Infection prevention practices can cause hand eczema

Hand eczema prevention should be covered in guidelines on hand hygiene. A new training film can be helpful.

Good hand hygiene is essential for preventing the spread of infection in healthcare settings. However, it can lead to hand eczema, which is not only a problem for individual employees but also increases the risk of infection transmission.

Hand eczema is twice as common among healthcare personnel as in the general population. Studies from several countries found a further increase in the incidence of hand eczema among healthcare personnel during the COVID-19 pandemic, which is attributed to the more stringent hand hygiene requirements in place (1, 2).

To prevent work-related hand eczema, it is recommended that employees in high-risk occupations, such as healthcare personnel, are trained in how to care for their skin and reduce risk factors at an early stage, for example through the correct use of gloves and hand sanitiser (3).

There is a clear correlation between poor hand hygiene and an increased risk of infection. All healthcare institutions are therefore required to have written guidelines for hand hygiene. Dermatological problems resulting from hygiene practices are known to be one of the factors leading to non-compliance with these measures.

The guidelines often recommend practising hand hygiene before putting on non-sterile disposable gloves. This is justified by the possibility of contaminating the outside of the gloves when putting them on, and contaminating other gloves in the same box. However, this is not well documented. On the contrary, several studies indicate that this is not a significant problem (4–6). If the skin is moist before donning gloves, this can increase the risk of hand eczema. We therefore think that this recommendation should be removed from the guidelines.

Efforts to prevent hand eczema should be viewed in conjunction with hand hygiene guidelines and training, as maintaining healthy skin is vital for adhering to these guidelines and also for effective infection control.

At Oslo University Hospital, the Department of Infection Prevention, the Department of Dermatology, and Environmental and Occupational Medicine have jointly produced a short training film giving advice on how to avoid hand eczema (7). The film contains information that we believe is useful for all staff working in a clinical setting, and serves as a practical tool that managers can use in staff training.