Restricted accessResearch articleFirst published online 2025-5
Impact of infection prevention measures on the occurrence of cutaneous lesions and the quality of life of frontline and non-frontline healthcare workers: A multicentre cross-sectional study
Infection prevention measures are crucial to prevent contamination among frontline healthcare workers (FL-HCWs) and non-frontline healthcare workers (NFL-HCWs). However, these measures can lead to skin lesions, potentially affecting their quality of life.
Objectives
Determine the prevalence of skin lesions caused by infection prevention measures and assess the impact of skin lesions on the quality of life.
Methods
A cross-sectional study was conducted, utilizing a self-administered questionnaire covering demographic and occupational information, self-reported skin lesions, and the Dermatology Life Quality Index (DLQI) for healthcare workers (HCWs) from three medical centres.
Results
Out of the 190 FL-HCWs and 199 NFL-HCWs surveyed, 37.2% reported skin lesions. Female and FL-HCWs exhibited a higher occurrence of skin lesions. Prolonged use of masks was significantly associated with facial skin lesions. While the use of personal protective equipment and hand hygiene had little to no effect on the Dermatology Life Quality Index (DLQI) for 80.7% of healthcare workers (HCWs) with skin lesions, those with facial skin lesions, papules, or a history of any skin lesions, as well as those who more frequently washed their hands, showed a more altered DLQI.
Conclusions
FL-HCWs had more skin symptoms than NFL-HCWs, but these issues were generally not severe and had minimal impact on overall quality of life.
AbiakamNWorsleyPJayabalH, et al. (2021) Personal protective equipment related skin reactions in healthcare professionals during COVID-19. International Wound Journal18(3): 312–322.
2.
AguileraSDe La PenaIVieraM, et al. (2020) The impact of COVID-19 on the faces of frontline healthcare workers. Journal of Drugs in Dermatology19(9): 858–864.
3.
BalatoAAyalaFBruzeM, et al. (2020) European Task Force on Contact Dermatitis statement on coronavirus disease-19 (COVID-19) outbreak and the risk of adverse cutaneous reactions. Journal of the European Academy of Dermatology and Venereology34(8): e353–e354.
4.
BasraMKAFenechRGattRM, et al. (2008) The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. British Journal of Dermatology159(5): 997–1035.
5.
BhatiaRSharmaVKRamamM, et al. (2015) Clinical profile and quality of life of patients with occupational contact dermatitis from New Delhi, India. Contact Dermatitis73(3): 172–181.
6.
BlicharzLCzuwaraJSamochockiZ, et al. (2020) Hand eczema—a growing dermatological concern during the COVID-19 pandemic and possible treatments. Dermatologic Therapy33(5): e13545.
7.
ChernyshovPVKolodzinskaL (2020) Prospective study on hand dermatitis in nurses and doctors during COVID-19 pandemic and its improvement by use of adopted recommendations of the European Academy of Dermatology and Venereology Task Force on Contact Dermatitis. Dermatologic Therapy33(6): 2–7.
8.
DayeMCihanFGDurduranY (2020) Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic. Dermatologic Therapy33(6): e14346.
9.
ErdemYAltunayIKAksu ÇermanA, et al. (2020) The risk of hand eczema in healthcare workers during the COVID-19 pandemic: do we need specific attention or prevention strategies?Contact Dermatitis83(5): 422–423.
10.
FinlayAYKhanGK (1994) Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use. Clinical and Experimental Dermatology19(3): 210–216.
11.
FooCCIGoonATJLeowY, et al. (2006) Adverse skin reactions to personal protective equipment against severe acute respiratory syndrome – a descriptive study in Singapore. Contact Dermatitis55(5): 291–294.
12.
GuertlerAMoellhoffNSchenckTL, et al. (2020) Onset of occupational hand eczema among healthcare workers during the SARS-CoV-2 pandemic: comparing a single surgical site with a COVID-19 intensive care unit. Contact Dermatitis83(2): 108–114.
13.
GuptaSBGuptaAShahB, et al. (2018) Hand eczema in nurses, nursing auxiliaries and cleaners—a cross-sectional study from a tertiary hospital in western India. Contact Dermatitis79(1): 20–25.
14.
HamneriusNPonténABergendorffO, et al. (2021) Skin exposures, hand eczema and facial skin disease in healthcare workers during the covid-19 pandemic: a cross-sectional study. Acta Dermato-Venereologica101(9): adv00543.
15.
