1
|
Glenn Ullum A, Barati Sedeh F, Jemec GBE, Ibler KS. Professional Cleaners' and Healthcare Workers' Ability to Recognize Hand Eczema. Acta Derm Venereol 2024; 104:adv27985. [PMID: 38501841 DOI: 10.2340/actadv.v104.27985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/30/2024] [Indexed: 03/20/2024] Open
Abstract
Timely intervention reduces the risk of a poor prognosis in hand eczema, making early recognition of symptoms important in high-risk professions. However, limited data exist regarding the ability of cleaners and healthcare workers to recognize hand eczema. The aim of this study was to examine cleaners' and healthcare workers' ability to recognize hand eczema in clinical photographs and to assess the severity of the disease. Cleaners and healthcare workers completed a questionnaire consisting of 16 questions and participated in a structured interview referring to a validated photographic severity guide for chronic hand eczema, which comprised clinical photographs of hand eczema at varying levels of severity. Eighty cleaners and 201 healthcare workers (total N = 281) participated in the study. The rates of correctly identified hand eczema in clinical photographs (cleaners/ healthcare workers) were: 41.2%/57.7% (mild hand eczema), 81.2%/92.0% (moderate hand eczema), 85.0%/94.5% (severe hand eczema) and 82.5%/97.0% (very severe hand eczema). The proficiency of healthcare workers in recognizing hand eczema was significantly higher than that of cleaners. The results indicate that a large proportion of cleaners and healthcare workers fail to recognize mild hand eczema in clinical photographs. Healthcare workers had higher success rates in recognizing hand eczema in all severity categories. Symptom underestimation may lead to under-reporting of the true prevalence of hand eczema, with consequent loss of opportunities for prevention.
Collapse
Affiliation(s)
- Anna Glenn Ullum
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Farnam Barati Sedeh
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Sophie Ibler
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Brans R, John SM, Wilke A, Hübner A. Programme for prevention of foot dermatoses in patients with work-related skin diseases: Baseline data and first results of a prospective cohort study (OCCUPES). Contact Dermatitis 2023; 89:259-269. [PMID: 37599097 DOI: 10.1111/cod.14400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Programmes for prevention of hand dermatoses in patients with work-related skin diseases (WRSD) are well established. Similar interventions for foot dermatoses (FD) are widely missing. OBJECTIVE To evaluate the effectiveness of a programme for prevention of FD based on health education in patients with WRSD while investigating the impact and possible causative factors of FD. METHODS In a prospective cohort study (OCCUPES), 231 patients with WRSD and FD participating in the programme were recruited. The skin was examined and questionnaires were completed, including assessment of footwear, FD severity, symptoms and health-related quality of life. RESULTS The baseline and some early results are presented. A work-related causation of FD was likely in 60 patients (26.0%) with irritant contact dermatitis being the most frequent diagnosis. Work-related FD were associated with male sex (p = 0.012), sweating in footwear (p = 0.004) and wearing of safety footwear (p = 0.013). FD were often long-lasting with a high degree of work-absenteeism, quality of life impairment, itch and pain, particularly in work-related FD. CONCLUSIONS Interventions are needed to reduce the burden of FD in patients with WRSD. The programme addresses current shortcomings in prevention of FD. A long-term evaluation of its effectiveness follows.
Collapse
Affiliation(s)
- Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Swen Malte John
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Annika Wilke
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Anja Hübner
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| |
Collapse
|
3
|
Prevalence, risk factors, and prevention of occupational contact dermatitis among professional cleaners: a systematic review. Int Arch Occup Environ Health 2023; 96:345-354. [PMID: 36409350 DOI: 10.1007/s00420-022-01937-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the prevalence, risk factors, and prevention of occupational contact dermatitis (OCD), as well as risk factors and consequences of OCD among professional cleaners. METHODS A systematic review following PRISMA guidelines was performed using Medline, EMBASE, and Cochrane Library. RESULTS Thirty-nine studies containing over 109.000 participants were included in the review. The prevalence of OCD varied between 2.2% and 30.1%. Main occupational risk factors for developing OCD among cleaners included wet work and irritants in cleaning products (bleach, chlorine, ammonia, multi-use-cleaning) and skin contact to metal. The most common contact allergies included rubber, biocides, nickel/cobalt, and perfumes. Other risk factors were inconsistent use of protective gloves and low educational level. Consequences associated with OCD included significant impairment in quality of life, tendency to have unscheduled absence from work, sick leave, increased rate of disability, and recognized degree of injury. Only one prevention study has been published investigating the effect of an educative course in skin-protective behavior in cleaners. The study reported a higher degree of knowledge of skin protection, a decrease in the severity of hand eczema, and a shift toward fewer daily hand washings at follow-up after 3 months. CONCLUSION Our study proves that OCD is common in cleaners, and the main risk factors included wet work, irritants, and contact allergies, as well as inconsistent use of protective gloves and low educational level. More focus and a greater number of studies are needed on skin protection in this population.
