Occupational Contact Dermatitis among Health Care Workers in Yangon General Hospital

Khine Khine Zaw, Thurein Htun, Thu Wai Hlaing & Wai Wai Phyo Kyaw

Myanmar Health Sciences Research Journal

Health care workers (HCWs) are at high risk of developing occupational contact dermatitis (OCD) because they are daily exposed to various irritants and allergens in their workplace, but the extent of the problem varies between countries and regions. This study was carried out on HCWs at Yangon General Hosptial (YGH) from October 2017 to September 2018. A cross-sectional hospital-based descriptive study was designed to assess the prevalence, demographic characteristic, risk factors, clinical patterns, responsible irritants and allergens for development of OCD in HCWs. A self-administered questionnaire was distributed to all health care workers (except administrative officers and staff) in YGH and each subject who returned a positive response to this questionnaire was asked for examination and patch testing with 20 allergens and additionally with their own contactants appropriately diluted. The total study population was 548 HCWs and the overall prevalence of occupational contact dermatitis in this study was 30.5% (167/548). A total of 82 participants underwent patch testing. Final diagnoses of the HCWs with OCD were allergic contact dermatitis (ACD) 51.2%, irritant contact dermatitis (ICD) 36.7% and contact urticaria 12.1%.

Occupational skin diseases are any abnormal conditions of the skin caused or aggravated by substances or processes associated with the work environment.¹ Occupational contact dermatitis (OCD) is the most frequent cause of occupational skin diseases.² and health care workers (HCWs) are the most commonly affected occupational group.^{3, 4} HCWs are at high risk of developing OCD particularly affecting the hands, because they are daily exposed to disinfectants, various medications, metal instruments and frequent hand washing, as well as wearing of occlusive glove, which of all  may  cause  irritant  and/or  allergic  contact dermatitis.^{5, 7}

A cross-sectional hospital-based descriptive study was designed and the study period was from October 2017 to September 2018. All health care workers (except administrative officers and staff) working in Yangon General Hospital who are more likely exposed to disinfectants, antiseptic solutions, glove wearing, drugs and medical devices were included in this study. A self-admini-stered questionnaire (based on the Nordic Occupational Skin Questionnaire.⁹) with a consent form was distributed to all health care workers (except administrative officers and staff) in YGH at their respective wards. 

This study stated the prevalence of OCD among HCWs at 30.5%; this figure was comparable with previously reported inter-national data.^{13, 16} In this study, the overall prevalence of OCD in HCWs was calculated on self-administered questionnaire. The vali-dity of use of self-administered questionnaire for prevalence of occupational skin diseases was supported by previous studies.^{8, 17, 18}

This study was supported in part by DMR External Grant. We are grateful to all the health care workers in Yangon General Hospital who participated in our study.

Competing interests

The authors declare that they have no competing interests.

1.       Honari G, Taylor JS & Sood A. Occupational skin diseases due to irritants and allergens. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8^th ed. New York: McGraw-Hill; 2012. p. 2611-2622.

2.       Wilkinson SM. Occupational dermatoses. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3^rd ed. Canada: Elsevier; 2012. p. 261-272.

3.       Coman G, Zinsmeister C & Norris P. Occupational contact dermatitis: Workers’ compensation patch test results of Portland, Oregon, 2005-2014. Dermatitis 2015; 26(6): 276-283.

4.       Carøe TK, Ebbehøj N & Agner T. A survey of exposures related to recognized occupa-tional contact dermatitis in Denmark in 2010. Contact Dermatitis 2013; 70(1): 56-62.

5.       Behroozy A & Keegel TG. Wet-work exposure: A main risk factor for occupational hand dermatitis. Safety and Health at Work 2014; 5(4): 175-180.