The prevalence of hand dermatitis among intensive care unit nurses.

BACKGROUND: Healthcare workers are at high risk of developing occupational hand dermatitis (HD) due to their frequent exposure to wet-work and use of gloves. Complaints of HD may interfere with work and cause loss of work productivity, or sick leave, and may have impact on job pleasure and performing daily activities. The prevalence of HD among intensive care unit (ICU) nurses is unknown. OBJECTIVES: To investigate the point prevalence and the 1-year prevalence of HD among ICU nurses, and to determine the impact of HD on work and daily activities. METHOD: A questionnaire-based cross-sectional study was performed among ICU nurses. Participants were recruited in the Amsterdam University Medical Centre. A symptom-based questionnaire was used to determine HD and atopic predisposition, and an additional questionnaire was used concerning the influence of HD. ICU nurses with an atopic predisposition or symptoms suiting HD were invited for the hand dermatitis consultation hour (HDCH). Data were analysed with logistic regression. RESULTS: A total of 184 ICU nurses were included. The point prevalence of HD was 9.8% (95% CI: 5.9-15.0) and the 1-year prevalence was 26.6% (95% CI: 20.4-33.6). Sick leave was reported by 0.5%. HD seemed to have more impact on job pleasure than on work productivity. CONCLUSION: The high prevalence rate of HD resulting from our study highlights the need for the prevention of occupational HD among healthcare workers.

2-Cyanoethyl dimethyldithiocarbamate, a new contact allergen found in accelerator-free nitrile gloves.

BACKGROUND: Allergic contact dermatitis (ACD) from rubber glove usage is usually caused by rubber additives such as the accelerators. However, in analyses of the suspected gloves, ordinary rubber allergens are not always found. Accelerator-free rubber gloves are available, but some patients with accelerator allergy do not tolerate them and might also be patch test positive to them. OBJECTIVES: To identify and chemically characterize a new allergen, 2-cyanoethyl dimethyldithiocarbamate (CEDMC), in rubber gloves. We describe two patient cases: patient 1 that led us to the identification of CEDMC and patient 2 with occupational ACD caused by CEDMC. METHODS: The patients were examined with patch testing including baseline and rubber series, and their own rubber gloves. High-performance liquid chromatography (HPLC) was used for chemical analysis of rubber gloves. The allergen was synthesized and identified by nuclear magnetic resonance, mass spectrometry and infrared spectrometry, and tested on patient 2. RESULTS: CEDMC was identified by HPLC in a nitrile glove associated with hand eczema in patient 1. Patient 2 whose nitrile gloves contained CEDMC was patch test positive to CEDMC. CONCLUSIONS: CEDMC is a new contact allergen in nitrile gloves and probably forms during vulcanization from residual monomer acrylonitrile and rubber additives.

Artificial nail modelling systems in healthcare workers: An emerging risk of contact sensitization to a well-known occupational allergen in an alternative way.

BACKGROUND: Artificial nail modelling systems (ANMS) pose a significant risk for nail stylists and their clients regarding acrylate sensitization, which might jeopardize the use of acrylate-containing medical devices. OBJECTIVES: To evaluate the frequency of artificial nail practices among female healthcare workers (HCWs) compared with controls and assess ANMS-related side effects. METHODS: In this comparative, cross-sectional, single-centre study, a face-to-face interview with 200 female HCWs and 200 age-matched female dermatology patients (controls) was conducted regarding the use of ANMS between March and November 2023. RESULTS: Among 400 participants (median age: 25), 85 (21.3%) have applied ANMS at least once. The prevalence of ANMS application was significantly higher in HCWs (n = 54/200, 27%) compared with controls (n = 31/200, 15.5%) (p < 0.05). Long-lasting nail polish was the most commonly preferred technique (n = 82/85, 96.5%). ANMS were mainly performed in nail studios by nail stylists (n = 79/85, 92.9%), while three participants were using home kits. Nail brittleness was the most frequently reported side effect (n = 19/85, 22.4%). No case of allergic contact dermatitis (ACD) was detected. CONCLUSIONS: The popularity of ANMS among young female HCWs is growing. This striking trend might further put these individuals not only at risk of medical device-related adverse events but also occupational ACD.

Contact allergy in Swedish professional ice hockey players.

BACKGROUND: Professional ice hockey players may contract irritant and allergic contact dermatitis. AIMS: To investigate the presence of contact allergy (CA) in professional ice hockey players in Sweden. METHODS: Ten teams from the two top leagues were assessed for potential occupational exposure to sensitizers. Exactly 107 players were patch tested with an extended baseline series and a working series, in total 74 test preparations. The CA rates were compared between the ice hockey players and controls from the general population and dermatitis patients. RESULTS: One out of 4 players had at least one contact allergy. The most common sensitizers were Amerchol L 101, nickel and oxidized limonene. CA was as common in the ice hockey players as in dermatitis patients and significantly more common than in the general population. Fragrances and combined sensitizers in cosmetic products (fragrances + preservatives + emulsifier) were significantly more common in ice hockey players compared with the general population. CONCLUSION: The possible relationship between CA to fragrances and cosmetic products on the one hand and the presence of dermatitis on the other should be explored further.

