The prevalence and risk factors of hand eczema among emergency healthcare workers during the COVID-19 pandemic
Öz
Aim: The preventive measures to decelerate the spread of the novel coronavirus include intense hand sanitizing which is a risk factor for hand eczema. Occupational hand eczema is common among healthcare workers due to their exposure to wet work and chemical irritants. We aimed to evaluate the prevalence of hand eczema among healthcare workers currently working in the emergency department and investigate the alterations regarding the risk factors during the COVID-19 pandemic that began in March 2020 in Turkey.
Materials and Methods: An online survey was sent to healthcare workers in emergency departments all over Turkey. Participants were asked to evaluate their frequency of hand washing, hand eczema, glove use and moisturizer use as prior to and during the COVID-19 pandemic. Hand eczema and associated symptoms were self-reported.
Results: Three hundred fifty-four healthcare workers, consisting of 260 emergency physicians and 94 nurses returned the survey. The prevalence of HE among 354 participants with a median age of 32 was 48.6% (n=161). HE was associated with having an atopic history (p<0.001). 54.8% (n=194) of the participants reported having symptoms associated with HE prior to the pandemic and the rate increased significantly to 64.7% (n=229) during the pandemic (p<0.001). The exposure to the risk factors of hand eczema such as hand washing frequency and duration of glove use showed a relevant increase during the pandemic (p<0.001). As well as moisturizer applying frequency which also increased during the pandemic (p<0.001).
Conclusion: With the outbreak of the COVID-19 pandemic, Healthcare workers intensified their hand hygiene practices as recommended and increased their risk for hand eczema.
Anahtar Kelimeler
Kaynakça
- Liu Y, Ning Z, Chen Y, Guo M, Liu Y, Gali NK, et al. Aerodynamic characteristics and RNA concentration of SARS-CoV-2 aerosol in Wuhan hospitals during COVID-19 outbreak. bioRxiv. doi :10.1101/2020.03.08.982637
- who.int WHO/ILO interim guidance COVID-19: Occupational health and safety for health workers, (updated 1 April 2020, cited 29 April 2021. Available from: https://www.who.int/docs/default-source/inaugural-who-partners-forum/who-interim-recommendation-on-obligatory-hand-hygiene-against-transmission-of-covid-19.pdf
- Case Report: Handwashing-Induced Dermatitis During the COVID-19 Pandemic. Am Fam Physician. 2020; 102 (6): 327-8.
- Kampf et al, Prevention of irritant contact dermatitis among health care workers by using evidence based hand hygiene practices:a review, Industrial Health,2007, 45, 645-52.
- Hamnerius N, Svedman C, Bergendorff O, Björk J, Bruze M, Pontén A. Wet work exposure and hand eczema among healthcare workers: a cross-sectional study. Br J Dermatol. 2018; 178 (2): 452-61.
- Kiely LF, Moloney E, O'Sullivan G, Eustace JA, Gallagher J, Bourke JF. Irritant contact dermatitis in healthcare workers as a result of the COVID-19 pandemic: a cross-sectional study. Clin Exp Dermatol. 2021; 46 (1): 142-4.
- Guertler A, Moellhoff N, Schenck TL, et al. Onset of occupational hand eczema among healthcare workers during the SARS-CoV-2 pandemic: Comparing a single surgical site with a COVID-19 intensive care unit. Contact Dermatitis. 2020; 83 (2): 108-14.
- Susitaival P, Flyvholm MA, Meding B, Kanerva L, Lindberg M, Svensson A, Olafsson JH. Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Dermatitis. 2003 Aug; 49 (2): 70-6.
- Lan J, Song Z, Miao X, et al. Skin damage among health care workers managing coronavirus disease-2019. J Am Acad Dermatol. 2020; 82 (5):1215-6.
- Al-Khateeb B. Primary health care and family physicians provide frontline care to the dermatology patients during the era of COVID-19: Recommendations and future directions. J Family Med Prim Care. 2020; 9 (12): 5862-6.
