Investigation of the prevalence of hand eczema among healthcare professionals in Turkey: A cross‐sectional study

Abstract

Background Hand eczema is one of the common occupational dermatoses, having high prevalence among healthcare professionals (HCP). We found no epidemiological data in the literature concerning the prevalence of hand eczema among HCP in Turkey. Aims The aim of the present study was to investigate the prevalence of hand eczema among HCP in Turkey and to determine the demographic characteristics and risk factors that cause eczema. Methods A clinical assessment‐ and questionnaire‐based cross‐sectional study was conducted with 734 HCP working in a tertiary hospital. Demographic characteristics and personal and occupational risk factors were evaluated in terms of the development of hand eczema. Results The survey response rate was 81.8%. The point prevalence of eczema was 27.6%, and the 12‐month prevalence was 45.9%. Age, occupation, duration of work, atopic diseases, handwashing frequency, dry skin, moisturizing frequency, and presence and duration of glove use were important factors in the development of hand eczema. Powdered glove reaction was significantly higher in those with hand eczema (p = 0.0001). Conclusions The prevalence of hand eczema is high among HCP in Turkey. Combining self‐reported questionnaires with clinical examination findings can provide a more accurate calculation of the prevalence of hand eczema. The availability of epidemiological data on hand eczema can provide guidelines for the prevention and treatment of this condition. Except for situations requiring absolute handwashing, disinfecting hands with alcohol‐based lotions and applying a powder‐free policy in all healthcare centers will reduce the prevalence of hand eczema among HCP.

Lifestyle factors and hand eczema: A systematic review and meta‐analysis of observational studies

“…A total of 55 studies (n = 40‐65 261), 1,5,31‐40,23,41‐50,24,51‐60,25,61‐70,26,71‐75,27‐30 comprising more than 42 500 individuals with HE on 98 different lifestyle factors and/or outcome measures, were included (Table 1). Study design included cohort (prospective (n = 13) 23,24,69,74,75,29,36‐38,51,52,56,58 and retrospective (n = 6) 27,44,55,57,61,62 ), case–control (n = 7), 1,25,39,46,53,64,71 and cross‐sectional studies (n = 29) 5,26,41‐43,45,47‐50,54,59,28,60,63,65‐68,70,72,73,30‐35,40 . HE was assessed in different study settings, including clinical (n = 15), 1,23,68,69,71,74,75,29,44,53,54,61,64,66,67 occupational (n = 22), 5,24,50,52,55‐60,62,63,25,65,73,27,30,36,40,45,47,49 and the general population (n = 18) …”

“…Study design included cohort (prospective (n = 13) 23,24,69,74,75,29,36‐38,51,52,56,58 and retrospective (n = 6) 27,44,55,57,61,62 ), case–control (n = 7), 1,25,39,46,53,64,71 and cross‐sectional studies (n = 29) 5,26,41‐43,45,47‐50,54,59,28,60,63,65‐68,70,72,73,30‐35,40 . HE was assessed in different study settings, including clinical (n = 15), 1,23,68,69,71,74,75,29,44,53,54,61,64,66,67 occupational (n = 22), 5,24,50,52,55‐60,62,63,25,65,73,27,30,36,40,45,47,49 and the general population (n = 18) 26,28,41‐43,46,48,51,70,72,31‐35,37‐39 . The diagnoses of HE was either retrieved from medical records (n = 5), 23,44,55,61,62 self‐reported (n = 24), 5,26,37,39‐41,43,45,46,49‐51,27,53,59,70,73,28,30‐35 or physician diagnosed (n = 23),…”

“…HE was assessed in different study settings, including clinical (n = 15), 1,23,68,69,71,74,75,29,44,53,54,61,64,66,67 occupational (n = 22), 5,24,50,52,55‐60,62,63,25,65,73,27,30,36,40,45,47,49 and the general population (n = 18) 26,28,41‐43,46,48,51,70,72,31‐35,37‐39 . The diagnoses of HE was either retrieved from medical records (n = 5), 23,44,55,61,62 self‐reported (n = 24), 5,26,37,39‐41,43,45,46,49‐51,27,53,59,70,73,28,30‐35 or physician diagnosed (n = 23), 1,24,58,60,63‐69,71,25,72,74,75,29,42,47,48,54,56,57 or a combinations of self‐reported and physician diagnoses (n = 3) 36,38,52 . For the association between smoking and prevalence of HE a meta‐analysis could be performed.…”

“…Seventeen 23,27,41‐43,45‐47,50,30‐34,36,38,39 of the 29 included studies reporting the association between smoking and prevalence of HE could be included in a meta‐analysis. This included 23 983 subjects with HE and 191 352 subjects without HE, and showed a positive overall effect in the direction of HE compared with no HE (OR 1.18, 95% CI 1.09‐1.26) (Figure 2).…”

“…Sub‐analysis of studies with a low risk of bias (N = 8) 30‐34,41‐43 demonstrated only a minor difference (OR 1.16, 95% CI 1.07‐1.26) (Figure S4). A sub‐analysis comparing studies in a non‐occupational setting (n = 11) 23,31,46,32‐34,38,39,41‐43 versus an occupational setting (n = 6) 27,30,36,45,47,50 showed ORs of 1.21 (95% CI 1.12‐1.31) and 1.09 (95% CI 0.92‐1.28), respectively (Figures S5,S6). According to the GRADE approach, the quality of the evidence was very low (Table 2).…”