Safety and Health at Work

  • 제9권4호
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  • Pages.398-407
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  • 2018
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  • 2093-7911(pISSN)
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  • 2093-7997(eISSN)
산업안전보건연구원 (Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency)
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Skin Protection Seminars to Prevent Occupational Skin Diseases: Results of a Prospective Longitudinal Study in Apprentices of High-risk Professions

  • Wilke, Annika (Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabruck) ;
  • Brans, Richard (Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabruck) ;
  • Nordheider, Kathrin (Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabruck) ;
  • Braumann, Antje (Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabruck) ;
  • Hubner, Anja (Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabruck) ;
  • Sonsmann, Flora K. (Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabruck) ;
  • John, Swen M. (Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabruck) ;
  • Wulfhorst, Britta (Faculty of Human Sciences/Department of Educational Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University)
  • 투고 : 2017.08.14
  • 심사 : 2018.05.12
  • 발행 : 2018.12.30
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초록

Background: Occupational skin diseases (OSDs) are frequent in professions with exposure to skin hazards. Thus, a health educational intervention for apprentices of high-risk professions was conducted. It was the aim of this study to gain insight into possible effects of this intervention. Methods: A one-time skin protection seminar was conducted in 140 apprentices of health-related and non-health-related professions [trained cohort (TC)]. In addition, 134 apprentices of the same occupations were monitored [untrained cohort (UTC)]. The OSD-specific knowledge and the skin condition of the hands were assessed at baseline (T0), after the seminar (T1), and after 6 (T2) and 12 months (T3). Results: The OSD-specific knowledge increased in all cohorts from T0 to T3, but we found a significantly higher knowledge in the TC at T2 (p < 0.001, t = 3.6, df = 196, 95% confidence interval = 0.9, 3.3) and T3 (p < 0.001, t = 3.8, df = 196, 95% confidence interval = 1.0, 3.2) compared to the UTC. Our results indicated a better skin condition of the hands in the TC of the health-related professions but not in the non-health-related professions. Conclusion: The study indicates that an educational intervention may positively influence the disease-specific knowledge and the prevalence of OSD in apprentices. However, definite conclusions cannot be drawn because of the heterogeneous study cohorts and the study design. Future research should aim at tailoring primary prevention to specific target groups, e.g., in view of the duration and frequency of skin protection education, different professions, and gender-specific prevention approaches.

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참고문헌

  1. Coenraads PJ, Uter W, Diepgen T. Epidemiology. In: Johansen JD, Frosch P, Lepoittevin JP, editors. Contact Dermatitis. 5th ed. Berlin, Heidelberg: Springer-Verlag; 2011. p. 193-211.
  2. European Commission Employment, Social Affairs and Equal Opportunities. Health and safety at work in Europe (1999-2007). A statistical portrait. Eurostat Statistical Books. Luxembourg: Publications Office of the European Union. 2010. Available from, http://ec.europa.eu/eurostat/documents/3217494/5718905/KS-31-09-290-EN.PDF/88-ef9f7-c229-40de-b1cd-43126bc4a946. 97 p. [cited 2018 Feb 14].
  3. Diepgen TL. Occupational skin-disease data in Europe. Int Arch Occup Environ Health 2003;76:331-8. https://doi.org/10.1007/s00420-002-0418-1
  4. DGUV [German Statutory Accident Insurance]. DGUV Statistics 2016. Figures and long-term trends. Paderborn (Germany): Bonifatius GmbH. 2016. Available from, http://publikationen.dguv.de/dguv/pdf/10002/12640neu.pdf. 91 p. [cited 2018 Feb 14].
