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Surya D, Marissa M, Budianti WK, Rihatmadja R, Krisanti IA, Friska D, Widaty S. Correlation between serum 25(OH)D levels with severity of work-related hand eczema among healthcare workers: a cross-sectional study. Dermatol Reports 2024; 16:9861. [PMID: 38957633 PMCID: PMC11216147 DOI: 10.4081/dr.2023.9861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 07/04/2024] Open
Abstract
Hand eczema (HE) is a common condition seen in medical facilities, particularly during the COVID-19 pandemic. The effects of vitamin D on skin inflammation are diverse. The purpose of this study is to examine the relationship between vitamin D levels in healthcare workers as determined by serum 25(OH)D and the severity of HE. In Indonesia, between September and October of 2022, a cross-sectional design was employed for this analytical descriptive study. The hand eczema severity index was used to determine the severity of HE. Out of the 44 healthcare workers who had HE, the findings indicated that 29 had mild HE, 11 had moderate HE, and 4 had severe HE. Subjects with mild, moderate, and severe HE had mean serum 25(OH)D levels of 17.85 ng/mL, 16.45 ng/mL, and 17.87 ng/mL, respectively, falling into the vitamin D deficiency category. Serum 25(OH)D levels and the severity of HE did not significantly correlate (r=-0.056; p=0.359). Serum 25(OH)D levels did not significantly differ between subjects with mild, moderate, and severe HE. The degree of HE was not negatively correlated with serum 25(OH)D levels.
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Affiliation(s)
- Danny Surya
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta
| | - Melani Marissa
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta
| | - Windy Keumala Budianti
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta
| | - Rahadi Rihatmadja
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta
| | - Inge Ade Krisanti
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta
| | - Dewi Friska
- Department of Community Medicine, Faculty of Medicine, Universitas Jawa BaratIndonesia, Jawa Barat, Indonesia
| | - Sandra Widaty
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta
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Alzaid RM, Togoo RA, Alshehri AS, Alribah RM, Asiri RZ, Alhefze RM. Dermatological conditions associated with dental professionals in Saudi Arabia. J Family Med Prim Care 2023; 12:523-530. [PMID: 37122669 PMCID: PMC10131953 DOI: 10.4103/jfmpc.jfmpc_1051_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 11/23/2022] [Accepted: 12/08/2022] [Indexed: 05/02/2023] Open
Abstract
Background Dental professionals and students are commonly exposed to occupation-related skin lesions, characterized as contact dermatitis (like allergic and irritant contact dermatitis, contact urticaria), that are commonly observed on hands and fingers. The present study evaluated the prevalence of skin lesions, knowledge about risk factors, and prevention of dermatological lesions among dental students and dental professionals. Methods The present observational study was carried out on 100 study subjects, including dental students and staff, using a self-administered and structured questionnaire to assess demographic variables, awareness information, and knowledge about work-related skin lesions. The data was subjected to statistical analysis using IBM's Statical Package for the Social Sciences (SPSS) version 20. Results Sixty percent of the total number of subjects were dental students and 40% were dentists. 56.8% of the subjects were female and 43.2% were male, with a maximum of 0-5 years of practice/experience. The most common symptoms of skin lesions were itching and erythema, especially on the hands and fingers. Only 15.6% had their treatment done by dermatologists, and 7% underwent skin prick tests. Latex allergy was most familiar with feature of facial edema. The use of hand sanitizers, soaps, and protective cream was limited among the subjects. Conclusion There was a lack of awareness among both the dentists and students regarding work-related skin lesions and getting them treated by dermatologists at the earliest, though the dentists' level of knowledge was better than that of the students. Thus, various educational programs on dermatological lesions should be implemented so that dental professionals and students take necessary precautions and seek treatment for skin disorders.
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Affiliation(s)
- Raghad Mohammed Alzaid
- Department of Pediatric Dentistry and Orthodontic Sciences, King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia
| | - Rafi Ahmad Togoo
- Department of Pediatric Dentistry and Orthodontic Sciences, King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia
- Address for correspondence: Prof. Rafi Ahmad Togoo, Department of Pediatric Dentistry and Orthodontic Sciences, King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia. E-mail:
| | - Amjad Saad Alshehri
- Department of Pediatric Dentistry and Orthodontic Sciences, King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia
| | - Raneem Mohammed Alribah
- Department of Pediatric Dentistry and Orthodontic Sciences, King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia
| | - Rawan Zaid Asiri
- Department of Pediatric Dentistry and Orthodontic Sciences, King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia
| | - Raneem Mohammed Alhefze
- Department of Pediatric Dentistry and Orthodontic Sciences, King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia
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Gallo R, Guarneri F, Gasparini G, Oddenino G, Carmisciano L, Rovini E, Parodi A. IMPLEMENTATION OF A DISTANCE LEARNING HAND ECZEMA PREVENTION PROGRAM FOR HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC. Contact Dermatitis 2022; 87:297-300. [PMID: 35538621 PMCID: PMC9544915 DOI: 10.1111/cod.14159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/29/2022] [Accepted: 05/07/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Rosella Gallo
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Fabrizio Guarneri
- Division of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Giulia Gasparini
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Giorgio Oddenino
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Luca Carmisciano
- Division of Biostatistics, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Elisabetta Rovini
- Formation and Communication Department, Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Aurora Parodi
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
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Gupta B, Li D, Dong P, Acri MC. From intention to action: A systematic literature review of provider behaviour change-focused interventions in physical health and behavioural health settings. J Eval Clin Pract 2021; 27:1429-1445. [PMID: 33565177 DOI: 10.1111/jep.13547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/31/2020] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES It is clear there are significant delays in the uptake of best practices as part of routine care in the healthcare system, yet there is conflicting evidence on how to specifically align provider behaviour with best practices. METHOD We conducted a review of interventions utilized to change any aspect of provider behaviour. To extend prior research, studies were included in the present review if they had an active intervention targeting behaviour change of providers in health or behavioural-health settings and were published between 2001 and 2020. RESULTS Of 1547 studies, 44 met inclusion criteria. Of 44 studies identified, 28 studies utilized contextually relevant interventions (eg, tailored to a specific provider population). Twenty six interventions with a contextually relevant approach resulted in provider behaviour change. CONCLUSIONS Findings are promising for encouraging provider behaviour change when interventions are tailored to be contextually relevant, as both single-component and multifaceted interventions were successful when they were contextually relevant. It is critical to conduct additional research to ensure that providers sustain behaviour changes over a long-term beyond an intervention's implementation and evaluation period.
