Dermatitis: Occupational aspects of management 2009

This national guideline offers evidence-based advice on the management of dermatitis in the workplace. It provides advice on the risk of colonisation and transmission of infection from skin lesions, interventions to improve the condition of the skin, and workplace-based health surveillance for the early detection of symptoms and signs.

Key recommendations

For questions that addressed the risk of bacterial colonisation of dermatitis (in healthcare workers specifically), and interventions for managing dermatitis in a workplace setting, a small bdy of good-quality evidence was identified, appraised and synthesised. The evidence was sufficient to make graded recommendations to advise healthcare workers of an increased risk of colonisation of skin affected by dermatitis, and to support the use of workplace interventions including skin care programmes (eg education about good hand care, good hand-washing techniques, limiting glove use and use of conditioning creams), the use of alcohol rub by healthcare workers as a substitute for full hand washing where appropriate, and the provision of conditioning creams in the workplace. Although based on studies in healthcare settings, the recommendations for workplace interventions (with the exception of using alcohol hand rubs) are intended to be useful for occupations outside healthcare. For three of the five key questions (one about the risk of transmitting organisms from colonised hand dermatitis to patients in a healthcare setting, and two about the effectiveness of health surveillance) no useful papers were identified. We were not able to generate graded evidence-based recommendations for occupational health practice for these questions, but instead recommended good practice points about the early clinical management of dermatitis and adjustments to work in healthcare. These good practice points were based on further evidence from case reports, consensus within the Guideline Development Group and opinions from experts in microbiology and infection control.

Because of the paucity of high-quality published evidence to address our key questions, we also made a number of research recommendations. These aim to build an evidence base for the future assessment of the risk of infection in, and nosocomial transmission from, healthcare workers who have dermatitis, and for controlled trials of occupational health interventions for dermatitis in workplace settings.

The guideline is accompanied by summary leaflets for employers, employees and health care professionals.

Who's involved

Organisations

The Faculty of Occupational Medicine

NHS Plus