Contact dermatitis in healthcare workers: Results of patch testing and review of the literature

ABSTRACT

Aim: Occupational contact dermatitis (OCD) is common amongst healthcare workers (HCW). This retrospective study describes the causes of allergic contact dermatitis in HCW in New Zealand and reviews the current literature review on OCD in HCW during the COVID-19 pandemic. Material and Methods: All HCW undergoing patch testing between July 2008 and January 2020 at a public hospital patch-test clinic, and between June 2019 and January 2020 at a private dermatology clinic were included. Data collected included patient demographics, occupation, results of patch testing and pre and post-patch test diagnoses. Literature search was performed on Pubmed with keywords healthcare workers, occupational, allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), COVID-19. Results: Out of 837 patients patch tested during the study period, 67 were HCW. The mean age of HCW was 41 years (standard deviation 14) and 58 (87%) were female. The most common occupations were nurses (40%), allied health (22%) and doctors (18%). Forty-six (69%) patients had a background of atopic dermatitis. Hand dermatitis was the most common presentation (49%), followed by facial/neck dermatitis (25%). The most common relevant positive reactions were to rubber accelerators (24%), fragrances (16%), perservatives (15%) and topical steroids (9%). Literature review reflects that the incidence of ICD increased significantly due to increased frequency of hand washing and use of personal protective equipment during the COVID-19 pandemic. Contemporary data regarding ACD is limited. Conclusion: The most common allergens in HCW are rubber chemicals, fragrances and preservatives. The COVID- 19 pandemic has highlighted the incidence of OCD amongst HCWs. While rates of ICD have risen, data does not yet suggest increased rates of ACD.