Meike Strunk - Academia.edu (original) (raw)

Papers by Meike Strunk

Research paper thumbnail of Secondary prevention of occupational skin diseases in hairdressers: Long term efficacy 5 years after intervention

Research paper thumbnail of Sekundäre Individualprävention: Langzeiteffektivität von Schulungsprogrammen für Patienten mit berufsbedingten Hauterkrankungen

Dermatologie in Beruf und Umwelt

Research paper thumbnail of Barriereregeneration unter wasserdampfdurchlässigen Handschuhmembranen

Dermatologie in Beruf und Umwelt

Research paper thumbnail of Site variations in susceptibility to SLS at the volar forearm

Research paper thumbnail of Worker’s Protection: Gloves and Creams

Quick Guide to Contact Dermatitis, 2016

Research paper thumbnail of Worker´s Education and Teaching Programmes: The German Experience

Research paper thumbnail of Okklusionseffekt von Schutzhandschuhen

Dermatologie in Beruf und Umwelt

Research paper thumbnail of Optimizing skin protection with semipermeable gloves

Dermatitis : contact, atopic, occupational, drug, 2004

Occlusion due to gloves is one important cause of glove irritation. Macerated softened skin gives... more Occlusion due to gloves is one important cause of glove irritation. Macerated softened skin gives poor protection against microbes and chemical injuries. The introduction of a breathable protective glove material would represent a significant step toward improved prevention of occupational skin disease. Performance levels of semipermeable and occlusive gloves were examined under conditions typical of the hairdressing profession. In two studies, tests comparing breathable semipermeable gloves to single-use gloves made of occlusive materials were conducted. In an initial study, a user survey was carried out in conjunction with bioengineering examinations. Values at baseline and values after gloves were worn were recorded by measuring transepidermal water loss (TEWL), skin humidity (SH), and skin surface hydrogen ion concentration (pH) in 20 healthy volunteers. In a second study, the gloves were tested for penetrability and permeability with three chemical compounds typically used in t...

Research paper thumbnail of Standardization of skin cleansing in vivo : part II. Validation of a newly developed Automated Cleansing Device (ACiD)

Skin Research and Technology, 2014

To date, there are no legally binding requirements concerning product testing in cosmetics. This ... more To date, there are no legally binding requirements concerning product testing in cosmetics. This leads to various manufacturer-specific test methods and absent transparent information on skin cleansing products. A standardized in vivo test procedure for assessment of cleansing efficacy and corresponding barrier impairment by the cleaning process is needed, especially in the occupational context where repeated hand washing procedures may be performed at short intervals. For the standardization of the cleansing procedure, an Automated Cleansing Device (ACiD) was designed and evaluated. Different smooth washing surfaces of the equipment for ACiD (incl. goat hair, felt, felt covered with nitrile caps) were evaluated regarding their skin compatibility. ACiD allows an automated, fully standardized skin washing procedure. Felt covered with nitrile as washing surface of the rotating washing units leads to a homogenous cleansing result and does not cause detectable skin irritation, neither clinically nor as assessed by skin bioengineering methods (transepidermal water loss, chromametry). Automated Cleansing Device may be useful for standardized evaluation of the cleansing effectiveness and parallel assessment of the corresponding irritancy potential of industrial skin cleansers. This will allow objectifying efficacy and safety of industrial skin cleansers, thus enabling market transparency and facilitating rational choice of products.

Research paper thumbnail of Lowering lesional surface pH in acne: A new treatment modality for Herpifix ®

Journal of Dermatological Treatment, 2009

The acid skin surface pH has antimicrobial activities. Increased growth of Propionibacterium acne... more The acid skin surface pH has antimicrobial activities. Increased growth of Propionibacterium acnes contributes to the pathogenesis of acne. Therefore, the pH of inflammatory acne lesions was determined prior to and after lesional acidification employing Herpifix (Courage + Khazaka, Cologne, Germany), a microphoretic system. The pH was correlated with the number of acne lesions. A total of 30 volunteers with acne vulgaris participated in this crossover study applying either Herpifix or a dummy to inflammatory lesions. Prior to treatment, the pH of acne lesions was 5.7 +/- 0.2 (mean +/- SD) and 22 lesions (mean +/- 10) were counted in an 8 x 8 cm(2) facial surface area. Fifteen volunteers (group A) used Herpifix first for 3 weeks and then the dummy, while the other group of 15 volunteers (group B) used the dummy first and then Herpifix. In group A, the lesional surface pH and number of lesions decreased (p < 0.01) initially. When the dummy was used over a second 3-week treatment period, the skin surface pH and number of acne lesions increased. Findings for group B were vice versa. When both groups were compared at the end of the study, a significant difference in pH values (p < 0.001) and the number of acne lesions (p < 0.05) was obtained. Herpifix may be considered as a new therapeutic option for inflammatory acne.