HongboYThomasCLHarrisonMA, et al. (2005) Translating the science of quality of life into practice: what do dermatology life quality index scores mean?Journal of Investigative Dermatology125(4): 659–664.
16.
JoseSCyriacMCDhandapaniM (2021) Health problems and skin damages caused by personal protective equipment: experience of frontline nurses caring for critical COVID-19 patients in intensive care units. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine25(2): 134.
17.
KalboussiHKacemIArouiH, et al. (2019) Impact of allergic contact dermatitis on the quality of life and work productivity. Dermatology Research and Practice2019: 1–14.
18.
LanJSongZMiaoX, et al. (2020) Skin damage among health care workers managing coronavirus disease-2019. Journal of the American Academy of Dermatology82(5): 1215–1216.
19.
MarrahaFAl FakerICharifF, et al. (2021) Skin reactions to personal protective equipment among first-line COVID-19 healthcare workers: a survey in northern Morocco. Annals of work exposures and health65(8): 998–1003.
20.
MauroMDe GiustiVBovenziM, et al. (2017) Effectiveness of a secondary prevention protocol for occupational contact dermatitis. Journal of the European Academy of Dermatology and Venereology31(4): 656–663.
21.
Montero-VilchezTCuenca-BarralesCMartinez-LopezA, et al. (2021) Skin adverse events related to personal protective equipment: a systematic review and meta-analysis. Journal of the European Academy of Dermatology and Venereology35(10): 1994–2006.
22.
Montero-VilchezTMartinez-LopezACuenca-BarralesC, et al. (2022) Assessment of hand hygiene strategies on skin barrier function during COVID-19 pandemic: a randomized clinical trial. Contact Dermatitis86(4): 276–285.
23.
MushtaqSTerziERecalcatiS, et al. (2021) Cutaneous adverse effects due to personal protective measures during COVID-19 pandemic: a study of 101 patients. International Journal of Dermatology60(3): 327–331.
24.
NguyenLHDrewDAGrahamMS, et al. (2020) Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. The Lancet Public Health5(9): e475–e483.
25.
ParkSJHanHSShinSH, et al. (2021) Adverse skin reactions due to use of face masks: a prospective survey during the COVID-19 pandemic in Korea. Journal of the European Academy of Dermatology and Venereology35(10): e628–e630.
26.
ReillyMCLavinPTKahlerKH, et al. (2003) Validation of the dermatology life quality index and the work productivity and activity impairment-chronic hand dermatitis questionnaire in chronic hand dermatitis. Journal of the American Academy of Dermatology48(1): 128–130.
27.
SahaMPodderIDasA (2021) Skin damage induced by enhanced protective measures in frontline doctors during covid-19 pandemic: a web-based descriptive study. Indian Journal of Dermatology66(2): 145–150.
28.
SantosEJFFerreiraRJOBatistaR, et al. (2020) Health care workers not in the frontline are more frequently carriers of coronavirus disease 2019: the experience of a tertiary Portuguese hospital. Infection Prevention in Practice2(4): 100099.
29.
SinghPBhandoriaGMaheshwariA (2021) Pharmacological prophylaxis and personal protective equipment ( PPE ) practices in gynecological cancer surgery during COVID-19 pandemic. Indian Journal of Gynecologic Oncology19(1): 1–7.
30.
WanXLuQSunD, et al. (2021) Skin barrier damage due to prolonged mask use among healthcare workers and the general population during the COVID-19 pandemic: a prospective cross-sectional survey in China. Dermatology238(2): 218–225. DOI: 10.1159/000517219.
31.
World Health Organization (2020a) Water, sanitation, hygiene, and waste management for SARS-CoV-2, the virus that causes COVID-19. In: Interim Guidance. Geneva, Switzerland: World Health Organization, 1–11.
32.
World Health Organization (2020b) Rational Use of Personal Protective Equipment for Coronavirus Disease 2019 (COVID-19) and Considerations during Severe Shortages. Geneva, Switzerland: WHO, 1–28.
33.
WuMZhangLNingN, et al. (2021) Survey and enlightenment on the wearing of protective equipment of nurses working on the front line against COVID-19. Medicine100(19): e25924.
34.
YanYChenHChenL, et al. (2020) Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatologic Therapy33(4): 1–7.
35.
ZahrallayaliAAl-DobokeAAlosaimyR, et al. (2021) The prevalence and clinical features of skin irritation caused by infection prevention measures during covid-19 in the mecca region, Saudi Arabia. Clinical, Cosmetic and Investigational Dermatology14(May): 889–899.
