pital cleaning personnel is not abundant. It
has been summarized in Table 1. The results of
investigations are not quite comparable since
different methods were used and different
populations studied (1-3). Complaints on the
occurrence of hand dermatoses among cleaning
personnel of the University Hospital of
Groningen led to an investigation by the Section
of Occupational Dermatology.
Material and Methods
The investigation was carried out in the period
from February to May 1984. In the University
Hospital, 378 persons are employed for cleaning
purposes: 356 of them (268 males and 88
females) were included in the study (4 were
absent due to long illness, 18 refused cooperation).
The age ranged from 20 to 63 years,
the mean being 40.1 years.
Their medical history of dermatological
complaints, localized to hands and forearms
was carefully screened. If considered necessary,
mycology (direct microscopy and culture) was
performed. In view of the fact that eczema
often has a varying course, we were interested
in the period prevalence. A person was considered
as a case of hand eczema if, at the time
of the examination or in the previous 3 years,
he/she had suffered from an episode of eczema
of the hands lasting at least 3 weeks. Such
persons were asked to visit the Section of
Occupational Dermatology for further history
taking according to a standardized questionnaire,
in order to evaluate exposure to allergens
and irritants in the working environment,
the nature and duration of the skin problems,
and for medical consultation.
They were patch tested with 35 substances
from the ICDRG series (Table 2), and with
25 substances to which cleaning personnel are frequently exposed (Table 3). The test substances
were obtained from Trolab (Denmark)
or prepared in our own laboratory. The tests
were applied to the back for 48 h using Patch
Test Chambers (fa. v.d. Bend, Brielle, the Netherlands)
with Fixomull tape Reading was
performed following the guidelines of the
ICDRG after 48, 72 h, and in doubtful cases
again after 96 or 120 h.
For the severity of the eczematous changes
we adopted a modification of the grading used
by Rea et al. (4):