Prevalencija i prediktori profesionalnog kontaktnog dermatitisa u učenika za zanimanje medicinske sestre i tehničara

master's thesis

• Title (english): Prevalence and predictors of occupational contact dermatitis in student nurses and medical technicians
• Author: Franka Šakić
• Mentor: Vera Musil (mentor)
• Committee member: Milan Milošević (predsjednik povjerenstva)
• Committee member: Marjeta Majer (član povjerenstva)
• Committee member: Vera Musil (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Social Medicine and Health Care Organization); Zagreb
• Defense date and country: 2021-09-29, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Social Medicine

Abstract

Uvod i cilj rada: najčešće profesionalne kožne bolesti su iritativni i alergijski kontaktni dermatitisi
na šakama. Najznačajniji profesionalni rizični čimbenici su kontakt s iritansima, rad u vodi i
alergenima na radnom mjestu. Cilj ovoga rada bio je istražiti čimbenike radnog okoliša i
konstitucijske čimbenike koji utječu na prevalenciju i tijek profesionalnog kontaktnog dermatitisa u
uzorku učenika medicinskih škola Grada Zagreba.
Ispitanici i metode: za potrebe ovoga rada izvršena je retrospektivna analiza podataka prvih 100
ispitanika (81% djevojaka), prikupljenih za potrebe projekta: „Prevalencija i prediktori
profesionalnog kontaktnog dermatitisa u učenika za zanimanje medicinska sestra/tehničar (Nurse
Skin)“. Analizirani su odgovori na pitanja iz upitnika i zabilješki o kliničkom pregledu kožnih
promjena na šakama pomoću Osnabrueck Hand Eczema Severity Indeks (OHSI), mjerenja
transepidermalnog gubitka vode (TEWL) i pH kože. Podaci su obrađeni metodama deskriptivne
statistike i interpretirani na razini značajnosti P<0,05.
Rezultati: dermatitis na šakama tijekom života imalo ih je 47%, a kliničkim pregledom utvrđen je u
njih 35%. Čimbenicima rizika za razvoj dermatitisa šaka na stručnoj praksi kao što su: pranje ruku
više od 20 puta na dan bilo je izloženo 16% ispitanika, korištenje dezinficijensa za ruke više od 20
puta na dan 27% i nošenje zaštitnih rukavica više od dva sata na dan, 38%. Učenici sa prisutnim
simptomima dermatitisa imali su značajno više vrijednosti TEWL-a (32,4 vrs. 18,11; p<0,001) u
odnosu na one bez i OHSI zbroj je bio značajno povezan samo s TEWL-om na šakama (Spearmanov
rho=0.381, p<0.001). Učenici s višim vrijednostima TEWL imali su 1,07 puta značajno veći omjer
izgleda za prisutnost kožnih promjena (OR 1,07 (95% CI 1,03- 1,12; p<0,001), stoga se TEWL može
smatrati prediktorom profesionalnog kontaktnog dermatitisa u učenika koji se školuju za
zanimanje medicinske sestre i tehničara.
Zaključak: rezultati analize pridonose saznanjima o izloženosti učenika koji se školuju za zanimanje
medicinska sestra i tehničar rizičnim čimbenicima profesionalnog okoliša za nastanak dermatitisa na
šakama već tijekom školovanja i ukazuju na potrebu kontinuirane edukacije svih dionika obrazovnog
i zdravstvenog sustava uključenih u obrazovanje o postupcima pravilne njege i zaštite kože, kako bi
se smanjio broj onih koji će razviti dermatitis.

Abstract (english)

Introduction and aim
The most common occupational skin diseases are irritative and allergic contact dermatitis on the
hands. The most significant occupational risk factors are contact with irritants, working in water, and
allergens in the workplace. The aim of this study was to investigate factors in work environment
which influence prevalence and course of occupational contact dermatitis in a sample of students
attending medical secondary schools in the City of Zagreb.
Sample and methods
We conducted retrospective analysis of data collected in project Prevalence and predictors of
occupational contact dermatitis at students attending programme for the occupation of
nurse/medical technician (Nurse Skin) (N=100, 81% girls). We analysed answers from questionnaire,
notes on hands skin clinical exam using Osnabrück Hand Eczema Severity Index (OHSI) and results
of trans epidermal water loss (TEWL) and skin's pH measurements. The data were analysed using
descriptive statistics and interpreted on the significance level P<0.05.
Results
Hand dermatitis occurred in 47% of subjects; clinical examination determined the existence of the
same condition in 35% subjects. Risk factors for the development of dermatitis in occupation were:
washing hands for more than 20 times a day (16%), use of hand disinfectant more than 20 times a
day (27%) and wearing gloves for more than two hours a day (38%). The students with ongoing
symptoms had significantly higher values of TEWL (32.4 vs. 18.11, p<0.001) in comparison to those
with no symptoms, and OHSI sum was significantly correlated only to TEWL of the hands
(Spearman rho=0.381, p<0.001). Students with higher TEWL values had a 1.07 significantly higher
odds ratio for the presence of skin changes (OR 1.07 (95% CI 1.03-1.12; p <0.001), so TEWL can
be considered as a predictor of occupational contact dermatitis in students studying for the profession
of nurse and technician.
Conclusion
The results of the analysis contribute to knowledge about exposure of nurse and technician students
to professional environment risk factors for dermatitis on the hands, already during schooling and
indicate need for continuous education of all stakeholders in the educational and health system to
reduce number of those who will develop dermatitis.

• Keywords: čimbenici rizika; dermatitis; učenici; medicinska sestra/tehničar
• Keywords (english): risk factors; dermatitis; students; nurse
• Language: croatian
• URN:NBN: urn:nbn:hr:105:269296
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-06-08 12:39:22