A job-exposure matrix addressing hand exposure to wet work

The association between wet work and hand eczema in the Dutch general population: Application of a job exposure matrix to the lifelines cohort study

BACKGROUND

Studies on wet work and hand eczema (HE) frequently rely solely on self-reports regarding wet work.

OBJECTIVES

To assess the association between wet work and moderate-to-very-severe HE, within the Dutch general population, by using a (sex-specific) job exposure matrix (JEM).

METHODS

Within the Lifelines Cohort Study, participants with self-reported moderate-to-very-severe HE at worst in the past year were linked to data from the Danish (sex-specific) wet work JEM, a tool that links occupations with wet work indices (including duration and probability of glove use, wet hands and total wet work for at least 2 and 4 h/working day).

RESULTS

In total, 56 978 (41.9%) participants were included. The multivariate binary logistic regression analyses showed significant associations between all facets of wet work and moderate-to-very-severe HE. When using the sex-specific JEM, significant associations were found in females, but not in males.

CONCLUSIONS

This study is the first to use a wet work-specific JEM in a general population sample, and found positive associations between wet work and HE. The sex-specific findings should be interpreted with caution, due to limitations inherent in using a JEM, and should be further explored with observational studies, with a focus on duration, frequency, and exposure type.

Prevalence and associated factors of suspected occupational skin diseases among restaurant workers in peninsular Malaysia: secondary data analysis of Registry for Occupational Disease Screening (RODS)

OBJECTIVES

Occupational skin diseases (OSDs) pose significant risks to the health and well-being of restaurant workers. However, there is presently limited evidence on the burden and determinants of OSDs among this occupational group. This research aims to estimate the prevalence and associated factors of suspected OSDs among restaurant workers in Peninsular Malaysia.

DESIGN

A secondary data analysis of the 2023 Registry of Occupational Disease Screening (RODS) was performed. The RODS survey tool, which included the Nordic Occupational Skin Questionnaire, a symptoms checklist and items on work-relatedness, was used to screen for OSDs. Logistic regression analyses were performed to identify associated factors.

SETTING AND PARTICIPANTS

Restaurant workers (n=300) registered in RODS from February 2023 to April 2023, aged 18 years and above and working in restaurants across Selangor, Melaka and Pahang for more than 1 year, were included in the study, whereas workers who had pre-existing skin diseases were excluded.

RESULTS

The prevalence of suspected OSDs among study participants was 12.3%. Higher odds of suspected OSDs among study participants were observed among those exposed to wet work (adjusted OR (AOR) 22.74, 95% CI 9.63 to 53.68) and moderate to high job stress levels (AOR 4.33, 95% CI 1.80 to 10.43).

CONCLUSIONS

These findings suggest that OSDs are a significant occupational health problem among restaurant workers. Interventions targeting job content and wet work may be vital in reducing OSDs among this group of workers.

Prevalence and incidence of hand eczema in healthcare workers: A systematic review and meta-analysis

Healthcare workers (HCWs) are considered a high-risk group for developing hand eczema (HE), mainly owing to wet work and contact with allergens at work. To meta-analyse the prevalence and incidence of HE in HCWs, as well as mapping the prevalence of atopic dermatitis (AD) and HE severity in HCWs. A systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. Published literature from 2000 to 2022 was eligible based on predefined inclusion and exclusion criteria. A total of 18 studies were included. Pooled life-time, 1-year and point prevalence of self-reported HE in HCWs was 33.4% (95% confidence interval [CI]: 28.3-38.6), 27.4% (95% CI: 19.3-36.5) and 13.5% (95% CI: 9.3-18.4), respectively. AD prevalence was 15.4% (95% CI: 11.3-19.9). Overall, the majority of HCWs reported mild HE. One included study assessed HE incidence reporting 34 cases/1000 person years. Most studies scored low-moderate using the New Ottawa Scale and the pooled point prevalence data showed broad CIs. In conclusion, the high prevalence of HE in HCWs underlines the increased risk and need for preventive measures for this professional group. There is, however, a need of further standardized high-quality studies.

