Improved hand-hygiene compliance may pose hidden danger

Healthcare providers' emphasis on improving hand hygiene among workers may also be increasing dermatitis, according to a study from the University of Manchester.

Researchers, led by Jill Stocks, Ph.D., analyzed United Kingdom dermatologists' reports submitted to a national database between 1996 and 2012. This database, designed to document skin problems caused or exacerbated in the workplace, was used by 60 percent of eligible dermatologists.

Of 7,138 reported cases of irritant contact dermatitis, 1,796 were healthcare workers, according to Stocks and her team. At an annual level, healthcare workers were 4.5 times more likely to develop the condition in 2012 compared to 1996. Incidence of dermatitis either declined or remained flat in two control groups.

This increased risk may work against the goals of hand-hygiene protocols, as previous research indicates damaged or broken skin can carry infections longer, according to a statement about the study.

The increase tracked closely with the U.K.'s National Health Service campaign to improve hand hygiene among healthcare workers. U.S. providers have made similar efforts to reduce hospital-acquired infections (HAIs) such as methicillin-resistant Staphylococcus aureus. However, a December study called for further research into the causes of HAIs, suggesting a meaningful solution may require more than improved hand hygiene.

"Campaigns to reduce these infections have been very successful and many lives have been saved. However, we need to do all we can to prevent skin irritation among these frontline workers," Stock said in a statement. "Obviously we don't want people to stop washing their hands, so more needs to be done to procure less irritating products and to implement practices to prevent and treat irritant contact dermatitis."

Further complicating the issue of hand hygiene, a survey last October found hand-washing compliance rates are lower than reported, with just 44 percent of respondents saying they followed the Centers for Disease Control and Prevention and World Health Organization hand-hygiene guidelines, FierceHealthcare previously reported.

"While there are gaps in the measurement and reporting of hand-hygiene compliance throughout hospitals, and facilities face stretched budgets and priorities, there is a clear increase in awareness of and commitment to better practices," said Heather McLarney, spokeswoman for DebMed, the hand-hygiene product company that conducted the survey.

To learn more:
- read the study abstract
- here's the statement

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