  5. Lau MY, Matheson MC, Burgess JA, Dharmage SC, Nixon R. Disease severity and quality of life in a follow-up study of patients with occupational contact dermatitis. Contact Dermatitis 2011;65:138-45. https://doi.org/10.1111/j.1600-0536.2011.01896.x
  6. Cvetkovski RS, Rothman KJ, Olsen J, Mathiesen B, Iversen L, Johansen JD, Agner T. Relation between diagnoses on severity, sick leave and loss of job among patients with occupational hand eczema. Br J Dermatol 2005;152:93-8. https://doi.org/10.1111/j.1365-2133.2005.06415.x
  7. Funke U, Fartasch M, Diepgen TL. Incidence of work-related hand eczema during apprenticeship: first results of a prospective cohort study in the car industry. Contact Dermatitis 2001;44:166-72. https://doi.org/10.1034/j.1600-0536.2001.044003166.x
  8. Wilke A, Gediga K, John SM, Wulfhorst B. Evaluation of structured patient education in occupational skin diseases: a systematic assessment of the disease-specific knowledge. Int Arch Occup Environ Health 2014;87:861-9. https://doi.org/10.1007/s00420-014-0926-9
  9. Brans R, Skudlik C, Weisshaar E, Scheidt R, Ofenloch R, Elsner P, Wulfhorst B, Schonfeld M, John SM, Diepgen TL. Multicentre cohort study 'Rehabilitation of Occupational Skin Diseases - Optimization and Quality Assurance of Inpatient Management (ROQ)': results from a 3-year follow-up. Contact Dermatitis 2016;75:205-12. https://doi.org/10.1111/cod.12614
  10. Weisshaar E, Skudlik C, Scheidt R, Matterne U, Wulfhorst B, Schonfeld M, Elsner P, Diepgen TL, John SM. Multicentre study 'rehabilitation of occupational skin diseases -optimization and quality assurance of inpatient management (ROQ)'-results from 12-month follow-up. Contact Dermatitis 2013;68:169-74. https://doi.org/10.1111/j.1600-0536.2012.02170.x
  11. Wilke A, Gediga G, Schlesinger T, John SM, Wulfhorst B. Sustainability of interdisciplinary secondary prevention in patients with occupational hand eczema: a 5-year follow-up survey. Contact Dermatitis 2012;67:208-16. https://doi.org/10.1111/j.1600-0536.2012.02132.x
  12. van Gils RF, Boot CR, van Gils PF, Bruynzeel D, Coenraads PJ, van Mechelen W, Riphagen II , Anema JR. Effectiveness of prevention programmes for hand dermatitis: a systematic review of the literature. Contact Dermatitis 2011;64:63-72. https://doi.org/10.1111/j.1600-0536.2010.01825.x
  13. Soder S, Diepgen TL, Radulescu M, Apfelbacher C, Bruckner T, Weisshaar E. Occupational skin diseases in cleaning and kitchen employees: Course and quality of life after measures of secondary individual prevention. J Dtsch Dermatol Ges 2007;5:670-7. https://doi.org/10.1111/j.1610-0387.2007.06419.x
  14. Wilke A. Studies to evaluate the effectiveness of preventive interventions in occupational dermatology. E-Dissertation. urn:nbn:de:gbv:700-2014101312863. Osnabruck (Germany): University of Osnabruck; 2014. 319 p.
  15. Ibler KS, Jemec GB, Diepgen TL, Gluud C, Lindschou Hansen J, Winkel P, Thomsen SF, Agner T. Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema: randomised clinical trial. BMJ 2012;345:e7822. https://doi.org/10.1136/bmj.e7822
  16. Nicholson PJ, Llewellyn D, English JS. Evidence-based guidelines for the prevention, identification and management of occupational contact dermatitis and urticaria. Contact Dermatitis 2010;63:177-86. https://doi.org/10.1111/j.1600-0536.2010.01763.x
  17. Wulfhorst B, Bock M, Skudlik C, John SM. Worker Education and Teaching Programs: The German Experience. In: Frosch PJ, Menne T, Lepoittevin JP, editors. Contact Dermatitis. Berlin Heidelberg: Springer Verlag; 2006. p. 855-61.
  18. WHO [World Health Organization]. Ottawa Charter for Health Promotion; 1986. Available from: http://www.euro.who.int/__data/assets/pdf_file/0004/129532/Ottawa_Charter.pdf?ua-1. 5 p. [cited 2018 Feb 15].
  19. Dulon M, Kahler B, Kirvel S, Schlanstedt G, Schoning S. A new approach for primary prevention of occupational skin disease in hairdressers. Arbeitsmed Sozialmed Umweltmed 2011;46:618-23.
  20. Attwa E, el-Laithy N. Contact dermatitis in car repair workers. J Eur Acad Dermatol Venereol 2009;23:138-45. https://doi.org/10.1111/j.1468-3083.2008.02952.x
  21. Dulon M, Pohrt U, Skudlik C, Nienhaus A. Prevention of occupational skin disease: a workplace intervention study in geriatric nurses. Br J Dermatol 2009;161:337-44. https://doi.org/10.1111/j.1365-2133.2009.09226.x
  22. Flyvholm MA, Mygind K, Sell L, Jensen A, Jepsen KF. A randomised controlled intervention study on prevention of work related skin problems among gut cleaners in swine slaughterhouses. Occup Environ Med 2005;62:642-9. https://doi.org/10.1136/oem.2004.016576
  23. Sell L, Flyvholm MA, Lindhard G, Mygind K. Implementation of an occupational skin disease prevention programme in Danish cheese dairies. Contact Dermatitis 2005;53:155-61. https://doi.org/10.1111/j.0105-1873.2005.00674.x
  24. Held E, Mygind K, Wolff C, Gyntelberg F, Agner T. Prevention of work related skin problems: an intervention study in wet work employees. Occup Environ Med 2002;59:556-61. https://doi.org/10.1136/oem.59.8.556
  25. Clemmensen KK, Randboll I, Ryborg MF, Ebbehoj NE, Agner T. Evidence-based training as primary prevention of hand eczema in a population of hospital cleaning workers. Contact Dermatitis 2015;72:47-54. https://doi.org/10.1111/cod.12304
  26. van der Meer EW, Boot CR, van der Gulden JW, Knol DL, Jungbauer FH, Coenraads PJ, Anema JR. Hands4U: the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial. Contact Dermatitis 2015;72:312-24. https://doi.org/10.1111/cod.12313
  27. Bregnhoj A, Menne T, Johansen JD, Sosted H. Prevention of hand eczema among Danish hairdressing apprentices: an intervention study. Occup Environ Med 2012;69:310-6. https://doi.org/10.1136/oemed-2011-100294
  28. Bock M, Radulescu M, Stein M, Bruckner T, Diepgen TL. Primary prevention of occupational skin diseases - development, establishment and evaluation of a lesson on skin protection and occupational dermatoses for trainees. Arbeitsmed Sozialmed Umweltmed 2007;42:320-4 [in German].
  29. Loffler H, Bruckner T, Diepgen T, Effendy I. Primary prevention in health care employees: a prospective intervention study with a 3-year training period. Contact Dermatitis 2006;54:202-9. https://doi.org/10.1111/j.0105-1873.2006.00825.x
  30. Bauer A, Kelterer D, Bartsch R, Schlegel A, Pearson J, Stadeler M, Kleesz P, Grieshaber R, Schiele R, Elsner P, Williams H. Prevention of hand dermatitis in bakers' apprentices: different efficacy of skin protection measures and UVB hardening. Int Arch Occup Environ Health 2002;75:491-9. https://doi.org/10.1007/s00420-002-0336-2
  31. Riehl U. Intervention study for the prevention of skin diseases in hairdressing apprentices. Osnabruck (Germany): Rasch; 2001. 424 p.
  32. John SM. Week of Ocupational Skin Diseases" from 20 to 24th September - a concerted Action of all German Dermatologist. J Dtsch Dermatol Ges 2010;8:575-8. https://doi.org/10.1111/j.1610-0387.2010.07509.x
  33. Johnson RB, Christensen L. Educational Research: Quantitative, Qualitative, and Mixed Approaches. Thousand Oaks: SAGE Publications, Inc; 2017. 709 p.
  34. Schwarzer R. Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors. Appl Psychol 2008;57:1-29.
  35. Skudlik C, Weisshaar E, Scheidt R, Wulfhorst B, Diepgen TL, Elsner P, Schonfeld M, John SM. Multicenter study "Medical-Occupational Rehabilitation Procedure Skin - optimizing and quality assurance of inpatientmanagement (ROQ)". J Dtsch Dermatol Ges 2009;7:122-7.
  36. MRC [Medical Research Council]. Developing and evaluating complex interventions: new guidance; 2006 [cited 2018 Feb 14]. Available from: https://www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/. 39 p.
  37. German Federal Ministry of Research and Technology [Bundesministerium fur Wirtschaft und Technologie]. Verordnung uber die Berufsausbildung zum Kraftfahrzeugmechatroniker und zur Kraftfahrzeugmechatronikerin; 2013. Available from: https://www.bibb.de/tools/berufesuche/index.php/regulation/kraftfahrzeugmechatroniker2013.pdf. 18 p. [cited 2018 Feb 15].
