title: Long-term effectiveness of secondary prevention in geriatric nurses with occupational hand eczema: the challenge of a controlled study design.
abstract: BACKGROUND
  The high prevalence of occupational dermatoses indicates the need for effective and sustainable prevention strategies.
  
  
  OBJECTIVE
  To evaluate the long-term effectiveness of secondary prevention in geriatric nurses.
  
  
  METHODS
  One hundred and two geriatric nurses with occupational hand eczema participated in an interdisciplinary prevention programme [intervention group (IG)]. Members of the control group (CG) (n = 107) were medically treated by local dermatologists. Six years after intervention (T2), data on job continuation, skin lesions and skin protection behaviour were obtained by standardized questionnaires and compared with baseline values (T0) and data from a 3-month follow-up (T1).
  
  
  RESULTS
  At T2, 65.3% of the IG and 56.8% of the CG still worked as geriatric nurses; 6.9% of the IG and 13.6% of the CG had given up work because of occupational hand eczema. The skin status improved in both cohorts. The data indicated a lower frequency of skin lesions and morphological signs in the IG, for example vesicles (IG, 12.8%; CG, 40.0%; χ(2) = 7.00, degrees of freedom = 1, p = 0.008).
  
  
  CONCLUSIONS
  The results indicate long-term effects regarding job continuation and disease severity, although few results showed statistical significance. It is outlined that controlled long-term studies aiming at proving the general effectiveness of secondary prevention are no longer feasible in Germany, as the statutory accident insurance has led to a legal entitlement of all patients affected by occupational hand eczema to immediate preventive intervention.
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Sedanstrasse 115, 49090 Osnabrück, Germany. awilke@uos.de
authors.forename: Annika
authors.initials: A
authors.lastname: Wilke
authors.forename: Kathrin
authors.initials: K
authors.lastname: Gediga
authors.forename: Ulrike
authors.initials: U
authors.lastname: Weinhöppel
authors.forename: Swen Malte
authors.initials: SM
authors.lastname: John
authors.forename: Britta
authors.initials: B
authors.lastname: Wulfhorst
mesh_terms: D000328:Adult; D009783:Dermatitis, Occupational / Q000517:prevention & control*; D004485:Eczema / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D005851:Geriatric Nursing; D006229:Hand Dermatoses / Q000517:prevention & control*; D006801:Humans; D008297:Male; D015397:Program Evaluation; D012107:Research Design; D055502:Secondary Prevention / Q000379:methods*