Effects of impermeable and semipermeable glove materials on resolution of inflammation and epidermal barrier impairment after experimental skin irritation.

BACKGROUND: Semipermeable membranes might be suitable for glove liners or comfort gloves in individuals with irritant contact dermatitis (ICD). OBJECTIVES: To evaluate the effects of different glove materials on inflammation and epidermal barrier impairment after experimental skin irritation. METHODS: Nine test areas on the volar forearms of 24 healthy volunteers were irritated with sodium lauryl sulfate (1%) and afterward covered for 6 days (6 or 8 h/day) with semipermeable Sympatex (SYM), vinyl (OCC), combinations of vinyl with Sympatex (SYM/OCC) or cotton (COT/OCC), or left uncovered (CON). Up to day 10, measurements of transepidermal water loss (TEWL), erythema (a*), skin humidity (SH) and visual scoring (VS) were applied. RESULTS: No significant differences in skin parameters were found between COT/OCC and SYM/OCC as well as between each of the combinations and CON. SYM, COT/OCC and SYM/OCC led to better results for most skin parameters than OCC alone. CONCLUSIONS: Occlusive material has a negative impact on skin barrier recovery and inflammation after skin irritation whereas SYM is not inferior to uncovered areas indicating good tolerability. Altogether, the data suggest that SYM is a useful alternative to COT as material for glove liners and comfort gloves in ICD patients.

Effects and acceptance of semipermeable gloves compared to cotton gloves in patients with hand dermatoses: Results of a controlled intervention study.

BACKGROUND: Semipermeable gloves might be an alternative to cotton gloves in management of hand dermatoses. OBJECTIVES: To compare acceptance and tolerability of gloves made of cotton or a semipermeable Sympatex membrane in patients with hand dermatoses and their effect on skin lesions when worn overnight. METHODS: A total of 199 patients with work-related symmetrical hand dermatoses were asked to wear a cotton glove (COT) on one hand and a Sympatex glove underneath a cotton glove (SYM/COT) on the other hand for 19 consecutive nights. The severity of skin lesions was regularly examined. A questionnaire on acceptance and tolerability was used in a subset of 126 patients. RESULTS: Data on skin lesions were available for 183 participating patients (92%). The severity did not differ substantially between hands covered with SYM/COT or COT over time. Questionnaire data were available for 120 patients (95%). SYM/COT received better ratings regarding climate conditions while COT showed superiority in wearing comfort, practicality and appearance. CONCLUSIONS: Both SYM/COT and COT were well tolerated and accepted in patients with hand dermatoses. Hence, SYM/COT may serve as suitable alternative for COT as comfort gloves supporting therapeutic efforts. The observed slight differences may influence the decision when selecting the glove type.

Acceptance of semipermeable glove liners compared to cotton glove liners in health care workers with work-related skin diseases: Results of a quasi-randomized trial under real workplace conditions.

BACKGROUND: Glove liners (GLs) made of cotton (COT) are worn under impermeable gloves to prevent occlusion effects. Semipermeable GLs made of Sympatex (SYM) might be an alternative. OBJECTIVES: To evaluate the acceptance of GLs (COT/SYM) in health care workers (HCWs) with work-related skin diseases (WRSDs). METHODS: One hundred sixty-one HCWs with WRSDs were asked to wear GLs in combination with occlusive gloves for 10 ±2 weeks under workplace conditions. A questionnaire was applied to compare acceptance and usability of the respective glove combinations and previously used protective gloves (PUGs). RESULTS: A total of 120 data sets were available (SYM: n = 65, 77.4%; COT: n = 55, 71.4%). Both GLs provided a significantly lower sweating sensation, more pleasant climate, comfortable wearing experience, and moist or dry feeling on the skin compared to PUGs. SYM-GLs performed significantly better than COT-GLs regarding mobility of hands, sensitivity, and sense of touch. COT-GLs were significantly better than SYM-GLs in the categories fit, donning and doffing, and material contact. CONCLUSIONS: Both GLs did not impair work performance, were applicable in various areas of health care activities, and were preferred over PUGs. Our results indicate that SYM-GLs are an alternative to COT-GLs and thus may contribute to current prevention strategies.

