title: Winter season, frequent hand washing, and irritant patch test reactions to detergents are associated with hand dermatitis in health care workers.
abstract: BACKGROUND
  Irritant hand dermatitis (IHD) is common in health care workers.
  
  
  OBJECTIVE
  We studied endogenous irritant contact dermatitis threshold by patch testing and exogenous factors such as season and hand washing for their association with IHD in health care workers.
  
  
  METHODS
  Irritant patch testing with sodium lauryl sulfate (SLS), sodium hydroxide, and benzalkonium chloride at varying concentrations was measured in 113 health care workers. Examination for hand dermatitis occurred at 1-month intervals for a period of 6 months in the Midwestern United States.
  
  
  RESULTS
  Positive patch testing to low-concentration SLS was associated with IHD (P = 0.0310) after adjusting for age, sex, ethnicity, season, history of childhood flexural dermatitis, mean indoor relative humidity, and glove and hand sanitizer usage. Subjects with a positive patch test to SLS were 78% more likely to have occurrence of IHD (incidence rate ratio [IRR] = 1.78; 95% confidence interval [CI], 0.92-3.45). Hand washing frequency (≥10 times a day; IRR = 1.55; 95% CI, 1.01-2.39) and cold season (IRR = 2.76; 95% CI, 1.35-5.65) were associated with IHD. No association was found between history of childhood flexural dermatitis and IHD in this population.
  
  
  CONCLUSIONS
  Both genetic and environmental factors are important in the etiology of IHD and should be considered in designing strategies to protect, educate, and treat susceptible individuals.
authors.affiliation: Department of Dermatology, University Hospitals, Cleveland, OH 44106-5028, USA.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Callahan
authors.forename: Elma
authors.initials: E
authors.lastname: Baron
authors.forename: Desta
authors.initials: D
authors.lastname: Fekedulegn
authors.forename: Michael
authors.initials: M
authors.lastname: Kashon
authors.forename: Berran
authors.initials: B
authors.lastname: Yucesoy
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Johnson
authors.forename: Diana Santo
authors.initials: DS
authors.lastname: Domingo
authors.forename: Brent
authors.initials: B
authors.lastname: Kirkland
authors.forename: Michael I
authors.initials: MI
authors.lastname: Luster
authors.forename: Susan
authors.initials: S
authors.lastname: Nedorost
mesh_terms: D000328:Adult; D000485:Allergens; D015984:Causality; D003080:Cold Temperature / Q000009:adverse effects; D009783:Dermatitis, Occupational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006229:Hand Dermatoses / Q000175:diagnosis* / Q000453:epidemiology*; D006235:Hand Disinfection; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D007509:Irritants; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D012621:Seasons; D012967:Sodium Dodecyl Sulfate; D055815:Young Adult
chemical_list: D000485:Allergens; D007509:Irritants; D012967:Sodium Dodecyl Sulfate