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Background The preventive measures of coronavirus disease-19 (COVID-19) transmissions require the healthcare workers (HCWs) to be more cautious. Irritants or allergens exposure from these measures might induce adverse skin reactions and lead to the development of occupational contact dermatitis (OCD). Methods Questionnaires were distributed to HCWs in COVID-19 isolation ward of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. The questionnaire consisted of personal and work characteristics, clinical history, skin complaints, and occupational exposures. Results Fifty-three completed questionnaires were gathered from eligible subjects. History of atopic dermatitis (AD) was found on 8 subject (15.09%). Many of the subjects had complained of dry skin (28.30%), itchy skin (26.41%), and redness of skin (20.75%) on the hands in the last 12 months. As many as 50.94% of the subjects washed their hands with water and soap at least 6-10 times a day and 49.06% used hand sanitizers 6-10 times a day. The use of PPE were mostly 4 hours a day or less. There were associations between history of AD with complaints related to hand dermatitis (p=0.004) and history of AD with incidence of OCD assessed with Mathias criteria (p=0.016). It was also found that the use of gloves for 2 or more hours a day was associated with skin complaints after gloves use (p=0.021) and the use of hand sanitizer for more than 10 times a day was associated with complaints related to hand dermatitis (p=0.041). Conclusion The repeated and prolonged exposure to irritative or allergenic substances contained in PPE and hand hygiene products is related to OCD, particularly hand dermatitis, among HCWs in COVID-19 isolation ward. Copyright © 2023 Pakistan Association of Dermatologists. All rights reserved.
ABSTRACT
Irritant contact dermatitis (ICD) affects over 20% of health care workers, who manage their condition by substituting soap with an emollient cleanser. It is not clear whether emollient cleansers have the same level of virus eliminating activity as soap. Therefore, we evaluated a range of emollient cleansers for virus eliminating activity against enveloped (coronavirus and herpes simplex virus) and nonenveloped viruses (adenovirus (Ad)). In accordance with European standards a range of cleansers were combined with viruses under different (‘clean’ and ‘dirty’ hand hygiene) conditions. Virus viability and architecture were determined by plaque /TCDI50 assays and transmission electron microscopy. Traditional soaps (natural fatty acid), synthetic soaps and emollient cleansers (e.g., ceramide-containing cleansers) exhibited significant antiviral activity in enveloped viruses. However, the antiviral activity of traditional soaps reduced drastically when combined with hard water. Moreover, nonenveloped viruses were less susceptible to both synthetic soaps and emollients cleansers. Interestingly, traditional soaps inhibited the viability of Ad at high concentrations, but only in soft water. Most emollient cleansers were effective at eliminating enveloped viruses, suggesting that they are an acceptable substitute for soap to control the spread of viruses, like SARS-CoV-2, and protect against ICD. Nonenveloped viruses showed resistance to most of the hand hygiene products tested, except for traditional soap. This suggests that hand washing alone may not be sufficient to control the spread of nonenveloped viruses. Taken together this suggests that different virus strains respond differently to soaps and cleansers, and that this should be considered in the guidance for hand hygiene.
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1“I want to break free” - the famous lyric from Queen's song seems appropriate for today’s times, when everyone wants to escape the restrictions that were enforced with the COVID-19 pandemic. Looking back, the alarming spread of SARS-CoV-2 infection has induced fear and panic among people. The fear of getting sick with the “unknown virus” made us self-isolate at home, and be very careful about hand hygiene and interactions with others. Since March 2020, face masks have become an essential part of our lives, together with hand hygiene products. The initial months of the pandemic have been marked by a significant disruption of the availability of these products on the market, which, in turn, exponentially increased people’s fears.
