Prevention of Hand Eczema: Gloves, Barrier Creams and Workers’ Education



To date, there is fair-quality evidence from a large number of countries, where preventive initiatives for occupational contact dermatitis (OCD) in selected settings and professions have proven significantly effective and successful; in this context, early dermatological intervention as well as specific teaching of affected individuals has been demonstrated as pivotal. Undoubtedly, awareness to OCD, its pathogenesis and prevention by those at risk have, as yet, to be improved in all countries. Thus, it is an imminent future task to improve on workers’ education, multi-disciplinary approaches being advisable. Prevention may increasingly become a stronghold for dermatology: by their specific knowledge and competence – in close cooperation with other disciplines – dermatologists can save their patients’ health and jobs, and thus also save expenses for tax-payers and insurance systems. Of course, preventive intervention needs to be accompanied by common regulatory efforts including evidence-based standards for adequate manufacturing and use of gloves, protective creams and after-work skin care to limit exposure to hazardous substances.


Skin Care Natural Rubber Latex Hand Eczema Skin Protection Irritant Contact Dermatitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Agner T, Andersen KE, Brandao FM, Bruynzeel DP, Bruze M, Frosch P, Goncalo M, Goossens A, Le Coz CJ, Rustemeyer T, White IR, Diepgen T (2008) Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients. Contact Dermatitis 59:43–47PubMedGoogle Scholar
  2. 2.
    Moberg C, Alderling M, Meding B (2009) Hand eczema and quality of life: a population-based study. Br J Dermatol 161:397–403PubMedGoogle Scholar
  3. 3.
    Diepgen TL, Andersen KE, Brandao FM, Bruze M, Bruynzeel DP, Frosch P, Goncalo M, Goossens A, Le Coz CJ, Rustemeyer T, White IR, Agner T (2009) Hand eczema classification: a cross-sectional, multicentre study of the aetiology and morphology of hand eczema. Br J Dermatol 160:353–358PubMedGoogle Scholar
  4. 4.
    Brown T (2004) Strategies for prevention: occupational contact dermatitis. Occup Med (Lond) 54(7):450–457Google Scholar
  5. 5.
    Skudlik C, Breuer K, Junger M, Allmers H, Brandenburg S, John SM (2008) Optimal care of patients with occupational hand dermatitis: considerations of German occupational health insurance. Hautarzt 59:690–695PubMedGoogle Scholar
  6. 6.
    Diepgen TL, Schmidt A (2002) Werden Inzidenz und Prävalenz berufsbedingter Hauterkrankungen unterschätzt? Arbeitsmed Sozialmed Umweltmed 37:477–480Google Scholar
  7. 7.
    Emmett EA (2002) Occupational contact dermatitis I: incidence and return to work pressures. Am J Contact Dermat 13:30–34PubMedGoogle Scholar
  8. 8.
    Mathias CGT (1985) The cost of occupational skin disease. Arch Dermatol 121:1519–1524Google Scholar
  9. 9.
    Allmers H, Schmengler J, John SM (2004) Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German healthcare workers. J Allergy Clin Immunol 114:347–351PubMedGoogle Scholar
  10. 10.
    Attwa E, el-Laithy N (2009) Contact dermatitis in car repair workers. J Eur Acad Dermatol Venereol 23:138–145Google Scholar
  11. 11.
    Bauer A, Kelterer D, Bartsch R, Stadeler M, Elsner P (2007) Skin protection in the food industry. Curr Probl Dermatol 34:138–150PubMedGoogle Scholar
  12. 12.
    Brown TP, Rushton L, Williams HC, English JS (2007) Intervention implementation research: an exploratory study of reduction strategies for occupational contact dermatitis in the printing industry. Contact Dermatitis 56(1):16–20PubMedGoogle Scholar
  13. 13.
    Held E, Agner T (2006) The Danish experience: prevention of skin problems in wet work employees. In: Frosch PJ, Menné T, Lepoittevin J-P (eds) Contact dermatitis. Springer, Berlin, pp 864–867Google Scholar
  14. 14.
    Held E, Wolff C, Gyntelberg F, Agner T (2001) Prevention of work-related skin problems in student auxiliary nurses: an intervention study. Contact Dermatitis 44:297–303PubMedGoogle Scholar
  15. 15.
    Kaatz M, Ladermann R, Stadeler M, Fluhr JW, Elsner P, Bauer A (2008) Recruitment strategies for a hand dermatitis prevention programme in the food industry. Contact Dermatitis 59:165–170PubMedGoogle Scholar
  16. 16.
    Kütting B, Weistenhöfer W, Baumeister T, Uter W, Drexler H (2009) Current acceptance and implementation of preventive strategies for occupational hand eczema in 1355 metalworkers in Germany. Br J Dermatol 161:390–396PubMedGoogle Scholar
  17. 17.
    Löffler H, Bruckner T, Diepgen TL, Effendy I (2006) Primary prevention in health care employees: a prospective intervention study with a 3-year training period. Contact Dermatitis 54:202–209PubMedGoogle Scholar
  18. 18.