Collapse
|
4
|
Larese Filon F, Maculan P, Crivellaro MA, Mauro M. Effectiveness of a Skin Care Program With a Cream Containing Ceramide C and a Personalized Training for Secondary Prevention of Hand Contact Dermatitis. Dermatitis 2023; 34:127-134. [PMID: 36939821 PMCID: PMC10029085 DOI: 10.1089/derm.2022.29002.flf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Background/Objectives: The aim of our study was to investigate the effectiveness of personalized training on skin protection associated with the regular use of ceramide-containing cream (CC) versus other creams (OC) for improving hand contact dermatitis. Methods: We performed a double-center randomized trial that enrolled workers with hand dermatitis. All workers received personalized training. The intervention was 3 times per day application of the study emollient. The control arm used an emollient of choice without ceramide, as needed. The primary outcome was improvement in hand dermatitis at 1 and 3 months of follow-up. Results: In total, 102 patients with hand dermatitis were enrolled in this study. Improvement in dermatitis was found in 40%, 52.5%, 50%, and 63% of OC and CC, at the first and second follow-ups, respectively. The use of CC was significantly associated with an improvement in dermatitis (odds ratios 2.6; 95% confidence intervals 1.30-5.2), analyzed using generalized equation estimation during the follow-up. Conclusion: Our study demonstrated that an educational personalized intervention could improve the signs and symptoms in patients with hand dermatitis, and the use of a CC resulted in a significantly better outcome during the 3 months of follow-up.
Collapse
Affiliation(s)
| | - Pietro Maculan
- Unit of Occupational Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | | | - Marcella Mauro
- From the *Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| |
Collapse
|
5
|
Thyssen JP, Schuttelaar MLA, Alfonso JH, Andersen KE, Angelova-Fischer I, Arents BWM, Bauer A, Brans R, Cannavo A, Christoffers WA, Crépy MN, Elsner P, Fartasch M, Larese Filon F, Giménez-Arnau AM, Gonçalo M, Guzmán-Perera MG, Hamann CR, Hoetzenecker W, Johansen JD, John SM, Kunkeler ACM, Ljubojevic Hadzavdic S, Molin S, Nixon R, Oosterhaven JAF, Rustemeyer T, Serra-Baldrich E, Shah M, Simon D, Skudlik C, Spiewak R, Valiukevičienė S, Voorberg AN, Weisshaar E, Agner T. Guidelines for diagnosis, prevention and treatment of hand eczema. Contact Dermatitis 2021; 86:357-378. [PMID: 34971008 DOI: 10.1111/cod.14035] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Jacob P Thyssen
- Dep. Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jose H Alfonso
- Dep. of Dermatology, Oslo University Hospital, Oslo, Norway.,Dep. of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Klaus E Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Irena Angelova-Fischer
- Department of Dermatology, Comprehensive Allergy Center, Kepler University Hospital, Linz, Austria
| | - Bernd W M Arents
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Alicia Cannavo
- Contact Dermatitis and Occupational Dermatoses, Hospital de Clínicas "José de San Martín", Buenos Aires University, Argentina
| | | | - Marie-Noelle Crépy
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, Paris, France.,Department of Dermatology, University Hospital of Centre of Paris, Cochin Hospital, AP-HP, Paris, France
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Manigé Fartasch
- Institute for Prevention and Occupational Medicine (IPA) of the German Social Accident Insurance, Department of Clinical and Experimental Occupational Dermatology, Ruhr University Bochum, Bochum, Germany
