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Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014.
Contact Dermatitis 2016; 75(4):213-22CD

Abstract

BACKGROUND

Healthcare workers (HCWs) are at risk of developing occupational skin disease (OSD).

OBJECTIVES

To ascertain the causes of OSD in Australian HCWs in a tertiary referral clinic.

METHODS

A retrospective review was performed of patients assessed at the Occupational Dermatology Clinic in Melbourne from 1993 to 2014.

RESULTS

Of 685 HCWs assessed in the clinic over a period of 22 years, 555 (81.0%) were diagnosed with OSD. The most common diagnosis was irritant contact dermatitis (ICD) (79.1%), followed by allergic contact dermatitis (ACD) (49.7%). Natural rubber latex allergy was also relatively frequent (13.0%). The major substances causing ACD were rubber glove chemicals (thiuram mix and tetraethylthiuram disulfide), preservatives (formaldehyde, formaldehyde releasers, and isothiazolinones), excipients in hand cleansers, which are hard-to-avoid weak allergens, and antiseptics. ACD caused by commercial hand cleansers occurred more frequently than ACD caused by alcohol-based hand rubs (ABHRs). Occupational ICD was mostly caused by water/wet work and hand cleansers, and environmental irritants such as heat and sweating.

CONCLUSIONS

Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD.

Authors+Show Affiliations

Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, 3053, Australia. chiggins@skincancer.asn.au.Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, 3053, Australia.Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, 3053, Australia.Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, 3053, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27436328

Citation

Higgins, Claire L., et al. "Occupational Skin Disease Among Australian Healthcare Workers: a Retrospective Analysis From an Occupational Dermatology Clinic, 1993-2014." Contact Dermatitis, vol. 75, no. 4, 2016, pp. 213-22.
Higgins CL, Palmer AM, Cahill JL, et al. Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014. Contact Derm. 2016;75(4):213-22.
Higgins, C. L., Palmer, A. M., Cahill, J. L., & Nixon, R. L. (2016). Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014. Contact Dermatitis, 75(4), pp. 213-22. doi:10.1111/cod.12616.
Higgins CL, et al. Occupational Skin Disease Among Australian Healthcare Workers: a Retrospective Analysis From an Occupational Dermatology Clinic, 1993-2014. Contact Derm. 2016;75(4):213-22. PubMed PMID: 27436328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014. AU - Higgins,Claire L, AU - Palmer,Amanda M, AU - Cahill,Jennifer L, AU - Nixon,Rosemary L, Y1 - 2016/07/20/ PY - 2016/01/20/received PY - 2016/04/17/revised PY - 2016/04/19/accepted PY - 2016/7/21/entrez PY - 2016/7/21/pubmed PY - 2017/4/26/medline KW - alcohol-based hand rub KW - allergic contact dermatitis KW - contact allergy KW - hand cleanser KW - hand wash KW - irritant contact dermatitis KW - nurses KW - patch test KW - preservatives KW - rubber chemicals KW - rubber gloves SP - 213 EP - 22 JF - Contact dermatitis JO - Contact Derm. VL - 75 IS - 4 N2 - BACKGROUND: Healthcare workers (HCWs) are at risk of developing occupational skin disease (OSD). OBJECTIVES: To ascertain the causes of OSD in Australian HCWs in a tertiary referral clinic. METHODS: A retrospective review was performed of patients assessed at the Occupational Dermatology Clinic in Melbourne from 1993 to 2014. RESULTS: Of 685 HCWs assessed in the clinic over a period of 22 years, 555 (81.0%) were diagnosed with OSD. The most common diagnosis was irritant contact dermatitis (ICD) (79.1%), followed by allergic contact dermatitis (ACD) (49.7%). Natural rubber latex allergy was also relatively frequent (13.0%). The major substances causing ACD were rubber glove chemicals (thiuram mix and tetraethylthiuram disulfide), preservatives (formaldehyde, formaldehyde releasers, and isothiazolinones), excipients in hand cleansers, which are hard-to-avoid weak allergens, and antiseptics. ACD caused by commercial hand cleansers occurred more frequently than ACD caused by alcohol-based hand rubs (ABHRs). Occupational ICD was mostly caused by water/wet work and hand cleansers, and environmental irritants such as heat and sweating. CONCLUSIONS: Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD. SN - 1600-0536 UR - https://www.unboundmedicine.com/medline/citation/27436328/Occupational_skin_disease_among_Australian_healthcare_workers:_a_retrospective_analysis_from_an_occupational_dermatology_clinic_1993_2014_ L2 - https://doi.org/10.1111/cod.12616 DB - PRIME DP - Unbound Medicine ER -