Hand Dermatitis Increases In Health Care Workers Due To Hand Washing Measures

MedicalResearch.com Interview with:
Dr Jill Stocks PhD, Research Fellow
Centre for Occupational and Environmental Health,
Centre for Epidemiology; NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care
Institute of Population Health, University of Manchester, UK.

Medical Research: What is the background for this study? What are the main findings?

Dr. Stocks: Reducing healthcare-associated infections has been a priority in the UK over recent decades; and this has been reflected in interventions and guidelines focussing on improving hygiene procedures. During 2004 to 2008 the Cleanyourhands campaign promoted hand hygiene in all NHS trusts. There was anecdotal evidence from dermatologists and occupational physicians that irritant contact dermatitis was on the increase in healthcare workers, and that it was caused by hand hygiene. We investigated whether or not there was an increase in the incidence of irritant contact dermatitis in healthcare workers due to hand hygiene or other types of hygiene coinciding with the interventions and guidelines promoting hygiene. We used reports made by dermatologists to the Occupational and Health reporting network, a voluntary surveillance scheme collecting reports of work-related ill-health. Trends in incidence of irritant contact dermatitis due to hygiene in healthcare workers were compared with trends in control groups (irritant contact dermatitis in workers with other jobs) using a quasi-experimental (interrupted time series) design. We found a 4.5 fold increase in irritant contact dermatitis due to hand hygiene and hygiene in general in healthcare workers between 1996 and 2012. The results also suggested a steepening of the increase in incidence during the rollout period of the Cleanyourhands campaign but the limitations of the data made this less clear cut.

Medical Research: What should clinicians and patients take away from your report?

Dr. Stocks: The benefit of good hand hygiene in controlling healthcare-associated infections is indisputable, but this study shows that irritant contact dermatitis is a serious problem for some healthcare workers. All healthcare workers should carefully follow the latest evidence-based guidelines for hand hygiene regarding the use of hand rubs rather than soap and water where possible, the use of moisturisers and emollients, thorough drying of hands and the use of less irritating products. Infection control teams should provide advice to healthcare workers and patients based on these same guidelines. Decisions regarding which hand hygiene products to purchase should involve healthcare workers as well as infection control and prevention professionals, occupational disease professionals and administrative staff.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Stocks: Future evaluations of interventions promoting infection control through hygiene should also assess the impact on the worker’s skin. Further research to identify and promote products and practices to reduce the incidence of irritant contact dermatitis is needed. The question of whether workers with dermatitis remain colonised longer than those with healthy skin, and the risk of transmission to the patient, needs to be investigated.

Citation:

The impact of national level interventions to improve hygiene on the incidence of irritant contact dermatitis in healthcare workers: changes in incidence from 1996-2012 and interrupted times series analysis

S J Stocks, R McNamee, S Turner, M Carder, R M Agius

Br J Dermatol. 2015 Feb 5. doi: 10.1111/bjd.13719. [Epub ahead of print]

 
MedicalResearch.com Interview with:, & Dr Jill Stocks PhD, Research Fellow (2015). Hand Dermatitis Increases In Health Care Workers Due To Hand Washing Measures MedicalResearch.com