first signs and symptoms of eczema to prevent the progression of AD to flares. Flares were prevented in over 50% of patients who used pimecrolimus cream 1%, reducing or completely eliminating the need for topical corticosteroids during a 1-year treatment period. Results in pimecrolimus studies in chronic irritant hand dermatitis and chronic hand dermatitis of mixed causes indicate potential for use in these important diseases, and further study in these indications is warranted.
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Affiliation(s)
- A A Hebert
- Department of Dermatology, The University of Texas Medical School, Houston, USA
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Abstract
Contact sensitivity to drugs administered systemically occurs mainly among healthcare workers, pharmaceutical operatives, and veterinary surgeons. Of the 14,689 patients suspected of contact allergy examined in our department from 1978 to 2001, occupational allergic contact dermatitis from drugs in healthcare workers was diagnosed in 33, the first in 1980. The most common sensitizers were antibiotics such as penicillins, cephalosporins, and aminoglycosides. They accounted altogether for 35 positive patch tests, followed by propacetamol hydrochloride, and ranitidine hydrochloride, which elicited 10 and 7 positive reactions, respectively. The aim of this report is to draw attention to the importance of occupational contact allergy to drugs in healthcare workers. By far the greatest number of the sensitized patients in this series were nurses, there being 26 nurses, 4 veterinarians, 2 pharmacists, and 1 medical doctor.
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Affiliation(s)
- K Gielen
- Department of Dermatology, Katholieke Universiteit Leuven, B-3000 Leuven, Belgium
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