Skin Protection Seminars to Prevent Occupational Skin Diseases: Results of a Prospective Longitudinal Study in Apprentices of High-risk Professions.

BACKGROUND: Occupational skin diseases (OSDs) are frequent in professions with exposure to skin hazards. Thus, a health educational intervention for apprentices of high-risk professions was conducted. It was the aim of this study to gain insight into possible effects of this intervention. METHODS: A one-time skin protection seminar was conducted in 140 apprentices of health-related and non-health-related professions [trained cohort (TC)]. In addition, 134 apprentices of the same occupations were monitored [untrained cohort (UTC)]. The OSD-specific knowledge and the skin condition of the hands were assessed at baseline (T0), after the seminar (T1), and after 6 (T2) and 12 months (T3). RESULTS: The OSD-specific knowledge increased in all cohorts from T0 to T3, but we found a significantly higher knowledge in the TC at T2 (p < 0.001, t = 3.6, df = 196, 95% confidence interval = 0.9, 3.3) and T3 (p < 0.001, t = 3.8, df = 196, 95% confidence interval = 1.0, 3.2) compared to the UTC. Our results indicated a better skin condition of the hands in the TC of the health-related professions but not in the non-health-related professions. CONCLUSION: The study indicates that an educational intervention may positively influence the disease-specific knowledge and the prevalence of OSD in apprentices. However, definite conclusions cannot be drawn because of the heterogeneous study cohorts and the study design. Future research should aim at tailoring primary prevention to specific target groups, e.g., in view of the duration and frequency of skin protection education, different professions, and gender-specific prevention approaches.

Interdisciplinary and multiprofessional outpatient secondary individual prevention of work-related skin diseases in the metalworking industry: 1-year follow-up of a patient cohort.

BACKGROUND: In Germany, work-related skin diseases are predominant within the spectrum of reported occupational diseases. Metal workers are among the high-risk professions. Offering effective prevention programs to affected patients is of utmost importance to avoid deterioration of the disease and job loss. We conducted a 1-year follow-up in patients who participated in a multidisciplinary, complex outpatient prevention program representing a standard procedure of patient care by the respective statutory accident insurance. METHODS: The multi-component prevention program consists of multiprofessional individual patient counseling, a structured skin protection seminar in a group, as well as workplace visits and on-site counseling in terms of appropriate skin protection (e.g. gloves). An observational study with a 1-year follow-up and four measurements (T1-T4, longitudinal pre/post-test design) including dermatological examinations and standardized written questionnaires was conducted between 2013 and 2016 to assess changes over time regarding job loss and disease severity. RESULTS: Data from 94 patients (87 male, mean age: 45.4 years) were included in the analysis. One year after the skin protection seminar (T4), 83 patients (88.3%) remained in their original professional metalworking activity and four patients (4.3%) had given up their profession because of their skin disease. At baseline (T1), irritant contact dermatitis of the hands was the most frequent diagnosis (80.7%). Methods for self-reported disease severity showed good correlation with the clinical gold standard at T1 and T2 (dermatological examination with the Osnabrück Hand Eczema Severity Index / OHSI), and a significant decrease of the self-reported disease severity was found over time from T1 to T4 (p < 0.001). Further results indicate an improved self-perceived disease control and an overall satisfaction with the prevention program. CONCLUSIONS: The results of this observational study demonstrate that the comprehensive prevention program positively influences the course of work-related skin diseases, increases the possibility to continue working in a "high-risk" profession and improves the disease management of metal workers. In the long term, the prevention program may lead to cost savings by preventing high therapy costs or professional retraining.