Skin barrier function in nursing apprentices during the coronavirus disease 2019 (COVID-19) pandemic

Abstract

Background: Studies investigating simultaneous influence of personal and work-related factors on skin health during the coronavirus disease 2019 (COVID-19) pandemic are missing.

Objectives: To investigate the associations of skin hazards relevant for nursing apprentices with parameters of skin barrier function.

Methods: A total of 238 nursing apprentices attending the final year of education (median age 19 years) from vocational schools in Zagreb, Croatia, were enrolled in this study. We administered a questionnaire based on the Nordic Occupational Skin Questionnaire to the nursing apprentices, performed clinical examination of skin on the hands, and evaluated transepidermal water loss (TEWL) and stratum corneum (SC) pH on the dorsum of the hand.

Results: Around half of nursing apprentices had compromised hand skin barrier function, as indicated by TEWL values >25 g/m² /h (48%) and SC pH >5.5 (57%). Skin barrier was compromised in around 40% of nursing apprentices without clinically observed skin symptoms. Elevated SC pH was independent of ambient conditions associated with skin symptoms and female sex.

Conclusions: Measurement of SC pH was shown to be less sensitive to field conditions than TEWL, and should be employed more in the field studies. Strengthening of skin health promotion in healthcare workers and apprentices is needed in pandemic conditions.

Keywords: COVID-19; TEWL; nursing; nursing apprentices; pH; skin barrier.

FIGURE 1

Comparison of hand skin symptoms found in nursing apprentices with strained skin condition (hand TEWL >25 g/m²/h; N = 114) and those with normal hand TEWL values (N = 124). TEWL values above 25 g/m²/h were considered elevated. Significance of difference tested by χ² test. Differences with regard to papules and vesicles were not tested due to extremely small numbers. TEWL, transepidermal water loss