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Affiliation(s)
- Brinda Gupta
- Social Policy Institute, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Dongze Li
- Social Policy Institute, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Peiyu Dong
- Social Policy Institute, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Mary C Acri
- Social Policy Institute, Washington University in St. Louis, St. Louis, Missouri, USA
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Coppeta L, De Zordo LM, Papa F, Pietroiusti A, Magrini A. Skin sensitization among night shift and daytime healthcare workers: a cross sectional study. Cent Eur J Public Health 2021; 29:191-194. [PMID: 34623118 DOI: 10.21101/cejph.a6260] [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: 05/03/2020] [Accepted: 07/15/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Allergic contact dermatitis (ACD) in the healthcare sector is a major occupational health hazard. There are many reasons for a higher frequency of ACD in healthcare personnel compared to other populations: among others, simultaneous exposure to multiple substances, use of aggressive detergents and wet work. However, studies that systematically correlate skin symptoms with the presence of sensitization investigated through patch tests in specific categories of health workers are very rare and conflicting. Although some studies have reported a correlation between skin disease and night shift, the strength of the evidence is rather limited. The purpose of our study was to investigate by means of patch testing the skin sensitization (SS) to common allergens in the hospital setting in a group of healthcare workers (HCW) reporting symptoms related to dermatitis, according to their job activity and their shift status. METHODS 132 HCWs visiting a health surveillance centre were investigated by means of specific questionnaire for dermatitis, followed by patch test evaluation including 40 haptens of the SIDAPA 2016 series. RESULTS Skin sensitization was observed in 1/3 of the subjects investigated by patch tests. The nursing job was strongly associated with cutaneous reactivity after controlling for the confounding of gender, age and other factors. Shift work was related to the prevalence of SS. CONCLUSIONS In our study, the nurse's role and shift work were significantly associated with the risk of cutaneous sensitization, in particular for common antigens.
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Affiliation(s)
- Luca Coppeta
- Occupational Medicine Department, Tor Vergata University of Rome, Rome, Italy
| | | | - Francesca Papa
- Occupational Medicine Department, Tor Vergata University of Rome, Rome, Italy
| | - Antonio Pietroiusti
- Occupational Medicine Department, Tor Vergata University of Rome, Rome, Italy
| | - Andrea Magrini
- Occupational Medicine Department, Tor Vergata University of Rome, Rome, Italy
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Moldovan HR, Manole I, Suru A, Butacu AI, Tatu AL, Lupu A, Dascalu M, Tiplica GS, Salavastru CM. Prevention of Hand Eczema among Nurse Apprentice (PREVEDERM): An Interventional Study. Ann Work Expo Health 2021; 65:167-175. [PMID: 33559677 DOI: 10.1093/annweh/wxaa122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 11/03/2020] [Accepted: 11/11/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Workers in the healthcare sector are at high risk of developing occupational hand eczema mainly due to frequent exposure to irritants and/or allergens. Amongst workers in healthcare, nurses are at higher risk of developing hand dermatitis. OBJECTIVES To evaluate the effectiveness of a short educational intervention program in preventing occupational hand eczema in nurse apprentices, using two objective tools, namely TEWL and EH, and the HECSI score. METHODS Data regarding professions, wet work exposure, activities performed during working hours, self-reported eczema were collected from 230 nurse students, divided in two study groups: the intervention and the control group (CG). The intervention group (IG) was given education about risks and proper skin care and was provided with cosmeceuticals to be used for skin care during hospital activity. The evaluation of skin properties was performed using questionnaires, HECSI score, measurement of transepidermal water loss (TEWL) and epidermal hydration (EH). RESULTS A number of 139 apprentice nurses completed the study. Of those participants who completed the study, 19.1% from CG and 19.6% from IG reported, at T1, hand eczema in the last 3 months, while at T2 (3 months later), 59.52 % of the CG and only 11.34 % from the IG stated having eczema in the last 3 months. In the IG, results showed an improvement of CM with 17% and of TEWL with 16%, with only a 0.5% improvement of CM in CG and a marked impairment of TEWL by 33%. CONCLUSION Hand eczema is a common occupational dermatosis affecting the medical staff, even during apprenticeship. Early preventive training programs are effective in reducing the burden of occupational contact dermatitis.
