Occupational Dermatoses in Healthcare Workers during the COVID-19 Pandemic: A Narrative Review

Authors

  • Ana Inês Vasques Gabinete de Medicina do Trabalho. Instituto Português de Oncologia do Porto. Porto.
  • Carlos Ochoa-Leite Gabinete de Medicina do Trabalho. Instituto Português de Oncologia do Porto. Porto. https://orcid.org/0000-0003-0489-9677
  • Diana Ramos Rocha Gabinete de Medicina do Trabalho. Instituto Português de Oncologia do Porto. Porto.
  • João Bento Gabinete de Medicina do Trabalho. Instituto Português de Oncologia do Porto. Porto.
  • Luís Rocha Gabinete de Medicina do Trabalho. Instituto Português de Oncologia do Porto. Porto.

DOI:

https://doi.org/10.20344/amp.16633

Keywords:

COVID-19, Dermatitis, Occupational, Health Personnel, Pandemics, Personal Protective Equipment/adverse effects, SARS-CoV-2, Skin Diseases/etiology

Abstract

Introduction: On the 11th March 2020, the World Health Organization declared the novel coronavirus outbreak as a pandemic. Preventive measures such as the appropriate use of personal protective equipment and proper hand hygiene are essential in decreasing transmissibility. Healthcare workers have been required to wear personal protective equipment and to wash their hands even more frequently. These preventive measures are associated with an increased risk of skin conditions, namely, contact dermatitis and exacerbation of pre-existing skin lesions such as acne and seborrheic dermatitis. The aim of this article is to provide an overview of the main skin lesions, and highlighting the role in occupational dermatology and preventive measures.
Methods: A search was conducted on PubMed and some guidelines from organizations like World Health Organization and Portuguese General Directorate of Health were included.
Results: Most skin conditions seen in healthcare professionals throughout the pandemic were associated with hand hygiene and the use of personal protective equipment and comprised hand eczema, mask-induced contact dermatitis, personal protective equipment related irritant contact dermatitis, cheilitis and exacerbation of pre-existing conditions such as acne and seborrheic dermatitis. Prevention and early recognition of dermatitis associated with personal protective equipment and hand hygiene are essential to maximize work performance, healthcare workers’ safety and the adherence to preventive measures.
Conclusion: Protection of healthcare workers’ health and safety is an essential measure in the fight against the pandemic. Occupational Health has a fundamental role, acting in terms of disease prevention and health promotion, for example, through educational sessions and orientation of skin conditions associated with work, thus maximizing workers’ well-being.

Downloads

Download data is not yet available.

References

World Health Organization. Coronavirus disease 2019 (COVID-19). Situation report – 59. 2020. [consultado 2021 mar 21]. Disponível em:https://www.who.int/docs/default-source/coronaviruse/situationreports/20200319-sitrep-59-covid-19.pdf?sfvrsn=c3dcdef9_2.

Rundle CW, Presley CL, Militello M, Barber C, Powell DL, Jacob SE, et al. Hand hygiene during COVID-19: recommendations from the American Contact Dermatitis Society. J Am Acad Dermatol. 2020;83:1730-7. DOI: https://doi.org/10.1016/j.jaad.2020.07.057

World Health Organization. Rational use of personal protective equipment for COVID-19 and considerations during severe shortages: Interim guidance. 2020. [consultado 2021 mar 28]. Disponível em: https://apps.who.int/iris/handle/10665/338033.

Direção-Geral da Saúde. Norma nº007/2020 de 29/03/2020. Prevenção e controlo de infeção por SARS-CoV-2 (COVID-19): equipamentos de proteção rndividual (EPI). 2020. [consultado 2021 mar 10]. Disponível em: https://covid19.min-saude.pt/normas/.

Lin P, Zhu S, Huang Y, Li L, Tao J, Lei T, et al. Adverse skin reactions among healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions. Br J Dermatol. 2020;183:190-2. DOI: https://doi.org/10.1111/bjd.19089

Zuo Y, Hua W, Luo Y, Li L. Skin reactions of N95 masks and medial masks among health care personnel: a self-report questionnaire survey in China. Contact Dermatitis. 2020;83:145-7. DOI: https://doi.org/10.1111/cod.13555

Yan Y, Chen H, Chen L, Cheng B, Diao P, Dong L, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther. 2020;33:e13310. DOI: https://doi.org/10.1111/dth.13310

Lan J, Song Z, Miao X, Li H, Li Y, Dong L, et al. Skin damage among health care workers managing coronavirus disease-2019. J Am Acad Dermatol. 2020;82:1215-6. DOI: https://doi.org/10.1016/j.jaad.2020.03.014

Guertler A, Moellhoff N, Schenck TL, Hagen C, Kendziora B, Giunta R, et al. Onset of occupational hand eczema among healthcare workers during the SARS-CoV-2 pandemic: comparing a single surgical site with a COVID-19 intensive care unit. Contact Dermatitis. 2020;83:108-14. DOI: https://doi.org/10.1111/cod.13618

Bolognia JL, Schaffer JV, Duncan KO, Ko CJ. Dermatology essentials. Oxford: Saunders/Elsevier; 2014.

Monjardinho T, Amaro J, Batista A, Norton P. Trabalho e Saúde em Portugal 2016. Lucas R, Benavides FG, coordenadores. Porto: ISPUP; 2016.

