Concomitant allergic contact dermatitis and aquagenic urticaria caused by personal protective equipment in a healthcare worker during the COVID-19 pandemic

Assessing contact dermatitis risk among Manitoba workers in the Manitoba Occupational Disease Surveillance System

INTRODUCTION

This exploratory study aimed to assess contact dermatitis (CD) risk among workers using the Manitoba Occupational Disease Surveillance System (MODSS).

METHODS

The MODSS linked accepted time-loss claims from the Workers' Compensation Board of Manitoba (2006-2019), with administrative health data from medical and hospital records (1996-2020). CD risk by occupation and industry (hazard ratio, 95% confidence intervals) was estimated using Cox proportional hazard models, adjusted for age and stratified by sex.

RESULTS

Increased risk of new onset CD was observed among some occupations and industries with known skin irritants and allergens. Some occupations with known increased risks of CD remained elevated when removing the accepted WCB cases was performed, suggesting that all CD cases in these occupations may not show up in WCB statistics. Increased risk was also observed for occupations and industries with unknown exposures related to CD, whereas some groups known to be at risk of CD were not observed to have elevated risks in this cohort.

DISCUSSION

The MODSS successfully identified some occupations and industries known to be at high risk of occupational CD, but not others. Some occupations not typically associated with work-related CD were also identified, which warrants further investigation.

Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review

Introduction

During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD).

Methods

Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included.

Discussion

This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.

Myths and misconception of COVID-19 among hospital sanitary workers in Pakistan: Efficacy of a training program intervention

OBJECTIVE

Hospital sanitary workers are among the prime source to disseminate information at a massive level, however they received least attention during the pandemic COVID-19. The study was designed to investigate the prevailing myths and misconceptions of the coronavirus pandemic among the sanitary workers of health care system. Further, a systematic training program is devised and tested to demystify the false myths with discerning truth and awareness-raising in hospital sanitary workers.

METHOD

A pre-post face-to-face intervention design was opted and the intervention was conducted at five locations by the project team. The intervention consisted a 3 days training program to target myths and misconceptions of hospital sanitary workers. The study was completed in 8 months starting from August, 2019 to March, 2020. Participants were recruited from local hospitals having a specialized indoor COVID treatment facility. The sample consisted of 82 participants (n = 25, 30.09% females) with age ranging from 18 to 60 years (M ± SD = 37.41 ± 10.09).

FINDINGS

The results indicated that 86.4% of the participants never heard the name of the coronavirus before the pandemic in Pakistan. A majority of the participants (> 50%) believed on a very alarming but unrealistic rate of mortality i.e., 30-60%. The pre-testing showed a high prevalence of myths in all four domains (i.e., popular treatments = 24.44, conspiracy myths = 7.93, home remedies = 16.46, and COVID-reliance = 7.82). The pre and post comparison of individual myths showed significant improvement on 24 of the 26 myths with a decline ranging from 0.18 to 1.63. Overall, the intervention significantly decreased scores on all four domains of coronavirus myths.

CONCLUSION

The training intervention appeared to effectively reduce myths and misconceptions of sanitary staff workers and is advised to be included as a standard training program for sanitary workers of health care system.

Contact dermatitis due to personal protective equipment use and hygiene practices during the COVID-19 pandemic: A systematic review of case reports

BACKGROUND

Prolonged use of personal protective equipment (PPE) may lead to contact dermatitis during the coronavirus disease 19 (COVID-19) pandemic. This paper aims to identify the causative factors of contact dermatitis from PPE and hygiene practices.

METHODS

The search was conducted adhering to PRISMA 2020 guidelines. A Delphi process was employed to ensure that the aims of this study were met. PubMed and Web of Science databases were systematically searched through September 12, 2021, using search terms: Contact dermatitis, case report, covid-19. The findings were tabulated as author/year, gender, age, presentation, cause, dermatological diagnosis, testing modality, provided treatment, symptom resolution (time in days), prognosis, and follow-up.

RESULTS

The mean age of all individuals was 29.75 years, with 75% females. All cases presented with erythema, with 62.5% reporting pruritus and 37.5% reporting burning facial symptoms. Surgical masks and hand-hygiene products (37.5%) were the most commonly reported causative agent with 25% due to KN95/FFP type 2 use. Allergic contact dermatitis (50%) and irritant contact dermatitis (25%) were common diagnoses. Treatments included creams, emollients, and desloratadine, with restriction of irritant-causing factors. The prognosis was generally good among the cases, with 62.5% presenting complete resolution within a week and 12.5% showing moderate improvement at the fourth month after discontinuing use.

CONCLUSION

This study finds pertinent links between PPE use and contact dermatitis during the COVID-19 pandemic. While many cases are bound to go underreported in literature, well-designed, large-scale studies in the future may help promote these associations in a more comprehensive manner.