Evaluation of the secondary and tertiary prevention strategies against occupational contact dermatitis in Germany: A systematic review

Abstract

In Germany, a stepwise multidisciplinary approach has been established to prevent occupational skin diseases (OSDs), primarily occupational contact dermatitis. This review aims to perform a systematic evaluation of the short‐ and long‐term effects of the German secondary and tertiary individual prevention programmes (SIP and TIP, respectively) for OSDs. Primary outcomes were continuation of employment, severity of hand dermatitis, and quality of life (QoL). The PubMed and Embase databases were searched for studies reporting the effects of the SIP and TIP. A total of 19 studies encompassing 5527 patients with OSDs were included: 11 studies evaluated the SIP and 8 evaluated the TIP. Following the SIP, approximately 70% to 90% and 60% to 70% of patients remained in their occupation after 1 and 5 years, respectively. At 3 years after the TIP, 82.7% of patients remained in their occupation and exhibited a significant decrease in hand dermatitis severity, as well as an increase in QoL. Most of these studies were uncontrolled and the interventions, outcomes, and measurement instruments used were heterogeneous. The SIP and TIP lead to decreased disease severity, improved QoL, and enabled most patients to continue working in their chosen professions. Implementing a similar multidisciplinary approach across Europe may be beneficial.

Irritant potential of different washing procedures used for heavy‐duty soiling: Short and intense or longer and mild?

“…33 Our results are important for future preventive measures and should be communicated in preventive occupational check-up's and health educational seminars. 2,[34][35][36] Hand washing is an important factor for development of IHE that is responsible for about 80% of occupational skin diseases. 37,38 The findings corroborate the recommendation to use mild cleansers even when heavy soiling is present.…”

A nationwide skin protection program introduced in hairdressing vocational schools was followed by a decreased risk of occupational hand eczema

“…Prevention of occupational hand eczema in hairdressers have so far mainly focused on secondary and tertiary prevention. In Germany, a tertiary individual prevention program (TIP) has since 1994 been offered to patients, including hairdressers with OHE 17 . The TIP consists of a combination of inpatient rehabilitation and long‐term outpatient dermatological treatment and support.…”

“…In Germany, a tertiary individual prevention program (TIP) has since 1994 been offered to patients, including hairdressers with OHE. 17…”

Programme for prevention of foot dermatoses in patients with work‐related skin diseases: Baseline data and first results of a prospective cohort study (OCCUPES)

“…4 In Germany, a multi-step intervention approach funded by the statutory accident insurance has been established to reduce the burden of WRSD. [5][6][7] It is mainly directed at prevention of WRSD affecting the hands, but is covers also patients with WRSD of other body parts. Apart from outpatient treatment and diagnostics, patients with early or mild symptoms of WRSD are offered to participate in a secondary individual prevention programme (SIP) which usually involves an interprofessional outpatient skin protection seminar with emphasis on health education.…”

“…7 Patients with severe WRSD refractory to secondary prevention measures are invited to take part in the inpatient/ outpatient TIP which combines intensified treatment and health education. 7,8 Both, the secondary and tertiary prevention measure have been shown to be beneficial in terms of reducing the severity of hand dermatoses and improving the ability to work. 7 Nothing, however, is known about their efficacy in skin diseases of other body parts.…”