| | | | - Ana M Giménez-Arnau
- Department of Dermatology, Hopsital del Mar, IMIM , Universitat Autònoma de Barcelona
| | - Margarida Gonçalo
- Clinic of Dermatology - University Hospital and Faculty of Medicine, University of Coimbra, Portugal
| | | | - Carsten R Hamann
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Wolfram Hoetzenecker
- Department of Dermatology, Kepler University Hospital and Kepler University Linz, Linz, Austria
| | - Jeanne Duus Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Amalia C M Kunkeler
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Sonja Molin
- Division of Dermatology, Queen's University, Kingston, Canada
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Melbourne, Australia
| | - Jart A F Oosterhaven
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Mili Shah
- Liverpool University Hospitals NHS Trust, Liverpool, UK
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Angelique N Voorberg
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Tove Agner
- Dep. Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
6
|
Hand Dermatitis in the Time of COVID-19: A Review of Occupational Irritant Contact Dermatitis. Dermatitis 2021; 32:86-93. [PMID: 33606414 DOI: 10.1097/der.0000000000000721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Occupational contact dermatitis accounts for 95% of all cases of occupational skin disease with irritant contact dermatitis (ICD) constituting 80% to 90% of these cases. Health care workers, hairdressers, and food service workers are typically most affected by occupational ICD of the hands as these occupations require frequent hand hygiene and/or prolonged exposure to water, also known as "wet work." In the context of the current COVID-19 pandemic, frequent hand hygiene has become a global recommendation for all individuals, and new workplace guidelines for hand sanitization and surface sterilization are affecting occupations not previously considered at risk of excessive wet work including grocery or retail workers, postal workers, sanitization workers, and others. In this review, we discuss the etiology and pathogenesis of occupational ICD with additional focus on treatment and interventions that can be made at an institutional and even national level for education and prevention of ICD resulting from frequent hand hygiene.
Collapse
|
7
|
Silvestre Salvador JF, Heras Mendaza F, Hervella Garcés M, Palacios-Martínez D, Sánchez Camacho R, Senan Sanz R, Apellaniz González A, Giménez-Arnau AM. Guidelines for the Diagnosis, Treatment, and Prevention of Hand Eczema. ACTAS DERMO-SIFILIOGRAFICAS 2021; 111:26-40. [PMID: 32197684 DOI: 10.1016/j.ad.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/11/2019] [Accepted: 04/21/2019] [Indexed: 12/28/2022] Open
Abstract
Hand eczema is a common condition associated with significantly impaired quality of life and high social and occupational costs. Managing hand eczema is particularly challenging for primary care and occupational health physicians as the condition has varying causes and both disease progression and response to treatment are difficult to predict. Early diagnosis and appropriate protective measures are essential to prevent progression to chronic eczema, which is much more difficult to treat. Appropriate referral to a specialist and opportune evaluation of the need for sick leave are crucial to the good management of these patients. These guidelines cover the diagnosis, prevention, and treatment of chronic hand eczema and highlight the role that primary care and occupational health physicians can play in the early management of this disease.