Research paper thumbnail of Sicherheit, Wirksamkeit und Vergleichbarkeit von beruflichen Hautreinigern

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 2010

Research paper thumbnail of Safety, effectiveness and comparability of professional skin cleansers

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 2010

There are no widely-accepted methodical specifications with which to objectify cleansing effectiv... more There are no widely-accepted methodical specifications with which to objectify cleansing effectiveness and skin compatibility of occuptional skin cleansing products in Europe. Therefore the German Social Insurance Agency (DGUV) initiated a study with the goal to evaluate such products in view of the potency and the safety of hand cleansers. A market analysis was a part of the project. The product descriptions and safety data sheets of 120 products (5-20/manufacturer) of 11 manufacturers were evaluated between 02/2008 and 04/2008. The manufacturers used mainly ingredients of low irritancy. The declaration of the applied ingredients was in the majority of the cases correctly labeled according to the INCI Declaration. Although there was documentation of skin tolerability for most products, the manufacturers used widely differing tests of skin compatibility. Evidences for cleansing effectiveness were not declared or have not been provided. One manufacturer even promised medical effects of its products. There was no uniform general classification of products making it difficult to identify characteristics of cleansers and choose between them. Presently, there are no commonly accepted criteria to classify products in view of cleansing effectiveness und skin compatibility. Generally accepted criteria and test methods are needed for the evaluation of hand cleansers in order to provide the possibility of transparency and comparability.

Research paper thumbnail of Sustainability of an interdisciplinary secondary prevention program for hairdressers

International Archives of Occupational and Environmental Health, 2010

Two hundred and fifteen hairdressers suffering from occupational skin diseases (OSD) have attende... more 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. 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 (IG(1994), participants in 1994, N = 62) was followed up again 10 years after their participation. 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.

Research paper thumbnail of Skin care management: educational aspects

International Archives of Occupational and Environmental Health, 2003

Health education is effective in primary, secondary and tertiary prevention of occupational skin ... more Health education is effective in primary, secondary and tertiary prevention of occupational skin disorders, as clearly demonstrated by interventional studies carried out at the University of Osnabrueck. Health education may intervene with (a) habituated behaviour of affected employees and (b) the condition of working environments. In conclusion, prevention of occupational skin diseases and maintenance of health can be achieved by the conditioning of individual behaviour via specific educational programmes in addition to dermatological care.

Research paper thumbnail of Sustainability of interdisciplinary secondary prevention in patients with occupational hand eczema: a 5-year follow-up survey

Contact Dermatitis, 2012

Occupational hand eczema (OHE) is common in &... more Occupational hand eczema (OHE) is common in 'wet work' occupations. Thus, effective and sustainable prevention strategies are needed. To investigate the long-term effectiveness (sustainability) of an interdisciplinary secondary prevention programme. One hundred and thirty-four patients with OHE consecutively participated in an outpatient skin protection seminar comprising dermatological and educational interventions. Data were obtained at baseline (T0) and at 9 months (T1) and 5 years (T2) after participation. A cohort of 84 patients was available for analysis of the outcomes 'job continuation', 'skin condition', 'skin protection behaviour', and 'disease management'. At T2, 71.4% of patients remained in their occupation. The prevalence and severity of self-reported OHE were significantly reduced as compared with T0 (p = 0.007, p = 0.002). Of the patients, 13.1% gave up work because of OHE at T2. The intervention was most successful in patients suffering from milder forms of OHE, and there was less success in patients with severe OHE. The results showed a significant reduction in the frequency of 'hand washing' (p = 0.003) but no measurable change in the use of skin care products (p = 1.000). The intervention showed sustainable long-term effects. Early detection and reporting of OHE in the initial stages of the disease is of utmost importance for the effectiveness of secondary prevention. In cases of severe OHE, inpatient programmes may be indicated.

