Martin Seed, NHS Consultant and Honorary Senior Lecturer in Occupational Medicine at The University of Manchester, discusses examples of dermatoses associated with PPE within the data collected by THOR.

The ‘Hands, Face, Space’ public health mantra was reinforced by the government as the second wave of the UK COVID-19 epidemic started to take off between October and December 2020. THOR reporter activity was inevitably lower than usual due to COVID related pressures on physicians, but the EPIDERM reports for the quarter make for interesting analysis with 21 of 27 (78%) cases being within the health and social care sector.

There were 18 cases of hand dermatosis reported in health and social care for which the diagnosis in 13 cases was irritant contact dermatitis, hand hygiene measures being the attributed cause in 12. In the recently updated EPIDERM source coding there is a clearer category ‘hand hygiene’ to include soaps, detergents and disinfecting agents in addition to wet-work. The ‘PPE’ category is also divided into gloves and other body part protection. There were two cases affecting the face in this quarter: irritant dermatitis attributed to wearing a face mask in a hospital nurse; allergic contact dermatitis attributed to the green/blue anti fog foam nose strip within the type IIR face mask in another nurse/support worker.

Health and social care has gradually overtaken manufacturing as the sector most affected by contact dermatitis since the turn of the millennium [1]. The overwhelming predominance of cases in health and social care staff described this quarter is likely to reflect, at least in part, the pandemic situation. Workers who cannot maintain Space have significant dermatological risks to Hands and Face.

[1] Meyer, JD; Chen, Y; Holt, DL; et al. Occupational contact dermatitis in the UK: a surveillance report from EPIDERM and OPRA. Occupational Medicine 2000;50:265-273.

Written by: Martin Seed

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