Skip to main content

Sustainability of an interdisciplinary secondary prevention program for hairdressers

Abstract

Objective

Two hundred and fifteen hairdressers suffering from occupational skin diseases (OSD) have attended a 6-month combined dermatological and educational prevention program with an education and counseling scheme as well as an intervention in the respective hairdressers’ shops. The aim of this program, conducted from 1994 to 1997, was to enable the affected hairdressers to remain at work without suffering from major OSD.

Methods

To assess the sustainability of this interdisciplinary medical and educational training program, the intervention group (IG, N = 215) and a control group (CG, hairdressers with OSD who solely received dermatological treatment, N = 85) were followed up 9 month and 5 years after their individual project participation by a standardized questionnaire. A subcohort of the intervention group (IG1994, participants in 1994, N = 62) was followed up again 10 years after their participation.

Results

The follow-up survey 9 months after the beginning of the program (response rate: IG: N = 163, 75.8%; CG: N = 80, 94.1%) showed that 71.8% (N = 117) of the intervention group could remain in work as opposed to 60.0% (N = 48) in the control group. In the intervention group 14.7% gave up work due to OSD versus 22.5% in the control group (no statistically significant effect).

In the 5-year follow-up (response rate: IG: N = 172, 80%; CG: N = 55, 64.7%) 58.7% (N = 101) of the IG remained at work versus 29.1% (N = 16) of the CG. In the IG 12.8% had stopped work because of OSD versus 27.3% in the CG (p < 0.001, Cramer’s V = 0.26). Ten years after intervention, the follow-up showed a stabilization of the effects shown by the 5-year follow-up results.

In addition to the criteria ‘remaining’ or ‘not remaining at work’ the results show that our interdisciplinary intervention program led to an increased and sustained knowledge on OSD and more adequate prevention at the work place in the IG. The results confirm that interdisciplinary training can be successful in effecting self-protection against workplace hazards by using positive approaches that include the learning of “safe” behavior and insuring transferability to real workplace settings (“empowerment”). Combined preventive measures as studied in this program have recently become the standard offered by different statutory accident liability insurances for patients in different wet work occupations with OSD in Germany.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Agner T, Held E (2002) Skin protection programmes. Contact Dermat 47:253–256

    Article  Google Scholar 

  2. Bauer A, Kelterer D, Bartsch R, Pearson J, Stadeler M, Kleesz P, Elsner P, Williams H (2002) Skin protection in bakers’ apprentices. Contact Dermat 46:81–85

    Article  Google Scholar 

  3. Berndt U, Hinnen U, Iliev D, Elsner P (2000) Hand eczema in metalworker trainees—an analysis of risk factors. Contact Dermat 43:327–332

    Article  CAS  Google Scholar 

  4. Ehlers A, Gieler U, Stangier U (1995) Treatment of atopic dermatitis: a comparison of psychological and dermatological approaches to relapse prevention. J Consult Clin Psychol 63:624–635

    Article  CAS  Google Scholar 

  5. Flyvholm MA, Mygind K, Sell L, Jensen A, Jepsen KF (2005) A randomised controlled intervention study on prevention of work related skin problems among gut cleaners in swine slaughterhouses. Occup Environ Med 62:642–649

    Article  Google Scholar 

  6. Frosch PJ, John SM (2006) Clinical aspects of irritant contact dermatitis. In: Frosch PJ, Menné T, Lepoittevin JP (eds) Contact dermatitis, 4th edn. Springer, Berlin, pp 255–294

    Google Scholar 

  7. Geraut C, Tripodi D (2002) Prevention of occupational dermatitis. Rev Prat 52:1446–1450

    Google Scholar 

  8. Graziani C, Rosenthal MP, Diamond JJ (1999) Diabetes education program use and patient-perceived barriers to attendance. Fam Med 31:358–363

    CAS  Google Scholar 

  9. Held E, Wolff C, Gyntelberg F, Agner T (2001) Prevention of work-related skin problems in student auxiliary nurses: an intervention study. Contact Dermat 44:297–303

    Article  CAS  Google Scholar 

  10. Held E, Mygind K, Wolff C, Gyntelberg F, Agner T (2002) Prevention of work related skin problems: an intervention study in wet work employees. Occup Environ Med 59:556–561

    Article  CAS  Google Scholar 

  11. Heron RJL (1997) Worker education in the primary prevention of occupational dermatoses. Occup Med 47:407–410

    Article  CAS  Google Scholar 

  12. Jensen LK, Kofoed LB (2002) Musculoskeletal disorders among floor layers: is prevention possible? Appl Occup Environ Hyg 17:797–806