Collapse
Affiliation(s)
| | - F Heras Mendaza
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - M Hervella Garcés
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España
| | - D Palacios-Martínez
- Medicina de Atención Primaria, Centro de Salud Isabel II, Parla, Madrid, España
| | | | - R Senan Sanz
- Equipo de Atención Primaria el Clot, Instituto Catalán de la Salud, Barcelona, España
| | - A Apellaniz González
- Departamento de Estomatología, Facultad de Medicina y Enfermería, Euskal Herriko Unibertsitatea-Universidad del País Vasco, Leioa, Bizkaia, España
| | - A M Giménez-Arnau
- Departamento de Dermatología, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, España
| |
Collapse
|
8
|
Brans R, John SM, Frosch PJ. Clinical Aspects of Irritant Contact Dermatitis. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
9
|
Brans R, Wilke A, Rodríguez E, Boraczynski N, Weidinger S, Reich A, Geier J, Schön MP, Skudlik C, John SM. Effectiveness of secondary prevention in metalworkers with work-related skin diseases and comparison with participants of a tertiary prevention program: A prospective cohort study. Contact Dermatitis 2020; 83:497-506. [PMID: 32743831 DOI: 10.1111/cod.13682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND In Germany, a multistep approach has been established to prevent work-related skin diseases (WRSDs). OBJECTIVES To evaluate the effect of a secondary individual prevention program (SIP) in metalworkers with WRSD and to compare their characteristics with those of participants of a tertiary individual prevention program (TIP). PATIENTS AND METHODS In a prospective cohort study, metalworkers with WRSD of the hands participating either in the SIP (n = 114) or in the TIP (n = 83) were recruited. At baseline and at the respective follow-up 8-12 weeks after the SIP or at dismissal from the TIP (3-4 weeks later), questionnaires were completed and the severity of WRSD was assessed. Saliva samples were collected for assessment of filaggrin (FLG) mutations and an explorative genome-wide association study (GWAS). RESULTS Ninety-three SIP patients (81.6%) attended the follow-up. Disease severity was significantly reduced, and knowledge and protective behavior were significantly improved compared to baseline. Significant differences between SIP and TIP patients were found regarding duration and severity of symptoms, work absenteeism, tobacco smoking, and presence of atopic dermatitis, but not regarding FLG mutations and by GWAS. CONCLUSIONS The SIP was effective in metalworkers with WRSDs. Individual factors may influence the course of the disease and the need for the TIP.
Collapse
Affiliation(s)
- Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| | - Annika Wilke
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| | - Elke Rodríguez
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Nicole Boraczynski
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Stephan Weidinger
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Anna Reich
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Johannes Geier
- Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany.,Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| |
Collapse
|
10
|
|
11
|
Reich A, Wilke A, Gediga G, Baurecht H, Rodríguez E, Jakasa I, Geier J, Mempel M, Buhl T, Weidinger S, Kezic S, John SM, Schön MP, Brans R. Health education decreases incidence of hand eczema in metal work apprentices: Results of a controlled intervention study. Contact Dermatitis 2020; 82:350-360. [DOI: 10.1111/cod.13502] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/22/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Anna Reich
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity of Osnabrück Osnabrück Germany
| | - Annika Wilke
- Lower Saxony Institute of Occupational DermatologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity of Osnabrück Osnabrück Germany
- Department of Dermatology, Environmental Medicine and Health TheoryUniversity of Osnabrück Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück Osnabrück Germany
| | - Günther Gediga
- Department of Dermatology, Environmental Medicine and Health TheoryUniversity of Osnabrück Osnabrück Germany
| | - Hansjörg Baurecht
- Department of Dermatology, Allergology and VenereologyUniversity Hospital Schleswig‐Holstein Kiel Germany
- Department of Epidemiology and Preventive MedicineUniversity of Regensburg Regensburg Germany
| | - Elke Rodríguez
- Department of Dermatology, Allergology and VenereologyUniversity Hospital Schleswig‐Holstein Kiel Germany
| | - Ivone Jakasa
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and BiotechnologyUniversity of Zagreb Zagreb Croatia
| | - Johannes Geier
- Lower Saxony Institute of Occupational DermatologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity of Osnabrück Osnabrück Germany
- Information Network of Department of DermatologyGeorg August University Göttingen Germany
| | - Martin Mempel
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity of Osnabrück Osnabrück Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity of Osnabrück Osnabrück Germany