Changes in Infection Prevention Practices and Occurrence of Skin Symptoms among Healthcare Workers, Cleaners and Day-care Workers in Norway during the COVID-19 Pandemic

The COVID-19 pandemic has resulted in increased attention on infection prevention measures. This study aims to assess whether changes in hand hygiene procedures, use of personal protective equipment and moisturizers during the first year of the COVID-19 pandemic were associated with changes in the occurrence of skin symptoms among healthcare workers, cleaners, and day-care workers. A total of 602 participants (40%) responded to an electronic questionnaire, including questions on previous and current occupational exposure and skin problems. Increased frequency of hand washing, use of hand disinfectants, use of disposable gloves and moisturizers were all associated with an increased symptom score on the hands, wrists, forearms. Participants who increased their use of masks or respirators had a higher risk of facial skin symptoms, compared with those with non-increased occupational exposure. In conclusion, a change of behaviour among healthcare workers, cleaners and day-care workers during the first year of the COVID-19 pandemic, with an increase in occupational exposures and use of moisturizers, was associated with higher occurrence of facial skin symptoms and symptoms on the hands, wrists and forearms.

Irritant Contact Dermatitis — a Review

Purpose of Review

Recent Findings

Summary

Differences between hairdressers and consumers in skin exposure to hair cosmetic products: a review

Hairdressers are at high risk of developing occupational hand eczema. Opinions on the health and safety concerns of non-food consumer products, such as cosmetics and their ingredients, consider the exposure of a 'common consumer', which may not account for occupational exposure of hairdressers. As result, there is a parlous scenario in which serious safety concerns about occupational exposures are present. The purpose of this review is to compare the frequency of exposure to various types of hair cosmetic products among hairdressers and consumers. Database searches for this review yielded a total of 229 articles. 7 publications were ultimately included. The analysis showed that - dependent on the task - hairdressers were exposed 4 to 78 times more than consumers regarding a wide spectrum of hair cosmetic products used in the daily working life ranging from shampoo, conditioner, oxidative and non-oxidative hair colours, and bleaching agents. The highest frequency was found for colouring hair with oxidative hair colour. Consumer usage frequency does not appear to be appropriate for representing hairdresser exposure. The current standards do not effectively address the occupational risks associated with hairdressers' use of cosmetics. The findings of this study should cause current risk assessment procedures to be reconsidered. This article is protected by copyright. All rights reserved.

Sex and Gender Differences in Occupational Hazard Exposures: a Scoping Review of the Recent Literature

PURPOSE OF REVIEW

Comparative research on sex and/or gender differences in occupational hazard exposures is necessary for effective work injury and illness prevention strategies. This scoping review summarizes the peer-reviewed literature from 2009 to 2019 on exposure differences to occupational hazards between men and women, across occupations, and within the same occupation.

RECENT FINDINGS

Fifty-eight studies retrieved from eight databases met our inclusion criteria. Of these, 30 studies were found on physical hazards, 38 studies on psychological/psychosocial hazards, 5 studies on biological hazards, and 17 studies on chemical hazards. The majority of studies reported that men were exposed to noise, vibration, medical radiation, physically demanding work, solar radiation, falls, biomechanical risks, chemical hazards, and blood contamination; while women were exposed to wet work, bullying and discrimination, work stress, and biological agents. Within the same occupations, men were more likely to be exposed to physical hazards, with the exception of women in health care occupations and exposure to prolonged standing. Women compared to men in the same occupations were more likely to experience harassment, while men compared to women in the same occupations reported higher work stress. Men reported more exposure to hazardous chemicals in the same occupations as women. The review suggests that men and women have different exposures to occupational hazards and that these differences are not solely due to a gendered distribution of the labor force by occupation. Findings may inform prevention efforts seeking to reduce gender inequalities in occupational health. Future research is needed to explain the reasons for sex/gender inequality differences in exposures within the same occupation.

