Effectiveness of skin protection measures in prevention of occupational hand eczema: results of a prospective randomized controlled trial over a follow-up period of 1 year.
BACKGROUND
We recently found a very low adherence to a generally recommended skin protection regimen in a sample of 1355 metalworkers.


OBJECTIVE
The present study assessed the effectiveness of skin protection as presently recommended, especially the differential contribution of skin care and skin protection, to the prevention of occupational hand eczema. Methods Of 1355 metalworkers screened, 1020 male volunteers, all fit for work, were recruited for a prospective intervention study with four arms (skin care, skin protection, both combined, and control group, i.e. no recommendation). The study was performed from winter 2006/2007 to spring 2008, following each subject for up for 12 months. Both hands were examined using a quantitative skin score, and a standardized personal interview was performed three times. The change of the objective skin score from baseline to 12 months was used as primary outcome measure.


RESULTS
After 12 months 800 subjects were included (78.4% of those recruited). The compliance to follow the randomized measure depended on the recommended measure and ranged from 73.7% to 88.7%. While in the control group a significant deterioration was found, the largest and significant improvement was noted in the group following the generally recommended skin protection programme (skin care + skin protection) followed by skin protection alone as second best.


CONCLUSIONS
The generally recommended skin protection regimen seems to provide effective prevention of occupational skin disease. Therefore, the compliance to follow the skin protection regimen, especially the use of skin protection, should be enhanced.
Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University of Erlangen-Nuremberg, D-91054 Erlangen, Germany. birgitta.kuetting@ipasum.uni-erlangen.de
B
B
Kütting
T
T
Baumeister
W
W
Weistenhöfer
A
A
Pfahlberg
W
W
Uter
H
H
Drexler
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D009783:Dermatitis, Occupational / Q000517:prevention & control*; D005500:Follow-Up Studies; D005858:Germany; D006229:Hand Dermatoses / Q000517:prevention & control*; D006235:Hand Disinfection; D006801:Humans; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D009824:Ointments / Q000008:administration & dosage*; D010349:Patient Compliance / Q000706:statistics & numerical data; D011446:Prospective Studies; D017592:Skin Care / Q000379:methods*; D013223:Statistics as Topic; D016896:Treatment Outcome; D055815:Young Adult
D009824:Ointments