ABSTRACT
Centar za kontrolu otrovanja je 24-satna informacijska služba pri Institutu za medicinska istraživanja i medicinu rada u Zagrebu koja prima upite zdravstvenih radnika i drugih pravnih i fizičkih osoba na području Republike Hrvatske u vezi sa slučajevima akutnih ili kroničnih otrovanja. U preostala 2 slučaja radilo se o izloženosti otapalima putem očiju: radnik kojem je stiren špricnuo u oko, no ispostavilo se da radnik ima i opće simptome u vidu proljeva, zimice i promuklosti te je poslan svojem specijalistu medicine rada kako bi se isključila eventualna kronična inhalacijska izloženost stirenu;radnik kojem je industrijsko otapalo špricnulo u oko uz razvoj pečenja i crvenila očiju. Ljepila i sintetske smole takoðer su uzrokovali 2 slučaja profesionalnih otrovanja: radnik koji je prilikom postavljanja umjetnog travnjaka radio s dvokomponentnim ljepilom za umjetne travnjake na osnovi diizocijanatnih smola te je razvio otok lica i očnih vjeða, osip na rukama i potkoljenicama s odgodom 3 - 4 dana te je upućen na dermatološku obradu;radnica koja je radila s epoksidnim smolama i nakon tjedan dana izloženosti razvila rinitis i kašalj, za što je malo vjerojatno da je uzrokovano epoksidnim smolama. Inhalacija je i dalje bila najčešći put unosa štetnih tvari na radnom mjestu te je taj put unosa jednako zastupljen kao i 2020. godine (55 % ), iako treba napomenuti da se nastavlja silazni trend u odnosu na ranije godine (npr. 66 % slučajeva u 2019. godini).
ABSTRACT
BACKGROUND: Studies investigating simultaneous influence of personal and work-related factors on skin health during the coronavirus disease 2019 (COVID-19) pandemic are missing. OBJECTIVES: To investigate the associations of skin hazards relevant for nursing apprentices with parameters of skin barrier function. METHODS: A total of 238 nursing apprentices attending the final year of education (median age 19 years) from vocational schools in Zagreb, Croatia, were enrolled in this study. We administered a questionnaire based on the Nordic Occupational Skin Questionnaire to the nursing apprentices, performed clinical examination of skin on the hands, and evaluated transepidermal water loss (TEWL) and stratum corneum (SC) pH on the dorsum of the hand. RESULTS: Around half of nursing apprentices had compromised hand skin barrier function, as indicated by TEWL values >25 g/m2 /h (48%) and SC pH >5.5 (57%). Skin barrier was compromised in around 40% of nursing apprentices without clinically observed skin symptoms. Elevated SC pH was independent of ambient conditions associated with skin symptoms and female sex. CONCLUSIONS: Measurement of SC pH was shown to be less sensitive to field conditions than TEWL, and should be employed more in the field studies. Strengthening of skin health promotion in healthcare workers and apprentices is needed in pandemic conditions.
Subject(s)
COVID-19 , Dermatitis, Allergic Contact , Adult , Dermatitis, Allergic Contact/diagnosis , Female , Humans , Pandemics , Skin , Surveys and Questionnaires , Water Loss, Insensible , Young AdultABSTRACT
BACKGROUND: Apprentice nurses are considered at high risk to developing occupational skin diseases. OBJECTIVES: This study assessed the frequency and origin of hand eczema, and work-related risk factors in apprentice nurses. METHODS: The study involved 240 final-year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months. RESULTS: Clinically observed and self-reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin (P = .001). Median OHSI was 4 (interquartile range 2-6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel. CONCLUSIONS: Hand eczema was common in final-year apprentice nurses during the COVID-19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier.