De Hands4U-studie. Preventie van handeczeem bij zorgverleners

  • 9 min.
  • Shortpaper

Summary

The Hands4U study. Implementing a guideline for the prevention of hand eczema among healthcare workers

Hand eczema is one of the most prevalent occupational diseases in Europe. Healthcare workers are at risk for developing this disease. Although recommendations for the prevention of hand eczema exist, the compliance to these measures among healthcare workers appears to be low. Therefore, a multifaceted implementation strategy was developed to enhance the implementation of these recommendations among healthcare workers. To investigate the (cost) effectiveness of this strategy, a randomized controlled trial was performed. In this trial, 773 healthcare workers participated in the control group and 876 participated in the intervention group. The intervention group received the strategy consisting of participatory working groups, role models, education, reminders and a leaflet. The control group only rece ived a leaflet. Hand eczema and behaviour related to the prevention of hand eczema were measured by means of a questionnaire at baseline, as well as 3, 6, 9 and 12 months after baseline. After one year, the multifaceted implementation strategy appears to be effective in terms of behaviours associated with the implemented recommendations for the prevention of hand eczema. However the economic evaluation demonstrates very high costs for the implementation strategy. Consequently, the strategy is not recommended for use at this time. Another finding is more hand eczema after one year in the intervention group compared to the control group. Further research is needed to investigate this unexpected result.

Inleiding

In Europa is handeczeem een van de meest prevalente arbeidsgerelateerde aandoeningen (1). Vooral mensen die in de zorg werken, hebben een verhoogd risico op hand eczeem, omdat ze regelmatig in contact komen met water en zeep tijdens hun werk (2,3). Door herhaalde blootstelling aan deze irriterende stoffen kan op den duur handeczeem ontstaan (4). Wanneer gekeken wordt naar de jaarprevalentie van handeczeem ligt deze voor zorgverleners op 20% (5,6). Gezien dit hoge prevalentiecijfer is de preventie van handeczeem bij deze beroepsgroep van groot belang. Daarom ontwikkelde de Nederlandse Vereniging voor Arbeids- en Bedrijfsgeneeskunde (NVAB) de richtlijn Contacteczeem: preventie en behandeling (7). In deze richtlijn staan aanbevelingen over hoe zorgverleners op het werk de handen gezond kunnen houden:

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