What do COVID-19-associated hygiene measures mean for the skin health of healthcare workers? Results of a controlled, prospective intervention study

ABSTRACT

Introduction: More than 100,000 occupational COVID-19 infections in healthcare workers (HCW) were reported in Germany from 12/2020 to 6/2021. Hygiene measures were consequently tightened further. We investigated the impact of current hygiene measures on the incidence of hand eczema (HE) and the effect of prevention measures during the above-mentioned period. Materials and Methods: 302 nurses from two hospitals were recruited for a controlled intervention study. The intervention group (IG, n=135) underwent a two-part intervention (online health education course and provision of a skin cleansing and skin care product ad libitum). The control group (CG, n=167) received no intervention. The skin condition of the hands was assessed by a dermatologist at baseline (T0) and after 6 months (T2) using the Osnabrueck Hand Eczema Severity Index (OHSI). Results: The drop-out rate was 16.9% at T2. New HE developed in none of the 115 participants of the IG but in 12 (8.8%) of the 136 participants of the CG. With the same baseline score (1.5 points in both groups at T0), the OHSI showed statistically significantly better values in the IG than in the CG at T2 (0.6 points vs. 2.1 points, p<.001). Conclusions: The intervention did not only contribute to maintenance but even to improvement of the skin condition. A decrease in hygiene measures is not to be expected in the foreseeable future. The use of the intervention concept in the context of the prevention of occupational HE among HCW seems reasonable. Skin protection and skin care recommendations of the online health education course can also be adapted for other high-risk occupations.