    Article  Google Scholar 

  13. Kanzler MH, Gorsulowsky DC (2002) Patients’ attitudes regarding physical characteristics of medical care providers in dermatologic practices. Arch Dermatol 138:463–466

    Article  Google Scholar 

  14. Lorish CD, Boutaugh ML (1997) Patient education in rheumatology. Curr Opin Rheumatol 9:106–111

    Article  CAS  Google Scholar 

  15. Napalkov N (1995) The role of the World Health Organization in promoting patient education with emphasis on chronic diseases. In: Assal J-P, Golay A, Visser AP (eds) New trends in patient education. Elsevier, Amsterdam, pp 5–7

    Google Scholar 

  16. Nienhaus A, Rojahn K, Skudlik C, Wulfhorst B, Dulon M, Brandenburg S (2004) Sekundäre Individualprävention bei FriseurInnen mit arbeitsbedingten Hauterkrankungen. Gesundheitswesen 66:759–764

    Article  CAS  Google Scholar 

  17. Radulescu M, Bock M, Bruckner T, Ellsäßer G, Fels H, Diepgen TL (2007) Health education on occupational allergies and dermatoses for adolescents. JDDG 5: 576–582, English online version www.blackwell-synergy.com/loi/ddg

  18. Schmid-Ott G, Jaeger B, Kuensebeck HW, Ott R, Lamprecht F (1996) Dimension of stigmatisation in patients with psoriasis in a “Questionnaire on experience with skin complaints”. Dermatology 193:304–310

    Article  CAS  Google Scholar 

  19. Schurer NY, Klippel U, Schwanitz HJ (2005) Secondary individual prevention of hand dermatitis in geriatric nurses. Int Arch Occup Environ Health 78:149–157

    Article  Google Scholar 

  20. Schwanitz HJ, Wulfhorst B (2000) Workers education. In: Kanerva L et al (eds) Occupational dermatoses handbook. Springer, Berlin, pp 441–443

    Google Scholar 

  21. Schwanitz HJ, Riehl U, Schlesinger T, Bock M, Skudlik C, Wulfhorst B (2003) Skin care management: educational aspects. Int Arch Occup Environ Health 76:374–381

    Article  Google Scholar 

  22. Skudlik C, Breuer K, Junger M, Allmers H, Brandenburg S, John SM (2008a) Optimal care of patients with occupational hand dermatitis. Considerations of German occupational health insurance. Hautarzt 59:690–695

    Article  CAS  Google Scholar 

  23. Skudlik C, John SM (2007) Skin protection in hairdressers. In: Schliemann S, Elsner P (eds) Skin protection; series: current problems in dermatology, vol 34. Karger, Basel, pp 133–137

    Google Scholar 

  24. Skudlik C, Wulfhorst B, Gediga G, Bock M, Allmers H, John SM (2008b) Tertiary individual prevention of occupational skin diseases: a decade’s experience with recalcitrant occupational dermatitis. Int Arch Occup Environ Health 81:1059–1064

    Article  CAS  Google Scholar 

  25. Skudlik C, Weisshaar E, Scheidt R, Wulfhorst B, Diepgen TL, Elsner P, Schönfeld M, John SM (2008c) Multicenter study “medical-occupational rehabilitation procedure skin—optimizin and quality assurance of inpatient-management (ROQ)”. JDDG 6. doi: 10.1111/j.1610-0387.2008.06864.x

  26. Weisshaar E, Radulescu M, Bock M, Albrecht U, Diepgen TL (2006) Educational and dermatological aspects of secondary individual prevention in healthcare workers. Contact Dermat 54:254–260

    Article  Google Scholar 

  27. World Health Organization (WHO) (1986) Ottawa Charta for Health Promotion. WHO, Genf

  28. Wulfhorst B, Schwanitz HJ (2003) Gesundheitserziehung in Hautrisikoberufen. Allergologie 29:387–395

    Google Scholar 

  29. Wulfhorst B, Bock M, John SM (2006) Worker’s education and teaching programmes: the German experience. In: Frosch PJ, Menné T, Lepoittevin J-P (eds) Textbook of contact dermatitis, 4th edn. Springer, Berlin, pp 855–860

    Google Scholar 

Download references

Conflict of interest statement

The authors declare that they have no conflict of interest.

Author information

Affiliations

Authors

Corresponding author

Correspondence to B. Wulfhorst.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Wulfhorst, B., Bock, M., Gediga, G. et al. Sustainability of an interdisciplinary secondary prevention program for hairdressers. Int Arch Occup Environ Health 83, 165–171 (2010). https://doi.org/10.1007/s00420-009-0480-z

Download citation

Keywords

  • Occupational skin diseases (OSD)
  • Prevention program
  • Health education
  • Educational training program
  • Long-term effectiveness
  • Hairdressers