    Mygind K, Borg V, Flyvholm MA, Sell L, Jepsen KF (2006) A study of the implementation process of an intervention to prevent work-related skin problems in wet-work occupations. Int Arch Occup Environ Health 79:66–74PubMedGoogle Scholar
  19. 19.
    Schurer NY, Klippel U, Schwanitz HJ (2005) Secondary individual prevention of hand dermatitis in geriatric nurses. Int Arch Occup Environ Health 78:149–157PubMedGoogle Scholar
  20. 20.
    Schwanitz HJ, Riehl U, Schlesinger T, Bock M, Skudlik C, Wulfhorst B (2003) Skin care management: educational aspects. Int Arch Occup Environ Health 76:374–381PubMedGoogle Scholar
  21. 21.
    Skudlik C, Weisshaar E, Scheidt R, Wulfhorst B, Diepgen TL, Elsner P, Schonfeld M, John SM (2009) Multicenter study “Medical-Occupational Rehabilitation Procedure Skin - optimizing and quality assurance of inpatient-management (ROQ)”. J Dtsch Dermatol Ges 7(2):122–126PubMedGoogle Scholar
  22. 22.
    Weisshaar E, Radulescu M, Soder S, Apfelbacher CJ, Bock M, Grundmann JU, Albrecht U, Diepgen TL (2007) Secondary individual prevention of occupational skin diseases in health care workers, cleaners and kitchen employees: aims, experiences and descriptive results. Int Arch Occup Environ Health 80:477–484PubMedGoogle Scholar
  23. 23.
    Winker R, Salameh B, Stolkovich S, Nikl M, Barth A, Ponocny E, Drexler H, Tappeiner G (2009) Effectiveness of skin protection creams in the prevention of occupational dermatitis: results of a randomized, controlled trial. Int Arch Occup Environ Health 82:653–662PubMedGoogle Scholar
  24. 24.
    Agner T, Held E (2002) Skin protection programmes. Contact Dermatitis 47:253–256PubMedGoogle Scholar
  25. 25.
    Bourke J, Coulson I, English J (2009) Guidelines for the management of contact dermatitis: an update. Br J Dermatol 160:946–954PubMedGoogle Scholar
  26. 26.
    English JS (2004) Current concepts of irritant contact dermatitis. Occup Environ Med 61(722–726):674Google Scholar
  27. 27.
    European Agency for Safety and Health at Work (2008) European Risk Observatory report: Occupational skin diseases and dermal exposure in the EU (EU-25).
  28. 28.
    Batzdorfer L, Schwanitz HJ (2004) Direkte und indirekte Kosten berufsbedingter Hauterkrankungen. Arbeitsmed, Sozialmed, Umweltmed 11:578–582Google Scholar
  29. 29.
    National Occupational Research Agenda (o. J.) Developing dermal policy based on laboratory and field studies. A new National Institute for Occupational Safety and Health (NIOSH) research program in response to the National Occupational Research Agenda (NORA). DHHS (NIOSH) Publication No. 2000-142. Accessed 10 Aug 2009
  30. 30.
    Uter W, Geier J, Lessmann H, Schnuch A (2006) Is contact allergy to glyceryl monothioglycolate still a problem in Germany? Contact Dermatitis 55:54–56PubMedGoogle Scholar
  31. 31.
    de Jongh CM, John SM, Bruynzeel DP, Calkoen F, van Dijk FJH, Khrenova L, Rustemeyer T, Verberk MM, Kezic S (2008) Cytokine gene polymorphisms and susceptibility to chronic irritant contact dermatitis. Contact Dermatitis 58:269–277PubMedGoogle Scholar
  32. 32.
    de Jongh CM, Khrenova L, Verberk M, Calkoen F, van Dijk FJH, Voss H, John SM, Kezic S (2008) Loss-of-function polymorphisms in the filaggrin gene increase susceptibility to chronic irritant contact dermatitis. Br J Dermatol 159:621–627PubMedGoogle Scholar
  33. 33.
    Li H, Dai Y, Huang H, Li L, Leng S, Cheng J, Niu Y, Duan H, Liu Q, Zhang X, Huang X, Xie J, Feng Z, Wang J, He J, Zheng Y (2007) HLA-B*1301 as a biomarker for genetic susceptibility to hypersensitivity dermatitis induced by trichloroethylene among workers in China. Environ Health Perspect 115:1553–1556PubMedGoogle Scholar
  34. 34.
    Rogosky E, Zec S (2009) Präventionskampagne Haut. Deutsche Gesetzliche Unfallversicherung (DGUV), BerlinGoogle Scholar
  35. 35.
    John SM (2008) Occupational skin diseases: options for multidisciplinary networking in preventive medicine. GMS Ger Med Sci 6:Doc07.
  36. 36.
    Slodownik D, Lee A, Nixon R (2008) Irritant contact dermatitis: a review. Australas J Dermatol 49(1):1–11PubMedGoogle Scholar
  37. 37.
    Dickel H, Kuss O, Schmidt A, Diepgen TL (2002) Impact of preventive strategies on trend of occupational skin disease in hairdressers: population based register study. BMJ 324:1422–1423Google Scholar
  38. 38.