| | - Stephan Weidinger
- Department of Dermatology, Allergology and VenereologyUniversity Hospital Schleswig‐Holstein Kiel Germany
| | - Sanja Kezic
- Coronel Institute of Occupational HealthAmsterdam University Medical Center Amsterdam The Netherlands
| | - Swen M. John
- Lower Saxony Institute of Occupational DermatologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity of Osnabrück Osnabrück Germany
- Department of Dermatology, Environmental Medicine and Health TheoryUniversity of Osnabrück Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück Osnabrück Germany
| | - Michael P. Schön
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity of Osnabrück Osnabrück Germany
| | - Richard Brans
- Lower Saxony Institute of Occupational DermatologyUniversity Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational DermatologyUniversity of Osnabrück Osnabrück Germany
- Department of Dermatology, Environmental Medicine and Health TheoryUniversity of Osnabrück Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück Osnabrück Germany
| |
Collapse
|
12
|
Ludewig M, Rocholl M, John SM, Wilke A. Secondary prevention of UV-induced skin cancer: development and pilot testing of an educational patient counseling approach for individual sun protection as standard procedure of patient care. Int Arch Occup Environ Health 2020; 93:765-777. [PMID: 32162123 PMCID: PMC7320965 DOI: 10.1007/s00420-020-01532-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/23/2020] [Indexed: 01/07/2023]
Abstract
Objective To outline the development and pilot testing of a patient counseling approach for individual sun protection for patients in outdoor professions diagnosed with squamous cell carcinoma or multiple actinic keratosis due to solar UV radiation. This is a secondary prevention measure as part of the standard procedure of patient care by the respective statutory accident insurance. Methods Results of guideline-based qualitative interviews with seven outdoor workers and a search of literature formed the basis for the counseling approach, which was compiled in a manual. Interdisciplinary experts (dermatologists and educators) reviewed and consented the final manual. The pilot testing was conducted in consecutive steps (N1 = 36 patients and N1 = 2 counselors; N4 = 12 patients and N4 = 6 counselors). The first two stages of the revised guideline ‘Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare (CReDECI 2)’ serve as background and structure for presenting the results. Results The ‘counseling approach for individual sun protection (ILB: Individuelle Lichtschutz-Beratung)’ consists of seven general and eight add-on modules. These can be combined and tailored according to the patient’s individual needs. Interactive, educational components (e.g. haptic experiments) are crucial elements of the counseling approach. Conclusions The special requirements of outdoor workers are hardly taken into consideration in Germany, even though the interest for an improved sun protection behavior of some occupational groups is high. The advantage of the presented approach is that the heterogeneous needs of patients can be specifically addressed with its various modules.
Collapse
Affiliation(s)
- Michaela Ludewig
- Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education, University of Osnabrück, Osnabrück, Germany. .,Institute for Interdisciplinary Prevention and Rehabilitation at the University of Osnabrück, Osnabrück, Germany.
| | - Marc Rocholl
- Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Prevention and Rehabilitation at the University of Osnabrück, Osnabrück, Germany
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Prevention and Rehabilitation at the University of Osnabrück, Osnabrück, Germany
| | - Annika Wilke
- Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Prevention and Rehabilitation at the University of Osnabrück, Osnabrück, Germany
| |
Collapse
|
13
|
|
14
|
Abstract
Apart from endogenous factors, hand eczema is often caused by irritant or allergic contact dermatitis related to occupational or non-occupational exposure to skin hazards. This enables several complementary approaches on the level of primary, secondary and tertiary prevention. A high priority is set on identification and subsequent reduction or elimination of causative exposures. Important preventive approaches include legal regulations, technical and organizational measures as well as correct use of adequate personal protective equipment (e.g. protective gloves). Interventions based on health education are conducted to improve individual protective behaviour. Even though evidence-based proof of effectiveness is limited, preventive measures are considered of particular importance for avoidance of occupational hand eczema and its adverse sequelae. Therefore, a complex, step-wise approach to occupational skin diseases has been established in Germany. In recent years, the positive impact of secondary and tertiary preventive measures of this approach has been demonstrated.
Collapse
Affiliation(s)
- R Brans
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland.
