Skin protection in the healthcare setting.

Professions of the healthcare setting are at high risk for occupational skin diseases. Irritant and allergic contact dermatitis of the hands frequently occurs, whereas contact urticaria and hospital-acquired infections are less common. Wet work and irritant exposure are frequent due to hand hygiene which is indispensable with regard to prevention of crossinfections. In the healthcare setting, protection gloves are frequently used alternating with protection creams. Since the use of occlusive protection gloves has adversary effects on the skin barrier, use times have to be limited. Furthermore, a 3-step concept consisting of skin protection before work, cleaning and skin care after work is one of the generally recommended measures to prevent occupational contact dermatitis. Recently, educational programmes for skin protection as measure of primary, secondary and tertiary prevention of occupational skin diseases have been effectively introduced in the healthcare setting. The effectiveness of skin care programmes is based on 3 factors: the effectiveness of the products used, the frequency of the application and, finally, the effectiveness of the education (reduction of exposure to skin-damaging substances). For the identification of contact allergens in healthcare workers with hand dermatitis, supplementary work-specific series as well as substances used at work should be patch-tested in addition to the standard series.