  38. Standing Conference of the Ministers of Education and Cultural Affairs [Kultusministerkonferenz]. Rahmenlehrplan fur den Ausbildungsberuf Kraftfahrzeugmechatroniker und Kraftfahrzeugmechatroniker; 2013. Available from: https://www.kmk.org/fileadmin/Dateien/pdf/Bildung/BeruflicheBildung/rlp/KFZ-Mechatroniker13-04-25-E.pdf. 50 p. [cited 2018 Feb 15].
  39. Lower Saxony Ministry of Culture [Niedersachsisches Kultusministerium]. Rahmenrichtlinien fur den berufsbezogenen Lernbereich - Theorie - in der berufsqualifizierenden Berufsfachschule Pflegeassistenz; 2013. Available from: http://nibis.de/nli1/bbs/archiv/rahmenrichtlinien/pflegeassistenz2013.pdf. 17 p. [cited 2018 Feb 15].
  40. Mertin M. Evaluation of patient education. Development and validation of an instrument for assessing the disease specific knowledge of patients with occupational skin diseases. E-Dissertation. urn:nbn:de:gbv:700-201004206227. Osnabruck (Germany): University of Osnabruck; 2010. 311 p [in German].
  41. Federal Institute for Vocational Education and Training [Bundesinstitut fur Berufsbildung]. Datensystem Auszubildende (DAZUBI). Aktueller Datenstand: Berichtsjahr 2016; 2018. Available from: https://www2.bibb.de/bibbtools/de/ssl/1871.php [cited 2018 Feb 15].
  42. Giordano A, Uccelli MM, Pucci E, Martinelli V, Borreani C, Lugaresi A, Trojano M, Granella F, Confalonieri P, Radice D, Solari A. The Multiple Sclerosis Knowledge Questionnaire: a self-administered instrument for recently diagnosed patients. Mult Scler 2010;16:100-11. https://doi.org/10.1177/1352458509352865
  43. Jennings F, Toffolo S, de Assis MR, Natour J. Brazil Patient Knowledge Questionnaire (PKQ) and evaluation of disease-specific knowledge in patients with rheumatoid arthritis. Clin Exp Rheumatol 2006;24:521-8.
  44. White R, Walker P, Roberts S, Kalisky S, White P. Bristol COPD Knowledge Questionnaire (BCKQ): testing what we teach patients about COPD. Chron Respir Dis 2006;3:123-31. https://doi.org/10.1191/1479972306cd117oa
  45. Suda AL, Jennings F, Bueno VC, Natour J. Development and validation of Fibromyalgia Knowledge Questionnaire: FKQ. Rheumatol Int 2012;32:655-62. https://doi.org/10.1007/s00296-010-1627-7
  46. Han HR, Chan K, Song H, Nguyen T, Lee JE, Kim MT. Development and Evaluation of a Hypertension Knowledge Test for Korean Hypertensive Patients. J Clin Hypertens 2011;13:750-7. https://doi.org/10.1111/j.1751-7176.2011.00497.x
  47. Fitzgerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG, Davis WK. The Reliability and Validity of a Brief Diabetes Knowledge Test. Diabetes Care 1998;21:706-10. https://doi.org/10.2337/diacare.21.5.706
  48. Leake B, Nyamathi A, Gelberg L. Reliability, Validity, and Composition of a Subset of the Centers for Disease Control and Prevention Acquired Immunodeficiency Syndrome Knowledge Questionnaire in a Sample of Homeless and Impoverished Adults. Med Care 1997;35:747-55. https://doi.org/10.1097/00005650-199708000-00001
  49. Schuler M, Musekamp G, Faller H, Ehlebracht-Konig I, Gutenbrunner C, Kirchhof R, Bengel J, Nolte S, Osborne RH, Schwarze M. Assessment of proximal outcomes of self-management programs: translation and psychometric evaluation of a German version of the Health Education Impact Questionnaire (heiQ). Qual Life Res. 2013;22:1391-403. https://doi.org/10.1007/s11136-012-0268-6
  50. Bauer A, Kelterer D, Bartsch R, Pearson J, Stadeler M, Kleesz P, Elsner P, Williams H. Skin protection in bakersapprentices. Contact Dermatitis 2002;46:81-5. https://doi.org/10.1034/j.1600-0536.2002.460204.x
  51. Apfelbacher CJ, Funke U, Radulescu M, Diepgen TL. Determinants of current hand eczema: results from case-control studies nested in the PACO follow-up study (PACO II). Contact Dermatitis 2010;62:363-70. https://doi.org/10.1111/j.1600-0536.2010.01729.x
  52. Dickel H, Bruckner TM, Schmidt A, Diepgen TL. Impact of atopic skin diathesis on occupational skin disease incidence in a working population. J Invest Dermatol 2003;121:37-40. https://doi.org/10.1046/j.1523-1747.2003.12323.x
  53. Coenraads PJ, Diepgen TL. Risk for hand eczema in employees with past or present atopic dermatitis. Int Arch Occup Environ Health 1998;71:7-13. https://doi.org/10.1007/s004200050243