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Affiliation(s)
- Horatiu Remus Moldovan
- Occupational Medicine Department, GE Palade University of Medicine, Pharmacy, Science and Technology of Targu-Mures, Gheorghe Marinescu, Târgu Mureș, Romania
| | - Ionela Manole
- Dermatology Research Unit, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania
| | - Alina Suru
- Dermatology Research Unit, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania
| | - Alexandra-Irina Butacu
- Dermatology Research Unit, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania
| | - Alin Laurentiu Tatu
- Faculty of Medicine and Pharmacy, Dunarea de Jos University, Clinical Medical Department, Galati, Romania, Alexandru Ioan Cuza, Galati, Romania.,Saint Parascheva Clinical Hospital of Infectious Diseases, Dermatology Department, Traian, Galati, Romania
| | - Adriana Lupu
- Faculty of Medicine and Pharmacy, University Dunarea de Jos, Alexandru Ioan Cuza,Galati, Romania
| | - Mihai Dascalu
- Department of Computer Science, Faculty of Automated Control and Computers, University Politehnica of Bucharest, Splaiul Independentei, Bucharest, Romania
| | - George-Sorin Tiplica
- Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania.,Second Department of Dermatology, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania
| | - Carmen Maria Salavastru
- Carol Davila University of Medicine and Pharmacy, Eroii Sanitari, Bucharest, Romania.,Pediatric Dermatology Department, Colentina Clinical Hospital, Stefan cel Mare, Bucharest, Romania
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Parsons V, Juszczyk D, Gilworth G, Ntani G, McCrone P, Hatch S, Shannon R, Henderson M, Coggon D, Molokhia M, Smedley J, Griffiths A, Walker-Bone K, Madan I. A case management occupational health model to facilitate earlier return to work of NHS staff with common mental health disorders: a feasibility study. Health Technol Assess 2021; 25:1-94. [PMID: 33641712 PMCID: PMC7957455 DOI: 10.3310/hta25120] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The NHS is the biggest employer in the UK. Depression and anxiety are common reasons for sickness absence among staff. Evidence suggests that an intervention based on a case management model using a biopsychosocial approach could be cost-effective and lead to earlier return to work for staff with common mental health disorders. OBJECTIVE The objective was to assess the feasibility and acceptability of conducting a trial of the clinical effectiveness and cost-effectiveness of an early occupational health referral and case management intervention to facilitate the return to work of NHS staff on sick leave with any common mental health disorder (e.g. depression or anxiety). DESIGN A multicentre mixed-methods feasibility study with embedded process evaluation and economic analyses. The study comprised an updated systematic review, survey of care as usual, and development of an intervention in consultation with key stakeholders. Although this was not a randomised controlled trial, the study design comprised two arms where participants received either the intervention or care as usual. PARTICIPANTS Participants were NHS staff on sick leave for 7 or more consecutive days but less than 90 consecutive days, with a common mental health disorder. INTERVENTION The intervention involved early referral to occupational health combined with standardised work-focused case management. CONTROL/COMPARATOR Participants in the control arm received care as usual. PRIMARY OUTCOME The primary outcome was the feasibility and acceptability of the intervention, study processes (including methods of recruiting participants) and data collection tools to measure return to work, episodes of sickness absence, workability (a worker's functional ability to perform their job), occupational functioning, symptomatology and cost-effectiveness proposed for use in a main trial. RESULTS Forty articles and two guidelines were included in an updated systematic review. A total of 49 of the 126 (39%) occupational health providers who were approached participated in a national survey of care as usual. Selected multidisciplinary stakeholders contributed to the development of the work-focused case management intervention (including a training workshop). Six NHS trusts (occupational health departments) agreed to take part in the study, although one trust withdrew prior to participant recruitment, citing staff shortages. At mixed intervention sites, participants were sequentially allocated to each arm, where possible. Approximately 1938 (3.9%) NHS staff from the participating sites were on sick leave with a common mental health disorder during the study period. Forty-two sick-listed NHS staff were screened for eligibility on receipt of occupational health management referrals. Twenty-four (57%) participants were consented: 11 (46%) received the case management intervention and 13 (54%) received care as usual. Follow-up data were collected from 11 out of 24 (46%) participants at 3 months and 10 out of 24 (42%) participants at 6 months. The case management intervention and case manager training were found to be acceptable and inexpensive to deliver. Possible contamination issues are likely in a future trial if participants are individually randomised at mixed intervention sites. HARMS No adverse events were reported. LIMITATIONS The method of identification and recruitment of eligible sick-listed staff was ineffective in practice because uptake of referral to occupational health was low, but a new targeted method has been devised. CONCLUSION All study questions were addressed. Difficulties raising organisational awareness of the study coupled with a lack of change in occupational health referral practices by line managers affected the identification and recruitment of participants. Strategies to overcome these barriers in a main trial were identified. The case management intervention was fit for purpose and acceptable to deliver in the NHS. TRIAL REGISTRATION Current Controlled Trials ISRCTN14621901. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 12. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Vaughan Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Dorota Juszczyk
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Gill Gilworth
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Georgia Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- National Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Paul McCrone
- King's Health Economics, King's College London, London, UK
| | - Stephani Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Robert Shannon
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Max Henderson
