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      Self-report occupational-related contact dermatitis: prevalence and risk factors among healthcare workers in Gondar town, Northwest Ethiopia, 2018—a cross-sectional study

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          Abstract

          Background

          Occupational skin diseases are the second most common occupational diseases and are responsible for an estimated 25% of all lost work days. Occupational contact dermatitis (OCD) comprises 70–90% of all occupational skin diseases. In Ethiopia, information about the prevalence and factors which determine developments of contact dermatitis is not recognized. The objective of this study was to investigate prevalence and factors influencing the occurrences of occupational-related contact dermatitis among healthcare workers in Gondar town, Northwest Ethiopia.

          Methods

          We employed a healthcare-based cross-sectional study from March to April 2018. A stratified sampling method followed by simple random sampling method was used to select 422 participants. The standardized Nordic Occupational Skin Questionnaire was pretested and interviewer-administered for data collection. We used SPSS version 20 to conduct a binary logistic regression analysis. We set ≤ 0.05 p value to ascertain significance and 95% CI with odds ratios to evaluate the strength of associations.

          Results

          Response rate was 100%. The majority, 52.4% ( N = 221), were males. The mean age was 22.6 (SD ± 6.3) years. The overall prevalence of self-report occupational contact dermatitis in the previous 12 months was 31.5% ( N = 133) [95% CI (27, 36.2)]. The highest symptoms indicated was redness, 28.5% ( n = 38), followed by burning, 17.3% ( n = 23). The hand is the most commonly affected body sites, 22% ( N = 93). Hand washing frequency [AOR 1.80, 95% CI (1.10, 3.20)], pairs of hand gloves used per day [AOR 3.22, 95% CI (2.05, 5.87)], personal history of allergy [AOR 2.37, 95% CI (1.32, 4.61)], and lack of health and safety training [AOR 2.12, 95% CI (1.12, 2.25)] were factors considerably associated with contact dermatitis.

          Conclusions

          The prevalence of occupational-induced contact dermatitis is common among healthcare workers in Ethiopia. Therefore, our finding indicates that intervention aiming at workers’ health and safety training demands urgent public health responses to tackle the ailment. The result also demonstrates that healthcare workers should be aware of when and how hands should be washed. The number of pairs of gloves used per day should also be taken into consideration while devising prevention strategies.

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          Most cited references27

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          Enhanced expression levels of IL-31 correlate with IL-4 and IL-13 in atopic and allergic contact dermatitis.

          IL-31 is produced by activated T lymphocytes, preferentially by TH2 cells. Transgenic mice overexpressing IL-31 have a phenotype resembling allergic dermatitis in human subjects. We sought to evaluate the potential importance of IL-31 in the pathogenesis of human T cell-mediated skin diseases. We analyzed total RNA taken from 149 skin biopsy specimens from patients with atopic dermatitis (AD), allergic contact dermatitis (ACD), or psoriasis in comparison with specimens taken from patients with healthy skin (n = 13) by using quantitative real-time PCR for the expression of TH1/TH2 cytokines. We found statistically increased mRNA levels of IL-31 in biopsy specimens taken from patients with AD, irrespective of the severity of the disease and serum IgE levels. Moreover, IL-31 mRNA levels were strongly increased in many biopsy specimens taken from patients with ACD. However, no increased transcription of IL-31 could be detected in biopsy specimens taken from psoriatic plaques. A comparison of mRNA levels of IL-31 with TH1 or TH2 cytokines demonstrates a correlation of the expression of IL-31 with IL-4 and IL-13 but not with IFN-gamma. No significant increase of IL-31 receptor mRNA could be detected in any disease, whereas the second receptor subunit of IL-31, the oncostatin M receptor, seems to be enhanced transcribed in patients with psoriasis. IL-31 expression is not only increased in patients with AD but also in those with ACD, 2 pruritic skin disorders. In both types of eczema, expression of IL-31 is associated with the expression of the TH2 cytokines IL-4 and IL-13. IL-31 might contribute not only to the development of AD but also to ACD-provoked skin inflammation.
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            Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure.

            Occupational skin diseases are among the most frequent work-related diseases in industrialized countries. Good occupational skin disease statistics exist in few countries. Questionnaire studies are needed to get more data on the epidemiology of occupational skin diseases. The Nordic Occupational Skin Questionnaire Group has developed a new questionnaire tool - Nordic Occupational Skin Questionnaire (NOSQ-2002) - for surveys on work-related skin disease and exposures to environmental factors. The 2 NOSQ-2002 questionnaires have been compiled by using existing questionnaires and experience. NOSQ-2002/SHORT is a ready-to-use 4-page questionnaire for screening and monitoring occupational skin diseases, e.g. in a population or workplace. All the questions in the short questionnaire (NOSQ-2002/SHORT) are included in the long version, NOSQ-2002/LONG, which contains a pool of questions to be chosen according to research needs and tailored to specific populations. The NOSQ-2002 report includes, in addition to the questionnaires, a comprehensive manual for researchers on planning and conducting a questionnaire survey on hand eczema and relevant exposures. NOSQ-2002 questionnaires have been compiled in English and translated into Danish, Swedish, Finnish and Icelandic. The use of NOSQ-2002 will benefit research on occupational skin diseases by providing more standardized data, which can be compared between studies and countries.
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              Wet-work Exposure: A Main Risk Factor for Occupational Hand Dermatitis

              Wet-work can be defined as activities where workers have to immerse their hands in liquids for >2 hours per shift, or wear waterproof (occlusive) gloves for a corresponding amount of time, or wash their hands >20 times per shift. This review considers the recent literature on wet-work exposure, and examines wet-work as a main risk factor for developing irritant contact dermatitis of the hands. The aim of this paper is to provide a detailed description of wet-work exposure among specific occupational groups who extensively deal with water and other liquids in their occupations. Furthermore, it highlights the extent and importance of the subsequent adverse health effects caused by exposure to wet-work.
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                Author and article information

                Contributors
                +251-927-474-924 , tajan2022@gmail.com
                dawitgetachew105@gmail.com
                beyenemindaye2008@gmail.com
                Journal
                Environ Health Prev Med
                Environ Health Prev Med
                Environmental Health and Preventive Medicine
                BioMed Central (London )
                1342-078X
                1347-4715
                14 February 2019
                14 February 2019
                2019
                : 24
                : 11
                Affiliations
                ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, , University of Gondar, ; P.O. Box 196, Gondar, Ethiopia
                Article
                765
                10.1186/s12199-019-0765-0
                6376784
                30764759
                3fc6f6de-549f-4535-a319-3846c414bda3
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 September 2018
                : 30 January 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Occupational & Environmental medicine
                occupational-related contact dermatitis,healthcare workers,self-report,ethiopia

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