Structured diagnostic assessment of hand eczema in cleaning workers

Hand dermatitis is a widespread problem among cleaners. In most cases, it is caused by a combination of wet work and contact with irritants, which can result in irritant (toxic) contact dermatitis. In some cases, the irritant contact eczema then evolves into allergic contact dermatitis, although not all cases of allergic contact dermatitis are preceded by irritant contact dermatitis. This mini-review proposes a two-step diagnostic algorithm based on patch testing, which can be used if allergic contact dermatitis is suspected in cleaning workers. As a first step, we recommend performing the DKG standard series (German Contact allergy research group, DKG), the DKG rubber series, both DKG "further fragrances" series as well as the DKG preservative and disinfectant series. If there are clear hints of an occupational contact dermatitis, the first step can also involve testing patients' own products alongside the standardized tests. In a second step (at the latest), if standardized tests do not suffice to identify the culprit allergen and there is well-founded suspicion, we recommend testing the patients' own products. If necessary, the second step can also include testing the individual contact allergens contained in the screening mixes that are part of the standard series.

Evaluation of hand hygiene and onset of hand eczema after the outbreak of SARS-CoV-2 in Munich

BACKGROUND

Since the outbreak of SARS-CoV-2, authorities have preached the importance of personal hygiene, including hand washing and disinfection.

OBJECTIVE

To evaluate changes in the frequency of hand washing and hand care, the onset of hand eczema (HE) and risk factors associated with HE since the outbreak of SARS-CoV-2 in Munich in January 2020.

MATERIALS & METHODS

All dermatologic outpatients at the university hospital between April 6 and April 19 were asked to complete a structured questionnaire.

RESULTS

Data of 512 patients with a median age of 49 years (243 females, 267 males) were analysed. The frequency of hand washing and hand disinfection increased after the outbreak of SARS-CoV-2 (p < 0.001, respectively). While symptoms associated with HE were reported by 29.9% (149/499) of patients, the actual diagnosis of HE was reported less frequently by 11.2% (53/473) with a median duration of 120 days. Frequent hand disinfection (p = 0.039), atopic dermatitis (p = 0.006) and young age (p = 0.0499) were identified as risk factors for symptoms of HE. Hand care was performed more frequently during the pandemic than before (p < 0.001). A high frequency of hand care during the pandemic was not significantly associated with symptoms of HE (p = 0.172), but was associated with self-recognition of HE symptoms (p = 0.002).

CONCLUSION

After the outbreak of SARS-CoV-2, the frequency of hand hygiene measures increased. A considerably high prevalence of HE symptoms was associated with frequent hand disinfection, atopic dermatitis and young age. Awareness of HE should be raised in order for preventive measures to be taken earlier.

Hand eczema among healthcare workers in Guangzhou City: a cross-sectional study

Background

Healthcare workers are at high risk of developing hand eczema. This study aimed to investigate the association between occupational hygiene and self-reported hand eczema among nurses and doctors in Guangzhou.

Methods

A cross-sectional study using a self-administrated questionnaire sent to 740 health care workers in two tertiary hospitals between 1^st April and 1^st July 2019 was conducted.

Results

In total, 521 healthcare workers responded (70.4%). The prevalence of self-reported hand eczema was 9.6% [95% confidence interval (CI): 7.1-12.1%], with 10.8% in nurses and 6.9% in doctors. According to multivariable logistic regression analysis, the prevalence was higher in those who were excessively exposed to hair dye (OR: 3.871, 95% CI: 1.106-13.549) and those having a history of food allergy were at 3.013 (95% CI: 1.314-6.907) times greater risk of having hand eczema than those who did not. The odds of having hand eczema were 4.863 (95% CI: 1.037-22.803) times greater in those who hand washed more than 50 times daily in comparison to those who washed hands less than 10 times per day. The symptoms of hand eczema were mild during the investigation period.

Conclusions

Hand eczema is common among healthcare workers in Guangzhou. The prevention of hand eczema by educational programs is needed for Chinese healthcare workers.