- Liaison Psychiatry, Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - David Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Mariam Molokhia
- Population Health Sciences, King's College London, London, UK
| | - Julia Smedley
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Amanda Griffiths
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- National Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Ira Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
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Giménez-Arnau AM, Skudlik C. Occupational Contact Dermatitis: Health Personnel. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Madan I, Parsons V, Ntani G, Wright A, English J, Coggon D, McCrone P, Smedley J, Rushton L, Murphy C, Cookson B, Lavender T, Williams H. A behaviour change package to prevent hand dermatitis in nurses working in health care: the SCIN cluster RCT. Health Technol Assess 2020; 23:1-92. [PMID: 31635689 DOI: 10.3310/hta23580] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although strategies have been developed to minimise the risk of occupational hand dermatitis in nurses, their clinical effectiveness and cost-effectiveness remain unclear. OBJECTIVES The Skin Care Intervention in Nurses trial tested the hypothesis that a behaviour change package intervention, coupled with provision of hand moisturisers, could reduce the point prevalence of hand dermatitis when compared with standard care among nurses working in the NHS. The secondary aim was to assess the impact of the intervention on participants' beliefs and behaviour regarding hand care, and the cost-effectiveness of the intervention in comparison with normal care. DESIGN Cluster randomised controlled trial. SETTING Thirty-five NHS hospital trusts/health boards/universities. PARTICIPANTS First-year student nurses with a history of atopic tendency, and full-time intensive care unit nurses. INTERVENTION Sites were randomly allocated to be 'intervention plus' or 'intervention light'. Participants at 'intervention plus' sites received access to a bespoke online behaviour change package intervention, coupled with personal supplies of moisturising cream (student nurses) and optimal availability of moisturising cream (intensive care unit nurses). Nurses at 'intervention light' sites received usual care, including a dermatitis prevention leaflet. MAIN OUTCOME MEASURE The difference between intervention plus and intervention light sites in the change of point prevalence of visible hand dermatitis was measured from images taken at baseline and at follow-up. RANDOMISATION Fourteen sites were randomised to the intervention plus arm, and 21 sites were randomised to the intervention light arm. BLINDING The participants, trial statistician, methodologist and the dermatologists interpreting the hand photographs were blinded to intervention assignment. NUMBERS ANALYSED An intention-to-treat analysis was conducted on data from 845 student nurses and 1111 intensive care unit nurses. RESULTS The intention-to-treat analysis showed no evidence that the risk of developing dermatitis was greater in the intervention light group than in the intervention plus group (student nurses: odds ratio 1.25, 95% confidence interval 0.59 to 2.69; intensive care unit nurses: odds ratio 1.41, 95% confidence interval 0.81 to 2.44). Both groups had high levels of baseline beliefs about the benefits of using hand moisturisers before, during and after work. The frequency of use of hand moisturisers before, during and after shifts was significantly higher in the intensive care unit nurses in the intervention plus arm at follow-up than in the comparator group nurses. For student nurses, the intervention plus group mean costs were £2 lower than those for the comparator and 0.00002 more quality-adjusted life-years were gained. For intensive care unit nurses, costs were £4 higher and 0.0016 fewer quality-adjusted life-years were gained. HARMS No adverse events were reported. LIMITATIONS Only 44.5% of participants in the intervention plus arm accessed the behaviour change package. CONCLUSION The intervention did not result in a statistically significant decrease in the prevalence of hand dermatitis in the intervention plus group. FUTURE WORK Participants had a high level of baseline beliefs about the importance of using hand moisturisers before, during and after work. Future research should focus on how workplace culture can be changed in order for that knowledge to be actioned. TRIAL REGISTRATION Current Controlled Trials ISRCTN53303171. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 58. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ira Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Vaughan Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Georgia Ntani
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Alison Wright
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - John English
- Dermatology, Circle Nottingham NHS Treatment Centre, Nottingham, UK
| | - David Coggon
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Paul McCrone
- Centre for the Economics of Mental and Physical Health, King's College London, London, UK
| | - Julia Smedley
- Occupational Health Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lesley Rushton
- Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Caroline Murphy
- King's Clinical Trial Unit, King's College London, London, UK
| | - Barry Cookson
- Medical Microbiology, University College London, London, UK
| | - Tina Lavender
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Hywel Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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10
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Abstract
OBJECTIVE To determine the frequency of self-reported hand dermatitis and the factors influencing its prevalence among nursing students. METHODS Researchers collected demographic data and used a self-assessment form to identify dermatologic symptoms. The questionnaires were distributed to the students and collected again after the students completed the forms. RESULTS Hand dermatitis was present in 20.9% of nursing students. The most common symptoms were irritation/pruritus, redness/cracking, flaking/rash, swelling, and vesicles in hands. The grade of the student, the presence of allergy complaints, and medication used to treat dermatitis were statistically significantly associated with dermatitis prevalence. The use of gloves and cleansing agents used in handwashing were factors linked to hand dermatitis. CONCLUSIONS Hand dermatitis increases in parallel with the increase of clinical practice hours among nursing students. Familial and environmental factors also increase the risk of hand dermatitis.