    Nienhaus A, Rojahn K, Skudlik C, Wulfhorst B, Dulon M, Brandenburg S (2004) Secondary individual prevention and rehabilitation in female hairdressers suffering from skin diseases. Gesundheitswesen 66:759–804PubMedGoogle Scholar
  39. 39.
    Skudlik C, Dulon M, Wendeler D, John SM, Nienhaus A (2009) Hand eczema in geriatric nurses in Germany. Prevalence and risk factors. Contact Dermatitis 60: 136–143PubMedGoogle Scholar
  40. 40.
    John SM, Skudlik C, Römer W, Blome O, Brandenburg S, Diepgen TL, Harwerth A, Köllner A, Pohrt U, Rogosky E, Schindera I, Stary A, Worm M (2007) Recommendation: Dermatologist’s procedure. Recommendations for quality assurance of the German Society of Dermatology (DDG) and the Task Force on Occupational and Environmental Dermatology (ABD). JDDG 5(12):1146–1148Google Scholar
  41. 41.
    Voss H, Mentzel F, Wilke A, Maier B, Gediga G, Skudlik C, John SM (2009) Optimized dermatologist’s report and hierarchical multi-step invention: randomized evaluation of the cornerstones of preventive occupational dermatology. Hautarzt 60:695–701Google Scholar
  42. 42.
    Skudlik C, Junger M, Palsherm K, Breuer K, Brandenburg S, John SM (2009) Cooperation among clinics and practices: integrated medical care in occupational dermatology. Hautarzt 60:722–726Google Scholar
  43. 43.
    Skudlik C, Wulfhorst B, Gediga G, Bock M, Allmers H, John SM (2008) Tertiary individual prevention of occupational skin diseases: a decade’s experience with recalcitrant occupational dermatitis. Int Arch Occup Environ Health 81:1059–1064PubMedGoogle Scholar
  44. 44.
    Skudlik C, Schwanitz HJ (2004) Tertiary prevention of occupational skin diseases. JDDG 2:424–434PubMedGoogle Scholar
  45. 45.
    Packham CL (2006) Gloves as chemical protection - can they really work? Ann Occup Hyg 50(6):545–548PubMedGoogle Scholar
  46. 46.
    Health & Safety Executive (2009) Choosing the right gloves to protect skin. []
  47. 47.
    Council Directive of 21 December 1989 on the approximation of the laws of the Member States relating to personal protective equipment: 89/686/EECGoogle Scholar
  48. 48.
    CEN (2003) EN374-I -3,2003, protective gloves against chemicals and micro-organisms. Comité Européen de Normalisation, BrusselsGoogle Scholar
  49. 49.
    EU (2006) Regulation (EC) 1907/2006. Registration, evaluation, authorisation and restriction of chemicals (REACH). Official J Eur Union (30.12.2006) L396/1-L396/849Google Scholar
  50. 50.
    Leuchtenberg-Auffahrt E, Rühl R (2007) Safety of gloves for chemical protection. Ann occup Hyg 51(8):739–740Google Scholar
  51. 51.
    Mellström GA, Carlsson B (2005) European Standards on protective gloves. In: Boman A, Estlander T, Wahlberg JE, Maibach HI (eds) Protective gloves for occupational use, 2nd edn. CRC Press, Boca Raton, pp 29–34Google Scholar
  52. 52.
    CEN (2003) EN455 I-III Medical gloves for single use. Part I: requirements and testing for freedom from holes, part II: requirements and testing for physical properties, part III: requirements and testing for biological evaluation. Comité Européen de Normalisation, BrusselsGoogle Scholar
  53. 53.
    CEN (2003) EN374-I-III Protective gloves against chemicals and micro-organisms. Part I: terminology and performance requirements, part II: determination of resistance for penetration, part III: determination of resistance to permeation by chemicals. Comité Européen de Normalisation, BrusselsGoogle Scholar
  54. 54.
    Henry NW III (2005) U.S. rules, regulations and standards for protective gloves for occupational use. In: Boman A, Estlander T, Wahlberg JE, Maibach HI (eds) Protective gloves for occupational use, 2nd edn. CRC, Boca Raton, pp 35–42Google Scholar
  55. 55.
    BAuA (2008) TRGS 401. Risks resulting from skin contact – determination, evaluation, measures. []
  56. 56.
    CEN (2003) EN374-2:2003, protective gloves against chemicals and micro-organisms. Part 2: determination of resistance to penetration. Comité Européen de Normalisation, BrusselsGoogle Scholar
  57. 57.
    American Society of Testing and Materials ASTM (2009) F 903 standard test method for resistance of protective clothing materials to penetration by liquids. In: ASTM annual book of ASTM standards, vol 11.03.
  58. 58.
    CEN (2003) EN374-III: protective gloves against chemicals and micro-organisms. Part 3: determination of resistance to permeation by chemicals. Comité Européen de Normalisation, BrusselsGoogle Scholar
  59. 59.
    American Society of Testing and Materials ASTM (2009) F 739 standard test method for resistance of protective clothing materials to permeation by liquids or gases under conditions of continuous contact. In: ASTM annual book of ASTM standards, vol 11.03.
  60. 60.
    American Society of Testing and Materials ASTM (2009) F 1383 standard test method for resistance of protective clothing materials to permeation by liquids or gases under conditions of intermittent contact. In: ASTM annual book of ASTM standards, vol 11.03.
  61. 61.
    Boman A, Mellström GA (2006) Protective gloves. In: Frosch PJ, Menné T, Lepoittevin JP (eds) Contact dermatitis, 4th edn. Springer, Berlin, pp 845–853Google Scholar
  62. 62.
    Mellström GA, Boman A (2005) Gloves: types, materials, and manufacturing. In: Boman A, Estlander T, Wahlberg JE, Maibach HI (eds) Protective gloves for occupational use, 2nd edn. CRC, Boca Raton, pp 15–28Google Scholar
  63. 63.
    Mellström GA, Boman A (2006) Protective gloves. In: Chew A-L, Maibach HI (eds) Irritant dermatitis. Springer, Berlin, pp 409–419Google Scholar
  64. 64.
    Packham CL, Packham HE (2005) Practical considerations when selecting and using gloves for chemical protection in a workplace. In: Boman A, Estlander T, Wahlberg JE, Maibach HI (eds) Protective gloves for occupational use, 2nd edn. CRC, Boca Raton, pp 255–285Google Scholar
  65. 65.
    Rawson BV, Cocker J, Evans PG, Wheeler JP, Akrill PM (2005) Internal contamination of gloves: routes and consquences. Ann Occup Hyg 49(6):535–541PubMedGoogle Scholar
  66. 66.
    Jungbauer FHW, Van der Harst JJ, Groothoff JW, Coenraads PJ (2004) Skin protection in nursing work: promoting the use of gloves and hand alcohol. Contact Dermatitis 51:135–140PubMedGoogle Scholar
  67. 67.
    Zhai H, Maibach HI (2001) Skin occlusion and irritant and allergic contact dermatitis: an overview. Contact Dermatitis 44:201–206PubMedGoogle Scholar
  68. 68.
    Kligman AM (1996) Hydration injury to human skin. In: Van der Valk PGM, Maibach HI (eds) The irritant contact dermatitis syndrome. CRC, Boca Raton, pp 187–194Google Scholar
  69. 69.
    Schäfer P, Bewick-Sonntag C, Capri MG, Berardesca E (2002) Physiological changes in skin barrier function in relation to occlusion level, exposure time and climatic conditions. Skin Pharmacol Appl Skin Physiol 15:7–19PubMedGoogle Scholar
  70. 70.
    Wetzky U, Bock M, Wulfhorst B, John SM (2009) Short- and long-term effects of single and repetitive glove occlusion on the epidermal barrier. Arch Dermatol Res 301(8):595–602PubMedGoogle Scholar
  71. 71.
    Fartasch M (2009) Veränderungen der Haut durch das feuchte Milieu versus Okklusion durch Schutzhandschuhe. JDDG (Suppl.4)7:14Google Scholar
  72. 72.
    Geier J, Krautheim A, Lessmann H (2009) Allergological diagnostics and current allergens in occupational Dermatology. Hautarzt 2009 Jul 22 Epub ahead of print, PMID: 19621203Google Scholar
  73. 73.
    Bhargava K, White IR, White JML (2009) Thiuram patch test positivity 1980-2006: incidence is now falling. Contact Dermatitis 60:222–223PubMedGoogle Scholar
  74. 74.
    Knudsen B, Lerbaek A, Johansen JD, Menné T (2006) Reduction in the frequency of sensitization to thiurams. A result of legislation? Contact Dermatitis 54:170–171PubMedGoogle Scholar
  75. 75.
    Geier J, Lessmann H, Uter W, Schnuch A (2003) Occupational rubber glove allergy: results of the Information Network of Departments of Dermatology (IVDK), 1995 to 2001. Contact Dermatitis 48:39–44PubMedGoogle Scholar
  76. 76.
    Geier J, Uter W, Lessmann H, Schnuch A (2003) The positivity ratio – another parameter to assess the diagnostic quality of a patch test preparation. Contact Dermatitis 48:280–282PubMedGoogle Scholar
  77. 77.
    Aalto-Korte K, Ackermann L, Henriks-Eckerman ML, Välimaa J, Reinikka-Railo H, Leppänen E, Jolanki R (2007) 1, 2-benzisothiazolin-3-one in disposable polyvinyl chloride gloves for medical use. Contact Dermatitis 57:365–370PubMedGoogle Scholar
  78. 78.
    Pontén A (2006) Formaldehyde in reusable protective gloves. Contact Dermatitis 54:268–271PubMedGoogle Scholar
  79. 79.
    Sommer S, Wilkinson SM, Beck MH, English JS, Gawkrodger DJ, Green C (2002) Type IV hypersensitivity reactions to natural rubber latex: results of a multicentre study. Br J Dermatol 146:114–117PubMedGoogle Scholar
  80. 80.
