Hand Dermatitis Screening Tool Feasible, Easy to Use in Healthcare Workers

washing hands
washing hands
As the number of hand washes per day increased, the presence of a positive screen was significantly increased.

The Hand Dermatitis Screening Tool is quick and easy to usein a busy hospital setting for healthcare workers concerned with occupational contact dermatitis, according to a study recently published in Contact Dermatitis.

In this cross-sectional study, the Hand Dermatitis Screening Tool was assessed for its validity in the acute health care sector and its feasibility of implementing workplace screening for occupational contact dermatitis in hospital workers who are at high risk for exposure to wet work.The study was conducted in 2 phases and carried out in 3 different acute healthcare organizations within the Greater Toronto Area in Ontario, Canada. The first phase involved workplace screening for hand dermatitis using the Hand Dermatitis Screening Tool. The one-page tool consisted of 5 sections:demographics and workplace characteristics; current exposures to wet work, the frequency of hand-washing, and protective glove practices; history of skin conditions; screening results; and feasibility evaluation. The second phase included a review by 2 expert occupational dermatologists for independent assessment based on digital images of participants’ hands.

Of the workers who participated (N=508), 69.5% screened as normal, 28.3% screened as mild, and 2.2% screened as moderate to severe. Among those who were screened by occupational health nurses, 28% of participants screened positive compared with 32.5% of those who self-screened. As the number of hand washes per day increased, the presence of a positive screen (P =.018) was significantly increased. Age, years in healthcare, and past rash were also associated with positive screens, though not significantly. Nearly all participants (99%)reported that the tool was easy or very easy to use. Workplace screening for hand dermatitis was deemed to be somewhat or very important by 86% of participants(n=430). Fair agreement was shown when comparing workplace screening and dermatologist photo screening.

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This study was limited by potential bias by the motivation of workers to participate. Photographs of hands were not standardized for review by the expert dermatologists.

More studies are needed to better inform best practices intesting agreement that are feasible to implement as well as further testing of the sensitivity and specificity of the Hand Dermatitis Screening Tool.

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Nichol K, Copes R, Kersey K, Eriksson J, Holness DL. Screening forhand dermatitis in healthcare workers: Comparing workplace screening withdermatologist photo screening [published online January24, 2019]. Contact Dermatitis.doi: 10.1111/cod.13231