Research paper thumbnail of Standardized dirts for testing the efficacy of workplace cleaning products: validation of their workplace relevance

Contact Dermatitis, 2013

In order to assess the cleaning efficacy of occupational skin cleansers, standardized test dirts ... more In order to assess the cleaning efficacy of occupational skin cleansers, standardized test dirts mimicking the spectrum of skin soiling at dirty workplaces are necessary. To validate newly developed standardized test dirts (compliant with the EU Cosmetics Directive) for their occupational relevance. In this single-blinded, monocentric questionnaire-based clinical trial, 87 apprentices of three trades (household management; house painting and varnishing; and metal processing) evaluated the cleanability of six standardized test dirts in relation to their workplace dirts. In addition, they judged the similarity of the test dirts to actual dirts encountered in their working environments. Most of the household management participants assessed the hydrophilic model dirt ('mascara'), the lipophilic model dirt ('W/O cream') and a film-forming model dirt ('disperse paint') as best resembling the dirts found at their workplaces. Most of the painters and varnishers judged the filmogenic model dirts ('disperse paint' and 'acrylic paint') as best resembling the dirts found at their workplaces. For the metal workers, the lipophilic and paste-like model dirts were most similar to their workplace dirts. The spectrum of standardized test dirts developed represents well the dirts encountered at various workplaces. The test dirts may be useful in the development and in vivo efficacy testing of occupational skin cleansers.

Research paper thumbnail of Effects of CO2-enriched water on barrier recovery

Archives of Dermatological Research, 2004

The objective of the present study was to evaluate the impact of CO 2 -enriched water on barrier ... more The objective of the present study was to evaluate the impact of CO 2 -enriched water on barrier recovery of detergent-damaged skin compared to tap water employing bioengineering methods and thin-layer chromatography (TLC) analysis of stratum corneum (SC) lipids. Irritation of the skin was elicited on the forearms of 20 volunteers using 1% sodium lauryl sulphate (SLS). The degree of skin irritation was followed over 10 days in terms of skin colour reflectance (L*a*b*), transepidermal water loss (TEWL), and skin capacitance expressed as median values. For TLC analysis, SC lipids were extracted prior to and during the observation period. Clinical examination showed the efficacy of CO 2 -enriched water on barrier recovery. Compared to unenriched tap water, CO 2 -enriched water produced a significant (P<0.01) increase in total SC lipids and in particular in the ceramide fraction. Furthermore, TEWL was significantly (P<0.01) lower in skin treated with CO 2 -enriched water than in skin treated with unenriched water. These findings may indicate that rinsing with CO 2 -enriched water enhances (1) clinical regeneration of detergent-damaged skin, (2) epidermal lipid synthesis, and (3) barrier repair after detergent-induced perturbation.

Research paper thumbnail of Short- and long-term effects of single and repetitive glove occlusion on the epidermal barrier

Archives of Dermatological Research, 2009

The aim of this study was to analyse the occlusive eVects of glove materials (polyvinyl chloride,... more The aim of this study was to analyse the occlusive eVects of glove materials (polyvinyl chloride, natural rubber latex) on epidermal barrier function and to relate the Wndings to the deWnitions of wet work in the current German ordinance on hazardous substances (2007) and in the German technical regulations on hazardous substances (TRGS 401;). Short-term eVects of wearing gloves once for 4 h, as well as the long-term eVects of wearing gloves for 4 h daily for 7 days were assessed in a group of 20 healthy volunteers using non-invasive methods (transepidermal water loss (TEWL), capacitance, skin colour, skin surface pH). Data were collected 30 min and 3 h after single use, as well as 1 day after a 1-week application. TEWL and capacitance data showed hyperhydration of the horny layer 30 min after a 4-h occlusion as compared to baseline (p < 0.05). Three hours later, full recovery to basal values was observed. Additionally, a signiWcant long-term eVect after daily occlusion for 4 h for 7 days could not be demonstrated. In current literature, there is controversial evidence concerning the eVects of glove occlusion. This study could not verify signiWcant damage to skin barrier after 7 days of repeated occlusion 4 h daily in healthy volunteers. These Wndings require further discussion regarding the deWnitions in the current German ordinance on hazardous substances and in the TRGS 401.

