Prevalence and risk factors for hand eczema among professional hospital cleaners in Denmark: A cross-sectional questionnaire-based study

BACKGROUND: Professional cleaners are commonly affected by hand eczema (HE) due to wet work and exposure to cleaning products in the work environment.

OBJECTIVE: To investigate (1) the prevalence of HE in a group of professional hospital cleaners, (2) the association of HE with various comorbidities and self-reported signs/symptoms of skin lesions and (3) the association of HE with various occupational and personal risk factors in the same population.

METHODS: A cross-sectional questionnaire-based study including all cleaners working in three hospitals in Denmark. The questionnaire was composed of 35 questions. Prevalence is reported using proportions with 95% confidence intervals and compared using difference of proportions and Fisher's exact test.

RESULTS: A total of 122 out of 180 cleaners (response rate = 68%) participated in this study. The self-reported lifetime prevalence of HE among the cleaners was 30.3%, while the 1-year prevalence was 18.9%. HE was significantly associated with a history of atopic diseases. There was a significant correlation between having HE, and self-reported redness and itch of the hands in the last 12 months, as well as the use of hydrochloric acid ≥4 days/week during the last 12 months. Logistic regression analysis found HE significantly associated with washing hands ≥20 times during a working day and a history of atopic dermatitis.

CONCLUSION: Cleaners are at an elevated risk of developing HE. More focus on education/information regarding the prevention and treatment of HE is necessary for the cleaning profession. Self-reported redness and itching of the hands may be a useful prediction of HE in cleaners.