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Prävention des Handekzems

Prevention of hand eczema

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Zusammenfassung

Handekzeme können neben anlagebedingtem Ursprung auch Ausdruck eines beruflich oder außerberuflich bedingten irritativen oder allergischen Kontaktekzems sein. Dies bietet Ansatzpunkte für sich ergänzende Maßnahmen auf der Ebene der primären, sekundären und tertiären Prävention. Im Vordergrund steht dabei die Identifikation des/der Auslöser(s) mit nachfolgender Reduktion oder Elimination der entsprechenden Exposition. Wichtige Präventionsansätze sind gesetzliche Regelungen, technische und organisatorische Maßnahmen sowie die korrekte Verwendung einer adäquaten persönlichen Schutzausrüstung (z. B. Schutzhandschuhe). Gesundheitspädagogische Interventionen können dabei das individuelle Hautschutzverhalten verbessern. Auch wenn die Evidenz zur Effektivität von Präventionsansätzen beim Handekzem begrenzt ist, haben diese besonders bei beruflicher Verursachung eine große Bedeutung, da dadurch die Entstehung einer Berufskrankheit (BK-Nr. 5101) verhindert bzw. deren Folgen gemindert werden können. In Deutschland wurde daher ein komplexes, abgestuftes Präventionskonzept für Berufsdermatosen etabliert. In den letzten Jahren konnte gezeigt werden, dass insbesondere die daran beteiligten Maßnahmen der sekundären und tertiären Individualprävention einen hohen Stellenwert haben.

Abstract

Apart from endogenous factors, hand eczema is often caused by irritant or allergic contact dermatitis related to occupational or non-occupational exposure to skin hazards. This enables several complementary approaches on the level of primary, secondary and tertiary prevention. A high priority is set on identification and subsequent reduction or elimination of causative exposures. Important preventive approaches include legal regulations, technical and organizational measures as well as correct use of adequate personal protective equipment (e.g. protective gloves). Interventions based on health education are conducted to improve individual protective behaviour. Even though evidence-based proof of effectiveness is limited, preventive measures are considered of particular importance for avoidance of occupational hand eczema and its adverse sequelae. Therefore, a complex, step-wise approach to occupational skin diseases has been established in Germany. In recent years, the positive impact of secondary and tertiary preventive measures of this approach has been demonstrated.

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Authors and Affiliations

  1. Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland

    R. Brans &  C. Skudlik

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  1. R. Brans
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Correspondence to R. Brans.

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Interessenkonflikt

R. Brans und C. Skudlik geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Brans, R., Skudlik, C. Prävention des Handekzems. Hautarzt 70, 797–803 (2019). https://doi.org/10.1007/s00105-019-4463-z

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