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Thomas L. Diepgen - One of the best experts on this subject based on the ideXlab platform.
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A longitudinal application of three health behaviour models in the context of Skin Protection behaviour in individuals with occupational Skin disease.
Psychology & health, 2011Co-Authors: Uwe Matterne, Thomas L. Diepgen, Elke WeisshaarAbstract:Occupational Skin disease (OSD) is common, associated with poor prognosis and poses a significant burden to the individual and society. We applied the theory of planned behaviour (TPB), the prototype-willingness model (PWM) and the health action process approach (HAPA) to the prediction and explanation of occupationally relevant Skin Protection behaviour in individuals with OSD. We used a longitudinal design. In this study, 150 individuals participating in a 3-week inpatient tertiary prevention programme completed measures assessing the constructs of the TPB, PWM and HAPA at admission (T 0), discharge (T 1) and once the individual had returned to work and worked for 4 consecutive weeks (T 2) (n = 117). Intention was measured at T 0 and Skin Protection behaviour at T 2. Path analysis was used to assess the longitudinal associations of the models’ constructs with intention and Skin Protection behaviour. TPB as well as PWM variables accounted for 30% of variance in behaviour, HAPA variables for 33%. While no...
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Effects of a health-educational and psychological intervention on socio-cognitive determinants of Skin Protection behaviour in individuals with occupational dermatoses.
International archives of occupational and environmental health, 2009Co-Authors: Uwe Matterne, Thomas L. Diepgen, Elke WeisshaarAbstract:Purpose Occupational Skin diseases are a significant public health concern. Little is known about the cognitive representations individuals with occupational Skin disease have towards measures of personal Skin Protection and occupational safety and whether they change during an intervention. We aimed to evaluate whether social cognitions as embodied by the theory of planned behaviour become more favourable during a tertiary inpatient individual prevention programme (TIP) and whether the model’s predictions hold in a setting to which the model has not been applied.
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FS13.4 Prevention of occupational hand eczema by Skin-care management – results of an intervention study
Contact Dermatitis, 2008Co-Authors: Thomas L. DiepgenAbstract:Objectives: In the prevention of occupational contact dermatitis the usage of personal Skin Protection measures have a high priority, however there is a lack of intervention field studies to demonstrate its efficacy. Therefore we conducted a field study in a plant of the metal-working industry and investigated the efficacy of an established Skin Protection programme. Methods: First, a professional dermatological appraisal of the current status and a Skin-Protection analysis were carried out for 180 company employees, and a dermatological evaluation of each workplace from the aspect of prevention was conducted. Using the information obtained a Skin Protection programme for the whole company was devised and subsequently set up. The follow-up examination was performed eight months later. Results: At the beginning of the study 26% of the employees were found to have Skin problems related to the work they were doing. In 50% of the cases Skin Protection was never or only rarely used, with the right kind of Skin Protection almost never being applied. There was no Skin Protection programme in place meeting today’s professional dermatological requirements, or at the most there were just the first signs of one. After the programme had been set up and suitable instruction and information given there was a follow-up observation period of eight months, during which several professional dermatological examinations of the employees were carried out and further instruction (individual prevention) was given. In the final examination only 8.7% of the employees were found to have work related Skin problems. Conclusions: We could demonstrated that the occurrence of occupationally-related hand eczema can be significantly reduced by setting up and providing instruction in a Skin Protection concept matched to the hazards the Skin is exposed to at work. Additionally, valuable knowledge and experience were gained on implementing industrial Skin Protection programmes and performing intervention studies.
