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Meta-Analysis
. 2022 Oct;87(4):303-314.
doi: 10.1111/cod.14133. Epub 2022 May 2.

Hand hygiene and hand eczema: A systematic review and meta-analysis

Enver De Wei Loh  1 , Yik Weng Yew  1   2
Affiliations
Meta-Analysis

Hand hygiene and hand eczema: A systematic review and meta-analysis

Enver De Wei Loh et al. Contact Dermatitis. 2022 Oct.

Abstract

Hand eczema is a common inflammatory condition of the skin that has been linked to hand hygiene. This systematic review and meta-analysis aims to determine the risks of hand eczema associated with hand hygiene, including frequency of hand washing, wet work and use of alcohol hand rub. A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed for cohort, case-control or cross-sectional studies that analysed the association between hand hygiene and risk of hand eczema. Results of individual studies were presented in respective forest plots and pooled summary relative risks were estimated using a random-effects model. Forty-five studies were included in the analysis. Hand washing at least 8-10 times daily significantly increased risk of hand eczema (relative risk [RR] 1.51; 95% confidence interval [CI]: 1.35-1.68; p < 0.001). The risk was related to hand washing frequency, with higher pooled RR of 1.66 (95% CI: 1.51-1.83; p < 0.001) with increased hand washing at least 15-20 times daily. However, use of alcohol-based hand sanitizer was not significantly associated with risk of hand eczema. Given the widespread implementation of hand hygiene practices during the COVID-19 pandemic, there is a pertinent need to understand skin care habits specific to the hands to avoid a greater incidence of hand eczema.

Keywords: contact dermatitis; epidemiology; hand eczema; hand hygiene.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram showing summary of the systematic review and meta‐analysis
FIGURE 2
FIGURE 2
Forest plot of risks of hand eczema with at least 8–10 times of daily handwashing versus <8–10 times, with subgroup analysis by healthcare worker occupation. CI, confidence interval; ES, effect estimate
FIGURE 3
FIGURE 3
Forest plot of risks of hand eczema with at least 15–20 times of daily handwashing versus <15–20 times, with subgroup analysis by healthcare worker occupation. CI, confidence interval; ES, effect estimate
FIGURE 4
FIGURE 4
Forest plot of risks of hand eczema with wet work versus no wet work. CI, confidence interval; ES, effect estimate
FIGURE 5
FIGURE 5
Forest plot of risks of hand eczema with use of alcohol hand rub. CI, confidence interval; ES, effect estimate
See this image and copyright information in PMC

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