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Frequent hand hygiene increased incidence of dermatitis in HCWs
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New data published in the British Journal of Dermatology indicate that the incidence of dermatitis among health care workers has more than quadrupled after increasing hand hygiene practices for infection prevention.
“Campaigns to reduce these infections have been very successful and many lives have been saved,” Jill Stocks, PhD, of the University of Manchester Institute of Population Health in England, said in a press release. “However, we need to do all we can to prevent skin irritation among these frontline workers.”
According to the report, a national hand hygiene campaign — Cleanyourhands — was rolled out across England and Wales for health care workers (HCWs) from 2004 to 2008. Stocks and colleagues hypothesized that the increased hand hygiene would be associated with an increased incidence of occupational irritant contact dermatitis (ICD) among HCWs. They conducted a quasi-experimental study to estimate the changes in ICD cases related to hand hygiene in HCWs reported by dermatologists from 1996 to 2012, then used an interrupted time series based on the dates of the hand hygiene campaign to compare incidence before and after the campaign.
From 1996 to 2012, there were 1,796 cases of ICD documented among HCWs, of which 1,519 were attributed to hygiene measures. Of those, 775 were attributed to hand hygiene alone. There were significant increases in ICD among HCW attributed to hand hygiene alone (incidence rate ratio = 1.1; 95% CI, 1.07-1.12) and attributed to all hygiene (IRR = 1.05; 95% CI, 1.03-1.07). In 2012, there were 4.5 times as many reports of ICD attributed to hand hygiene compared with 1996.
There was no increased incidence of occupational ICD in control groups of workers, including wet workers (cleaners, hairdressers and food handlers) and other occupations.
When focusing only on the effect of the hand hygiene campaign, the researchers found a significant increase of ICD among HCWs during the roll-out period (IRR = 1.48; 95% CI, 1.2-1.84). In the post-roll-out period, there was a nonsignificant decline of ICD in this population.
“Obviously we don’t want people to stop washing their hands, so more needs to be done to procure less irritating products and to implement practices to prevent and treat irritant contact dermatitis,” Stocks said in the release.
Disclosure: The researchers report no relevant financial disclosures.
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