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.

Aims: To evaluate the effect of an intervention to reduce work related skin problems in gut cleaning departments in Danish swine slaughterhouses. The intervention consisted of an evidence based prevention programme and a documented method for implementation. Methods: Randomised controlled intervention study with a one year follow up. The intervention included educational activities and evidence based recommendations. The effect of the intervention was evaluated by telephone interviews using a standardised questionnaire based on the Nordic Occupational Skin Questionnaire (NOSQ-2002) with modified and additional questions on exposure, preventive measures, information, and discussions on prevention of skin problems, etc. Results: A total of 644 (87.5%) responded at the baseline interview and 622 (71.6%) at the one year follow up interview. A total of 495 participated in both interviews (67.3%). In the intervention departments the frequency of eczema on hands or forearms within the past three months at follow up was reduced significantly from 56.2% at baseline to 41.0% at follow up, while a slight non-significant increase was observed in the comparison departments (from 45.9% to 50.2%). The intervention activities resulted in more frequent use of protective gloves in general and the use of cotton gloves worn underneath rubber and plastic gloves. At follow up three times as many in the intervention departments used the recommended high fat skin care products introduced as part of the intervention activities. At follow up, discussion of skin problems was increased in the intervention group while no changes were observed in the comparison group. Conclusions: A significant 27% relative reduction of occupational eczema in a high risk group was feasible through implementation of an evidence based prevention programme.F or many years occupational skin diseases have been the most frequent recognised work related diseases in many industrialised countries. 1 2 Despite considerable knowledge on risk factors and prevention of occupational skin diseases obtained from clinical, epidemiological, and experimental studies, the eczema frequency in the working population remains high and has even increased in some populations. [2][3][4] Occupational skin diseases are often chronically relapsing, 5 they affect workers early in their working age, 3 6 impair their health related quality of life, and the social and economic impacts are often severe. 7-9 Wet work occupations, such as the healthcare sector and the food processing industry represent major risk groups. 6 A study from Japan made in 1983 found skin symptoms in 65.1% of 527 workers in four poultry slaughterhouse workers: most symptoms were caused by wet work. 10 Different kinds of evidence based prevention programmes have with more or less success been introduced in different occupations. [11][12][13][14][15] The working conditions in the food processing industry often involve wet work, various skin irritants, allergens (from, for example, foods, soaps, and disinfectants), and h...

Study objective-To examine the association between intake of diVerent types of alcoholic beverages and self reported subjective health. Design-Cross sectional health survey with assessment of intake of beer, wine and spirits (at last non-weekend day), smoking habits, social networks, physical activity, body mass index, educational level, presence of chronic disease, and self reported health. Setting-WHO Copenhagen Healthy City Survey, Denmark. Participants-4113 men and 7926 women aged 18 to 100 years. Main results-Of the 12 039 subjects, 8680 reported their health as optimal, and 3359 reported a suboptimal health. After controlling for the covariates, the relation between total alcohol intake and the proportion reporting suboptimal health was J shaped. Heavy drinkers of any of the three types of alcoholic beverages had a higher prevalence of suboptimal health than non-drinkers. However, only light (1-2 glasses of wine yesterday) and moderate (3-5) wine drinkers had significantly lower odds ratios for suboptimal health-0.72 (95% confidence limits; 0.56 to 0.92) and 0.65 (0.49 to 0.87), respectively-when compared with non-wine drinkers. Moderate beer or spirits drinkers did not differ significantly from non-drinkers of these beverages with regard to prevalence of suboptimal health. Consistently, beer preference drinkers had an odds ratio of 1.50 (1.25 to 1.80) for suboptimal health compared with wine preference drinkers. Conclusions-A light to moderate wine intake is related to good self perceived health, whereas this is not the case for beer and spirits. The causal relations creating this association are unknown and should be considered when interpreting the relation between diVerent types of alcoholic beverages and subsequent morbidity and mortality. (J Epidemiol Community Health 1999;53:721-724)

The purpose of this study was to implement an evidence-based prevention programme to reduce occupational skin diseases in a wet work occupation by educational activities and elements from an occupational health-management system. The effects were studied by telephone interviews using a standardized questionnaire (NOSQ-2002) with trade-modified questions on work and exposure. The study population consisted of all employees at 5 cheese dairies. At baseline, October 2002, a total of 557 answered (83.8%). At follow up 1 year later, a total of 650 current and former employees answered (81.8%). At 4 of the 5 dairies, the eczema frequency at baseline was relatively low (11.8% and 5.9% at intervention dairies; 7.0%, 10.4% and 33.3% at comparison dairies). On all the studied dairies, about one-third of the workers reported having 2 or more skin symptoms at baseline. At follow up, skin symptoms were reduced significantly on all dairies. Effects restricted to the intervention dairies included significant increases in the use of gloves and moisturizers. The comparison dairy with high eczema frequency at baseline introduced skin-care products, changed hand soap and mowed employees with skin problems, away from adverse working areas during the intervention period, and the frequency of eczema was significantly reduced at follow up.

The study evidences that a combination of a top-down and a bottom-up implementation method is effective to reduce work-related skin problems, and that the process of implementation is a significant determinant of the overall results.