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Educational and dermatological aspects of secondary individual prevention in healthcare workers
Contact Dermatitis, 2006Co-Authors: Elke Weisshaar, Magdalena Radulescu, Ursel Albrecht, Michael Bock, Thomas L. DiepgenAbstract:: Healthcare workers (HCW) have an increased risk of suffering from occupational Skin diseases (OSDs). Therefore, we established special prevention and Skin Protection courses for HCW. Medical aims are to optimize diagnostic procedures and individual therapy, educational aims are to improve individual Skin Protection/Skin care habits of the patient and also to influence the participants' attitudes towards health. Participants are patients that have been suspected to suffer from an OSD and are insured with the German Accident Prevention Insurance Association for Health Care Workers (BGW). Teaching units mainly focus on the texture and functioning of the Skin, general aspects of OSDs, general information concerning Skin Protection, instructions about the correct use of Skin cleansing and Skin Protection products. Besides, every participant is clinically examined by a dermatologist and a precise patient's history is obtained. Individually adapted Skin Protection strategies are developed. Patients can ask the dermatologist questions in confidence. 504 patients (mean age: 36.9 years, SD = 11.7) participated in the Skin Protection courses. 94.6% (n = 477) suffered from hand eczema frequently caused by a mixture of atopic, irritant and allergic contact dermatitis, but irritant contact dermatitis was the most frequent diagnosis (55.4%, n = 279). The participants rated the course as good to excellent. Health education and advisory services in occupational dermatology are still fragmentary. Prevention of OSD and maintenance of health through education are important complementary measures for dermatological care. In the future, similar educational programmes should be offered for employees of other professions with an increased risk for OSD.
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Hautschutzseminare zur sekundaren Individualpravention bei Beschaftigten in Gesundheitsberufen: erste Ergebnisse nach uber 2jahriger Durchfuhrung. Skin Protection and Skin disease prevention courses for secondary prevention in health care workers: fi
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2005Co-Authors: Elke Weisshaar, Magdalena Radulescu, Ursel Albrecht, Michael Bock, Elisabeth Zimmermann, Thomas L. DiepgenAbstract:BACKGROUND Healthcare workers have an increased risk of occupational dermatoses. In January 2002, the Department of Social Medicine, Occupational and Environmental Dermatology of the University of Heidelberg started organizing special prevention courses for this group of employees in cooperation with the Accident Prevention & Insurance Association for Health Care Workers (BGW). The major aims are to improve individual Skin Protection and Skin care habits, as well as to optimize diagnostic procedures and therapy. PATIENTS AND METHODS The two-day course has up to 14 participants. Teaching units mainly focus on Skin structure and function, general aspects of occupational Skin diseases, general information concerning Skin Protection and practical exercises emphasizing the correct use of Skin cleansing and Skin Protection products. Additionally, every participant undergoes a dermatological examination including a detailed history and Skin inspection. Individual Skin Protection strategies are developed, and the participants are provided with the opportunity to ask the dermatologist questions in confidence. RESULTS Most of the 355 participants have been female (87.3%) with a mean age of 36.9 years. 95% had hand eczema, predominantly dyshidrotic morphology. In many cases, there was a mixture of atopic, irritant and allergic contact dermatitis but irritant contact dermatitis was most common (43%). Atopy was present in 68% of the patients. The participants rated the course as good to excellent. Other benefits are the exchange of experience between patients working in the same or similar occupations and transfer of the new knowledge to colleagues, family and friends. CONCLUSIONS Examinations and advisory services in occupational dermatology are still fragmentary. Skin barrier creams and moisturizers are not sufficiently utilized in daily practice. In the future, similar courses should be offered for employees in other professions with an increased risk of occupational Skin diseases.
Hans Drexler - One of the best experts on this subject based on the ideXlab platform.
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effect of Skin Protection and Skin irritation on the internal exposure to carbon disulfide in employees of the viscose industry
Annals of Occupational Hygiene, 2015Co-Authors: Sonja Kilo, Wolfgang Uter, Nina Zonnur, Thomas Goen, Hans DrexlerAbstract:Introduction: Occupational exposure to carbon disulfide (CS 2 ) leads to inhalative and dermal uptake and thereby to internal exposure. In order to prevent occupational contact dermatitis, gloves and Skin pro- tection creams are used at the workplace. The aim of the study was the evaluation of the influence of per - sonal Skin Protection and irritation on the internal exposure to CS 2 of employees in the viscose industry. Methods: One hundred and eighty-two male CS 2 -exposed employees were included in the study and were examined regarding working conditions, use of personal protective measures und Skin status. Personal air monitoring and biological monitoring was performed and the 'relative internal exposure' (RIE, internal exposure in relation to external exposure) calculated. A multiple regression analysis cal- culated the influence of Skin Protection and irritation on CS 2 uptake. Results: Usage of Skin Protection creams and gloves (and both in combination) while working was associated with a significantly higher RIE indicating a higher dermal penetration of CS 2 . Equally, irri- tated Skin and younger age was associated with a higher internal burden. Conclusions: Gloves and Skin Protection creams are useful for preventing occupational Skin diseases. However, when handling Skin-resorptive substances like CS 2 , they can increase internal exposure or Skin irritation. Therefore, we recommend the careful consideration of benefits and risks of protective creams and gloves at the workplace.
