Hand hygiene compliance and irritant dermatitis: A juxtaposition of healthcare issues

Skin Sciences Program, Division of Pediatric Plastic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, U.S.A
International journal of cosmetic science (Impact Factor: 1.38). 06/2012; 34(5):402-15. DOI: 10.1111/j.1468-2494.2012.00733.x
Source: PubMed


Synopsis Reduction and prevention of health care-associated infections is a worldwide priority with emphasis on increasing hand hygiene compliance. Repetitive exposure to hand hygiene products and procedures is a significant factor in the development of occupational irritant hand dermatitis. Compliance has been difficult to achieve often due to skin irritation. The introduction of alcohol hand rubs has positively influenced compliance but rates remain lower than required. Genetic and environmental factors to the frequency and severity of irritant contact dermatitis have been identified. Because of the skin's role in innate immunity, maintenance of epidermal integrity is a key strategy for reducing health care-associated infections. In this review, we examine the interdependence of the two issues and the challenges of simultaneously accomplishing both goals. We emphasize research conducted among healthcare workers in their clinical settings. The factors that influence skin integrity and the challenges in meeting both goals simultaneously are explored. Cosmetic scientists have played key roles in the development of improved skin care products, and the issues present an excellent opportunity for them to provide potentially life-saving contributions to health care.

Download full-text


Available from: Marty O. Visscher, Feb 05, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. Healthcare professionals have a high risk of developing hand eczema. Hand eczema can interfere with their work. Objectives. To investigate the prevalence of self-reported hand eczema among healthcare professionals in the Netherlands, and to investigate absenteeism and presenteeism resulting from hand eczema. Methods. A questionnaire-based observational study was performed. Participants were recruited from hospitals and nursing homes in the Netherlands. The study population consisted of 1232 healthcare professionals. We used the NOSQ-2002 to measure hand eczema and the PRODISQ for absenteeism and presenteeism. Results. The 1-year prevalence of hand eczema among healthcare professionals was 12%. Among all participants, 47% reported symptoms related to hand eczema. Sick leave resulting from hand eczema was reported by 0.3% of healthcare professionals in general, and by 1.7% of healthcare professionals with hand eczema. In the group with hand eczema, 3.1% reported a large effect on presenteeism. Conclusions. The 1-year prevalence of hand eczema among healthcare professionals in the Netherlands is low, but the prevalence of symptoms related to hand eczema is quite high. Hand eczema seems to have little impact on work in terms of absenteeism and presenteeism.
    Full-text · Article · Jun 2013 · Contact Dermatitis
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hand washing is considered as the single most important strategy to prevent infections. World health organization (WHO) defines hand hygiene as a primary issue of personal care with particular reference to hospital personnel and health facility workers. In this work, we investigated a new combination for hand disinfection as an alternative to alcohol-based and chlorhexidine products. The new combination of 5-pyrrolidone-2-carboxylic acid (PCA) and copper sulphate pentahydrate (CS) was tested upon different bacterial species that normally colonize hands, including Staphylococcus aureus, methicillin resistant S. aureus (MR S. aureus), Staphylococcus epidermidis, multidrug resistant S. epidermidis (MDR S. epidermidis), Streptococcus pyogenes, Streptococcus agalactiae, Escherichia coli, Candida albicans and three clinical isolates: MR S. aureus , MDR S. epidermidis, and an E. coli strain. Minimal inhibitory concentrations (MICs), Minimal bactericidal concentrations (MBCs), fractional inhibitory concentration (FIC) indices, and fractional bactericidal concentration (FBC) indices were evaluated. Ethanol 70% V/V, isopropanol 60% V/V, and 4% w/V chlorhexidine solution were used as reference hand disinfectants. Copper sulphate pentahydrate was very effective against all tested microorganisms: The MIC and MBC for CS ranged from 781 mg/l against S. pyogenes to 12500 mg/l against E. coli strains and C. albicans. In addition, PCA exhibited a good antimicrobial activity, in particular, against S. pyogenes and S. agalactiae. The combination of CS and PCA showed a strong synergistic effect and all FIC indices were ≤0.500. The combination of CS and PCA were more effective than ethanol 70% V/V and isopropanol 60% V/V. In addition to antimicrobial activity, the new formulation possesses peculiar features such as residual activity and moisturizing effect. This work identifies a new strategy for hand disinfection.
    Full-text · Article · Jul 2013 · Journal of chemotherapy (Florence, Italy)
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There are a large number of workers in the United States, spanning a variety of occupational industries and sectors, who are potentially exposed to chemicals that can be absorbed through the skin. Occupational skin exposures can result in numerous diseases that can adversely affect an individual's health and capacity to perform at work. In general, there are three types of chemical-skin interactions of concern: direct skin effects, immune-mediated skin effects, and systemic effects. While hundreds of chemicals (metals, epoxy and acrylic resins, rubber additives, and chemical intermediates) present in virtually every industry have been identified to cause direct and immune-mediated effects such as contact dermatitis or urticaria, less is known about the number and types of chemicals contributing to systemic effects. In an attempt to raise awareness, skin notation assignments communicate the potential for dermal absorption; however, there is a need for standardization among agencies to communicate an accurate description of occupational hazards. Studies have suggested that exposure to complex mixtures, excessive hand washing, use of hand sanitizers, high frequency of wet work, and environmental or other factors may enhance penetration and stimulate other biological responses altering the outcomes of dermal chemical exposure. Understanding the hazards of dermal exposure is essential for the proper implementation of protective measures to ensure worker safety and health.
    Preview · Article · Dec 2014 · Environmental Health Insights
Show more