- Celik V, Ozkars MY. An overlooked risk for healthcare workers amid COVID-19: Occupational hand eczema. North Clin Istanb. 2020;7(6):527-33.
- Erdem Y, Altunay IK, Aksu Çerman A, et al. The risk of hand eczema in healthcare workers during the COVID-19 pandemic: Do we need specific attention or prevention strategies?. Contact Dermatitis. 2020; 83 (5): 422-3.
- Ahmed-Lecheheb D, Cunat L, Hartemann P, Hautemanière A. Prospective observational study to assess hand skin condition after application of alcohol-based hand rub solutions. Am J Infect Control. 2012; 40 (2): 160-4.
- Singh D, Joshi K, Samuel A, Patra J, Mahindroo N. Alcohol-based hand sanitisers as first line of defence against SARS-CoV-2: a review of biology, chemistry and formulations. Epidemiology and Infection. 2020; 148: e229.
- Hamnerius N, Svedman C, Bergendorff O, et al. Hand eczema and occupational contact allergies in healthcare workers with a focus on rubber additives. Contact Dermatitis. 2018; 79 (3): 149-56.
- Yan Y, Chen H, Chen L, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther. 2020; 33 (4): e13310.
- Rundle CW, Presley CL, Militello M, et al. Hand hygiene during COVID-19: Recommendations from the American Contact Dermatitis Society. J Am Acad Dermatol. 2020; 83 (6): 1730-7.
COVID-19 pandemisi süresince acil sağlık çalışanları arasındaki el egzaması prevalansı ve risk faktörleri
Öz
Amaç: Yeni koronavirüsün yayılma hızını yavaşlatmak amacıyla alınan önlemler arasında egzama risk faktörü olan yoğunlaştırılmış el dezenfeksiyonu bulunmakta. Sağlık çalışanlarının ıslak çalışma ve irritant kimyasallara maruziyetleri nedeniyle mesleki el egzaması oldukça yaygın. Bu çalışmamızda, acil servislerde çalışan sağlık çalışanları arasında var olan el egzaması prevalansını ortaya koyup, Türkiye’de Mart 2020’de başlayan COVID-19 pandemisi sürecinde risk faktörlerinde meydana gelen değişiklikleri irdelemeyi hedefledik.
Gereç ve Yöntem: Anketimizi Türkiye’deki acil servislerde çalışan sağlık çalışanlarına e-posta yoluyla ulaştırıldı. Katılımcılardan el yıkama sıklıklarını, eldiven kullanım sürelerini, el nemlendiricisi kullanım sıklıklarını pandemi öncesi ve süresince olarak değerlendirmeleri istendi. El egzamasının ve ilişkili semptomların varlığı kişisel beyana dayandırıldı.
Bulgular: Anketimizi cevaplayan 354 sağlık çalışanından 260’ı hekim, 94’ü hemşireydi.
Ortalama yaşın 32 olduğu örneklemimizde 48,6% (n=161) el egzaması görüldü ve atopik bir hikâyeye sahip olmak ile ilişkilendirildi (p<0,001). El egzamasıyla ilişkili semptomların görülme oranı pandemi öncesinde 54,8% (n=194) iken pandemi sürecinde 64,7% (n=229) olarak anlamlı bir artış gösterdi (p<0,001). Egzama risk faktörlerine maruziyeti el yıkama sıklığı ve eldiven kullanım süresini irdeleyerek ikisinde de anlamlı bir artış gözlemledik (p<0,001). Aynı zamanda sağlık çalışanları pandemi süresince ellerini daha sık nemlendirme ihtiyacı duyduklarını belirtti (p<0,001).
Sonuç: COVID-19 pandemisinin ortaya çıkmasıyla sağlık çalışanlarının uyması gereken el hijyen protokolleri yoğunlaştırıldı, bunun sonucunda sağlık çalışanlarında el egzaması oluşma riski arttı.