    Wilkinson SM, Beck MH (1996) Allergic contact dermatitis from latex rubber. Br J Dermatol 134:910–914PubMedGoogle Scholar
  81. 81.
    Wyss M, Elsner P, Wüthrich B, Burg G (1993) Allergic contact dermatitis from natural latex without contact urticaria. Contact Dermatitis 28:154–156PubMedGoogle Scholar
  82. 82.
    Wulfhorst B, Schwanitz HJ, Bock M (2004) Optimizing skin protection with semipermeable gloves. Dermatitis 15:184–191PubMedGoogle Scholar
  83. 83.
    Bock M, Wulfhorst B, John SM (2009) Semipermeable Glove Membranes – Effects on skin barrier repair following SLS-Irritation. Contact Dermatitis 61:276–280Google Scholar
  84. 84.
    Kresken J, Klotz A (2003) Occupational skin-protection products - a review. Int Arch Occup Environ Health 76:355–358PubMedGoogle Scholar
  85. 85.
    Frosch PJ, Kurte A (1994) Efficacy of skin barrier creams (IV). The repetitive irritation test (RIT) with a set of 4 standard irritants. Contact Dermatitis 31(3):161–168PubMedGoogle Scholar
  86. 86.
    Kütting B, Drexler H (2008) The three-step programme of skin protection. A useful instrument of primary prevention or more effective in secondary prevention? Dtsch Med Wochenschr 133:201–205PubMedGoogle Scholar
  87. 87.
    Wigger-Alberti W, Elsner P (1997) Preventive measures in contact dermatitis. Clin Dermatol 15:661–665PubMedGoogle Scholar
  88. 88.
    Berndt U, Gabard B, Schliemann-Willers S, Wigger-Alberti W, Zitterbart D, Elsner P (2002) Integrated skin protection from work place irritants: a new model for efficacy assessment. Exogeneous Dermatol 1:45–48Google Scholar
  89. 89.
    Kütting B, Drexler H (2003) Effectiveness of skin protection creams as a preventive measure in occupational dermatitis: a critical update according to criteria of evidence-based medicine. Int Arch Occup Environ Health 76:253–259PubMedGoogle Scholar
  90. 90.
    Ramsing DW, Agner T (1997) Preventive and therapeutic effects of a moisturizer. An experimental study of human skin. Acta Dermato Venereol (Stockh) 77:335–337Google Scholar
  91. 91.
    Alvarez MS, Brown LH, Brancaccio RR (2001) Are barrier creams actually effective? Curr Allergy Asthma Rep 1:337–341PubMedGoogle Scholar
  92. 92.
    Schliemann S (2007) Limitations of skin protection. Curr Probl Dermatol 34:171–177PubMedGoogle Scholar
  93. 93.
    Wigger-Alberti W, Elsner P (1998) Do barrier creams and gloves prevent or provoke contact dermatitis? Am J Contact Dermatitis 9:100–106PubMedGoogle Scholar
  94. 94.
    Berndt U, Wigger-Alberti W, Gabard B, Elsner P (2000) Efficacy of a barrier cream and its vehicle as protective measures against occupational irritant contact dermatitis. Contact Dermatitis 42:77–80PubMedGoogle Scholar
  95. 95.
    Frosch PJ, Peiler D, Grunert V, Grunenberg B (2003) Efficacy of barrier creams in comparison to skin care products in dental laboratory technicians – a controlled trial. JDDG 1(7):547–557PubMedGoogle Scholar
  96. 96.
    Goh CL, Gan SL (1994) Efficacies of a barrier cream and an afterwork emollient cream against cutting fluid dermatitis in metalworkers: a prospective study. Contact Dermatitis 31:176–180PubMedGoogle Scholar
  97. 97.
    Perrenoud D, Gallezot D, van Melle G (2001) The efficacy of a protective cream in a real-world apprentice hairdresser environment. Contact Dermatitis 45:134–138PubMedGoogle Scholar
  98. 98.
    Coenraads PJ, Diepgen TL (2003) Problems with trials and intervention studies on barrier creams and emollients at the workplace. Int Arch Occup Environ Health 76:362–366PubMedGoogle Scholar
  99. 99.
    Fartasch M, Diepgen TL, Drexler H, Elsner P, Fluhr JW, John SM, Kresken J, Wigger-Alberti W (2009) Berufliche Hautmittel (ICD-10:L23, L24) S1-Leitlinie der Arbeitsgemeinschaft für Berufs- und Umweltdermatologie (ABD) in der Deutschen Dermatologischen Gesellschaft (DDG). Arbeitsmed Sozialmed Umweltmed 44:53–67Google Scholar
  100. 100.
    Suskind RR (1955) The present status of silicone protective creams. Indust Med Surg 24:413–416Google Scholar
  101. 101.
    Boman A, Wahlberg JE, Johansson G (1982) A method for the study of the effect of barrier creams and protective gloves on the percutaneous absorption of solvents. Dermatologica 164:157–160PubMedGoogle Scholar
  102. 102.
    de Fraissinette A, Picarles V, Chibout S, Kolopp M, Medina J, Burtin P, Ebelin ME, Osborne S, Mayer FK, Spake A, Rosdy M, De Wever B, Ettlin RA, Cordier A (1999) Predictivity of an in vitro model for acute and chronic skin irritation (SkinEthic) applied to the testing of topical vehicles. Cell Biol Toxicol 15:121–135Google Scholar
  103. 103.