Research paper thumbnail of Secondary prevention of occupational skin diseases in hairdressers: Long term efficacy 5 years after intervention

Research paper thumbnail of Sekundäre Individualprävention: Langzeiteffektivität von Schulungsprogrammen für Patienten mit berufsbedingten Hauterkrankungen

Dermatologie in Beruf und Umwelt

Research paper thumbnail of Barriereregeneration unter wasserdampfdurchlässigen Handschuhmembranen

Dermatologie in Beruf und Umwelt

Research paper thumbnail of Site variations in susceptibility to SLS at the volar forearm

Research paper thumbnail of Worker’s Protection: Gloves and Creams

Quick Guide to Contact Dermatitis, 2016

Research paper thumbnail of Worker´s Education and Teaching Programmes: The German Experience

Research paper thumbnail of Okklusionseffekt von Schutzhandschuhen

Dermatologie in Beruf und Umwelt

Research paper thumbnail of Optimizing skin protection with semipermeable gloves

Dermatitis : contact, atopic, occupational, drug, 2004

Occlusion due to gloves is one important cause of glove irritation. Macerated softened skin gives... more Occlusion due to gloves is one important cause of glove irritation. Macerated softened skin gives poor protection against microbes and chemical injuries. The introduction of a breathable protective glove material would represent a significant step toward improved prevention of occupational skin disease. Performance levels of semipermeable and occlusive gloves were examined under conditions typical of the hairdressing profession. In two studies, tests comparing breathable semipermeable gloves to single-use gloves made of occlusive materials were conducted. In an initial study, a user survey was carried out in conjunction with bioengineering examinations. Values at baseline and values after gloves were worn were recorded by measuring transepidermal water loss (TEWL), skin humidity (SH), and skin surface hydrogen ion concentration (pH) in 20 healthy volunteers. In a second study, the gloves were tested for penetrability and permeability with three chemical compounds typically used in t...

Research paper thumbnail of Standardization of skin cleansing in vivo : part II. Validation of a newly developed Automated Cleansing Device (ACiD)

Skin Research and Technology, 2014

To date, there are no legally binding requirements concerning product testing in cosmetics. This ... more To date, there are no legally binding requirements concerning product testing in cosmetics. This leads to various manufacturer-specific test methods and absent transparent information on skin cleansing products. A standardized in vivo test procedure for assessment of cleansing efficacy and corresponding barrier impairment by the cleaning process is needed, especially in the occupational context where repeated hand washing procedures may be performed at short intervals. For the standardization of the cleansing procedure, an Automated Cleansing Device (ACiD) was designed and evaluated. Different smooth washing surfaces of the equipment for ACiD (incl. goat hair, felt, felt covered with nitrile caps) were evaluated regarding their skin compatibility. ACiD allows an automated, fully standardized skin washing procedure. Felt covered with nitrile as washing surface of the rotating washing units leads to a homogenous cleansing result and does not cause detectable skin irritation, neither clinically nor as assessed by skin bioengineering methods (transepidermal water loss, chromametry). Automated Cleansing Device may be useful for standardized evaluation of the cleansing effectiveness and parallel assessment of the corresponding irritancy potential of industrial skin cleansers. This will allow objectifying efficacy and safety of industrial skin cleansers, thus enabling market transparency and facilitating rational choice of products.

Research paper thumbnail of Lowering lesional surface pH in acne: A new treatment modality for Herpifix ®

Journal of Dermatological Treatment, 2009

The acid skin surface pH has antimicrobial activities. Increased growth of Propionibacterium acne... more The acid skin surface pH has antimicrobial activities. Increased growth of Propionibacterium acnes contributes to the pathogenesis of acne. Therefore, the pH of inflammatory acne lesions was determined prior to and after lesional acidification employing Herpifix (Courage + Khazaka, Cologne, Germany), a microphoretic system. The pH was correlated with the number of acne lesions. A total of 30 volunteers with acne vulgaris participated in this crossover study applying either Herpifix or a dummy to inflammatory lesions. Prior to treatment, the pH of acne lesions was 5.7 +/- 0.2 (mean +/- SD) and 22 lesions (mean +/- 10) were counted in an 8 x 8 cm(2) facial surface area. Fifteen volunteers (group A) used Herpifix first for 3 weeks and then the dummy, while the other group of 15 volunteers (group B) used the dummy first and then Herpifix. In group A, the lesional surface pH and number of lesions decreased (p &amp;amp;amp;amp;lt; 0.01) initially. When the dummy was used over a second 3-week treatment period, the skin surface pH and number of acne lesions increased. Findings for group B were vice versa. When both groups were compared at the end of the study, a significant difference in pH values (p &amp;amp;amp;amp;lt; 0.001) and the number of acne lesions (p &amp;amp;amp;amp;lt; 0.05) was obtained. Herpifix may be considered as a new therapeutic option for inflammatory acne.