| | - C Skudlik
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland
| |
Collapse
|
15
|
|
16
|
Brans R, John SM, Frosch PJ. Clinical Aspects of Irritant Contact Dermatitis. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_16-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Wilke A, Gediga G, Goergens A, Hansen A, Hübner A, John SM, Nordheider K, Rocholl M, Weddeling S, Wulfhorst B, Nashan D. Interdisciplinary and multiprofessional outpatient secondary individual prevention of work-related skin diseases in the metalworking industry: 1-year follow-up of a patient cohort. BMC DERMATOLOGY 2018; 18:12. [PMID: 30541516 PMCID: PMC6292163 DOI: 10.1186/s12895-018-0080-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 11/30/2018] [Indexed: 11/10/2022]
Abstract
Background In Germany, work-related skin diseases are predominant within the spectrum of reported occupational diseases. Metal workers are among the high-risk professions. Offering effective prevention programs to affected patients is of utmost importance to avoid deterioration of the disease and job loss. We conducted a 1-year follow-up in patients who participated in a multidisciplinary, complex outpatient prevention program representing a standard procedure of patient care by the respective statutory accident insurance. Methods The multi-component prevention program consists of multiprofessional individual patient counseling, a structured skin protection seminar in a group, as well as workplace visits and on-site counseling in terms of appropriate skin protection (e.g. gloves). An observational study with a 1-year follow-up and four measurements (T1-T4, longitudinal pre/post-test design) including dermatological examinations and standardized written questionnaires was conducted between 2013 and 2016 to assess changes over time regarding job loss and disease severity. Results Data from 94 patients (87 male, mean age: 45.4 years) were included in the analysis. One year after the skin protection seminar (T4), 83 patients (88.3%) remained in their original professional metalworking activity and four patients (4.3%) had given up their profession because of their skin disease. At baseline (T1), irritant contact dermatitis of the hands was the most frequent diagnosis (80.7%). Methods for self-reported disease severity showed good correlation with the clinical gold standard at T1 and T2 (dermatological examination with the Osnabrück Hand Eczema Severity Index / OHSI), and a significant decrease of the self-reported disease severity was found over time from T1 to T4 (p < 0.001). Further results indicate an improved self-perceived disease control and an overall satisfaction with the prevention program. Conclusions The results of this observational study demonstrate that the comprehensive prevention program positively influences the course of work-related skin diseases, increases the possibility to continue working in a “high-risk” profession and improves the disease management of metal workers. In the long term, the prevention program may lead to cost savings by preventing high therapy costs or professional retraining. Electronic supplementary material The online version of this article (10.1186/s12895-018-0080-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Annika Wilke
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany. .,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.
| | - Günther Gediga
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Andreas Goergens
- German Social Accident Insurance Institution for the woodworking and metalworking industries, district administration in Dortmund, Semerteichstraße 98, 44263, Dortmund, Germany
| | - Andreas Hansen
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Anja Hübner
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Kathrin Nordheider
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Sabine Weddeling
- Department of Dermatology, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Germany
| | - Britta Wulfhorst
- Faculty of Human Sciences/Department of Educational Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Dorothée Nashan
- Department of Dermatology, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Germany
| |
Collapse
|
18
|
Wilke A, Brans R, Nordheider K, Braumann A, Hübner A, Sonsmann FK, John SM, Wulfhorst B. Skin Protection Seminars to Prevent Occupational Skin Diseases: Results of a Prospective Longitudinal Study in Apprentices of High-risk Professions. Saf Health Work 2018; 9:398-407. [PMID: 30559987 PMCID: PMC6284163 DOI: 10.1016/j.shaw.2018.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 02/16/2018] [Accepted: 05/12/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Occupational skin diseases (OSDs) are frequent in professions with exposure to skin hazards. Thus, a health educational intervention for apprentices of high-risk professions was conducted. It was the aim of this study to gain insight into possible effects of this intervention. METHODS A one-time skin protection seminar was conducted in 140 apprentices of health-related and non-health-related professions [trained cohort (TC)]. In addition, 134 apprentices of the same occupations were monitored [untrained cohort (UTC)]. The OSD-specific knowledge and the skin condition of the hands were assessed at baseline (T0), after the seminar (T1), and after 6 (T2) and 12 months (T3). RESULTS The OSD-specific knowledge increased in all cohorts from T0 to T3, but we found a significantly higher knowledge in the TC at T2 (p < 0.001, t = 3.6, df = 196, 95% confidence interval = 0.9, 3.3) and T3 (p < 0.001, t = 3.8, df = 196, 95% confidence interval = 1.0, 3.2) compared to the UTC. Our results indicated a better skin condition of the hands in the TC of the health-related professions but not in the non-health-related professions. CONCLUSION The study indicates that an educational intervention may positively influence the disease-specific knowledge and the prevalence of OSD in apprentices. However, definite conclusions cannot be drawn because of the heterogeneous study cohorts and the study design. Future research should aim at tailoring primary prevention to specific target groups, e.g., in view of the duration and frequency of skin protection education, different professions, and gender-specific prevention approaches.