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11
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Madan I, Parsons V, Ntani G, Coggon D, Wright A, English J, McCrone P, Smedley J, Rushton L, Murphy C, Cookson B, Williams HC. A behaviour change package to prevent hand dermatitis in nurses working in the National Health Service: results of a cluster randomized controlled trial. Br J Dermatol 2020; 183:462-470. [PMID: 31989580 PMCID: PMC7497001 DOI: 10.1111/bjd.18862] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Occupational hand dermatitis poses a serious risk for nurses. OBJECTIVES To evaluate the clinical and cost-effectiveness of a complex intervention in reducing the prevalence of hand dermatitis in nurses METHODS: This was a cluster randomized controlled trial conducted at 35 hospital trusts, health boards or universities in the UK. Participants were (i) first-year student nurses with a history of atopic conditions or (ii) intensive care unit (ICU) nurses. Participants at intervention sites received access to a behavioural change programme plus moisturizing creams. Participants at control sites received usual care. The primary outcome was the change of prevalent dermatitis at follow-up (adjusted for baseline dermatitis) in the intervention vs. the control group. Randomization was blinded to everyone bar the trials unit to ensure allocation concealment. The trial was registered on the ISRCTN registry: ISRCTN53303171. RESULTS Fourteen sites were allocated to the intervention arm and 21 to the control arm. In total 2040 (69·5%) nurses consented to participate and were included in the intention-to-treat analysis. The baseline questionnaire was completed by 1727 (84·7%) participants. Overall, 789 (91·6%) ICU nurses and 938 (84·0%) student nurses returned completed questionnaires. Of these, 994 (57·6%) had photographs taken at baseline and follow-up (12-15 months). When adjusted for baseline prevalence of dermatitis and follow-up interval, the odds ratios (95% confidence intervals) for hand dermatitis at follow-up in the intervention group relative to the controls were 0·72 (0·33-1·55) and 0·62 (0·35-1·10) for student and ICU nurses, respectively. No harms were reported. CONCLUSIONS There was insufficient evidence to conclude whether our intervention was effective in reducing hand dermatitis in our populations. Linked Comment: Brans. Br J Dermatol 2020; 183:411-412.
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Affiliation(s)
- I Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - V Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - G Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - D Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - A Wright
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, U.K
| | - J English
- Dermatology, Circle Nottingham NHS Treatment Centre, Nottingham, U.K
| | - P McCrone
- Centre for the Economics of Mental and Physical Health, King's College London, London, U.K
| | - J Smedley
- Occupational Health Service, University Hospital Southampton NHS Foundation Trust, Southampton, U.K
| | - L Rushton
- Epidemiology and Biostatistics, Imperial College London, London, U.K
| | - C Murphy
- King's Clinical Trial Unit, King's College London, London, U.K
| | - B Cookson
- Medical Microbiology, University College London, London, U.K
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
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Papadatou Z, Williams H, Cooper K. Effectiveness of interventions for preventing occupational irritant hand dermatitis: a quantitative systematic review. ACTA ACUST UNITED AC 2019; 16:1398-1417. [PMID: 29894409 DOI: 10.11124/jbisrir-2017-003405] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The aim of this review was to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed here) in preventing occupational irritant hand dermatitis (OIHD) in wet workers, comparing each intervention to an alternative intervention or to usual care (workers' regular skin care regimen). INTRODUCTION The most significant occupational skin problem potentially encountered in wet work occupations is occupational dermatitis. When the skin comes into contact with hazardous substances at work, this can cause occupational dermatitis. Substances which may cause occupational dermatitis include cleaning products, organic solvents, metalworking fluids, cement, flour, adhesives, other chemicals and even certain plants. Occupational skin disease has adverse effects on quality of life and the long term prognosis for skin health is poor unless workplace exposures are addressed. To date, no systematic review has been undertaken to determine the effectiveness of interventions for the primary prevention of OIHD in wet workers. INCLUSION CRITERIA The review included any workers from healthcare (e.g. nurses, doctors and allied health professionals) and also people in different wet work occupations (e.g. hairdressers, florists, catering workers, metal workers) at similar risk of OIHD. Studies that assessed the following interventions in the primary prevention of OIHD in wet workers at the workplace and at home (before and after work) were included:Types of studies considered were experimental study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, and before and after studies. Primary outcome measures were OIHD incidence, and secondary outcome measures were product evaluation and change of occupation because of OIHD versus staying in the occupation. METHODS Published and unpublished literature in the English language was sought between 2004 and 2017. The databases searched included: COCHRANE CENTRAL, MEDLINE, CINAHL, AMED and Embase. The search for unpublished studies included: Google Scholar, Open DOAR and Robert Gordon University's thesis database, "OPEN AIR". RESULTS There were no studies located that met the inclusion requirements of this review. CONCLUSION There is currently no evidence available to determine the effectiveness of interventions to prevent OIHD amongst wet workers that met this review's inclusion criteria.
