Irritant Hand Dermatitis in Health Care Workers

Abstract

BACKGROUND: Health care workers (HCWs) are at increased risk of irritant contact dermatitis due to frequent hand washing and use of alcohol gel. This has increased the incidence of occupational skin diseases. AIMS: To evaluate hand dermatitis in HCWs in our hospital by means of a survey which also examined trends of exposure and the utility of patch testing. METHODS: HCWs diagnosed with hand dermatitis in our contact dermatitis clinic from January 2011 to July 2012 were included. Information was collected retrospectively from medical notes, computer records and the database of the British Cutaneous Allergy Society. RESULTS: A total of 69 HCWs were diagnosed with hand dermatitis, with a prevalence of ~4%. The majority were female and the clinical areas in which they worked were diverse. About 98% (68) had irritant contact dermatitis, and hand washing was the commonest cause of symptoms. About 75% (51) had irritant dermatitis exclusively. Patch test was positive in 42% with the commonest reaction to nickel, followed by formaldehyde. Associated atopy was found in less than half of the cases.CONCLUSIONS: Irritant hand dermatitis is prevalent in HCWs in this setting. Patch testing is useful to identify any additional allergic element in such cases.