Collapse
Affiliation(s)
- Annika Wilke
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Kathrin Nordheider
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Antje Braumann
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Hamburg, Germany
| | - Anja Hübner
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Flora K. Sonsmann
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Britta Wulfhorst
- Faculty of Human Sciences/Department of Educational Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| |
Collapse
|
19
|
Johnston G, Exton L, Mohd Mustapa M, Slack J, Coulson I, English J, Bourke J, McHenry P, Gibbon K, Buckley D, Leslie T, Mallon E, Wakelin S, Ungureanu S, Hunasehally R, Cork M, Natkunarajah J, Worsnop F, Chiang N, Donnelly J, Saunders C, Brain A, Exton LS. British Association of Dermatologists’ guidelines for the management of contact dermatitis 2017. Br J Dermatol 2017; 176:317-329. [DOI: 10.1111/bjd.15239] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 12/18/2022]
Affiliation(s)
- G.A. Johnston
- Department of Dermatology University Hospitals of Leicester NHS Trust Infirmary Square Leicester LE1 5WW U.K
| | - L.S. Exton
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
| | - M.F. Mohd Mustapa
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
| | - J.A. Slack
- Department of Dermatology University Hospitals of Leicester NHS Trust Infirmary Square Leicester LE1 5WW U.K
| | - I.H. Coulson
- Department of Dermatology Burnley General Hospital Casterton Avenue Burnley BB10 2PQ U.K
| | | | - J.F. Bourke
- Department of Dermatology South Infirmary Victoria University Hospital Old Blackrock Road Cork City Ireland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
|
21
|
Hines J, Wilkinson SM, John SM, Diepgen TL, English J, Rustemeyer T, Wassilew S, Kezic S, Maibach HI. 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. J Eur Acad Dermatol Venereol 2016; 31:53-64. [PMID: 27545662 PMCID: PMC5434821 DOI: 10.1111/jdv.13851] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/08/2016] [Indexed: 11/29/2022]
Abstract
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.
Collapse
Affiliation(s)
- J Hines
- Deb Group Ltd., Research & Development, Denby, Derbyshire, UK
| | | | - S M John
- Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Osnabrueck, Germany
| | - T L Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany
| | - J English
- Nottingham NHS Treatment Center, Nottingham, UK
| | - T Rustemeyer
- Department of Dermatology and Allergology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - S Wassilew
- Hautarztzentrum Krefeld, Krefeld, Germany
| | - S Kezic
- Coronel Institute of Occupational Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - H I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
22
|
Braun R, Dotterud LK. Occupational skin diseases from 1997 to 2004 at the Department of Dermatology, University Hospital of Northern Norway (UNN): an investigation into the course and treatment of occupational skin disease 10-15 years after first consultations with a dermatologist. Int J Circumpolar Health 2016; 75:30100. [PMID: 27172061 PMCID: PMC4864832 DOI: 10.3402/ijch.v75.30100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/01/2016] [Accepted: 03/07/2016] [Indexed: 11/21/2022] Open
Abstract
Objectives We investigate the impact of occupational skin disease consultations among outpatients at the Dermatological Department, University Hospital, Northern Norway. Study design From 1997 until 2004, 386 patients with occupational skin disease were examined and given advice on skin care, skin disease treatment, skin protection in further work, and on the legal rights of patients with this disease. Ten to fifteen years later, we wanted to look at these patients in terms of their work situation, the current status of their disease, the help they received from the labour offices, and their subjective quality of life. Material and methods In the autumn of 2011 until the spring of 2012, a number of the patients examined in the period from 1997 to 2004 were selected and sent a questionnaire, which they were asked to answer and return, regarding their work situation and the progress and current status of their occupational disease. Results A total of 153 (77%) patients answered the questionnaire; 71% of these patients were still in work, and further 15% had old-age retired, 13% were working until then; 16% had retired early because of disability; 54% had changed jobs because of their occupational skin disease; 86% of the patients indicated that the skin disease had improved since our previous investigation. Conclusions Our investigation into patients with occupational skin disease documented that the majority of patients who had received professional dermatological consultation and intervention offers were still in the labour market and had good control of their skin disease 10–15 years later. We discovered that 71% of the patients were still employed. 13% had remained in work until they became old age pensioners. Only 16% dropped out of work because of disability. These high percentages may indicate that our intervention has contributed positively to patients’ work conditions and the course of their skin disease.
