title: The three moments of skin cream application: an evidence-based proposal for use of skin creams in the prevention of irritant contact dermatitis in the workplace.
abstract: Contact dermatitis is one of the most common occupational diseases, with serious impact on quality of life, lost days at work and a condition that may be chronically relapsing. Regular prophylactic skin cream application is widely acknowledged to be an effective prevention strategy against occupational contact dermatitis; however, compliance rates remain low. To present a simple programme for skin cream application in the workplace with focus on implementation to drive down the rate of occupational irritant contact dermatitis, an expert panel of eight international dermatologists combined personal experience with extensive literature review. The recommendations are based on clinical experience as supported by evidence-based data from interventional studies. The authors identified three moments for skin cream application in the work place: (i) before starting a work period; (ii) after washing hands; and (iii) after work. Affecting behaviour change requires systematic communications, monitoring and reporting, which is proposed through Kotter's principles of organizational change management. Measurement tools are provided in the appendix. Interventional data based on application of this proposal is required to demonstrate its effectiveness.
authors.affiliation: Deb Group Ltd., Research & Development, Denby, Derbyshire, UK.
authors.forename: J
authors.initials: J
authors.lastname: Hines
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Wilkinson
authors.affiliation: Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Osnabrueck, Germany.
authors.forename: S M
authors.initials: SM
authors.lastname: John
authors.affiliation: Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany.
authors.forename: T L
authors.initials: TL
authors.lastname: Diepgen
authors.affiliation: Nottingham NHS Treatment Center, Nottingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: English
authors.affiliation: Department of Dermatology and Allergology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Rustemeyer
authors.affiliation: Hautarztzentrum Krefeld, Krefeld, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wassilew
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Kezic
authors.affiliation: Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
authors.forename: H I
authors.initials: HI
authors.lastname: Maibach
mesh_terms: D017453:Dermatitis, Irritant / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D007509:Irritants / Q000633:toxicity*; D063465:Skin Cream / Q000008:administration & dosage*; D017132:Workplace
chemical_list: D007509:Irritants