Occupational Hand Dermatitis in Health Care: Development and Evaluation of an Online Training E-Module

Background: Occupational hand dermatitis (OHD) is an important health concern for health care workers (HCWs), yet there is a lack of accessible training materials on this topic. Objectives: The objective of this study was to develop and evaluate an OHD training e-module for HCWs. Methods: The e-module was created in collaboration with an expert advisory committee and tested by Ontario HCWs through pre- and post-training OHD knowledge tests, a usability survey, and a survey about intent to change work skin care practices. Analyses of survey results included means and paired t-tests. Results: The 10-minute OHD training e-module for HCWs was tested by 254 HCWs and found to be highly usable, to increase OHD knowledge immediately and sustainably, and to change workplace skin care practices. Average OHD knowledge test scores significantly improved by 19% between the pretest (64.50%) and post-test (83.50%). Most 6-month follow-up survey respondents reported changing their skin care work practices (76.69%). Conclusions: This research addresses the previous lack of accessible OHD training for workers in health care settings. The creation and evaluation of a no-cost accessible OHD training e-module for workers in health care settings showed promising results across knowledge increase, knowledge retention, skin care behavior changes, and usability.

Occupational Dermatitis and Urticaria

Occupational contact dermatitis is the most common occupational skin disease (OSD), and most of them are irritant in nature. There is less information available about contact urticaria than contact dermatitis. There are several strategies to prevent OSD, although workplace studies suggest there are gaps in their use in the workplace. Because early detection leads to improved outcomes, screening for dermatitis in industries such as health care would be useful. Both diagnosis and management involve 2 components: the actual disease diagnosis and medical treatment and the work-relatedness and management of the workplace to reduce exposures.

What Do Occupational Hygienists Really Know About Skin Exposure?

This article describes responses to a questionnaire on current work practices and understanding of the management of dermal exposure issues in the workplace from members of the British Occupational Hygiene Society (BOHS) and the Australian Institute of Occupational Hygienists (AIOH). The survey comprised questions in four key areas: employment demographics, experience managing dermal exposure, knowledge of dermal exposure management, and opinions on professional knowledge gaps and preferred training methods. The survey was disseminated in 2016 in the UK and 2018 in Australia, with 116 and 114 responses from each jurisdiction, respectively. The majority of respondents had personally evaluated the risks of dermal exposure to chemicals (BOHS 92%; AIOH 86%), albeit infrequently (less than a few times per year). Occupational Hygienists reportedly adopted a range of strategies to control dermal exposure problems, including chemical elimination/substitution (BOHS 68%; AIOH 68%), changing work practices (BOHS 79%; AIOH 75%), and education (BOHS 77%; AIOH 83%). The use of gloves or other personal protective equipment remained the most commonly cited exposure control measure (BOHS 99%; AIOH 97%). While there appeared to be a good understanding of common dermal exposure workplace scenarios (e.g. isocyanate exposure in motor vehicle repair, solvent exposure during spray painting), the overwhelming majority of respondents wished to find out more about assessing the risks from dermal exposure to chemicals (BOHS 89%; AIOH 88%). The outcomes suggest ways to increase the competence of professionals in dealing with dermal exposure matters in the workplace, through mechanisms such as web-based guidance, interactive educational materials and webinars, as well as workshops and seminars.

Corneocyte Nanotexture as Biomarker for Individual Susceptibility to Skin Irritants

Irritant contact dermatitis is a wide spread occupational skin condition. In addition to generalized protection and teaching schemes, a knowledge about individual risk might add to an improved awareness for hazards. Here, we report on a novel candidate biomarker, which might stage individual susceptibility to irritant skin damage. Subclinical sensitivity was proven in recent studies. As a nano-anatomical measure, it works non-invasively on corneocytes from tape strips. Here, we report on a 7-day course after exposure to sodium lauryl sulphate and compare the novel cell texture index with the classical markers water loss (transepidermal water loss) and natural moisturizing factor. All parameters show a high degree of correlation.

The Utility of an Occupational Contact Dermatitis Patch Test Database in the Analysis of Workplace Prevention Activities in Toronto, Canada

BACKGROUND

Occupational skin diseases are common suggesting that there are still gaps in workplace prevention. Patch test surveillance systems provide an opportunity to collect work related information in addition to clinical information and patch test results.

OBJECTIVES

To examine 5 years of data related to workplace prevention by industry sector in a patch test surveillance database for workers with a diagnosis of occupational contact dermatitis.

METHODS

The study was approved by the Research Ethics Board of St Michael's Hospital. Information including demographics, clinical history, healthcare utilization, and workplace characteristics and prevention practices in addition to patch test results was collected from consenting patients.

RESULTS

Workers in the healthcare and manufacturing sectors were more likely to report workplace training including skin protection training, whereas those in services and construction were less likely to report training.

CONCLUSIONS

Collecting basic workplace information with patch test surveillance databases can inform the occupational health and safety system about prevention practices in the workplace and identify areas for focussed intervention.

A Qualitative Study to Identify Characteristics of a Desirable Training Program for Prevention of Occupational Skin Disease

BACKGROUND

Training and education may be effective strategies for the prevention of work-related contact dermatitis. While there is some information in the literature related to skin-specific training experiences, there is very little information available on workers' preferences related to content and format and to barriers and facilitators to training.

OBJECTIVES

To understand workers' experiences and preferences for workplace training and barriers and facilitators to training.

METHODS

Following ethics approval, 24 patients with work-related contact dermatitis participated in semi-structured interviews obtaining information on training experiences, perceived training effectiveness, desired training characteristics, and barriers and facilitators to training. An inductive thematic analysis was used to identify themes.

RESULTS

Though many workers had received general workplace health and safety training, none reported training about skin exposure and disease prevention. Examples of what the workers perceived as good training included first aid training, while Workplace Hazardous Materials Information System training was felt to be ineffective. Desired content of training for preventing skin exposures included information on the hazards, short- and long-term health impacts, and potential symptoms and personal protective equipment. They desired multi-modal presentation (e.g. in-person and online supplement), hands-on training with visual content and suggested the use of personal stories and negative messaging. Training that could be applied outside the workplace was also valued. Barriers and facilitators to implementation included factors related to the training program itself, the organization, and the regulatory landscape.

CONCLUSIONS

These findings can help to shape more effective workplace training programs for skin protection.