Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.
Department of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Contact Dermatitis. 2018 Sep;79(3):149-156. doi: 10.1111/cod.13042. Epub 2018 Jun 20.
Hand eczema (HE) in healthcare workers (HCWs) is common. Besides wet work, healthcare work also implies exposure to contact allergens.
To assess HE and contact allergy related to occupational exposures in HCWs.
In a cross-sectional study, 311 HCWs with HE within the preceding 12 months and a control group of 114 HCWs without HE were investigated with the baseline series and a special patch test series based on substances found in the gloves, soaps, alcoholic hand disinfectants and hand creams provided at the hospitals.
Contact allergy to rubber additives was significantly more common in HCWs with HE (6%) than in HCWs without HE (1%, P = .02). The corresponding percentages for fragrances were 11% and 3%, respectively (P = .004). Occupational HE was found in 193 of 311 (62%) HCWs. Of these, 22 of 193 (11%) had occupational allergic contact dermatitis, including 17 with glove-related rubber contact allergy. Contact allergy to diphenylguanidine was as common as contact allergy to thiurams. Occupational contact allergy to rubber additives was significantly associated with sick-leave related to HE.
Contact allergy to rubber additives in medical gloves is the most common cause of occupational allergic contact dermatitis in HCWs. Aimed patch testing with relevant rubber additives is mandatory when HE in HCWs is investigated.
医护人员（HCWs）手部湿疹（HE）很常见。除了接触水，医护工作还会接触到接触性过敏原。
评估与职业暴露相关的 HE 和接触过敏在 HCWs 中的情况。
在一项横断面研究中，对 311 名在过去 12 个月内患有手部湿疹的 HCWs 和 114 名没有手部湿疹的 HCWs 进行了调查，使用基线系列和特殊斑贴试验系列，基于手套、肥皂、酒精手部消毒剂和医院提供的护手霜中发现的物质。
手部湿疹的 HCWs 中接触橡胶添加剂过敏的比例（6%）明显高于没有手部湿疹的 HCWs（1%，P = 0.02）。对香料的相应比例分别为 11%和 3%（P = 0.004）。在 311 名 HCWs 中有 193 名（62%）患有职业性手部湿疹。其中，193 名中有 22 名（11%）患有职业性过敏性接触性皮炎，包括 17 名与手套相关的橡胶接触过敏。对二苯胍的接触过敏与硫脲类接触过敏一样常见。职业性接触橡胶添加剂与与手部湿疹相关的病假显著相关。
医用手套中的橡胶添加剂接触过敏是 HCWs 职业性过敏性接触性皮炎最常见的原因。当调查 HCWs 的手部湿疹时，有必要进行针对性的橡胶添加剂斑贴试验。
