Onset of occupational hand eczema among healthcare workers during the SARS‐CoV‐2 pandemic: Comparing a single surgical site with a COVID‐19 intensive care unit

Abstract

BackgroundDue to the COVID-19 outbreak, hygiene regulations have been intensified and hand sanitatio n has gained special attention. ObjectiveTo investigate the onset of hand eczema during the COVID-19 pandemic in health care workers (HCWs) directly involved in intensive care of COVID-19 patients and HCWs without direct contact. Hereby, we aim at increasing awareness with regard to occupational hand eczema and preventive measures that can be undertaken. MethodsA survey was distributed amongst 114 HCWs at a single surgical site and at a COVID-19 intensive care unit of the university hospital LMU Munich, Germany. Participants were questioned with regard to the daily frequency of hand hygiene prior to and during the pandemic.Participants self-reported onset of hand eczema and associated symptoms. ResultsOur study revealed a significant increase of hand washing, disinfection and use of hand cream across all participants (P-value<.001), regardless of having direct contact with COVID-19 patients. A high prevalence of symptoms associated with acute hand dermatitis was found in 90.4% across all HCWs, whereas hand eczema itself was underreported (14.9%). ConclusionThe increase of hand sanitation during the COVID-19 pandemic impairs the skin of the hands across all HCWs, independent of direct intensive care of affected patients.

The risk of hand eczema in healthcare workers during the COVID‐19 pandemic: Do we need specific attention or prevention strategies?

“…The majority of the study population (90.4%) reported symptoms associated with acute hand dermatitis, whereas the prevalence of self-reported HE was only 14.9%. 5 Previous reports have demonstrated that personal or familial atopy, >20 hand washings per day, using occlusive gloves, and long years of working are independent risk factors for HE. 3 On the other hand, HE prevalence was lower in individuals using moisturizers, and the use of moisturizers has been recommended for preventing HE.…”

“…1 Independent of COVID-19, healthcare workers (HCW) generally have an increased risk of hand eczema (HE). 2,3 Skin damage due to intensive hand hygiene measures during the COVID-19 pandemic in HCW has recently been reported, 4,5 as well as HE among HCW during the pandemic. 5 Therefore, we aimed to investigate the frequency, risk factors, and clinical features of HE among healthcare workers during the COVID-19 pandemic.…”

Pandemic public health policy: with great power comes great responsibility

“…It will often be reasonable to require specific groups to adhere to minimally burdensome but effective policies: for example, handwashing requirements among healthcare workers. 14,15 However, where burdens are disproportionately high (or unfairly shared across the population), this should be questioned. The over-policed and underresourced quarantine of Melbourne's public housing towers saw 2515 residents confined to their units under police guard for 5-14 days.…”

Hand hygiene practices and risk and prevention of hand eczema during the COVID-19 pandemic

“…[ 18 ] A higher incidence of 90.2% was also reported from Germany that correlated with two times an increase in the frequency of handwashing during the COVID-19 pandemic. [ 1 ] There are also reports of increased teledermatology consultations for hand eczema from India and Italy. [ 2 3 ] An Indian study reported 16 patients of hand eczema over a short span of 10 days imputed to excessive use of hand sanitizers/ handwashing.…”

“…However, there are reports of increased incidence of dermatology consultations for hand eczema attributed to frequent hand washing/ sanitization in healthcare workers and the general public. [ 1 2 3 ] This might just be the tip of the iceberg as a significant proportion of patients fail to seek expert advice especially in the current situation of stay at home directives. Further, the presence of hand eczema itself may decrease the adherence to hand hygiene practices.…”