Hand dermatitis among university hospital nursing staff with or without atopic eczema: assessment of risk factors

Background. Nurses are prone to develop hand dermatitis. Although an atopic constitution has been identified as a genetic risk factor, the behavioural risk factors associated with hand dermatitis in wet work conditions have not been fully explored. Objectives. This study aimed to clarify the impact of atopic eczema (fulfilling the diagnostic criteria during the past 1 year) on the occurrence of hand dermatitis and to identify the behavioural risk factors among non‐atopic nurses with hand dermatitis. Methods. From August 2007 to July 2009, nurses from Kaohsiung Medical University Hospital were recruited. The associations between different risk factors and hand dermatitis were documented. In addition, the behavioural risk factors among non‐atopic nurses were evaluated via observational study. Results. One thousand one hundred and thirty‐two nurses participated in the first part of the study, which revealed that individuals with atopic eczema had a 3.76‐fold increased risk for hand dermatitis. However, among 248 nurses with hand dermatitis, only 43 had atopic eczema. The observational study performed on 140 non‐atopic nurses identified frequency of hand washing as the behavioural risk factor associated with hand dermatitis. Conclusions. Although atopic eczema is the major risk factor for hand dermatitis, those with atopic eczema constitute only 17% of nurses with hand dermatitis. Decreasing hand washing frequency is the most effective strategy to reduce the occurrence of hand dermatitis among non‐atopic nurses.