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effectiveness of Skin Protection measures in prevention of occupational hand eczema results of a prospective randomized controlled trial over a follow up period of 1 year
British Journal of Dermatology, 2010Co-Authors: Birgitta Kutting, Thomas Baumeister, Wobbeke Weistenhofer, A Pfahlberg, Wolfgang Uter, Hans DrexlerAbstract:Summary Background We recently found a very low adherence to a generally recommended Skin Protection regimen in a sample of 1355 metalworkers. Objectives The present study assessed the effectiveness of Skin Protection as presently recommended, especially the differential contribution of Skin care and Skin Protection, to the prevention of occupational hand eczema. Methods Of 1355 metalworkers screened, 1020 male volunteers, all fit for work, were recruited for a prospective intervention study with four arms (Skin care, Skin Protection, both combined, and control group, i.e. no recommendation). The study was performed from winter 2006/2007 to spring 2008, following each subject for up for 12 months. Both hands were examined using a quantitative Skin score, and a standardized personal interview was performed three times. The change of the objective Skin score from baseline to 12 months was used as primary outcome measure. Results After 12 months 800 subjects were included (78·4% of those recruited). The compliance to follow the randomized measure depended on the recommended measure and ranged from 73·7% to 88·7%. While in the control group a significant deterioration was found, the largest and significant improvement was noted in the group following the generally recommended Skin Protection programme (Skin care + Skin Protection) followed by Skin Protection alone as second best. Conclusions The generally recommended Skin Protection regimen seems to provide effective prevention of occupational Skin disease. Therefore, the compliance to follow the Skin Protection regimen, especially the use of Skin Protection, should be enhanced.
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Effectiveness of Skin Protection creams in the prevention of occupational dermatitis: results of a randomized, controlled trial
International archives of occupational and environmental health, 2008Co-Authors: Robert Winker, Hans Drexler, Bayda Salameh, Sabine Stolkovich, Michael Nikl, Alfred Barth, Elisabeth Ponocny, Gerhard TappeinerAbstract:Objectives The aim of the trial was to investigate whether the publicized effects of Skin Protection creams can be replicated in a real occupational setting during activities that expose the Skin.
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effectiveness of Skin Protection creams as a preventive measure in occupational dermatitis a critical update according to criteria of evidence based medicine
International Archives of Occupational and Environmental Health, 2003Co-Authors: Birgitta Kutting, Hans DrexlerAbstract:Objectives This study attempts to assess the evidence of the generally recommended three-step programme of Skin Protection in the prevention of occupational Skin disease.
Frederic Guittard - One of the best experts on this subject based on the ideXlab platform.
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Silica-and perfluoro-based nanoparticular polymeric network for the Skin Protection against organophosphates
Materials Research Express, 2016Co-Authors: Sonia Amigoni, Frederic GuittardAbstract:Due to their small size, nanoparticles possess unique properties such as high absorption or pollutant degradation, making them useful for Skin Protection against chemicals. By covalently grafting to a hydrophobically modified alkali-soluble emulsion (HASE), a thickening polymer, nanoparticles can be dispersed as gels in water at neutral pH. With this modification the potential aggregation and toxicity typical of nanoparticles are avoided. Once integrated into a cosmetic formula, these gels can be spread onto Skin to afford protective barriers. This paper reports (1) the benefit of SiO2 nanoparticles grafted to a perfluorocarbon HASE polymer (HASE-F/SiO2) which is then integrated into a new formula and it is influence on the efficacy against the penetration of paraoxone, as well as (2) the stability of the barrier cream (BC) and (3) how the homogenous dispersion of nanoparticles maintains a high active surface area of SiO2 nanoparticles. The efficiency of the new active topical Skin protectant was proved at different doses (5-27 mg cm2), under occlusive conditions and validated on human Skin. Therefore, the combination of the HASE-F polymer, nanoparticle grafting, and polyvinylpyrrolidone and glycerol formulation led to a very effective active BC.
