Wet work exposure and hand eczema among healthcare workers: a cross‐sectional study

• Published in: British journal of dermatology (1951) Vol. 178; no. 2; pp. 452 - 461
• Main Authors: Hamnerius, N., Svedman, C., Bergendorff, O., Björk, J., Bruze, M., Pontén, A.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.02.2018
• Subjects: Adolescent; Adult; Age Distribution; Aged; Atopic dermatitis; Clinical Medicine; Cross-Sectional Studies; Dermatitis; Dermatitis, Occupational - epidemiology; Dermatologi och venereologi; Dermatology and Venereal Diseases; Disinfectants; Eczema; Eczema - epidemiology; Female; Gloves; Gloves, Protective - statistics & numerical data; Hand Dermatoses - epidemiology; Hand Disinfection; Health Personnel - statistics & numerical data; Humans; Hygiene; Klinisk medicin; Male; Medical and Health Sciences; Medical personnel; Medical Staff, Hospital - statistics & numerical data; Medicin och hälsovetenskap; Middle Aged; Multivariate analysis; Occupational exposure; Occupational Exposure - adverse effects; Occupational health; Surveys and Questionnaires; Sweden - epidemiology; Young Adult; Sweden
• ISSN: 0007-0963; 1365-2133; 1365-2133
• DOI: 10.1111/bjd.15813

Summary Background Hand eczema is more common in healthcare workers than in the general population. Hands are subject to changing occupational exposures as a result of mandatory hygiene regulations for healthcare workers. Objectives To describe exposure to hygiene procedures and investigate the associations between occupational hand washing, use of nonsterile gloves and hand disinfectant, and self‐reported hand eczema. Methods This was a cross‐sectional study; an electronic questionnaire was distributed to 28 762 hospital employees in southern Sweden. Nurses, assistant nurses or physicians constituted the group of healthcare workers analysed. Adjustments were made for sex, age, wet work at home, lifestyle factors and atopic dermatitis. Results In total, 12 288 (43%) responded, including 9051 healthcare workers. In this group the 1‐year prevalence of self‐reported hand eczema was 21%. On a daily basis, 30% reported hand washing with soap > 20 times at work, 45% used hand disinfectants > 50 times and 54% wore nonsterile gloves for > 2 h. After adjustment for confounding factors, a dose‐dependent association with self‐reported hand eczema was found for the daily number of hand washes with soap at work and time working with disposable gloves but not for alcoholic disinfectant use. Hand washing outside work was not associated with self‐reported hand eczema in the adjusted multivariate analysis. Conclusions In this study, we found a higher 1‐year prevalence of self‐reported hand eczema among Swedish healthcare workers than reported in the general population. Hand washing with soap and use of disposable gloves were associated with the occurrence of self‐reported hand eczema in a dose‐dependent way. Use of hand disinfectant was not associated with self‐reported hand eczema. What's already known about this topic? Frequent hand washing with soap and water is a risk factor for hand eczema in healthcare workers. Use of disposable gloves might be associated with hand eczema in health care, but data so far have been contradictory. What does this study add? There is a dose‐dependent association between daily time spent wearing disposable gloves and hand eczema in healthcare workers. The data do not support any dose‐dependent association between the use of hand disinfectant and hand eczema in healthcare workers. Linked Comment: Apfelbacher. Br J Dermatol 2018; 178:323–324. Linked Comment: Keegel and Nixon. Br J Dermatol 2018; 178:324–325. Plain language summary available online Respond to this article