Hand eczema in healthcare workers: a questionnaire survey of risk factors and work-related exposures

Recent data on the prevalence and causes of hand eczema among healthcare workers in Sweden are lacking. Multidrug-resistant bacteria have necessitated improved hand hygiene and preventive measures. This has led to an increase in the use of disposable rubber gloves and hand disinfectants, which might influence the risk of hand eczema. Our aims were to identify healthcare workers with hand eczema; to estimate quantitative and qualitative exposure to rubber gloves, hand disinfectants and other exposures; and to survey constitutional factors. An electronic questionnaire was distributed to all employees at the hospitals in southern Sweden. The results were statistically analysed using χ2-tests and binary logistic regression. The 1-year prevalence of self-reported hand eczema was 20% among the responding 9051 nurses and physicians. On a daily basis, 30% reported hand washing >20 times at work, 45% reported using hand disinfectants >50 times, and 28% used >20 pairs of nonsterile rubber gloves. The prevalence of hand eczema was significantly higher among the employees reporting a higher exposure to hand washing, hand disinfectants and rubber gloves than in those reporting a lower exposure. The prevalence of hand eczema was also significantly higher among respondents with a history of childhood eczema, who were smokers, who had a body mass index >30 kgm-2, who spent >30 min per day working in the kitchen or who had children aged