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New CeO2 nanoparticles-based topical formulations for the Skin Protection against organophosphates
Toxicology Reports, 2015Co-Authors: Arnaud Zenerino, Christophe Bignon, Tifenn Boutard, Thierry Devers, Sonia Amigoni, Denis Josse, Frederic GuittardAbstract:To reinforce Skin Protection against organophosphates (OPs), the development of new topical Skin protectants (TSP) has received a great interest. Nanoparticles like cerium dioxide (CeO2) known to adsorb and neutralize OPs are interesting candidates for TSP. However, NPs are difficult to disperse into formulations and they are suspected of toxicological issues. Thus we want to study: (1) the effect of the addition of CeO2 NPs in formulations for the Skin Protection (2) the impact of the doping of CeO2 NPs by calcium; (3) the effect of two methods of dispersion of CeO2 NPs: an O/W emulsion or a suspension of a fluorinated thickening polymer (HASE-F) grafted with these NPs. As a screening approach we used silicone membranes as a Skin equivalent and Franz diffusion cells for permeation tests. The addition of purum CeO2 NPs in both formulations permits the penetration to decrease by a 3 to 4-fold factor. The O/W emulsion is the best approach to obtain a film-forming coating with a good reproducibility of the penetration results; whereas the grafting of NPs to a thickener is the best way to obtain an efficient homogenous suspension of CeO2 NPs with a decreased of toxicological impact but the coating is less film-forming which slightly impacts the reproducibility of the penetration results.
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New CeO2 nanoparticles-based topical formulations for the Skin Protection against organophosphates
Toxicology Reports, 2015Co-Authors: Arnaud Zenerino, Christophe Bignon, Tifenn Boutard, Thierry Devers, Sonia Amigoni, Denis Josse, Frederic GuittardAbstract:To reinforce Skin Protection against organophosphates (OPs), the development of new topical Skin protectants (TSP) has received a great interest. Nanoparticles like cerium dioxide (CeO2) known to adsorb and neutralize OPs are interesting candidates for TSP. However, NPs are difficult to disperse into formulations and they are suspected of toxicological issues. Thus, we want to study: (1) the effect of the addition of CeO2 NPs in formulations for the Skin Protection (2) the impact of the doping of CeO2 NPs by calcium; (3) the effect of two methods of dispersion of CeO2 NPs: an O/W emulsion or a suspension of a fluorinated thickening polymer (HASE-F) grafted with these NPs. As a screening approach we used silicone membranes as a Skin equivalent and Franz diffusion cells for permeation tests. The addition of pure CeO2 NPs in both formulations permits the penetration to decrease by a 3–4-fold factor. The O/W emulsion allows is the best approach to obtain a film-forming coating with a good reproducibility of the penetration results; whereas the grafting of NPs to a thickener is the best way to obtain an efficient homogenous suspension of CeO2 NPs with a decreased of toxicological impact but the coating is less film-forming which slightly impacts the reproducibility of the penetration results.
Elke Weisshaar - One of the best experts on this subject based on the ideXlab platform.
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A longitudinal application of three health behaviour models in the context of Skin Protection behaviour in individuals with occupational Skin disease.
Psychology & health, 2011Co-Authors: Uwe Matterne, Thomas L. Diepgen, Elke WeisshaarAbstract:Occupational Skin disease (OSD) is common, associated with poor prognosis and poses a significant burden to the individual and society. We applied the theory of planned behaviour (TPB), the prototype-willingness model (PWM) and the health action process approach (HAPA) to the prediction and explanation of occupationally relevant Skin Protection behaviour in individuals with OSD. We used a longitudinal design. In this study, 150 individuals participating in a 3-week inpatient tertiary prevention programme completed measures assessing the constructs of the TPB, PWM and HAPA at admission (T 0), discharge (T 1) and once the individual had returned to work and worked for 4 consecutive weeks (T 2) (n = 117). Intention was measured at T 0 and Skin Protection behaviour at T 2. Path analysis was used to assess the longitudinal associations of the models’ constructs with intention and Skin Protection behaviour. TPB as well as PWM variables accounted for 30% of variance in behaviour, HAPA variables for 33%. While no...
