The present study was designed as an intervention study to investigate whether an educational programme was efficient in preventing work-related skin problems on the hands. 107 student auxiliary nurses (61 in the intervention group and 46 in the control group) were followed during the first 10 weeks of their initial practical training in county hospitals. The intervention group was given an educational programme before the practical training started. For evaluation the participants had questionnaires, clinical examination of the hands, measurement of transepidermal water loss (TEWL) and patch testing. The use of hand disinfectants, which was discouraged in the educational programme, was significantly lower in the intervention group as compared to the control group (p=0.002). 48% of the intervention group and 58% of the control group had aggravation of skin problems during practical training (p>0.05). Use of hand disinfectant agents was significantly associated with aggravation of skin problems (p=0.016). A significant increase in TEWL for the control group (p<0.005), but not for the intervention group, was seen after 10 weeks of practical training. In conclusion, the present intervention study shows promising results from the use of an educational programme.

Aims: To evaluate the effect of implementation of an evidence based skin care programme for wet work employees as part of an occupational health and safety management system. Methods: 375 wet work employees were included in a prospective randomised controlled trial, allocated to either intervention (n = 207) or control (n = 168). The intervention group was exposed to a skin care programme during the five month study period. The intervention included an educational programme for a group of frontline employees, who underwent formalised training, and subsequently introduced the information to their colleagues. As part of the intervention a skin care policy including written instructions was established at each workplace. Both groups answered a test quiz, completed questionnaires on behaviour and symptoms, and underwent clinical examination of their hands before and after the five month period. Results: No difference between the intervention and the control group was found at baseline with respect to clinical symptoms or behaviour. Evaluation after the five months of intervention revealed a significantly higher information level on skin care in the intervention group compared to the control group, a significant change in behaviour in the intervention group but not in the control group, and significantly less skin symptoms as evaluated clinically in the intervention group but not in the control group. No significant difference was found for self reported skin problems. Conclusions: The intervention was successful with respect to information level (knowledge), behaviour, and clinical symptoms. Implementation of a skin care programme as part of an occupational health and safety management system is recommended as a prophylactic measure for employees in wet occupations.

To evaluate the effects ofworking with modern insulation materials (rock and glass wool), the members of the Copenhagen Union of Insulation Workers were invited to participate in a study based on a health examination that included lung function tests. Three hundred and forty men (74%) agreed to participate, and 166 bus drivers served as the control group. Age distribution, height, and smoking habits were similar in the two groups. Forced vital capacity (FVC) and forced expiratory volume in one second (FEVy) were used as tests for lung function. There were no differences in FVC between the study and control groups, but the insulation workers had significantly lower values of FEV, (mean 2-5 1) compared with the controls (mean 3-4 1), independent of smoking habits. Six years before the present study, 114 of the insulation workers participated in a similar study, and eight years after the initial study, the lung function of 59 of the bus drivers was tested. The decline in FVC in insulation workers who smoked was significantly higher (7-7 cl/year) than in bus drivers who smoked (3-1 cl/year); the decline in FEV, was significantly higher in insulation workers independent of smoking habits (17-0 cl/year v 2-9 cl/year). Self assessed former exposure to asbestos was not associated with lung function in insulation workers. The study concludes that working with modern insulation materials is associated with increased risk of developing obstructive lung disease. ing extent to which insulation workers were able to protect themselves against effects of asbestos, a suspicion remained that insulation workers were still at risk of lung disease because of the exposure to other types of dust-for example, mineral wool.A Danish survey carried out in 1981 showed that the prevalence of chronic bronchitis was three times higher in insulation workers than in comparable groups.2 The survey also established a dose-response association between exposure to mineral wool and symptoms. A 1984 cross sectional study of insulation workers in Copenhagen showed that morning cough, chronic bronchitis, and episodes of acute bronchitis were three to four times more frequent among insulation workers compared with bus drivers (the control group).3 The lung function examinations showed that forced expiratory volume in one second (FEVI) was lower among insulation workers than among bus drivers aged 50 years and above. Forced vital capacity (FVC) decreased more with age in insulation workers than in bus drivers. Furthermore, the study showed through the obligatory x ray film of the thorax that asbestos related abnormalities showing on x ray film were found only in subjects who also had other symptoms such as coughing or difficulty in breathing.4 As this was a cross sectional study, however, the indicated fall in lung function was not an assessment of the real fall experienced by the individual insulation workers. Accordingly it was decided to undertake a follow up study.Exposure data Measurements of exposure to asbestos before 1972 are not availabl...

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