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Objective: The present study provides an overview of the number and type of calls to the Belgian Poison Centre (BPC), and the impact of COVID-19. Methods: Data of all calls to the BPC (1 January - 31 December 2020) were collected and analysed using appropriate statistics (SAS). Results: The BPC received 65,308 calls in 2020 (60,668 in 2019, p<0.05). The vast majority (35.9%) of exposures were drugrelated (21,151 in 2019 versus 20,666 in 2020, p>0.05), followed by the use of chemical household products (11,836 in 2019 versus 12,247 in 2020 (p>0.05)). A 12.3% increase in the number of cosmetic- and food-related exposures was noted (8,291 in 2019 versus 9,308 in 2020, p<0.05). Within this group, a stable number of exposures (877 in 2019 versus 876 in 2020, p>0.05) due to essential oil exposures were observed. Partly due to the impact of the COVID-19 [1] pandemic, exposures to biocides doubled (104.9%) from 1,964 in 2019 to 4,024 in 2020 (p<0.05). Exposures to type 1 biocides (i.e. human hygiene products, which include alcohol-based hand sanitisers (ABHS)) significantly increased from 322 in 2019 to 1,676 in 2020 (p<0.05), and exposures to type 2 biocides (i.e. disinfectants and algaecides not intended for direct application to humans or animals) from 406 to 902 (p<0.05). In 2020 the BPC received a five-fold increase in the number of calls involving ABHS incidents (both liquid and gel-based, as well as ethanol and isopropanol products) compared to 2019 (1,676 versus 323 in 2019 versus 1,676 in 2020 calls, p<0.05), accounting for 2.6% of all calls in 2020. In 71% of exposures, ingestion was the primary route (1,195/1,676), followed by 28.6% accidental ocular exposures (480/1,676) of which more than half of the incidents involved children (257/480, p<0.05), primarily young children aged 1-4 years (136/257, p<0.05). Finally, as people went into the garden and nature to relax during lockdown, a 28.2% increase in exposures related to the group 'plants, mushrooms and animals' was found, with 3,256 exposures in 2019 and 4,175 in 2020 (p<0.05). Conclusion: In its history, the BPC has never received as many calls as in 2020. The COVID-19 pandemic contributed to a significant number of additional exposures, and requests for toxicologic advice.
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Background. Non-pharmaceutical interventions (NPIs), such as sanitary measures and travel restrictions, aimed at controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may affect the transmission dynamics of human respiratory syncytial virus (HRSV). We aimed to quantify the contribution of the sales of hand hygiene products and the number of international and domestic airline passenger arrivals on HRSV epidemic in Japan. Methods. The monthly number of HRSV cases per sentinel site (HRSV activity) in 2020 was compared with the average of the corresponding period in the previous 6 years (from January 2014 to December 2020) using a monthly paired t-test. A generalized linear Poisson regression model was used to regress the time-series of the monthly HRSV activity against NPI indicators, including sale of hand hygiene products and the number of domestic and international airline passengers, while controlling for meteorological conditions (monthly average temperature and relative humidity) and seasonal variations between years (2014-2020). Results. The average number of monthly HRSV case notifications in 2020 decreased by approximately 85% (P < 0.001) compared to those in the preceding 6 years (2014-2019) (Figure 1A). For every average \1 billion (approximately $9,000,000/£6,800,00) spent on hand hygiene products during the current month and 1 month before (lag 0-1 months) there was a 0.22% (P = 0.02) decrease in HRSV infections (Table 1). An increase of average 1,000 domestic and international airline passenger arrivals during the previous 1-2 months (lag 1-2 months) was associated with a 4.6×10-4% (P < 0.001) and 1.1×10-3% (P = 0.007) increase in the monthly number of HRSV infections, respectively. Conclusion. This study suggests that there is an association between the decrease in the monthly number of HRSV cases and improved hygiene and sanitary measures and travel restrictions for COVID-19 in Japan, indicating that these public health interventions can contribute to the suppression of HRSV activity. These findings may help in public health policy and decision making.
