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Hand eczema and contact allergy in healthcare work

Hamnerius, Nils LU (2019) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2019(33).
Abstract
Hand eczema is common in healthcare workers. Besides wet work, healthcare work also implies exposure to contact allergens. Occupational hand exposures have changed in recent years owing to implementation of hand hygiene procedures including an increased use of medical gloves.
An increase of hand eczema caused by contact allergy to surgical gloves, in most cases owing to contact allergy to the rubber additive diphenylguanidine (DPG), was found in surgical theatre personnel (paper I). Most patients had worked with surgical gloves for decades, but their hand eczema was of recent onset. Contact allergy to DPG in medical gloves has previously been disputed, but in this study the presence of DPG in the patients' gloves was confirmed by... (More)
Hand eczema is common in healthcare workers. Besides wet work, healthcare work also implies exposure to contact allergens. Occupational hand exposures have changed in recent years owing to implementation of hand hygiene procedures including an increased use of medical gloves.
An increase of hand eczema caused by contact allergy to surgical gloves, in most cases owing to contact allergy to the rubber additive diphenylguanidine (DPG), was found in surgical theatre personnel (paper I). Most patients had worked with surgical gloves for decades, but their hand eczema was of recent onset. Contact allergy to DPG in medical gloves has previously been disputed, but in this study the presence of DPG in the patients' gloves was confirmed by chemical analysis.
In a questionnaire study distributed to healthcare workers in Southern Sweden (paper II) a 1-year prevalence of hand eczema of 21% was found. After adjustment for confounding factors a dose-dependent association with hand eczema was found for daily number of hand washes with soap at work, and for time working with medical gloves. No association was found between hand eczema and use of alcoholic hand disinfectant.
In a cross-sectional study healthcare workers with hand eczema were investigated (paper III). Occupational hand eczema was found in 62%. Of these 11% had occupational allergic contact dermatitis, in most cases caused by contact allergy to rubber glove additives. Occupational contact allergy to rubber additives was associated with sick-leave related to hand eczema
In an experimental study factors influencing DPG release from a polyisoprene rubber glove was investigated (paper IV). Alcoholic hand disinfectant prior to glove donning increased the amount of DPG recovered from the hands. Within 10 minutes more than 80% of available DPG was released from the glove into artificial sweat. Compared to a nitrile glove, proportionally more DPG was released into artificial sweat from the polyisoprene glove
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Please use this url to cite or link to this publication:
author
supervisor
opponent
  • professor Jakobsson, Kristina, Department of Public Health and Community Medicin, University of Gothenburg, Sweden
organization
publishing date
type
Thesis
publication status
published
subject
keywords
occupational dermatitis, healthcare worker, hand eczema, allergic contact dermatitis, rubber additives, diphenylguanidine, medical gloves
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2019
issue
33
pages
83 pages
publisher
Lund University: Faculty of Medicine
defense location
Öronklinikens föreläsningssal, Jan Waldenströms gata 38, Skånes Universitetssjukhus i Malmö
defense date
2019-05-03 09:15:00
ISSN
1652-8220
ISBN
978-91-7619-762-2
language
English
LU publication?
yes
id
0cc7d2ff-2278-4ff3-aeb0-a8a6446df411
date added to LUP
2019-04-08 12:26:11
date last changed
2021-07-16 08:20:19
@phdthesis{0cc7d2ff-2278-4ff3-aeb0-a8a6446df411,
  abstract     = {{Hand eczema is common in healthcare workers. Besides wet work, healthcare work also implies exposure to contact allergens. Occupational hand exposures have changed in recent years owing to implementation of hand hygiene procedures including an increased use of medical gloves. <br/>An increase of hand eczema caused by contact allergy to surgical gloves, in most cases owing to contact allergy to the rubber additive diphenylguanidine (DPG), was found in surgical theatre personnel (paper I). Most patients had worked with surgical gloves for decades, but their hand eczema was of recent onset. Contact allergy to DPG in medical gloves has previously been disputed, but in this study the presence of DPG in the patients' gloves was confirmed by chemical analysis. <br/>In a questionnaire study distributed to healthcare workers in Southern Sweden (paper II) a 1-year prevalence of hand eczema of 21% was found. After adjustment for confounding factors a dose-dependent association with hand eczema was found for daily number of hand washes with soap at work, and for time working with medical gloves. No association was found between hand eczema and use of alcoholic hand disinfectant.<br/>In a cross-sectional study healthcare workers with hand eczema were investigated (paper III). Occupational hand eczema was found in 62%. Of these 11% had occupational allergic contact dermatitis, in most cases caused by contact allergy to rubber glove additives. Occupational contact allergy to rubber additives was associated with sick-leave related to hand eczema<br/>In an experimental study factors influencing DPG release from a polyisoprene rubber glove was investigated (paper IV). Alcoholic hand disinfectant prior to glove donning increased the amount of DPG recovered from the hands. Within 10 minutes more than 80% of available DPG was released from the glove into artificial sweat. Compared to a nitrile glove, proportionally more DPG was released into artificial sweat from the polyisoprene glove<br/>}},
  author       = {{Hamnerius, Nils}},
  isbn         = {{978-91-7619-762-2}},
  issn         = {{1652-8220}},
  keywords     = {{occupational dermatitis, healthcare worker, hand eczema, allergic contact dermatitis, rubber additives, diphenylguanidine, medical gloves}},
  language     = {{eng}},
  number       = {{33}},
  publisher    = {{Lund University: Faculty of Medicine}},
  school       = {{Lund University}},
  series       = {{Lund University, Faculty of Medicine Doctoral Dissertation Series}},
  title        = {{Hand eczema and contact allergy in healthcare work}},
  url          = {{https://lup.lub.lu.se/search/files/62783178/Nils_Hamnerius_web.pdf}},
  volume       = {{2019}},
  year         = {{2019}},
}