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Effects of a health-educational and psychological intervention on socio-cognitive determinants of Skin Protection behaviour in individuals with occupational dermatoses.
International archives of occupational and environmental health, 2009Co-Authors: Uwe Matterne, Thomas L. Diepgen, Elke WeisshaarAbstract:Purpose Occupational Skin diseases are a significant public health concern. Little is known about the cognitive representations individuals with occupational Skin disease have towards measures of personal Skin Protection and occupational safety and whether they change during an intervention. We aimed to evaluate whether social cognitions as embodied by the theory of planned behaviour become more favourable during a tertiary inpatient individual prevention programme (TIP) and whether the model’s predictions hold in a setting to which the model has not been applied.
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Educational and dermatological aspects of secondary individual prevention in healthcare workers
Contact Dermatitis, 2006Co-Authors: Elke Weisshaar, Magdalena Radulescu, Ursel Albrecht, Michael Bock, Thomas L. DiepgenAbstract:: Healthcare workers (HCW) have an increased risk of suffering from occupational Skin diseases (OSDs). Therefore, we established special prevention and Skin Protection courses for HCW. Medical aims are to optimize diagnostic procedures and individual therapy, educational aims are to improve individual Skin Protection/Skin care habits of the patient and also to influence the participants' attitudes towards health. Participants are patients that have been suspected to suffer from an OSD and are insured with the German Accident Prevention Insurance Association for Health Care Workers (BGW). Teaching units mainly focus on the texture and functioning of the Skin, general aspects of OSDs, general information concerning Skin Protection, instructions about the correct use of Skin cleansing and Skin Protection products. Besides, every participant is clinically examined by a dermatologist and a precise patient's history is obtained. Individually adapted Skin Protection strategies are developed. Patients can ask the dermatologist questions in confidence. 504 patients (mean age: 36.9 years, SD = 11.7) participated in the Skin Protection courses. 94.6% (n = 477) suffered from hand eczema frequently caused by a mixture of atopic, irritant and allergic contact dermatitis, but irritant contact dermatitis was the most frequent diagnosis (55.4%, n = 279). The participants rated the course as good to excellent. Health education and advisory services in occupational dermatology are still fragmentary. Prevention of OSD and maintenance of health through education are important complementary measures for dermatological care. In the future, similar educational programmes should be offered for employees of other professions with an increased risk for OSD.
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Hautschutzseminare zur sekundaren Individualpravention bei Beschaftigten in Gesundheitsberufen: erste Ergebnisse nach uber 2jahriger Durchfuhrung. Skin Protection and Skin disease prevention courses for secondary prevention in health care workers: fi
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2005Co-Authors: Elke Weisshaar, Magdalena Radulescu, Ursel Albrecht, Michael Bock, Elisabeth Zimmermann, Thomas L. DiepgenAbstract:BACKGROUND Healthcare workers have an increased risk of occupational dermatoses. In January 2002, the Department of Social Medicine, Occupational and Environmental Dermatology of the University of Heidelberg started organizing special prevention courses for this group of employees in cooperation with the Accident Prevention & Insurance Association for Health Care Workers (BGW). The major aims are to improve individual Skin Protection and Skin care habits, as well as to optimize diagnostic procedures and therapy. PATIENTS AND METHODS The two-day course has up to 14 participants. Teaching units mainly focus on Skin structure and function, general aspects of occupational Skin diseases, general information concerning Skin Protection and practical exercises emphasizing the correct use of Skin cleansing and Skin Protection products. Additionally, every participant undergoes a dermatological examination including a detailed history and Skin inspection. Individual Skin Protection strategies are developed, and the participants are provided with the opportunity to ask the dermatologist questions in confidence. RESULTS Most of the 355 participants have been female (87.3%) with a mean age of 36.9 years. 95% had hand eczema, predominantly dyshidrotic morphology. In many cases, there was a mixture of atopic, irritant and allergic contact dermatitis but irritant contact dermatitis was most common (43%). Atopy was present in 68% of the patients. The participants rated the course as good to excellent. Other benefits are the exchange of experience between patients working in the same or similar occupations and transfer of the new knowledge to colleagues, family and friends. CONCLUSIONS Examinations and advisory services in occupational dermatology are still fragmentary. Skin barrier creams and moisturizers are not sufficiently utilized in daily practice. In the future, similar courses should be offered for employees in other professions with an increased risk of occupational Skin diseases.
