Funding sources This work was supported by the U.K. Health and Safety Executive.
Epidemiology and Health Services Research
The impact of national-level interventions to improve hygiene on the incidence of irritant contact dermatitis in healthcare workers: changes in incidence from 1996 to 2012 and interrupted times series analysis
Version of Record online: 2 JUN 2015
© 2015 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
British Journal of Dermatology
Volume 173, Issue 1, pages 165–171, July 2015
How to Cite
Stocks, S.J., McNamee, R., Turner, S., Carder, M. and Agius, R.M. (2015), The impact of national-level interventions to improve hygiene on the incidence of irritant contact dermatitis in healthcare workers: changes in incidence from 1996 to 2012 and interrupted times series analysis. British Journal of Dermatology, 173: 165–171. doi: 10.1111/bjd.13719
Conflicts of interest None declared.
Any opinions and conclusions expressed herein are solely those of the authors and not of the funding body. The funding body was not involved in the study design, data collection, data analysis, manuscript preparation and/or publication decisions. Data requests may be made in by writing to the Health and Occupation Research Network to email@example.com
- Issue online: 14 JUL 2015
- Version of Record online: 2 JUN 2015
- Accepted manuscript online: 5 FEB 2015 02:40AM EST
- Manuscript Accepted: 28 JAN 2015
- U.K. Health and Safety Executive
Reducing healthcare-associated infections (HCAI) has been a priority in the U.K. over recent decades and this has been reflected in interventions focusing on improving hygiene procedures.
To evaluate whether these interventions coincided with an increased incidence of work-related irritant contact dermatitis (ICD) attributed to hand hygiene or/and other hygiene measures in healthcare workers (HCWs).
A quasi-experimental (interrupted time series) design was used to compare trends in incidence of ICD in HCWs attributed to hygiene before and after interventions to reduce HCAI with trends in the same periods in control groups (ICD in other workers). Cases of ICD reported to a U.K. surveillance scheme from 1996 to 2012 were analysed. The time periods compared were defined objectively based on the dates of the publication of national evidence-based guidelines, the U.K. Health Act 2006 and the Cleanyourhands campaign.
The reported incidence of ICD in HCWs attributed to hygiene has increased steadily from 1996 to 2012 [annual incidence rate ratio (95% confidence interval): hand hygiene only 1·10 (1·07–1·12); all hygiene 1·05 (1·03–1·07)], whereas the incidence in other workers is declining. An increase in incidence of ICD in HCWs attributed to hand hygiene was observed at the beginning of the Cleanyourhands campaign.
The increasing incidence of ICD in HCWs combined with the popularity of interventions to reduce HCAI warrants increased efforts towards identifying products and implementing practices posing the least risk of ICD.