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Difference between hand and forearm transepidermal water loss and skin pH as an improved method to biomonitor occupational hand eczema: our findings in healthcare workers Cover

Difference between hand and forearm transepidermal water loss and skin pH as an improved method to biomonitor occupational hand eczema: our findings in healthcare workers

Open Access
|Sep 2024

Figures & Tables

Hand and forearm transepidermal water loss (TEWL) among healthcare professionals by sex and glove use (N=148)

SexGlove use (h)
Men N=67Women N=810–1 h N=261–4 h N=35>4 h N=87
Hand TEWL [g/m2/h] Median (IQR; total range)26.99 (19.21–36.56; 9.55–75.54) a18.70 (14.63–24.53; 8.91–46.77)17.98 (13.88–24.97; 8.91–57.70)19.79 (16.11–29.71; 11.67–75.54)21.77 (17.00–32.41; 9.55–59.95)
Compromised skin barrier (hand TEWL >30 g/m2/h) N (%)30 (45)a9 (11)3 (12)9 (26)27 (31)
ΔTEWL* Median (IQR, total range)14.94 (7.09–23.65; −12.27–43.02)a7.95 (3.78–11.23; −14.80–29.03)6.58 (1.85–10.65; −14.80–28.96)b7.99 (5.23–14.02; −12.27–37.91)b10.95 (5.70–19.57; −6.17–43.02)b
ΔTEWL%** [%] Median (IQR, total range)113 % (65–234; −38 –549)a63 % (41–106; −34–311)62 % (17–109; −32–394)b64 % (49–109; −38–336)b104 % (50–183; −34–549)b
Hand skin pH Median (IQR, total range)5.01 (4.59–5.37; 4.01–6.50)a5.36 (5.14–5.63; 4.06–6.39)5.21 (4.82–5.40; 4.09–6.16)5.07 (4.74–5.57; 4.01–6.18)5.25 (5.01–5.59; 4.23–6.50)
Compromised skin acidity (hand pH >5.5) N (%)13 (19)a30 (37)4 (15)10 (29)29 (33)
ΔpH*** Median (IQR, total range)0.23 (−0.02–0.48; −0.47–1.79)0.11 (−0.22–0.59; −0.87–1.39)0.06 (−0.22–0.31; −0.51–0.74)b0.16 (−0.16–0.35; −0.87–1.40)b0.27 (−0.02–0.66; −0.79–1.79)b
ΔpH%**** [%] Median (IQR, total range)5 % (0–11; −10–38)2 % (−4–12; −18–29)1 % (−5–6; −8–17)b3 % (−3–8; −18–31)b5 % (0–14; −15–38)b

Hand and forearm transepidermal water loss (TEWL) by groups of healthcare professionals (N=148)

Physicians, non–surgeon specialisations N=37Physicians, surgeons N=37Dentists, non–surgeon specialisations N=37Dentists, surgeons N=37
Hand TEWL [g/m2/h] Median (IQR; total range)19.73 (14.22–24.97; 8.91–57.70)a19.78 (16.08–26.99; 11.03–75.54)20.76 (17.79–30.02; 9.55–57.87)25.80 (19.24–34.31; 9.91–59.95)
Compromised skin barrier (hand TEWL >30 g/m2/h) N (%)5 (14)a8 (22)a10 (27)16 (43)
Forearm TEWL [g/m2/h] Median (IQR; total range)11.45 (9.65–14.76; 5.89–57.37)12.08 (9.70–14.22; 4.84–57.71)b9.86 (7.93–12.75; 5.31–45.02)10.48 (8.64–12.93; 6.98–45.11)
ΔTEWL* [g/m2/h] Median (IQR, total range)7.20 (2.73–10.67; −14.8–28.96)a; b7.21 (4.54–16.85; −12.27–43.02)a9.99 (4.00–19.52; 0.98–37.86)13.39 (7.78–24.16; 0.41–37.91)
ΔTEWL%** [%] Median (IQR; total range)56 (24–106; −34–394)a; b65 (42–107; −38–407)a104 (48–189; 3–549)108 (67–184; 4–383)

Personal characteristics of the participants (N=148), their habits related to skin health, and their skin condition

Physicians, non-surgeon specialisations N=37Physicians, surgeons N=37Dentists, non-surgeon specialisations N=37Dentists, surgeons N=37
Men, N (%)5 (14)24 (65)11 (30)27 (73)

Age [years]41 (31–46; 27–57)39 (32–53; 28–63)39 (33–47; 25–63)37 (34–43; 28–62)
Median (IQR; total range)

History of atopic dermatitis, N (%)2 (5)2 (5)8 (22)2 (5)

One or more skin lesions on clinical examination, N (%)*15 (41)15 (41)22 (59)17 (46)

Washing hands >20 times per day, N (%)14 (38)10 (27)15 (41)17 (46)

Disinfecting hands >10 times/day, N (%)17 (46)13 (35)6 (16)16 (43)

Gloves – time worn per day, N (%)
0–1h25 (68)1 (3)0 (0)0 (0)
1–4h8 (22)18 (49)4 (11)5 (14)
>4h/h4 (11)18 (49)33 (89)32 (86)

Hand and forearm pH by groups of healthcare professionals (N=148)

Physicians, non–surgeon specialisations N=37Physicians, surgeons N=37Dentists, non–surgeon specialisations N=37Dentists, surgeons N=37
Hand skin pH Median (IQR, total range)5.25 (4.84–5.43; 4.06–6.16)b5.07 (4.76–5.43; 4.01–6.18)b5.33 (5.15–5.60; 4.38–6.50)a5.22 (4.69–5.57; 4.26–6.23)
Compromised skin acidity (hand pH >5.5) N (%)8 (22)9 (24)14 (38)12 (32)
Forearm skin pH Median (IQR, total range)5.10 (4.65–5.53; 4.26–5.97)4.92 (4.51–5.22; 3.74–6.31)5.04 (4.69–5.54; 4.16–6.33)a4.70 (4.37–5.32; 4.01–5.88)
ΔpH* Median (IQR; total range)0.12 (−0.14–0.31; −0.87–0.90)a0.16 (−0.20–0.39; −0.63–1.40)0.30 (−0.11–0.64; −0.78–1.79)0.27 (0.01–0.72; −0.79–1.30)
ΔpH%** [%] Median (IQR, total range)2 (−3–7; −18–19)a3 (−4–8; −12–31)6 (−2–14; −2–38)6 (0–15; −15–29)
DOI: https://doi.org/10.2478/aiht-2024-75-3885 | Journal eISSN: 1848-6312 | Journal ISSN: 0004-1254
Language: English, Croatian, Slovenian
Page range: 172 - 179
Submitted on: Aug 1, 2024
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Accepted on: Sep 1, 2024
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Published on: Sep 29, 2024
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2024 Željka Babić, Franka Šakić, Iva Japudžić Rapić, Liborija Lugović-Mihić, Jelena Macan, published by Institute for Medical Research and Occupational Health
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.