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Interventions for preventing occupational irritant hand dermatitis.

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Area of Science:

  • Dermatology
  • Occupational Health
  • Evidence-Based Medicine

Background:

  • Occupational irritant hand dermatitis (OIHD) significantly impacts workers' function and comfort.
  • Preventive measures like gloves, barrier creams, and moisturizers are used, but their effectiveness is uncertain.
  • This review updates a previous Cochrane review from 2010 on OIHD prevention.

Purpose of the Study:

  • To assess primary preventive interventions for OIHD in at-risk workers.
  • Evaluated physical (creams, moisturizers, gloves) and behavioral (education) strategies.
  • Focused on individuals without pre-existing hand dermatitis.

Main Methods:

  • Updated systematic search of multiple databases (Cochrane Skin, CENTRAL, MEDLINE, Embase) up to January 2018.
  • Included parallel and cross-over randomized controlled trials (RCTs) of barrier creams, moisturizers, gloves, or educational interventions.
  • Primary outcomes: signs/symptoms of OIHD and treatment discontinuation due to adverse effects.

Main Results:

  • Nine RCTs (2888 participants) were included; no studies on gloves met criteria.
  • Barrier creams showed a potential slight risk reduction (RR 0.87, low-quality evidence).
  • Moisturizers (RR 0.71) and combined creams/moisturizers (RR 0.68) suggested possible clinically important protective effects (low-quality evidence).
  • Skin protection education showed imprecise effects, with uncertainty about its effectiveness (RR 0.76, very low-quality evidence).

Conclusions:

  • Moisturizers, alone or combined with barrier creams, may offer clinically important protection against OIHD.
  • Evidence for barrier creams alone and skin protection education is limited and imprecise.
  • Insufficient evidence exists to confidently assess OIHD prevention effectiveness; further high-quality trials with standardized measures are needed.