Water, soap, and hand-disinfectant exposure during the COVID-19 pandemic and self-reported hand eczema in frontline workers: A cross-sectional study.

BACKGROUND: During the COVID-19 pandemic, increased hand hygiene practices were implemented. Impaired skin health on the hands among healthcare workers has been reported previously. Knowledge of how worker in other occupations have been affected is scarce. OBJECTIVES: To investigate self-reported hand water-, and soap exposure and use of hand disinfectants, and hand eczema (HE) in frontline workers outside the hospital setting and in IT personnel during the COVID-19 pandemic. METHODS: In this cross-sectional study, a questionnaire was sent out between 1 March and 30 April in 2021, to 6060 randomly selected individuals representing six occupational groups. RESULTS: A significant increase in water exposure and hand disinfectant use was shown: Relative position (RP) 19; 95% confidence interval (CI) 0.17-0.21 and RP = 0.38: 95% CI 0.36-0.41, respectively. Newly debuted HE was reported by 7.4% of the population, more frequently among frontline workers (8.6%) compared to IT personnel (4.9%). CONCLUSIONS: Water and soap exposure and use of hand disinfectants increased during COVID-19 pandemic, which may increase the risk of hand eczema. This highlights the importance of communication and implementation of preventive measures to protect the skin barrier also in occupations other than healthcare workers.

Notification of hand eczema as an occupational disease among Danish hairdressers: a national survey on patients' perception.

OBJECTIVES: Self-reported hand eczema was previously found under-reported as an occupational disease to the authorities among Danish hairdressers graduating from 1985 to 2007. This study investigates whether self-reported hand eczema among Danish hairdressers graduating from 2008 to 2018 is under-reported as an occupational disease to the authorities. METHODS: A cross-sectional study on all Danish hairdressers graduating from 2008 to 2018 was conducted. The participants were identified using information from the Danish Hairdressers' and Beauticians' Union. In May 2020, a self-administered survey on hand eczema was sent to all hairdressers. RESULTS: A response rate of 30.7% (1485/4830) was obtained. The lifetime prevalence of self-reported hand eczema was 40.1%, and 84.1% of hairdressers with hand eczema believed it to be occupational of whom 27.0% answered it was reported as an occupational disease to the authorities. Of hairdressers believing their hand eczema was occupational, consulting a doctor and answering it was reported as an occupational disease, 94.4% had consulted a dermatologist. The main reason for not reporting was 'I would probably not gain anything from it anyway' (40.0%). CONCLUSIONS: Based on hairdressers' perception, occupational hand eczema still seems to be an under-reported disease which may lead to underestimation of the problem and impair prevention, diagnosis and treatment.

Prevalence of Occupational Contact Dermatitis Among Dental Personnel Using the Nordic Occupational Skin Questionnaire-2002: A Prospective Cross-Sectional Study.

BACKGROUND: Occupational skin disease (OSD), such as contact dermatitis, is widespread among dental professionals; however, reports regarding its prevalence have inconsistent findings and methodology. Therefore, we conducted a cross-sectional survey using a self-reported questionnaire to estimate the prevalence of work-related and occupational exposure-induced skin diseases. METHODOLOGY: A self-administered questionnaire, based on the validated Nordic Occupational Skin Questionnaire-2002, was distributed to 15 dental clinics in Israel in the first half of 2022. The questionnaire included questions about the occupation, exposure, and history of atopic disease, dry skin, and hand/arm and wrist eczema, as well as participant demographics. RESULTS: Overall, 312 dental professionals completed the questionnaires. Response rate was 80%. The lifetime prevalence of self-reported skin symptoms was 19.23%. Significant risk factors included exposure to metal objects, odds ratio (OR): 2.43, 95% confidence interval (CI): [1.02, 5.78]; p < .05, dry skin (OR: 3.54, 95% CI: [1.93, 6.5]; p < .001), itching when sweating (OR: 2.89, 95% CI: [1.39, 6]; p < .05), contact urticaria (OR: 10.67, 95% CI: [4.46, 25.49]; p < .001), hay fever (OR: 2.25, 95% CI: [1.14, 4.42]; p < .05), allergic symptoms (OR; 2.33, 95% CI: [1.18, 4.58]; p < .05), and asthma (OR: 4.8, 95% CI: [2.17, 10.36]; p < .001). CONCLUSIONS: This is the first study to use the NOSQ-2002 among dental professionals. Our study provides a better understanding of the prevalence and consequences of OSDs among dental personnel by utilizing the validated tool NOSQ-2002.