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Affiliation(s)
- Zoi Papadatou
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
| | - Hector Williams
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
| | - Kay Cooper
- The Scottish Centre for Evidence-based Multi-professional Practice: a Joanna Briggs Institute Centre of Excellence.,School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
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Gasparini G, Carmisciano L, Giberti I, Murgioni F, Parodi A, Gallo R. Healthy Hands: a pilot study for the prevention of chronic hand eczema in healthcare workers of an Italian University Hospital. GIORN ITAL DERMAT V 2019; 155:760-763. [PMID: 31195780 DOI: 10.23736/s0392-0488.19.06220-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Healthcare workers are at risk for occupational chronic hand eczema (CHE) because of frequent handwashing and prolonged use of occlusive gloves. Prevention programs based on skin care education have been shown to be beneficial. We developed and assessed the efficacy of a skin care educational intervention for healthcare workers of our hospital. METHODS The intervention consisted of two sessions, one week apart, each divided in a theoretical and a practical part, focusing on the skin barrier, types of eczema, risk factors for CHE, hand hygiene measures respectful of the skin, proper use of protective gloves and emollient creams. Its efficacy was assessed by a questionnaire, administered before and after the intervention, investigating the participants' knowledge of risk factors for CHE and risk behaviors. RESULTS Twenty-three subjects, mostly (65.2%) nurses, took part in the intervention; 60.9% had a self-reported atopic background and 65.2% participants reported a history of CHE. The intervention improved significantly the participants' knowledge on CHE risk factors, i.e. frequent handwashing (P=0.023), surgical scrubbing (P=0.016) and prolonged glove wearing (P=0.022). The frequency of hand washing was significantly reduced (P=0.022). The participants gave a positive unanimous feedback. CONCLUSIONS Our intervention was effective, by significantly improving the participants' knowledge and by inducing significant behavioral changes. Improving the formulation of alcoholic hand rubs may be a key factor to encourage their use. Coexisting nonoccupational risk behaviors are just as important in the prevention of CHE.
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Affiliation(s)
- Giulia Gasparini
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy - .,IRCCS San Martino University Hospital, Genoa, Italy -
| | - Luca Carmisciano
- Section of Biostatistics, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Irene Giberti
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,IRCCS San Martino University Hospital, Genoa, Italy
| | - Rosella Gallo
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,IRCCS San Martino University Hospital, Genoa, Italy
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Gran S. Within‐person studies – what, when and how? Br J Dermatol 2019; 180:445-446. [DOI: 10.1111/bjd.17524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Gran
- Centre of Evidence Based Dermatology University of Nottingham U.K
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15
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Burke KM, Wright AJ, Parsons V, Madan I. Influences on use of hand moisturizers in nurses. Occup Med (Lond) 2019; 68:340-342. [PMID: 29741666 DOI: 10.1093/occmed/kqy068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Nurses are at high risk of hand dermatitis. Regular hand moisturizing can prevent dermatitis, but nurses' use of hand moisturizers is suboptimal. Aims To establish (i) what beliefs about hand dermatitis and hand moisturizer use are associated with hand moisturizer use by nurses at home and at work and (ii) if hand moisturizer use behaviours in nurses are associated with the prevalence of hand dermatitis. Methods We used a questionnaire to investigate nurses' knowledge, beliefs and behaviours regarding hand dermatitis and use of hand moisturizers. Results The response rate was 55/65 (85%). Forty-two (76%) participants agreed that applying hand moisturizers reduced the risk of dermatitis, and 53 (96%) agreed that dermatitis increased the risk of skin carrying pathogenic organisms. Frequent moisturizer application was associated with beliefs that it was part of the nurse's role to apply hand creams, a belief that they had had training in the use of moisturizers and believing that patients approved of them moisturizing their hands. Conclusions Hand moisturizer use by nurses can be improved by enhancing their beliefs that it is part of their professional role to apply hand cream regularly.
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Affiliation(s)
- K M Burke
- Medical School, St George's University of London, London, UK
| | - A J Wright
- Division of Health and Social Care Research, King's College London, London, UK
| | - V Parsons
- Occupational Health Department, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - I Madan
- Occupational Health Department, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
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16
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Occupational Contact Dermatitis: Health Personnel. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_43-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Parsons V, Williams HC, English J, Llewellyn J, Ntani G, Madan I. The development of a protocol for diagnosing hand dermatitis from photographic images. Contact Dermatitis 2018; 79:270-275. [DOI: 10.1111/cod.13053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/25/2018] [Accepted: 05/23/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Vaughan Parsons
- Clinical Trials Unit; King's College London & Guy's and St Thomas’ NHS Foundation Trust; London UK
| | - Hywel C. Williams
- Centre of Evidenced Based Dermatology; University of Nottingham; Nottingham UK
| | - John English
- Department of Dermatology; Nottingham University Hospitals NHS Foundation Trust; Nottingham UK
| | - Joanne Llewellyn
- Centre of Evidenced Based Dermatology; University of Nottingham; Nottingham UK
| | - Georgia Ntani
- MRC Lifecourse Epidemiology Unit; University of Southampton; Southampton UK
| | - Ira Madan
- School of Medicine; Occupational Health Service, Guy's and St Thomas’ NHS Foundation Trust & King's College London; UK
