Prevention of Irritant Contact Dermatitis among Health Care Workers by Using Evidence-Based Hand Hygiene Practices: A Review

Abstract

Irritant contact dermatitis is often found on the hands of healthcare workers and is generally caused by frequent hand washing, gloves, aggressive disinfectants or detergents. Alcohols have only a marginal irritation potential, although they may cause a burning sensation on pre-irritated skin. A burning sensation when using alcohols therefore, suggests that the skin barrier is already damaged. Two options for hand hygiene are generally available in clinical practice: (1) hand washing with some type of soap and water or (2) hand disinfection with alcohol-based hand rubs. Most clinical situations require the use of an alcohol-based hand rub for decontamination, which is especially useful for reducing the nosocomial transmission of various infectious agents. Washing one's hands should be the exception, to be performed only when they are visibly soiled or contaminated with proteinaceous material, or visibly soiled with blood or other body fluids. The overall compliance rate in hand hygiene is around 50%, which is far too low. In addition, healthcare workers quite often wash their hands with soap and water, when they should use an alcohol-based hand rub. This not only adds to the degree of skin irritation, but is also potentially dangerous for patients, due to the low efficacy of hand washing when compared to hand disinfection with alcohol rubs. Adhering to evidence-based hand hygiene protocols and following international guidelines on hand hygiene practices therefore, can help prevent irritant contact dermatitis among healthcare workers.

Occupational Dermatitis in Health Care Workers Evaluated for Suspected Allergic Contact Dermatitis

“…Other authors have also noted that HCWs have higher rates of hand dermatitis than NHCWs. 10,11 Male HCWs were more likely to have a history of AD than were male NHCWs. When compared to female NHCWs, female HCWs had similar rates of AD.…”

Dermal tolerance and effect on skin hydration of an improved ethanol-based hand gel

“…12 Dermal tolerance is a pre-requisite for acceptance of a hand antiseptic for use among healthcare workers. We were able to show that Sterillium Comfort Gel has no clinically relevant potential for dermal irritation and sensitization, as shown by repetitive occlusive patch test.…”

A Survey of Work-Related Skin Diseases in Different Occupations in Poland

“…CD is generally caused by frequent hand washing (in water), gloves, soaps, aggressive disinfectants or detergents, drugs, epoxies and resins and nickel, which is present in the metal parts of medical instruments [6,7,8,9,10,11].…”