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Focus on handwashing in hospitals has led to rise in staff dermatitis


The incidence of dermatitis has increased 4.5 times in healthcare workers following increased hand hygiene as a drive to reduce infections, such as MRSA, has kicked in, claim UK researchers.

Researchers studied reports of skin problems caused or aggravated by work, which were submitted to a national database between 1996 and 2012 by 60% of UK dermatologists.

They found that out of 7,138 cases of irritant contact dermatitis reported 1,796 were in healthcare workers.

“We need to do all we can to prevent skin irritation among these frontline workers”

Jill Stocks

When the numbers were broken down by year, health workers were 4.5 times more likely to suffer from irritant contact dermatitis in 2012 as in 1996.

In two control groups, cases declined or did not change, said the study authors from Manchester University.

Prevention of healthcare associated infections, such as MRSA and C. difficile, became an NHS priority in 1999, and successive campaigns emphasised the washing of hands with soap or alcohol hand rub.

The campaign’s have been a success, with a reduction of infections reported and a greatly increased use of cleaning products, noted the study authors in the British Journal of Dermatology.

Dr Jill Stocks, who led the research, said: “Campaigns to reduce these infections have been very successful and many lives have been saved. However, we need to do all we can to prevent skin irritation among these frontline workers.

“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,” she said.



Readers' comments (9)

  • The answer has to be that the NHS must invest in good quality moisturising hand wash and gel. No one can expect to wash their hands continuously and not have it impact on their skin, but there are measures that can minimise the effect. With nursing staff missing shifts due to the condition of their hands, it must surely be cost effective.

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  • I was a staff nurse on a childrens isolation ward in 1970 where we had to hand wash 5 times for each patient. We only used ordinary soap and cold water. No gloves no dermatitis and no cross infections.

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  • I'm afraid I don't agree with the above. I worked on a surgical ward in the 70's, with constant washing, no access to proper gloves because we were not worth the cost of the good gloves that didn't fall off, and sore hands all the time.

    My hands are still sore and ruined even now and I can't tolerate much in the way of soap, alcohol gel etc.

    So yes, it's very important that Trusts buy into proper soap / wipes / creams and whatever else is needed to keep staff safe, and reduce cross-infection.

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  • why is there an increase? is it due to changes in the products or changes in hand washing habits of nurses? hand washing is something they have always done. We had to use the products available and hand cream was provided by the pharmacy but it didn't prevent or cure the problems of dryness and the formation of breaks in the skin with the risk of infection or the added risk of picking up infections. the only other option was the more frequent use of gloves which is not always desirable for many procedures. they were latex so some nurses and other staff had allergy problems with these. we didn''t have any support from OH. depending on the severity all they could do was put nurses off work and prescribe an ointment and visit to dermatology. if severe problems continued there was a possibility to move to a job where less hand washing was required but the chances of having support and finding another nursing job in the hospital to fit that description were slim and only a matter of chance when became available.
    the other alternative in extremely severe cases where the nurse was unable to continue working was to leave the profession.

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  • My hands are constantly sore with broken skin due to the handwash our trust uses. The previous product did not affect my skin I now have to use soap alternatives as advised by my dermatologist, this is not easy to do as I have to carry a supply with me when I go to different areas .

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  • Why is there an increase in skin problems amongst health care workers? I trained in the 60s and therefore have worked through many decades. Hand washing has always been important, but over the years there has been much more emphasis on it. Patients now are discharged much earlier than previously which means inpatients have more acute conditions than ever before, and have many more invasive devices. Because of this interactions between patient and carer have increased and therefore so has hand washing. Nursing is a predominately female profession and it is now common for them to nurse throughout their working lives, despite having a family. And finally - hands are now more decorative than before, and women are much more aware if they are dry, irritated and unattractive.

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  • cost savings = cheap products

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  • Advice in my workplace is to use the hand cream that is supplied alongside. However, even Occupational Health admit that doing that would make it impossible to put on your next pair of gloves so say in reality it's something just to do as you go on your break....break? I think I remember those.

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  • even if you supply you own highest quality hand cream it doesn't seem to help such frequent washing and aggressive products added to the dry air and winter cold.

    would talc help with the gloves or will that just exacerbate the situation?

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