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Background. Proper handwashing can reduce the burden of diseases related to hand hygiene (HH) and so contribute reducing under-5 mortality. Preschoolers can benefit from HH interventions by the burden of disease and absenteeism being reduced. Objective. To perform a scoping review of literature to assess the types and effectiveness of HH interventions at preschools, with a view to providing a guideline for appropriate interventions for South African facilities. Methods. A literature search was conducted through the PubMed database to identify relevant studies. An iterative screening process to focus the review allowed for information on the type and effectiveness of interventions to be collated. An updated PubMed search was conducted to determine whether any interventions related to COVID-19 at preschools could be included. Results. No additional studies relating to COVID-19 were found. Of the 305 studies identified during the initial search, only 12 fitted the specific search criteria. Of these, 10 studies showed improvements in HH-related indicators following the interventions. Only two studies used health education as an intervention, whereas the others included the supply of HH products (to varying extents) as part of the intervention. Conclusion. HH interventions appear successful in reducing diseases spread by poor HH, improving general HH practices and reducing absenteeism among preschoolers. Studies using innovative, entertaining methods of educating children have shown to be successful in improving handwashing techniques and decreasing microbial growth on children’s hands. HH interventions are suggested as an effective measure to improve HH during the COVID-19 pandemic.
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Introduction: This study investigates and describes the time course of fears and worries about COVID-19 among currently employed population during this outbreak. Methods: This study was a longitudinal study using the dataset from the Employee Cohort Study in Japan (E-COCO-J). The study comprised 4120 individuals from February 2019. A baseline survey in March 2020, a 2-month follow-up survey in May 2020, and a 5-month follow-up survey in August 2020 were conducted. Questions surveyed respondents’ global fear and worry and six items related to COVID-19. A mixed model for repeated measures of an analysis of variance was used. Results: A total of 1,421 respondents completed the baseline survey. At 2- and 5-month follow-ups, 1,032 and 1,181 respondents completed surveys, respectively. Of those, 64 and 33 individuals who were temporarily laid off or on leave were recorded as missing values. Global fear and worry about COVID-19 significantly increased from March to August 2020. Fears of personal or family infection, limiting one's activities and national and local government policies also significantly increased with time. In contrast, fears of lack of knowledge and difficulty of obtaining hygiene products significantly decreased. Conclusions: Global fear and worry about COVID-19 were increased even though people have stayed together longer with this infectious disease. To conduct efficient risk communication during a pandemic, knowing the concerns of the populace, providing correct information and a sufficient supply of products, and setting clear guidelines are essential.
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Background: Chlorhexidine is an antiseptic widely used in healthcare settings. There are increasing reports of significant hypersensitivity reactions associated with its use. While severe reactions have been reported predominantly in patients in perioperative situations, some small case reports have indicated significant reactions in healthcare workers exposed to chlorhexidine in the workplace. Development of chlorhexidine allergy has been identified as an important occupational risk to healthcare workers. We sought to evaluate the prevalence of sensitisation to chlorhexidine amongst healthcare workers at a large tertiary hospital in order to assess the potential allergic safety risks associated with chlorhexidine exposure amongst staff. Method: Sensitisation to chlorhexidine was evaluated by measurement of serum specific IgE in samples collected from staff assessed after a sharps injury incident and laboratory staff collected for quality assurance procedures. This test method has been shown to have high sensitivity and specificity in the diagnosis of chlorhexidine allergy. Prevalence of sensitisation was additionally evaluated with reference to changes in exposure to chlorhexidine-based hand hygiene products as a result of infection control procedures and the COVID-19 pandemic. Results: A total of 320 samples were examined. The prevalence of positive chlorhexidine-specific IgE was 2.1%. Prevalence of sensitisation in samples collected prior to onset of the COVID-19 pandemic was 1.4% and 2.8% in samples collected post onset. This did not represent a statistically significant difference. Conclusions: Increased exposure to chlorhexidine-based hand hygiene products was not demonstrated to increase sensitisation in this study. However, the prevalence figures for chlorhexidine sensitisation are higher than estimated for similar cohorts in previous studies. This highlights the importance of testing for chlorhexidine allergy when investigating occupational allergy, particularly given the risk of severe reactions in sensitised individuals.