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Skin Health of Health Care Workers

      Although the connection between skin health and hand hygiene is rather obvious, the infection control literature contains scant information about the skin properties of health care workers. Perhaps this is due in part to the complexity of the topic, because skin health is affected by many factors that are uncontrollable, such as age, season, and geographic locale. Nonetheless, it has also been suggested that skin health is influenced greatly by the products that are used for hand hygiene practices, and this topic deserves some added focus.
      Poor skin condition is potentially due at least in some measure to a combination of environmental factors and frequent hand hygiene practices. Skin damage is a well-recognized factor that contributes to the poor compliance rates for hand hygiene. The article by Kaiser and Newman
      • Kaiser N.E.
      • Newman J.L.
      Formulation technology as a key component in improving hand hygiene practices.
      explains the complexity of advanced formulation technology and how it can lead to products that can potentially reduce or eliminate damage resulting from frequent hand hygiene practices. These technologies also enable innovative strategies for hand hygiene practices and can be a part of the solution for compliance improvement, an imperative in today's health care environments.
      To most effectively use these technologies, it is important for formulation chemists and users to understand the science behind the interaction of formulations with the skin. Wickett and Visscher
      • Wicket R.R.
      • Vischer M.O.
      Structure and function of the epidermal barrier.
      provide insight into the complexity of skin, the largest organ of the body. They provide the knowledge of fundamental skin science that can help decision makers recognize the importance of the formulations they use for hand hygiene. Health care workers can also learn how to better care for their skin by using proper skin care at work and at home.
      The report by Visscher et al
      • Visscher M.
      • Canning J.
      • Said D.
      • Wickett R.
      • Bondurant P.
      Effect of hand hygiene regimens on skin condition in health care workers.
      shows how a set of products can potentially produce a better skin health outcome. A number of studies have convincingly shown that one individual product can be milder than another. However, few studies have looked at the interaction of several products recommended for use by health care workers—cleansers, alcohol-based hand sanitizers, and lotions. This is due to the stringent research requirements of properly conducted scientific studies of multiple products in the health care environment.
      • Boyce J.M.
      • Kelliher S.
      • Vallande N.
      Skin irritation and dryness associated with two hand-hygiene regimens: soap-and-water hand washing versus hand antisepsis with an alcoholic hand gel.
      • Larson E.
      • Silberger M.
      • Jakob K.
      • Whittier S.
      • Lai L.
      • Della Latta P.
      • et al.
      Assessment of alternative hand hygiene regimens to improve skin health among neonatal intensive care unit nurses.
      • Larson E.L.
      • Aiello A.E.
      • Bastyr J.
      • Lyle C.
      • Stahl J.
      • Cronquist A.
      • et al.
      Assessment of two hand hygiene regimens for intensive care unit personnel.
      • Lauharanta J.
      • Ojajarvi J.
      • Sarna S.
      • Makela P.
      Prevention of dryness and eczema of the hands of hospital staff by emulsion cleansing instead of washing with soap.
      The Visscher study
      • Visscher M.
      • Canning J.
      • Said D.
      • Wickett R.
      • Bondurant P.
      Effect of hand hygiene regimens on skin condition in health care workers.
      shows that a regimen of products used together can provide a better outcome for the health care worker.

      References

        • Kaiser N.E.
        • Newman J.L.
        Formulation technology as a key component in improving hand hygiene practices.
        Am J Infect Control. 2006; 34: S82-S97
        • Wicket R.R.
        • Vischer M.O.
        Structure and function of the epidermal barrier.
        Am J Infect Control. 2006; 34: S98-S110
        • Visscher M.
        • Canning J.
        • Said D.
        • Wickett R.
        • Bondurant P.
        Effect of hand hygiene regimens on skin condition in health care workers.
        Am J Infect Control. 2006; 34: S111-S123
        • Boyce J.M.
        • Kelliher S.
        • Vallande N.
        Skin irritation and dryness associated with two hand-hygiene regimens: soap-and-water hand washing versus hand antisepsis with an alcoholic hand gel.
        Infect Control Hosp Epidemiol. 2000; 21: 442-448
        • Larson E.
        • Silberger M.
        • Jakob K.
        • Whittier S.
        • Lai L.
        • Della Latta P.
        • et al.
        Assessment of alternative hand hygiene regimens to improve skin health among neonatal intensive care unit nurses.
        Heart Lung. 2000; 29: 136-142
        • Larson E.L.
        • Aiello A.E.
        • Bastyr J.
        • Lyle C.
        • Stahl J.
        • Cronquist A.
        • et al.
        Assessment of two hand hygiene regimens for intensive care unit personnel.
        Crit Care Med. 2001; 29: 944-951
        • Lauharanta J.
        • Ojajarvi J.
        • Sarna S.
        • Makela P.
        Prevention of dryness and eczema of the hands of hospital staff by emulsion cleansing instead of washing with soap.
        J Hosp Infect. 1991; 17: 207-215