Winter season, frequent hand washing, and irritant patch test reactions to detergents are associated with hand dermatitis in health care workers.
Callahan-A; Baron-E; Fekedulegn-D; Kashon-M; Yucesoy-B; Johnson-VJ; Santo Domingo-D; Kirkland-B; Luster-MI; Nedorost-S
Dermatitis 2013 Jul/Aug; 24(4):170-175
Background: Irritant hand dermatitis (IHD) is common in health care workers. Objective: We studied endogenous irritant contact dermatitis threshold by patch testing and exogenous factors such as season and hand washing for their association with IHD in health care workers. Methods: Irritant patch testing with sodium lauryl sulfate (SLS), sodium hydroxide, and benzalkonium chloride at varying concentrations was measured in 113 health care workers. Examination for hand dermatitis occurred at 1-month intervals for a period of 6 months in the Midwestern United States. Results: Positive patch testing to low-concentration SLS was associated with IHD (P = 0.0310) after adjusting for age, sex, ethnicity, season, history of childhood flexural dermatitis, mean indoor relative humidity, and glove and hand sanitizer usage. Subjects with a positive patch test to SLS were 78% more likely to have occurrence of IHD (incidence rate ratio [IRR] = 1.78; 95% confidence interval [CI], 0.92-3.45). Hand washing frequency (> / = 10 times a day; IRR = 1.55; 95% CI, 1.01-2.39) and cold season (IRR = 2.76; 95% CI, 1.35-5.65) were associated with IHD. No association was found between history of childhood flexural dermatitis and IHD in this population. Conclusions: Both genetic and environmental factors are important in the etiology of IHD and should be considered in designing strategies to protect, educate, and treat susceptible individuals.
Dermatitis; Skin-disorders; Skin-irritants; Contact-dermatitis; Hand-protection; Detergents; Health-care-personnel; Patch-tests; Skin-sensitivity; Skin-tests; Seasonal-factors; Sodium-compounds; Sulfates; Hydroxides; Chlorides; Exposure-assessment; Exposure-levels; Demographic-characteristics; Environmental-factors; Gloves; Genetic-factors; Sanitation; Cold-weather-operations; Statistical-analysis; Skin-exposure; Skin-absorption
Susan Nedorost, MD, Department of Dermatology, University Hospitals, 11100 Euclid Ave, Lakeside 3500, Cleveland, OH 44106-5028
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