    Guillemin M, Murset JC, Lob M, Riquez J (1974) Simple method to determine the efficiency of a cream used for skin protection against solvents. Br J Ind Med 31:310–316PubMedGoogle Scholar
  104. 104.
    Klotz A, zur Mühlen A, Thörner B, Kietzmann M, Holtmann W, Pittermann W (2003) Testing the efficacy of skin protection products in-vivo and in-vitro. SÖFW J 129:10–16Google Scholar
  105. 105.
    Korinth G, Geh S, Schaller KH, Drexler H (2003) In vitro evaluation of the efficacy of skin barrier creams and protective gloves on percutaneous absorption of industrial solvents. Int Arch Occup Environ Health 76(5):382–386PubMedGoogle Scholar
  106. 106.
    Lodén M (1986) The effect of 4 barrier creams on the absorption of water, benzene, and formaldehyde into excised human skin. Contact Dermatitis 14:292–296PubMedGoogle Scholar
  107. 107.
    Mahmoud G, Lachapelle JM, Van Neste D (1984) Histological assessment of skin damage by irritants: its possible use in the evaluation of a ‘barrier cream’. Contact Dermatitis 11:179–185PubMedGoogle Scholar
  108. 108.
    Marks R, Dykes PJ, Hamami I (1989) Two novel techniques for the evaluation of barrier creams. Br J Dermatol 120:655–660PubMedGoogle Scholar
  109. 109.
    Treffel P, Gabard B, Juch R (1994) Evaluation of barrier creams: an in vitro technique on human skin. Acta Derm Venereol (Stockh) 74:7–11Google Scholar
  110. 110.
    Zhai H, Maibach HI (1996) Percutaneous penetration (Dermatopharmacokinetics) in evaluating barrier creams. Curr Probl Dermatol 193–205Google Scholar
  111. 111.
    Zhai H, Willard P, Maibach HI (1998) Evaluating skin-protective materials against contact irritants and allergens. Contact Dermatitis 38:155–158PubMedGoogle Scholar
  112. 112.
    zur Mühlen A, Klotz A, Weimans S, Veeger M, Thorner B, Diener B, Hermann M (2004) Using skin models to assess the effects of a protection cream on skin barrier function. Skin Pharmacol Physiol 17:167–175Google Scholar
  113. 113.
    Wigger-Alberti W, Caduff L, Burg G, Elsner P (1999) Experimentally-induced irritant contact dermatitis to evaluate the efficacy of protective creams in vivo. J Am Acad Dermatol 40:590–596PubMedGoogle Scholar
  114. 114.
    Wigger-Alberti W, Rougier A, Richard A, Elsner P (1998) Efficacy of protective creams in a modified repeated irritation test (RIT): methodological aspects. Acta Derm Venereol (Stockh) 78:270–273Google Scholar
  115. 115.
    Schnetz E, Diepgen TL, Elsner P, Frosch PJ, Klotz AJ, Kresken J, Kuss O, Merk H, Schwanitz HJ, Wigger-Alberti W, Fartasch M (2000) Multicentre study for the development of an in vivo model to evaluate the influence of topical formulations on irritation. Contact Dermatitis 42:336–343PubMedGoogle Scholar
  116. 116.
    Wigger-Alberti W, Krebs A, Elsner P (2000) Experimental irritant contact dermatitis due to cumulative epicutaneous exposure to sodium lauryl sulphate and toluene: single and concurrent application. Br J Dermatol 143:551–556PubMedGoogle Scholar
  117. 117.
    Wigger-Alberti W, Spoo J, Schliemann-Willers S, Klotz A, Elsner P (2002) The tandem repeated irritation test: a new method to assess prevention of irritant combination damage to the skin. Acta Derm Venereol 82:94–97PubMedGoogle Scholar
  118. 118.
    Fluhr JW, Bankova L, Fuchs S, Kelterer D, Schliemann-Willers S, Norgauer J, Kleesz P, Grieshaber R, Elsner P (2004) Fruit acids and sodium hydroxide in the food industry and their combined effect with sodium lauryl sulphate: controlled in vivo tandem irritation study. Br J Dermatol 151:1039–1048PubMedGoogle Scholar
  119. 119.
    Boman A, Mellström GA (1989) Percutaneous absorption of 3 organic solvents in the guinea pig (III). Effect of barrier creams. Contact Dermatitis 21:134–140PubMedGoogle Scholar
  120. 120.
    Frosch P, Schulze-Dirks A, Hoffmann M, Axthelm I (1993) Efficacy of skin barrier creams (II). Ineffectiveness of a popular “skin protector” against various irritants in the repetitive irritation test in the guinea pig. Contact Dermatitis 29:74–77PubMedGoogle Scholar
  121. 121.