Peter Elsner - One of the best experts on this subject based on the ideXlab platform.
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How much Skin Protection cream is actually applied in the workplace? Determination of dose per Skin surface area in nurses
Contact dermatitis, 2012Co-Authors: Sibylle Schliemann, Maximilian Petri, Peter ElsnerAbstract:Background. Skin Protection creams (PCs) are used in the occupational setting to prevent irritant hand dermatitis. However, so far, the actual amounts of PC applied and the resulting dose per area unit on hands at work have not been a matter of systematic investigation. The quantities used in experimental studies investigating the efficacy of PCs range between 4 and 25 mg/cm2. Objectives. To develop a practical and accurate method to analyse the actual consumed quantities of PCs at workplaces in relation to hand surface area. Methods. Thirty-one hospital nurses without hand eczema were provided with a sample PC in special monitoring tubes with Medication Event Monitoring Systems (MEMS TrackCaps®; Aardex Ltd, Zug, Switzerland), and used the product over 5 working days as usual. The consumption was calculated by weighing of the tubes and analysis of the application frequency, and related to the individual calculated hand surface area. Results. The mean PC dose applied was 0.97 ± 0.6 mg/cm2. Conclusions. The amounts of PC applied by hospital nurses were significantly lower than the amounts that have been used in experimental studies. The method appears to be suitable for use in different in occupational settings. Further investigations are needed to gain realistic insights into consumers' attitudes regarding PCs.
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FS07.6 Efficacy of UVB radiation versus Skin Protection in the prevention of hand dermatitis in baker apprentices
Contact Dermatitis, 2008Co-Authors: Andrea Bauer, Daniela Kelterer, R. Bartsch, M. Stadeler, P. Kleesz, Romano Grieshaber, Peter ElsnerAbstract:In-vitro and in-vivo data suggest the efficacy of various Skin Protection measures in the prevention of hand dermatitis (HD). The aims and objectives of this intervention study was to quantify the efficacy of Skin Protection (SP) measures and UVB hardening in the prevention of HD. SP measures were compared against UVB hardening in a controlled clinical trial of 94 apprentices. The apprentices were assigned to the intervention arms class-wise. Baker apprentices involved in a previous follow-up study served as an additional historic control group representing no intervention. The apprentices were interviewed and examined in a standardised way at the beginning of the vocational training and at four follow-ups. Transepidermal water loss (TEWL) was measured at the back of the hands. Point prevalence of HD in the groups after 6 months was highest in the controls (C)(29.1%) followed by the UVB-group (19.4%) and the SP group (13.3%). UVB hardening and SP measures were associated with a reduction in HD prevalence by 9.7%(95%CI −8.5 to 28.1) and 15.8%(95%CI −2.4 to 33.9), respectively. Unadjusted logistic regression analysis showed atopy (OR = 4.74, 95%CI 1.12–20.11, p = 0.035) and Skin care (OR 0.39, 95%CI 0.16–0.86, p = 0.023) to be independent risk factors. Application of SP measures reduced the OR for HD 0.8 (95%CI 0.17–3.70) and 0.33 (95%CI 0.09–1.23) fold compared to the UVB and C group, respectively. The trends in the clinical results were confirmed by statistically significant differences in TEWL values. Apprentices in the SP group consistently had a lower prevalence of HD compared to the apprentices in the UVB and C group. These trends were reinforced by statistically significant differences in TEWL levels. A multi-centre trial is recommended to confirm the efficacy of SP measures in a larger randomised study.
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Skin Protection in the food industry.
Current problems in dermatology, 2007Co-Authors: Andrea Bauer, R. Bartsch, M. Stadeler, D. Kelterer, Peter ElsnerAbstract:In food occupations, like in many other Skin risk occupations, the regular use of personal Protection equipment, i.e. of Skin Protection ointments and protective gloves, is recommended as well as re
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Prevention of hand dermatitis in bakers' apprentices: different efficacy of Skin Protection measures and UVB hardening.
