Discussion
In this study, cleaners weremore likely to have a rash than
OBW. The rash was more likely to be on their hands and
they washed their handsmore often thanOBWsuggesting
that contact agents such as water and chemicals are the
causative agents of rash as has been previously reported
[1]. Cleaners were also more likely to indicate that their
rash was worse at work, suggesting that occupational factors
may be causative or exacerbating this.
Wet work has been cited as the main cause of occupational
contact dermatitis in the cleaning industry [20].
Jungbauer et al. [20] found that wet work comprised
50% of cleaning work. Nielson [21], in a study of female
cleaners in nursing homes, schools and offices, found that
20% reported problems with cleaning agents and a key
risk factor was the number of hours per week with wet
hands. Similarly, Nilsson [22] found that water, cleaning agents, disinfectants and wearing gloves were associated
with hand dermatitis in 92% of those studied.
Only 21% of male cleaners and 16% of female cleaners
reported that they had received workplace training about
skin care. Moreover, cleaners with a rash were less likely
to report receiving workplace training regarding their skin
as compared to cleaners without a rash.Workplace training
aimed at skin care awareness and prevention is an especially
importantmeasure [23]. Held et al. [23] found that formalized
educational training forwetwork employees as part of
an occupational health and safetymanagement system increased
knowledge about skin care, changed behaviour
with respect to wet work habits and decreased clinical dermatitis
symptoms. A similar educational programme directed
at cleaners may be a successful preventive measure.
Personal protection is a widely cited preventive strategy
for dermatitis among cleaners [6,20]. However, the role
of glove use was inconclusive in our study.