Characteristics of hand eczema in final‐year apprentice nurses during the COVID‐19 pandemic

Abstract

Background Apprentice nurses are considered at high risk to developing occupational skin diseases. Objectives This study assessed the frequency and origin of hand eczema, and work‐related risk factors in apprentice nurses. Methods The study involved 240 final‐year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months. Results Clinically observed and self‐reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin ( P = .001). Median OHSI was 4 (interquartile range 2‐6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel. Conclusions Hand eczema was common in final‐year apprentice nurses during the COVID‐19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier.

Skin barrier function in nursing apprentices during the coronavirus disease 2019 (COVID‐19) pandemic

“…According to their curriculum, practical work at healthcare facilities takes around half of the total teaching hours during the last 3 years of education. Collection of data on participants’ habits and skin symptoms was described in detail previously 12 . It was done under the prescribed epidemiological measures and consisted of implementation of questions from the Nordic Occupational Skin Questionnaire (NOSQ‐2002), 13 and clinical examination of skin on the hands by occupational physicians, scoring the skin changes with the validated Osnabrück Hand Eczema Severity Index (OHSI) 14,15 …”

“…This study is a part of the project investigating hand eczema among nursing apprentices in Croatia with a previously described protocol. 12 In brief, all 264 nursing apprentices from three vocational schools in the Croatian capital city, Zagreb, attending their final (fifth) year of education were invited to participate. All participants were aged 18 years or older, and gave their written informed consent to be included in the Due to the varying degree of epidemiological restrictions during the course of COVID-19 pandemic, recruitment and data collection were conducted in periods during November and December 2020 and from February to May 2021, when apprentices attended the classes in the schools and could be approached for assessments which were done in classrooms.…”

“…When investigating associations of work‐related exposure, personal factors should also be included in an analysis, because studies have shown significant associations of age, sex, and atopic status with parameters of skin barrier function 9,10 . Overall, there is a need for more studies investigating the simultaneous influence of several personal and work‐related factors in a real‐life setting of increased hand hygiene regimen, especially during the COVID‐19 pandemic, because the recent prevalence of hand dermatitis among healthcare workers was reported to be around 75% 11 and around 50% among nursing apprentices 12 …”

“…9,10 Overall, there is a need for more studies investigating the simultaneous influence of several personal and work-related factors in a real-life setting of increased hand hygiene regimen, especially during the COVID-19 pandemic, because the recent prevalence of hand dermatitis among healthcare workers was reported to be around 75% 11 and around 50% among nursing apprentices. 12 To address this need, the aim of our study was to investigate the associations of skin hazards relevant for healthcare workers including frequent hand washing, hand sanitizing, and prolonged glove use with parameters of skin barrier function among nursing apprentices attending the final year of their education during the COVID-19 pandemic.…”

“… 9 , 10 Overall, there is a need for more studies investigating the simultaneous influence of several personal and work‐related factors in a real‐life setting of increased hand hygiene regimen, especially during the COVID‐19 pandemic, because the recent prevalence of hand dermatitis among healthcare workers was reported to be around 75% 11 and around 50% among nursing apprentices. 12 …”