Secondary individual prevention of hand dermatitis in geriatric nurses

Abstract

Background: The incidence of occupational skin disease (OSD) in geriatric nurses (GNs) is increasing in Germany. Objectives: A prospective controlled study of secondary individual prevention ( SIP) of OSD in GNs was conducted. Methods: Two hundred and nine participants completed questionnaires prior to the start of the program and 3 months after its conclusion. One hundred and two GNs participated in an interventional program ( intervention group, IG). Severity of OSD was classified upon each visit. Delta-TEWL values were measured at regular intervals. Findings were compared with those for 107 control group (CG) participants consulting a dermatologist on demand. SIP was not offered to CG participants. Results: Upon entry, 89% of IG and 90% CG complained of OSD (NS). Dermatologic examination revealed skin changes in 90% of IG at first consultation. Upon study completion, 59% of IG was free of OSD. Questionnaires 3 months after study completion revealed skin lesions in 53% of IG and 82% of CG ( p< 0.01). Delta-TEWL measurements reflected significant improvement of the epidermal barrier during SIP in IG ( median 6.9 - 3.0 g/m(2)/ h, p< 0.001). Three months after study completion, 96% of IG and 86% of CG were still employed. Conclusions: Objective dermatologic and skin physiologic data reveal that SIP in GNs is effective in the secondary prevention of OSD. Further, IG was superior to CG in terms of health maintenance and employment.