Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993–2014

Abstract

Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD.

Dermatite de Contacto Alérgica em Profissionais de Saúde

“…1,[11][12][13] Actually, more than 70% of the studied HCW had a positive PT, which is not significantly different from the whole population tested. Although, only about half of the reactive patients had an occupationally relevant positive PT, occupational ACD was documented in 38% of the HCW that searched a dermato-allergology testing, much higher than the percentage of occupational cases in the whole population tested (16%).…”

“…12,19 Although hand dermatitis is a multifactorial disease, often combining also atopic dermatitis, chronic irritant contact dermatitis, immediate symptoms, like contact urticaria and protein contact dermatitis, 33 the high frequency of ACD in this subgroup is certainly explained by the tasks done mainly by hand, like frequent washing and use of hand soaps/disinfectants and protective gloves. 19 Moreover, wet work and the irritant effect of some of these substances, also favours sensitization in hand dermatitis.…”

“…1,5,6,[11][12][13][14] In the healthcare setting ACD can occur due both to delayed-type hypersensitivity mediated by allergen specific T lymphocytes that recognize low molecular weight chemicals, and immediate-type hypersensitivity, with IgE recognizing larger chemicals, like latex proteins. 12,15,16 Clinical manifestations depend on the chemical properties of the allergens, local and form of exposure (acute or chronic) 17,18 and may also be influenced by individual factors (atopy) or concomitant risk factors, like intensive exposure to wet work and skin irritants, namely with frequent and cumulative hand washing at work and at home. 19 Occupational ACD in HCW affects mainly the hands, and particularly females, younger workers, individuals working in acute care settings, facility support services, and laboratory assistants and technicians, due to the tasks required.…”

“…19 Occupational ACD in HCW affects mainly the hands, and particularly females, younger workers, individuals working in acute care settings, facility support services, and laboratory assistants and technicians, due to the tasks required. 20 ACD is reported to be mainly due to contact with rubber chemicals of protective gloves, surface and instrument disinfectants, drugs for systemic or topical use, or components of skin care products such as emollients, barrier creams, or liquid soaps [12][13][14]19 but culprit allergens may vary with time, occupational setting and exposure hazards. A correct diagnosis of occupational ACD is critical once the timeline of the diagnosis affects the outcome of the disease.…”

Hand eczema among Lebanese dentists: An epidemiological study

“…23 In addition, hand eczema caused by commercial hand cleansers occurred more frequently than hand eczema caused by alcohol-based hand rubs (ABHRs), which why we recommend the use of ABHRs daily in dental clinics. 30 …”