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Bauer A, Rönsch H, Elsner P, Dittmar D, Bennett C, Schuttelaar MA, Lukács J, John SM, Williams HC. Interventions for preventing occupational irritant hand dermatitis. Cochrane Database Syst Rev 2018; 4:CD004414. [PMID: 29708265 PMCID: PMC6494486 DOI: 10.1002/14651858.cd004414.pub3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Occupational irritant hand dermatitis (OIHD) causes significant functional impairment, disruption of work, and discomfort in the working population. Different preventive measures such as protective gloves, barrier creams and moisturisers can be used, but it is not clear how effective these are. This is an update of a Cochrane review which was previously published in 2010. OBJECTIVES To assess the effects of primary preventive interventions and strategies (physical and behavioural) for preventing OIHD in healthy people (who have no hand dermatitis) who work in occupations where the skin is at risk of damage due to contact with water, detergents, chemicals or other irritants, or from wearing gloves. SEARCH METHODS We updated our searches of the following databases to January 2018: the Cochrane Skin Specialised Register, CENTRAL, MEDLlNE, and Embase. We also searched five trials registers and checked the bibliographies of included studies for further references to relevant trials. We handsearched two sets of conference proceedings. SELECTION CRITERIA We included parallel and cross-over randomised controlled trials (RCTs) which examined the effectiveness of barrier creams, moisturisers, gloves, or educational interventions compared to no intervention for the primary prevention of OIHD under field conditions. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. The primary outcomes were signs and symptoms of OIHD developed during the trials, and the frequency of treatment discontinuation due to adverse effects. MAIN RESULTS We included nine RCTs involving 2888 participants without occupational irritant hand dermatitis (OIHD) at baseline. Six studies, including 1533 participants, investigated the effects of barrier creams, moisturisers, or both. Three studies, including 1355 participants, assessed the effectiveness of skin protection education on the prevention of OIHD. No studies were eligible that investigated the effects of protective gloves. Among each type of intervention, there was heterogeneity concerning the criteria for assessing signs and symptoms of OIHD, the products, and the occupations. Selection bias, performance bias, and reporting bias were generally unclear across all studies. The risk of detection bias was low in five studies and high in one study. The risk of other biases was low in four studies and high in two studies.The eligible trials involved a variety of participants, including: metal workers exposed to cutting fluids, dye and print factory workers, gut cleaners in swine slaughterhouses, cleaners and kitchen workers, nurse apprentices, hospital employees handling irritants, and hairdressing apprentices. All studies were undertaken at the respective work places. Study duration ranged from four weeks to three years. The participants' ages ranged from 16 to 67 years.Meta-analyses for barrier creams, moisturisers, a combination of both barrier creams and moisturisers, or skin protection education showed imprecise effects favouring the intervention. Twenty-nine per cent of participants who applied barrier creams developed signs of OIHD, compared to 33% of the controls, so the risk may be slightly reduced with this measure (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.72 to 1.06; 999 participants; 4 studies; low-quality evidence). However, this risk reduction may not be clinically important. There may be a clinically important protective effect with the use of moisturisers: in the intervention groups, 13% of participants developed symptoms of OIHD compared to 19% of the controls (RR 0.71, 95% CI 0.46 to 1.09; 507 participants; 3 studies; low-quality evidence). Likewise, there may be a clinically important protective effect from using a combination of barrier creams and moisturisers: 8% of participants in the intervention group developed signs of OIHD, compared to 13% of the controls (RR 0.68, 95% CI 0.33 to 1.42; 474 participants; 2 studies; low-quality evidence). We are uncertain whether skin protection education reduces the risk of developing signs of OIHD (RR 0.76, 95% CI 0.54 to 1.08; 1355 participants; 3 studies; very low-quality evidence). Twenty-one per cent of participants who received skin protection education developed signs of OIHD, compared to 28% of the controls.None of the studies addressed the frequency of treatment discontinuation due to adverse effects of the products directly. However, in three studies of barrier creams, the reasons for withdrawal from the studies were unrelated to adverse effects. Likewise, in one study of moisturisers plus barrier creams, and in one study of skin protection education, reasons for dropout were unrelated to adverse effects. The remaining studies (one to two in each comparison) reported dropouts without stating how many of them may have been due to adverse reactions to the interventions. We judged the quality of this evidence as moderate, due to the indirectness of the results. The investigated interventions to prevent OIHD probably cause few or no serious adverse effects. AUTHORS' CONCLUSIONS Moisturisers used alone or in combination with barrier creams may result in a clinically important protective effect, either in the long- or short-term, for the primary prevention of OIHD. Barrier creams alone may have slight protective effect, but this does not appear to be clinically important. The results for all of these comparisons were imprecise, and the low quality of the evidence means that our confidence in the effect estimates is limited. For skin protection education, the results varied substantially across the trials, the effect was imprecise, and the pooled risk reduction was not large enough to be clinically important. The very low quality of the evidence means that we are unsure as to whether skin protection education reduces the risk of developing OIHD. The interventions probably cause few or no serious adverse effects.We conclude that at present there is insufficient evidence to confidently assess the effectiveness of interventions used in the primary prevention of OIHD. This does not necessarily mean that current measures are ineffective. Even though the update of this review included larger studies of reasonable quality, there is still a need for trials which apply standardised measures for the detection of OIHD in order to determine the effectiveness of the different prevention strategies.