Nettis E, Colanardi M, Soccio A, Ferrannini A, Tursi A. Occupational irritant and allergic contact dermatitis among healthcare workers. Contact Dermatitis. 2002;46:101-7. DOI: https://doi.org/10.1034/j.1600-0536.2002.460208.x

Christopher P, Roren R, Tania C, Jayadi N, Cucunawangsih. Adverse skin reactions to personal protective equipment among health-care workers during COVID-19 pandemic: a multicenter cross-sectional study in Indonesia. Int J Dermatol Venereol. 2020;3:211-8. DOI: https://doi.org/10.1097/JD9.0000000000000132

Kantor J. Behavioral considerations and impact on personal protective equipment use: early lessons from the coronavirus (COVID-19) pandemic. J Am Acad Dermatol. 2020;82:1087-8. DOI: https://doi.org/10.1016/j.jaad.2020.03.013

Agner T, Elsner P. Hand eczema: epidemiology, prognosis and prevention. J Am Acad Dermatol. 2020;34:4-12. DOI: https://doi.org/10.1111/jdv.16061

Visscher O, Wickett R. Hand hygiene compliance and irritant dermatitis: a juxtaposition of healthcare issues. Int J Cosmet Sci. 2012;34:402-15. DOI: https://doi.org/10.1111/j.1468-2494.2012.00733.x

Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203:631-7. DOI: https://doi.org/10.1002/path.1570

Daye M, Cihan FG, Durduran Y. Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic. Dermatol Ther. 2020;33:e14346. DOI: https://doi.org/10.1111/dth.14346

Lee SW, Cheong SH, Byun JY, Choi YW, Choi HY. Occupational hand eczema among nursing staffs in Korea: self-reported hand eczema and contact sensitization of hospital nursing staffs. J Dermatol. 2013;40:182-7. DOI: https://doi.org/10.1111/1346-8138.12036

Zhang D, Zhang J, Sun S, Gao M, Tong A. Prevalence and risk factors of hand eczema in hospital-based nurses in northern China. Australas J Dermatol. 2018;59:194-7. DOI: https://doi.org/10.1111/ajd.12672

Direção-Geral da Saúde. Norma nº007/2019 de 16/10/2019. Higiene das mãos nas Unidades de Saúde. 2019. [consultado 2021 mar 16]. Disponível em: https://normas.dgs.min-saude.pt/wp-content/uploads/2019/10/higiene-das-maos-nas-unidades-de-saude.pdf.

Balato A, Ayala F, Bruze M, Crepy MN, Gonçalo M, Johansen J, et al. European task force on contact dermatitis statement on coronavirus 19 disease (COVID-19) outbreak and the risk of adverse cutaneous reactions. J Eur Acad Dermatol Venereol. 2020;34:e353-4. DOI: https://doi.org/10.1111/jdv.16557

Patruno C, Gabriella F, Stingeni L, Napolitano M. The role of occupational dermatology in the COVID-19 outbreak. Contact Dermatitis. 2020;83:174-5. DOI: https://doi.org/10.1111/cod.13568

Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions oh healthcare workers using personal protective equipment for COVID-19. Medicine. 2020;99:e20603. DOI: https://doi.org/10.1097/MD.0000000000020603

Pei S, Xue Y, Zhao S, Alexander N, Mohamad G, Chen X, et al. Occupational skin conditions on the front line: a survey among 484 Chinese healthcare professionals caring for COVID-19 patients. J Eur Acad Dermatol Venereol. 2020;34:e354-7. DOI: https://doi.org/10.1111/jdv.16570

Singh M, Pawar M, Bothra A, Maheshwari A, Dubey V, Tiwari A, et al. Personal protective equipment induced facial dermatoses in healthcare workers managing coronavirus disease 2019. J Eur Acad Dermatol Venereol. 2020;34:e378-80. DOI: https://doi.org/10.1111/jdv.16628

Al Badri F. Surgical mask contact dermatitis and epidemiology of contact dermatitis in healthcare workers. Curr Allergy Clin Immunol. 2017;30:183-8.

Xie Z, Yang YX, Zhang H. Mask-induced contact dermatitis in handling COVID-19 outbreak. Contact Dermatitis. 2020;83:166-7. DOI: https://doi.org/10.1111/cod.13599

Aerts O, Dendooven E, Foubert K, Stappers S, Ulicki M, Lambert J. Surgical mask dermatitis caused by formaldehyde (releasers) during the COVID-19 pandemic. Contact Dermatitis. 2020;83:172-3. DOI: https://doi.org/10.1111/cod.13626

Hamnerius N, Svedman C, Bergendorff O, Bjor J, Bruze M, Engfeldt M, et al. Hand eczema and occupational contact allergies in healthcare workers with a focus on rubber additives. Contact Dermatitis. 2018;79:149-56. DOI: https://doi.org/10.1111/cod.13042

Taylor JS, Erkek E. Latex allergy: diagnosis and management. Dermatol Ther. 2004;17:289-301. DOI: https://doi.org/10.1111/j.1396-0296.2004.04024.x

Kujala V, Alenius H, Palosuo T, Karvonen J, Pfaffli P, Reijula K. Extractable latex allergens in airborne glove powder and in cut glove pieces. Clin Exp Allergy. 2002;32:1077-81. DOI: https://doi.org/10.1046/j.1365-2222.2002.01413.x

Published

2022-06-29

How to Cite

1.
Vasques AI, Ochoa-Leite C, Ramos Rocha D, Bento J, Rocha L. Occupational Dermatoses in Healthcare Workers during the COVID-19 Pandemic: A Narrative Review. Acta Med Port [Internet]. 2022 Jun. 29 [cited 2026 Jun. 18];35(11):830-4. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/16633

Issue

Section

Review Articles