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Management of occupational dermatitis in healthcare workers: a systematic review
  1. J Smedley,
  2. S Williams,
  3. P Peel,
  4. K Pedersen on behalf of the Dermatitis Guideline Development Group
  1. Health and Work Development Unit, Royal College of Physicians, London, UK
  1. Correspondence to Dr Julia Smedley, c/o Health and Work Development Unit, Royal College of Physicians, 11 St Andrews Place, London NW1 4LE, UK; hwdu{at}


Objectives This systematic review informed evidence-based guidelines for the management of occupational dermatitis, with a particular focus on healthcare workers.

Methods A multidisciplinary guideline group formulated questions about the management of healthcare workers with dermatitis. Keywords derived from these questions were used in literature searches. We appraised papers and developed recommendations using the Scottish Intercollegiate Guideline Network (SIGN) methodology.

Results Literature searches identified 1677 papers; 11 met the quality standard (SIGN grading ++ or +). A small body of evidence indicated that dermatitis is more likely to be colonised with micro-organisms than normal skin, but there was insufficient evidence about the risk of transmission to patients. There was limited evidence that using alcohol gel for hand decontamination is less damaging to skin than antiseptics or soap. A small body of evidence showed that conditioning creams improve dermatitis, but are not more effective than their inactive vehicle. A small inconsistent body of evidence showed that workplace skin care programmes improve dermatitis.

Conclusions Healthcare workers should seek early treatment for dermatitis and should be advised about the risk of bacterial colonisation. Work adjustments should be considered for those with severe or acute dermatitis who work with patients at high risk of hospital-acquired infection. Healthcare workers with dermatitis should follow skin care programmes, and use alcohol gel where appropriate for hand decontamination. Further research should explore whether healthcare workers with dermatitis are more likely to transmit infection to their patients, and whether health surveillance is effective at reducing dermatitis.

  • Occupational health
  • dermatitis
  • evidence-based guideline
  • health and safety

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  • This article is a summary of the Royal College of Physicians guideline ‘Dermatitis: occupational aspects of management’, reproduced with permission.

  • Funding The review (and the development of the guideline) were funded by NHS Plus.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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