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Determinants of work-related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in Southern Africa

Background: Cleaning products and related agents are increasingly associated with occupational irritant and allergic contact dermatitis in health workers (HWs), but limited information is available on predictors for these outcomes. This study investigated the prevalence and risk factors for work-rel...

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Main Author: Sonday, Zahida
Other Authors: Jeebhay, Mohamed
Format: Thesis
Language:Eng
Published: Department of Public Health and Family Medicine 2024
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access_status_str Open Access
author Sonday, Zahida
author2 Jeebhay, Mohamed
author_browse Jeebhay, Mohamed
Sonday, Zahida
author_facet Jeebhay, Mohamed
Sonday, Zahida
author_sort Sonday, Zahida
collection Thesis
description Background: Cleaning products and related agents are increasingly associated with occupational irritant and allergic contact dermatitis in health workers (HWs), but limited information is available on predictors for these outcomes. This study investigated the prevalence and risk factors for work-related skin symptoms (WRSS) and skin disease phenotypes in HWs exposed to diverse cleaning agents in two Southern African tertiary hospitals. Methods: A cross-sectional study of 697 HWs used an interviewer administered questionnaire and assessed the presence of atopy using Phadiatop. Results: The median age of HWs was 42 years (IQR: 32 – 51), 77.0% were female and 42.5% were atopic. The lifetime prevalence of WRSS was 18.7% and WRSS in the last 12 months was slightly lower (14.8%). Among the skin disease phenotypes, 12.3% had probable contact dermatitis and 3.2% probable contact urticaria. In multivariate regression models, adjusted for family history of allergy and domestic cleaning frequency, technicians (ORadj 4.45, 95% CI: 1.21-21.48) and work activities involving cleaning and disinfection of skin wounds (ORadj 2.70, 95% CI: 1.64-4.57) was associated with WRSS in the past year. A consistent trend was observed for job tasks and cleaning agents related to these work activities. Risk factors for probable contact dermatitis included the use of liquid hand soap (ORadj 1.67, 95% CI: 1.03- 2.72), sterilising instruments manually (ORadj 1.94, 95% CI: 1.15-3.19) or automatically (ORadj 3.28, 95% CI: 1.01-9.32), disinfecting skin prior to procedures (ORadj 2.29, 95% CI: 1.45-3.66) and the use of adhesives for wounds (ORadj 1.91, 95% CI: 1.20-3.07). Risk factors for probable contact urticaria included specimen preparation (ORadj 2.65, 95% CI: 1.06-6.38) and wound cleaning and disinfection (ORadj 3.10, 95% CI: 1.24-8.81). Training on protection against adverse health effects of cleaning agents (ORadj 0.54, 95% CI: 0.31-0.89) was protective against WRSS in the past year. Conclusion: Workplace activities and related factors associated with cleaning and disinfecting of patients' skin and wounds are important risk factors for WRSS in HWs. Training on the adverse health effects of cleaning agents can contribute to decreasing risks in HWs. Keywords: health workers, skin symptoms, cleaning agents
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institution University of Cape Town (South Africa)
language Eng
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2024
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spelling oai:open.uct.ac.za:11427/40208 Determinants of work-related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in Southern Africa Sonday, Zahida Jeebhay, Mohamed Baatjies Roslynn Public Health and Family Medicine Background: Cleaning products and related agents are increasingly associated with occupational irritant and allergic contact dermatitis in health workers (HWs), but limited information is available on predictors for these outcomes. This study investigated the prevalence and risk factors for work-related skin symptoms (WRSS) and skin disease phenotypes in HWs exposed to diverse cleaning agents in two Southern African tertiary hospitals. Methods: A cross-sectional study of 697 HWs used an interviewer administered questionnaire and assessed the presence of atopy using Phadiatop. Results: The median age of HWs was 42 years (IQR: 32 – 51), 77.0% were female and 42.5% were atopic. The lifetime prevalence of WRSS was 18.7% and WRSS in the last 12 months was slightly lower (14.8%). Among the skin disease phenotypes, 12.3% had probable contact dermatitis and 3.2% probable contact urticaria. In multivariate regression models, adjusted for family history of allergy and domestic cleaning frequency, technicians (ORadj 4.45, 95% CI: 1.21-21.48) and work activities involving cleaning and disinfection of skin wounds (ORadj 2.70, 95% CI: 1.64-4.57) was associated with WRSS in the past year. A consistent trend was observed for job tasks and cleaning agents related to these work activities. Risk factors for probable contact dermatitis included the use of liquid hand soap (ORadj 1.67, 95% CI: 1.03- 2.72), sterilising instruments manually (ORadj 1.94, 95% CI: 1.15-3.19) or automatically (ORadj 3.28, 95% CI: 1.01-9.32), disinfecting skin prior to procedures (ORadj 2.29, 95% CI: 1.45-3.66) and the use of adhesives for wounds (ORadj 1.91, 95% CI: 1.20-3.07). Risk factors for probable contact urticaria included specimen preparation (ORadj 2.65, 95% CI: 1.06-6.38) and wound cleaning and disinfection (ORadj 3.10, 95% CI: 1.24-8.81). Training on protection against adverse health effects of cleaning agents (ORadj 0.54, 95% CI: 0.31-0.89) was protective against WRSS in the past year. Conclusion: Workplace activities and related factors associated with cleaning and disinfecting of patients' skin and wounds are important risk factors for WRSS in HWs. Training on the adverse health effects of cleaning agents can contribute to decreasing risks in HWs. Keywords: health workers, skin symptoms, cleaning agents 2024-07-02T10:14:28Z 2024-07-02T10:14:28Z 2023 2024-06-04T13:53:10Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/40208 Eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences
spellingShingle Public Health and Family Medicine
Sonday, Zahida
Determinants of work-related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in Southern Africa
thesis_degree_str Master's
title Determinants of work-related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in Southern Africa
title_full Determinants of work-related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in Southern Africa
title_fullStr Determinants of work-related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in Southern Africa
title_full_unstemmed Determinants of work-related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in Southern Africa
title_short Determinants of work-related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in Southern Africa
title_sort determinants of work related skin symptons and dermatitis associated with cleaning agents among health workers of two tertiary hospitals in southern africa
topic Public Health and Family Medicine
url http://hdl.handle.net/11427/40208
work_keys_str_mv AT sondayzahida determinantsofworkrelatedskinsymptonsanddermatitisassociatedwithcleaningagentsamonghealthworkersoftwotertiaryhospitalsinsouthernafrica