    Goh CL (1991) Cutting oil dermatitis on guinea pig skin (I). Cutting oil dermatitis and barrier cream. Contact Dermatitis 24:16–21PubMedGoogle Scholar
  122. 122.
    Xhauflaire-Uhoda E, Macarenko E, Denooz R, Charlier C, Piérard GE (2008) Skin protection creams in medical settings: successful or evil? J Occup Med Toxicol 25:3–15Google Scholar
  123. 123.
    Fartasch M, Deters A, Schnetz E, Goen T, Drexler H, Schmelz M (2006) Cutaneous penetration: its modulation by skin care products. Contact Dermatitis 55:10Google Scholar
  124. 124.
    Korinth G, Luersen L, Schaller KH, Angerer J, Drexler H (2008) Enhancement of percutaneous penetration of aniline and o-toluidine in vitro using skin barrier creams. Toxicol In Vitro 22:812–818PubMedGoogle Scholar
  125. 125.
    Korinth G, Weiss T, Penkert S, Schaller KH, Angerer J, Drexler H (2007) Percutaneous absorption of aromatic amines in rubber industry workers: impact of impaired skin and skin barrier creams. Occup Environ Med 64:366–372PubMedGoogle Scholar
  126. 126.
    Wigger-Alberti W, Maraffio B, Wernli M, Elsner P (1997) Self-application of a protective cream: pitfalls of occupational skin protection. Arch Dermatol 133:861–864PubMedGoogle Scholar
  127. 127.
    Kelterer D, Fluhr JW, Elsner P (2003) Application of protective creams: use of a fluorescence-based training system decreases unprotected areas on the hands. Contact Dermatitis 49:159–160PubMedGoogle Scholar
  128. 128.
    Wigger-Alberti W, Maraffio B, Elsner P (1997) Training workers at risk for occupational contact dermatitis in the application of protective creams: efficacy of a fluorescence technique. Dermatology 195:129–133PubMedGoogle Scholar
  129. 129.
    Zhai H, Maibach HI (1996) Effect of barrier creams: human skin in vivo. Contact Dermatitis 35:92–96PubMedGoogle Scholar
  130. 130.
    Fluhr JW, Miteva M, Elsner P (2007) Efficacy and safety testing. The clinical perspective. Curr Probl Dermatol 34:33–46PubMedGoogle Scholar
  131. 131.
    Buraczewska I, Berne M, Lindberg M, Törmä H, Lodén M (2007) Changes in skin barrier function following long-term treatment with moisturizers, a randomized controlle trial. Br J Dermatol Mar 156(3):492–498Google Scholar
  132. 132.
    Bikowski JB (2008) Hand eczema: diagnosis and management. Cutis Oct 82(4 suppl):9–15Google Scholar
  133. 133.
    Kalimo K, Kautiainen H, Niskanen T, Niemi L (1999) ‘Eczema school’ to improve compliance in an occupational dermatology clinic. Contact Dermatitis 41:315–319PubMedGoogle Scholar
  134. 134.
    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 62:642–649PubMedGoogle Scholar
  135. 135.
    Radulescu M, Bock M, Bruckner T, Ellsäßer G, Fels H, Diepgen TL (2007) Health education on occupational allergies and dermatoses for adolescents. JDDG 7:576–582Google Scholar
  136. 136.
    Wulfhorst B, Bock M, John SM (2006) Worker’s education and teaching programmes: the German experience. In: Frosch PJ, Menné, Lepoittevin JP (eds) Textbook of contact dermatitis, 4th edn. Springer, BerlinGoogle Scholar
  137. 137.
    Saary J, Qureshi R, Palda V, DeKoven J, Pratt M, Skotnicki-Grant S, Holness L (2005) A systematic review of contact dermatitis treatment and prevention. J Am Acad Dermatol 53(5):845Google Scholar
  138. 138.
    Jungbauer FH, van der Vleuten P, Groothoff JW, Coenraads PJ (2004) Irritant hand dermatitis: severity of disease, occupational exposure to skin irritants and preventive measures 5 years after initial diagnosis. Contact Dermatitis 50(4):245–251PubMedGoogle Scholar
  139. 139.
    Flyvolm MA, Rrydendall Jepsen K (2008) Experiences with implementation of evidence-based prevention programmes to prevent occupational skin diseases in different occupations. GITAL Dermatol Venereol 143(1):71–78Google Scholar
  140. 140.
    Falvo DR (2004) Effective patient education: a guide to increased compliance. Jones & Bartlett, SudburyGoogle Scholar
  141. 141.
    Tones K (2004) Health promotion, health education, and the public health. In: Detels R, McEwen J, Beaglehole R, Tanaka H (eds). Oxford textbooks of public health, 4th edn. Oxford University Press, Oxford, pp 829–863Google Scholar
  142. 142.
    Ersser SJ, Latter S, Sibley A, Satherley PA, Welbourne S (2007) Psychological and educational interventions for atopic eczema in children. Cochrane Database Syst Rev (Online) (3):CD004054Google Scholar
  143. 143.