  54. Hanifin JM, Rajka G. Diagnostic Features of Atopic-Dermatitis. Acta Dermatovenereologica 1980;60:44-7.
  55. Diepgen TL, Sauerbrei W, Fartasch M. Development and validation of diagnostic scores for atopic dermatitis incorporating criteria of data quality and practical usefulness. J Clin Epidemiol 1996;49:1031-8. https://doi.org/10.1016/0895-4356(96)00119-9
  56. Diepgen TL, Fartasch M, Hornstein OP. Criteria of Atopic Skin Diathesis. Dermatos Ber Umwelt 1991;39:79-83.
  57. Akdis CA, Akdis M, Bieber T, Bindslev-Jensen C, Boguniewicz M, Eigenmann P, Hamid Q, Kapp A, Leung DY, Lipozencic J, Luger TA, Muraro A, Novak N, Platts-Mills TA, Rosenwasser L, Scheynius A, Simons FE, Spergel J, Turjanmaa K, Wahn U, Weidinger S, Werfel T, Zuberbier T. European Academy of A, Clinical Immunology/American Academy of Allergy A, Immunology PCG. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. Allergy 2006;61:969-87. https://doi.org/10.1111/j.1398-9995.2006.01153.x
  58. Kantor R, Thyssen JP, Paller AS, Silverberg JI. Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of 'atopic dermatitis'. Allergy 2016;71:1480-5. https://doi.org/10.1111/all.12982
  59. Berndt U, Hinnen U, Iliev D, Elsner P. Role of the atopy score and of single atopic features as risk factors for the development of hand eczema in trainee metal workers. Br J Dermatol 1999;140:922-4. https://doi.org/10.1046/j.1365-2133.1999.02827.x
  60. Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Hand dermatitis in a prospectively-followed cohort of hairdressing apprentices: final results of the POSH study. Prevention of occupational skin disease in hairdressers. Contact Dermatitis 1999;41:280-6. https://doi.org/10.1111/j.1600-0536.1999.tb06162.x
  61. Dulon M, Skudlik C, Nubling M, John SM, Nienhaus A. Validity and responsiveness of the Osnabruck Hand Eczema Severity Index (OHSI): a methodological study. Br J Dermatol 2009;160:137-42. https://doi.org/10.1111/j.1365-2133.2008.08870.x
  62. Skudlik C, Dulon M, Pohrt U, Appl KC, John SM. Osnabrueck hand eczema severity index - a study of the interobserver reliability of a scoring system assessing skin diseases of the hands. Contact Dermatitis 2006;55:42-7. https://doi.org/10.1111/j.0105-1873.2006.00871.x
  63. Fisker MH, Ebbehoj NE, Jungersted JM, Agner T. What do patients with occupational hand eczema know about skin care? Contact Dermatitis 2013;69:93-8. https://doi.org/10.1111/cod.12060
  64. Andersson IM, Gunnarsson K, Rosen G. Role of Headmasters, Teachers, and Supervisors in Knowledge Transfer about Occupational Health and Safety to Pupils in Vocational Education. Saf Health Work 2015;6:317-23. https://doi.org/10.1016/j.shaw.2015.07.012

피인용 문헌

  1. Health education decreases incidence of hand eczema in metal work apprentices: Results of a controlled intervention study vol.82, pp.6, 2018, https://doi.org/10.1111/cod.13502
  2. Health education decreases incidence of hand eczema in metal work apprentices: Results of a controlled intervention study vol.82, pp.6, 2018, https://doi.org/10.1111/cod.13502