Anahtar Kelimeler
Kaynakça
- Liu Y, Ning Z, Chen Y, Guo M, Liu Y, Gali NK, et al. Aerodynamic characteristics and RNA concentration of SARS-CoV-2 aerosol in Wuhan hospitals during COVID-19 outbreak. bioRxiv. doi :10.1101/2020.03.08.982637
- who.int WHO/ILO interim guidance COVID-19: Occupational health and safety for health workers, (updated 1 April 2020, cited 29 April 2021. Available from: https://www.who.int/docs/default-source/inaugural-who-partners-forum/who-interim-recommendation-on-obligatory-hand-hygiene-against-transmission-of-covid-19.pdf
- Case Report: Handwashing-Induced Dermatitis During the COVID-19 Pandemic. Am Fam Physician. 2020; 102 (6): 327-8.
- Kampf et al, Prevention of irritant contact dermatitis among health care workers by using evidence based hand hygiene practices:a review, Industrial Health,2007, 45, 645-52.
- Hamnerius N, Svedman C, Bergendorff O, Björk J, Bruze M, Pontén A. Wet work exposure and hand eczema among healthcare workers: a cross-sectional study. Br J Dermatol. 2018; 178 (2): 452-61.
- Kiely LF, Moloney E, O'Sullivan G, Eustace JA, Gallagher J, Bourke JF. Irritant contact dermatitis in healthcare workers as a result of the COVID-19 pandemic: a cross-sectional study. Clin Exp Dermatol. 2021; 46 (1): 142-4.
- Guertler A, Moellhoff N, Schenck TL, et al. Onset of occupational hand eczema among healthcare workers during the SARS-CoV-2 pandemic: Comparing a single surgical site with a COVID-19 intensive care unit. Contact Dermatitis. 2020; 83 (2): 108-14.
- Susitaival P, Flyvholm MA, Meding B, Kanerva L, Lindberg M, Svensson A, Olafsson JH. Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Dermatitis. 2003 Aug; 49 (2): 70-6.
- Lan J, Song Z, Miao X, et al. Skin damage among health care workers managing coronavirus disease-2019. J Am Acad Dermatol. 2020; 82 (5):1215-6.
- Al-Khateeb B. Primary health care and family physicians provide frontline care to the dermatology patients during the era of COVID-19: Recommendations and future directions. J Family Med Prim Care. 2020; 9 (12): 5862-6.
- Celik V, Ozkars MY. An overlooked risk for healthcare workers amid COVID-19: Occupational hand eczema. North Clin Istanb. 2020;7(6):527-33.
- Erdem Y, Altunay IK, Aksu Çerman A, et al. The risk of hand eczema in healthcare workers during the COVID-19 pandemic: Do we need specific attention or prevention strategies?. Contact Dermatitis. 2020; 83 (5): 422-3.
- Ahmed-Lecheheb D, Cunat L, Hartemann P, Hautemanière A. Prospective observational study to assess hand skin condition after application of alcohol-based hand rub solutions. Am J Infect Control. 2012; 40 (2): 160-4.
- Singh D, Joshi K, Samuel A, Patra J, Mahindroo N. Alcohol-based hand sanitisers as first line of defence against SARS-CoV-2: a review of biology, chemistry and formulations. Epidemiology and Infection. 2020; 148: e229.
- Hamnerius N, Svedman C, Bergendorff O, et al. Hand eczema and occupational contact allergies in healthcare workers with a focus on rubber additives. Contact Dermatitis. 2018; 79 (3): 149-56.
- Yan Y, Chen H, Chen L, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther. 2020; 33 (4): e13310.
- Rundle CW, Presley CL, Militello M, et al. Hand hygiene during COVID-19: Recommendations from the American Contact Dermatitis Society. J Am Acad Dermatol. 2020; 83 (6): 1730-7.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2021 |
| Gönderilme Tarihi | 28 Nisan 2021 |
| Yayımlandığı Sayı | Yıl 2021 |