    Darsow U, Lübbe J, Taïeb A, Seidenari S, Wollenberg A, Calza AM, Giusti F, CA RJ (2005) European Task Force on Atopic Dermatitis Titel: position paper on diagnosis and treatment of atopic dermatitis. J Eur Acad Dermatol Venereol 19(3):286–295PubMedGoogle Scholar
  144. 144.
    Guevara JP, Wolf FM, Grum CM, Clark NM (2003) Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysis. BMJ 326(7402):1308–1309PubMedGoogle Scholar
  145. 145.
    Apfelbacher CJ, Soder S, Diepgen TL, Weisshaar E (2009) The impact of measures for secondary individual prevention of work-related skin diseases in health care workers: 1 year follow-Up study. Contact Dermatitis 60:144–149PubMedGoogle Scholar
  146. 146.
    Wulfhorst B, Bock M, Gediga G, Skudlik C, Allmers H, John SM (2009) Sustainability of an interdisciplinary secondary prevention program for hairdressers. International Archives of Occupational and Environmental Health 83(2):165–171Google Scholar
  147. 147.
    Glanz K, Rimer BK, Lewis FM (eds) (2002) Health behavior and health education. Theory, Research and Practice, 3rd edn. Jossey-Bass, San Francisco, p 4Google Scholar
  148. 148.
    Lindstrom B, Eriksson M (2005) Salutogenesis. J Epidemiol Community Health 59:440–442PubMedGoogle Scholar
  149. 149.
    WHO (1986) The Ottawa Charter. Who, GenevaGoogle Scholar
  150. 150.
    Schwarzer R (2004) Stage models of health behavior change: advances and problems. In: Keller S, Velicer WF (eds) Research on the transtheoretical model: where are we now, where are we going? Pabst Science, Lengerich, Germany, pp 110–113Google Scholar
  151. 151.
    Frauenknecht M (2005) Professional standards for health education teacher preparation. Health Educ 37(2):24–26Google Scholar
  152. 152.
    Staab D, Diepgen TL, Fartasch M, Kupfer J, Lob-Corzilius T, Ring J, Scheewe S, Scheidt R, Schmid-Ott G, Schnopp C, Szepanski R, Werfel T, Wittenmeier M, Wahn U, Gieler U (2006) Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: muticentre, randomised controlled trial. BMJ 332: 923–940Google Scholar
  153. 153.
    Harris M, Smith BJ, Veale A (2008) Patient education programmes – can they improve outcomes in COPD? Int J Chron Obstruct Pulmon Dis 3(1):109–112PubMedGoogle Scholar
  154. 154.
    Goldenhar LM, La Montagne AD, Katz T (2001) The intervention research process in occupational health: an overview from the National Occupational Research Agenda Intervention Effectiveness Research Team. J Occup Environ Med 43:616–622PubMedGoogle Scholar
  155. 155.
    Meding B, Wrangsjö K, Hosseiny S, Andersson E, Hagberg S, Toren J, Wass K, Brisman J (2006) Occupational skin exposure and hand eczema among dental technicians – need for improved prevention. Scand J Work Environ health 32:219–224PubMedGoogle Scholar
  156. 156.
    Schlesinger T, Revermann K, Schwanitz HJ (2001) Dermatosen bei Auszubildenden des Friseurhandwerks in Niedersachsen. Dermatol Beruf Umwelt 49:185–192Google Scholar
  157. 157.
    Nixon R, Roberts H, Frowen K, Sim M (2006) Knowledge of skin hazards and the use of gloves by Australian hairdressing students and practicing hairdressers. Contact Dermatitis 54:112–116PubMedGoogle Scholar
  158. 158.
    Riehl U (2000) Interventionsstudie zur Prävention von Hauterkrankungen bei Auszubildenden des Friseurhandwerks. Rasch, OsnabrückGoogle Scholar
  159. 159.
    Bauer A, Kelterer D, Bartsch R, Schlegel A, Pearson J, Stadeler M, Kleesz P, Grieshaber R, Schiele R, Elsner P, Williams H (2002) Prevention of hand dermatitis in bakers’ apprentice: different efficacy of skin protection measures and UVB hardening. Int Arch Occup Environ Health 75:491–499PubMedGoogle Scholar
  160. 160.
    Mertin M, Frosch P, Kügler K, Sieverding M, Goergens A, Wulfhorst B, John SM (2009) Skin disease prevention courses for secondary prevention in metal workers. Dermatologie Beruf Umwelt 57:29–35Google Scholar
  161. 161.
    Matterne U, Diepgen TL, Weisshaar E (2009) Effects of a health-educational and psychological intervention on socio-cognitive determinants of skin protection behavior in individuals with occupational dermatoses. Int Arch Occup Environ Health 83:183–189. doi  10.1007/s00420-009-0448-z Google Scholar
  162. 162.
    CEN (2003) EN 420-2003. Protective gloves – general requirements and test methods. Comité Européen de Normalisation, BrusselsGoogle Scholar
  163. 163.
    Tucker SB (1988) Prevention of occupational skin disease. Dermatol Clin 6:87–96PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of Dermatology, Environmental Medicine and Health TheoryUniversity of OsnabrueckOsnabrückGermany

Personalised recommendations