Collapse
Affiliation(s)
- Rosemarie Braun
- Department of Dermatology, University Hospital, Tromsø, Norway; @unn.no
| | | |
Collapse
|
23
|
Nichol K, Copes R, Spielmann S, Kersey K, Eriksson J, Holness DL. Workplace screening for hand dermatitis: a pilot study: Table 1. Occup Med (Lond) 2015; 66:46-9. [DOI: 10.1093/occmed/kqv126] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
24
|
|
25
|
de León FJ, Berbegal L, Silvestre JF. Management of Chronic Hand Eczema. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:533-44. [PMID: 26005193 DOI: 10.1016/j.ad.2015.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/16/2015] [Accepted: 04/15/2015] [Indexed: 11/17/2022] Open
Abstract
Management of hand eczema is complex because of the broad range of different pathogeneses, courses, and prognoses. Furthermore, the efficacy of most available treatments is not well established and the more severe forms can have a major impact on the patient's quality of life. Patient education, preventive measures, and the use of emollients are the mainstays in the management of hand eczema. High-potency topical corticosteroids are the treatment of choice, with calcineurin inhibitors used for maintenance. Phototherapy or systemic treatments are indicated in patients who do not respond to topical treatments. Switching from topical treatments should not be delayed to avoid sensitizations, time off work, and a negative impact on quality of life. Alitretinoin is the only oral treatment approved for use in chronic hand eczema.
Collapse
Affiliation(s)
- F J de León
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España.
| | - L Berbegal
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - J F Silvestre
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| |
Collapse
|
26
|
Skudlik C, Weisshaar E. Individuell ambulante und stationäre Prävention bei Berufsdermatosen. Hautarzt 2015; 66:160-6. [DOI: 10.1007/s00105-014-3562-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
27
|
Clemmensen KKB, Randbøll I, Ryborg MF, Ebbehøj NE, Agner T. Evidence-based training as primary prevention of hand eczema in a population of hospital cleaning workers. Contact Dermatitis 2014; 72:47-54. [DOI: 10.1111/cod.12304] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 08/09/2014] [Accepted: 08/13/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Kim K. B. Clemmensen
- Department of Dermatology; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| | - Ingelise Randbøll
- Department of Dermatology; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| | - Malene F. Ryborg
- Department of Dermatology; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| | - Niels E. Ebbehøj
- Department of Occupational and Environmental Medicine; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| |
Collapse
|
28
|
|
29
|
Mollerup A, Veien NK, Johansen JD. Effectiveness of the Healthy Skin Clinic - a randomized clinical trial of nurse-led patient counselling in hand eczema. Contact Dermatitis 2014; 71:202-14. [DOI: 10.1111/cod.12243] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 03/06/2014] [Accepted: 03/11/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Annette Mollerup
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; Niels Andersens Vej 65 2900 Hellerup Denmark
| | - Niels K. Veien
- The Dermatology Clinic; Fyrkildevej 7 9220 Aalborg Øst Denmark
| | - Jeanne D. Johansen
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; Niels Andersens Vej 65 2900 Hellerup Denmark
| |
Collapse
|
30
|
Evaluation of structured patient education in occupational skin diseases: a systematic assessment of the disease-specific knowledge. Int Arch Occup Environ Health 2014; 87:861-9. [DOI: 10.1007/s00420-014-0926-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 01/16/2014] [Indexed: 10/25/2022]
|
31
|
Carøe TK, Ebbehøj N, Agner T. A survey of exposures related to recognized occupational contact dermatitis in Denmark in 2010. Contact Dermatitis 2013; 70:56-62. [DOI: 10.1111/cod.12134] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 07/03/2013] [Accepted: 07/10/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Tanja Korfitsen Carøe
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen NV Denmark
| | - Niels Ebbehøj
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen NV Denmark
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen NV Denmark
| |
Collapse
|
32
|
Current world literature. Curr Opin Allergy Clin Immunol 2013; 13:217-21. [PMID: 23434741 DOI: 10.1097/aci.0b013e32835f8a7a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
33
|
Schwensen JF, Friis UF, Menné T, Johansen JD. One thousand cases of severe occupational contact dermatitis. Contact Dermatitis 2013; 68:259-68. [DOI: 10.1111/cod.12045] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
34
|
|