Research paper thumbnail of Sicherheit, Wirksamkeit und Vergleichbarkeit von beruflichen Hautreinigern

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 2010

Research paper thumbnail of Safety, effectiveness and comparability of professional skin cleansers

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 2010

There are no widely-accepted methodical specifications with which to objectify cleansing effectiv... more There are no widely-accepted methodical specifications with which to objectify cleansing effectiveness and skin compatibility of occuptional skin cleansing products in Europe. Therefore the German Social Insurance Agency (DGUV) initiated a study with the goal to evaluate such products in view of the potency and the safety of hand cleansers. A market analysis was a part of the project. The product descriptions and safety data sheets of 120 products (5-20/manufacturer) of 11 manufacturers were evaluated between 02/2008 and 04/2008. The manufacturers used mainly ingredients of low irritancy. The declaration of the applied ingredients was in the majority of the cases correctly labeled according to the INCI Declaration. Although there was documentation of skin tolerability for most products, the manufacturers used widely differing tests of skin compatibility. Evidences for cleansing effectiveness were not declared or have not been provided. One manufacturer even promised medical effects of its products. There was no uniform general classification of products making it difficult to identify characteristics of cleansers and choose between them. Presently, there are no commonly accepted criteria to classify products in view of cleansing effectiveness und skin compatibility. Generally accepted criteria and test methods are needed for the evaluation of hand cleansers in order to provide the possibility of transparency and comparability.

Research paper thumbnail of Sustainability of an interdisciplinary secondary prevention program for hairdressers

International Archives of Occupational and Environmental Health, 2010

Two hundred and fifteen hairdressers suffering from occupational skin diseases (OSD) have attende... more 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&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; 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. 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 (IG(1994), participants in 1994, N = 62) was followed up again 10 years after their participation. 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 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001, Cramer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;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 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;remaining&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;not remaining at work&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; 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 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;safe&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; behavior and insuring transferability to real workplace settings (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;empowerment&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;). 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.

Research paper thumbnail of Skin care management: educational aspects

International Archives of Occupational and Environmental Health, 2003

Health education is effective in primary, secondary and tertiary prevention of occupational skin ... more Health education is effective in primary, secondary and tertiary prevention of occupational skin disorders, as clearly demonstrated by interventional studies carried out at the University of Osnabrueck. Health education may intervene with (a) habituated behaviour of affected employees and (b) the condition of working environments. In conclusion, prevention of occupational skin diseases and maintenance of health can be achieved by the conditioning of individual behaviour via specific educational programmes in addition to dermatological care.

Research paper thumbnail of Sustainability of interdisciplinary secondary prevention in patients with occupational hand eczema: a 5-year follow-up survey

Contact Dermatitis, 2012

Occupational hand eczema (OHE) is common in &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;... more Occupational hand eczema (OHE) is common in &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;wet work&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; occupations. Thus, effective and sustainable prevention strategies are needed. To investigate the long-term effectiveness (sustainability) of an interdisciplinary secondary prevention programme. One hundred and thirty-four patients with OHE consecutively participated in an outpatient skin protection seminar comprising dermatological and educational interventions. Data were obtained at baseline (T0) and at 9 months (T1) and 5 years (T2) after participation. A cohort of 84 patients was available for analysis of the outcomes &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;job continuation&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;skin condition&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;skin protection behaviour&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;disease management&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;. At T2, 71.4% of patients remained in their occupation. The prevalence and severity of self-reported OHE were significantly reduced as compared with T0 (p = 0.007, p = 0.002). Of the patients, 13.1% gave up work because of OHE at T2. The intervention was most successful in patients suffering from milder forms of OHE, and there was less success in patients with severe OHE. The results showed a significant reduction in the frequency of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;hand washing&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; (p = 0.003) but no measurable change in the use of skin care products (p = 1.000). The intervention showed sustainable long-term effects. Early detection and reporting of OHE in the initial stages of the disease is of utmost importance for the effectiveness of secondary prevention. In cases of severe OHE, inpatient programmes may be indicated.

