"HEALTHY HANDS". A pilot study for the prevention of chronic hand eczema in healthcare workers of an Italian University Hospital.

BACKGROUND: Healthcare workers are at risk for occupational chronic hand eczema (CHE), because of frequent hand washing and prolonged use of occlusive gloves. Prevention programs based on skin care education have been shown to be beneficial. We developed and assessed the efficacy of a skin care educational intervention for healthcare workers of our hospital. METHODS: The intervention consisted of two sessions, one week apart, each divided in a theoretical and a practical part, focusing on the skin barrier, types of eczema, risk factors for CHE, hand hygiene measures respectful of the skin, proper use of protective gloves and emollient creams. Its efficacy was assessed by a questionnaire, administered before and after the intervention, investigating the participants' knowledge of risk factors for CHE and risk behaviors. RESULTS: Twenty-three subjects, mostly (65.2%) nurses, took part in the intervention; 60.9% had a self reported atopic background and 65.2% participants reported a history of CHE. The intervention improved significantly the participants' knowledge on CHE risk factors, i.e. frequent hand washing (p-value= 0.023), surgical scrubbing (p-value = 0.016) and prolonged glove wearing (p-value = 0.022). The frequency of hand washing was significantly reduced (p-value = 0.022). The participants gave a positive unanimous feedback. CONCLUSIONS: Our intervention was effective, by significantly improving the participants' knowledge and by inducing significant behavioral changes. Improving the formulation of alcoholic hand rubs may be a key factor to encourage their use. Coexisting non-occupational risk behaviors are just as important in the prevention of CHE.