International archives of occupational and environmental health, 2002Co-Authors: Andrea Bauer, Daniela Kelterer, R. Bartsch, James Pearson, M. Stadeler, P. Kleesz, Romano Grieshaber, Anja Schlegel, Rainer Schiele, Peter ElsnerAbstract:Objectives: The objective of this controlled intervention study was to quantify the efficacy of Skin Protection (SP) measures and ultraviolet B (UVB) hardening in the prevention of hand dermatitis in bak- ers' apprentices. Method: SPmeasures were compared against UVB hardening in a controlled clinical trial of 94 apprentices. The apprentices were assigned to the in- tervention arms class-wise. Bakers' apprentices involved in a previous follow-up study served as additional con- trols representing no intervention. The apprentices were interviewed and examined in a standardised way at the beginning of the training and at 4 monthly follow-ups. Transepidermal water loss (TEWL) was measured at the back of the hands. Results: Demographic profile and atopy criteria were equally distributed in the two inter- vention arms and the control group. Point prevalence of hand dermatitis after 6 months was highest in the con- trols (29.1%) followed by the UVB (19.4%) and the SP group (13.3%). UVB hardening and SPmeasures re- duced hand dermatitis prevalence by 9.7% (95%CI: -8.5 to 28.1) and 15.7% (95%CI: -2.4 to 33.9), respectively. Application of SPmeasures reduced the odds ratios (ORs) for hand dermatitis 0.8-fold (95%CI: 0.17-3.70) and 0.33-fold (95%CI: 0.09-1.23) compared with the UVB group and the controls, respectively. These clinical trends were confirmed by statistically significant differ- ences in TEWL values. TEWL values were consistently higher in the UVB group than in the SPgroup (P=0.002). Conclusions: This study provided evidence, based on significant differences in TEWL levels, that general SPmeasures may be more effective than UV light hardening of the Skin, which in turn was more ef- fective than no intervention. This trend was supported by the frequency of development of clinical hand der- matitis, although differences did not reach statistical significance. A multi-centre trial is recommended to confirm the efficacy of SPmeasures in a larger rando- mised study.
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Skin Protection in bakers' apprentices.
Contact dermatitis, 2002Co-Authors: Andrea Bauer, Daniela Kelterer, R. Bartsch, James Pearson, M. Stadeler, P. Kleesz, Peter Elsner, Hywel C. WilliamsAbstract:Skin Protection measures - barrier creams, protective gloves - and Skin care are widely recommended for the prevention of occupational hand dermatitis (HD) in Skin risk professions, but there is hardly anything known about uptake levels of the measures. The objective of this controlled intervention study was to quantify the uptake and maintenance of Skin Protection and Skin care measures in first-year bakers' apprentices. A total of 94 first-year bakers' apprentices were included in the study in September 2000. The apprentices were assigned to the Skin Protection and control group class-wise to reduce contamination. The Skin Protection group comprised 39 apprentices who were trained in Skin Protection measures at the beginning and after 4 weeks of training. 55 apprentices were assigned to the control group representing no Skin Protection intervention. Standardized interviews took place at the beginning of the training and at 4 monthly follow-ups (FU). The uptake of Skin Protection measures differed significantly between the groups (barrier cream p < 0.0001, protective gloves p = 0.046, Skin care p = 0.025). Barrier cream use in the Skin Protection group was incorporated in the daily routine very well from the start and reached 100% at the end of the examination period (4th FU). At this time, only 3.2% of the controls used barrier creams. The level of acceptance of protective gloves (4th FU: Skin Protection group 43.3%; controls 32.3%) was considerably lower than that of barrier creams. The initial level of regular Skin care was high in both groups (Skin Protection group 67.6%, controls 61.7%). After the intervention the acceptance of Skin care rose to 88.9% in the Skin Protection group compared to 68.1% in the controls (4th FU). The present study has shown that Skin Protection and Skin care measures can be introduced successfully in the daily routine of a Skin risk occupation and high uptake and maintenance rates can be achieved.