Research paper thumbnail of Standardized dirts for testing the efficacy of workplace cleaning products: validation of their workplace relevance

Contact Dermatitis, 2013

In order to assess the cleaning efficacy of occupational skin cleansers, standardized test dirts ... more In order to assess the cleaning efficacy of occupational skin cleansers, standardized test dirts mimicking the spectrum of skin soiling at dirty workplaces are necessary. To validate newly developed standardized test dirts (compliant with the EU Cosmetics Directive) for their occupational relevance. In this single-blinded, monocentric questionnaire-based clinical trial, 87 apprentices of three trades (household management; house painting and varnishing; and metal processing) evaluated the cleanability of six standardized test dirts in relation to their workplace dirts. In addition, they judged the similarity of the test dirts to actual dirts encountered in their working environments. Most of the household management participants assessed the hydrophilic model dirt (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;mascara&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;), the lipophilic model dirt (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;W/O cream&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;) and a film-forming model dirt (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;disperse paint&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;) as best resembling the dirts found at their workplaces. Most of the painters and varnishers judged the filmogenic model dirts (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;disperse paint&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;acrylic paint&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;) as best resembling the dirts found at their workplaces. For the metal workers, the lipophilic and paste-like model dirts were most similar to their workplace dirts. The spectrum of standardized test dirts developed represents well the dirts encountered at various workplaces. The test dirts may be useful in the development and in vivo efficacy testing of occupational skin cleansers.

Research paper thumbnail of Effects of CO2-enriched water on barrier recovery

Archives of Dermatological Research, 2004

The objective of the present study was to evaluate the impact of CO 2 -enriched water on barrier ... more The objective of the present study was to evaluate the impact of CO 2 -enriched water on barrier recovery of detergent-damaged skin compared to tap water employing bioengineering methods and thin-layer chromatography (TLC) analysis of stratum corneum (SC) lipids. Irritation of the skin was elicited on the forearms of 20 volunteers using 1% sodium lauryl sulphate (SLS). The degree of skin irritation was followed over 10 days in terms of skin colour reflectance (L*a*b*), transepidermal water loss (TEWL), and skin capacitance expressed as median values. For TLC analysis, SC lipids were extracted prior to and during the observation period. Clinical examination showed the efficacy of CO 2 -enriched water on barrier recovery. Compared to unenriched tap water, CO 2 -enriched water produced a significant (P<0.01) increase in total SC lipids and in particular in the ceramide fraction. Furthermore, TEWL was significantly (P<0.01) lower in skin treated with CO 2 -enriched water than in skin treated with unenriched water. These findings may indicate that rinsing with CO 2 -enriched water enhances (1) clinical regeneration of detergent-damaged skin, (2) epidermal lipid synthesis, and (3) barrier repair after detergent-induced perturbation.

Research paper thumbnail of Short- and long-term effects of single and repetitive glove occlusion on the epidermal barrier

Archives of Dermatological Research, 2009

The aim of this study was to analyse the occlusive eVects of glove materials (polyvinyl chloride,... more The aim of this study was to analyse the occlusive eVects of glove materials (polyvinyl chloride, natural rubber latex) on epidermal barrier function and to relate the Wndings to the deWnitions of wet work in the current German ordinance on hazardous substances (2007) and in the German technical regulations on hazardous substances (TRGS 401;). Short-term eVects of wearing gloves once for 4 h, as well as the long-term eVects of wearing gloves for 4 h daily for 7 days were assessed in a group of 20 healthy volunteers using non-invasive methods (transepidermal water loss (TEWL), capacitance, skin colour, skin surface pH). Data were collected 30 min and 3 h after single use, as well as 1 day after a 1-week application. TEWL and capacitance data showed hyperhydration of the horny layer 30 min after a 4-h occlusion as compared to baseline (p < 0.05). Three hours later, full recovery to basal values was observed. Additionally, a signiWcant long-term eVect after daily occlusion for 4 h for 7 days could not be demonstrated. In current literature, there is controversial evidence concerning the eVects of glove occlusion. This study could not verify signiWcant damage to skin barrier after 7 days of repeated occlusion 4 h daily in healthy volunteers. These Wndings require further discussion regarding the deWnitions in the current German ordinance on hazardous substances and in the TRGS 401.