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Affiliation(s)
- Andrea Bauer
- University Hospital Carl Gustav Carus, Technical University DresdenDepartment of DermatologyFetscherstr. 74DresdenGermany01307
| | - Henriette Rönsch
- University Hospital Carl Gustav Carus, Technical University DresdenDepartment of DermatologyFetscherstr. 74DresdenGermany01307
| | - Peter Elsner
- Friedrich Schiller UniversityDepartment of Dermatology and AllergologyErfurter Strasse 35JenaGermanyD 07743
| | - Daan Dittmar
- University Medical Center GroningenDepartment of DermatologyHanzeplein 1GroningenNetherlands9713 GZ
| | - Cathy Bennett
- Coventry UniversityCentre for Innovative Research Across the Life Course (CIRAL)Richard Crossman BuildingGosford StreetCoventryUKCV1 5FB
| | | | - Judit Lukács
- University Hospital JenaDepartment of DermatologyErfurter Str. 35JenaGermany07743
| | - Swen Malte John
- University of OsnabrueckDepartment of Dermatology, Environmental Medicine, Health TheorySedanstr 115OsnabrueckGermanyDE 49069
| | - Hywel C Williams
- University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
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Japundžić I, Novak D, Kuna M, Novak-Bilić G, Lugović-Mihić L. Analysis of Dental Professionals' and Dental Students' Care for their Skin. Acta Stomatol Croat 2018; 52:46-52. [PMID: 30034004 PMCID: PMC6050747 DOI: 10.15644/asc52/1/7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives To determine prevalence of undesirable, work-related skin lesions and their
localizations in dental professionals and students, and to collect data
about diagnostic procedures they undergo and skin care they take when these
lesions occur. Subjects and methods Our research included 444 respondents (dentists, dental assistants, dental
technicians, dental students) who filled out a questionnaire. They were
asked to specify if they had observed any lesions on their skin and where;
if they had undergone any treatments and in what way; if they had undergone
any allergy tests; and if they had taken any protective measures. Results Of all the respondents that took part in the survey, 249 (56.1%) reported
undesirable skin reactions commonly on their hands and fingers (96%). Before
our survey, only 15% of them had seen a dermatologist, while 33% had
undergone allergy tests (without a dermatologists’ clinical
examination). Also, 45% of them sometimes used soaps for sensitive skin and
the majority (61%) of them used protective hand creams 1-2 times per
day. Conclusion Although a large number of dental professionals and students have noticed
work-related skin lesions, only some of them sought dermatologists’
professional help and most of them did not take care of their skin
adequately when those lesions occurred. According to the results of this
study, it is necessary to take additional preventive measures to increase
dental professionals’ and students’ awareness of occupational
dermatoses and adequate skin care.
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Affiliation(s)
- Iva Japundžić
- Clinical Department of Dermatovenereology, University Hospital Centre "Sestre milosrdnice", Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Dario Novak
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Matea Kuna
- Clinical Department of Dermatovenereology, University Hospital Centre "Sestre milosrdnice", Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Gaby Novak-Bilić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Liborija Lugović-Mihić
- Clinical Department of Dermatovenereology, University Hospital Centre "Sestre milosrdnice", Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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20
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Weston D, Parsons V, Ntani G, Rushton L, Madan I. Mixed contact methods to improve response to a postal questionnaire. Occup Med (Lond) 2017; 67:305-307. [DOI: 10.1093/occmed/kqx032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Soltanipoor M, Kezic S, Sluiter JK, Rustemeyer T. The effectiveness of a skin care program for the prevention of contact dermatitis in health care workers (the Healthy Hands Project): study protocol for a cluster randomized controlled trial. Trials 2017; 18:92. [PMID: 28245835 PMCID: PMC5331718 DOI: 10.1186/s13063-017-1803-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 01/18/2017] [Indexed: 11/16/2022] Open
Abstract
Background Health care workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to frequent exposure to ‘wet work’. Amongst HCWs, nurses are at highest risk, with an estimated point prevalence of HD ranging between 12 and 30%. The burden of disease is high with chronicity, sick leave, risk of unemployment and impaired quality of life. Despite evidence from the medical literature on the risk factors and the importance of skin care in the prevention of HD, in practice, compliance to skin care protocols are below 30%. New preventive strategies are obviously needed. Methods/design This is a cluster randomized controlled trial, focusing on nurses performing wet work. In total, 20 wards are recruited to include 504 participating nurses in the study at baseline. The wards will be randomized to an intervention or a control group and followed up for 18 months. The intervention consists of the facilitation of creams being available at the wards combined with the continuous electronic monitoring of their consumption with regular feedback on skin care performance in teams of HCWs. Both the intervention and the control group receive basic education on skin protection (as ‘care as usual’). Every 6 months, participants of both groups will fill in the questionnaires regarding exposure to wet work and skin protective behavior. Furthermore, skin condition will be assessed and samples of the stratum corneum collected. The effect of the intervention will be measured by comparing the change in Hand Eczema Severity Index (HECSI score) from baseline to 12 months. The Natural Moisturizing Factor (NMF) levels, measured in the stratum corneum as an early biomarker of skin barrier damage, and the total consumption of creams per ward will be assessed as a secondary outcome. Discussion This trial will assess the clinical effectiveness of an intervention program to prevent hand dermatitis among health care workers Trial registration Netherlands Trial Register (NTR), identification number NTR5564. Registered on 2 November 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1803-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maryam Soltanipoor
- Department of Dermatology, VU University Medical Centre (VUmc), De Boelelaan 1117, Amsterdam, 1081HV, The Netherlands. .,Coronel Institute of Occupational Health, Academic Medical Center (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - Sanja Kezic
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Judith K Sluiter
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, VU University Medical Centre (VUmc), De Boelelaan 1117, Amsterdam, 1081HV, The Netherlands
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