[Use of Reusable Textile Undergloves for Medical Procedures: A Feasibility Study]. / Einsatz wiederaufbereitbarer textiler Unterziehhandschuhe für medizinische Tätigkeiten: eine Machbarkeitsstudie.

OBJECTIVE: Undergloves are a way to reduce moisture-related skin damage. The aim of this feasibility study was to gain experience with logistics, applicability, acceptability and cost of the routine use of reusable textile undergloves in a hospital setting. METHODS: Undergloves were tested with 18 health-care workers on an intensive care unit over three months. Data on usage as well as logistics were recorded. At baseline, personal data and knowledge and use of cotton undergloves, existing skin problems and the nursing behaviour of the hands by the subjects were determined by means of an input questionnaire. After each wearing, data on usage were collected by a questionnaire. Participants were interviewed by means of a questionnaire with respect to their experience with the use of the undergloves. RESULTS: Acceptance and compliance with the use of undergloves was remarkably good. This was partly due to the properties of the gloves, and partly to the reduction of sweating and very positive effect on the skin of the hands. In the study period 2165 underglove uses were documented, resulting in an average daily consumption of four pairs per person per day. The average wearing time was 28.6 min. The undergloves were suitable for application as well as reprocessing. Reprocessment-related fatigue was relatively low and did not lead to the loss of the properties, only few gloves had to be sorted out. Even if one assumes a complete write-off of the gloves with end of the study, costs for reprocessing were about 0.46 € or 64 % less than the single use. CONCLUSION: The routine use of textile, reprocessable undergloves is feasible. Major challenges for broad usage are within logistics and acceptance by the user.

Duration of wet work in hairdressers.

AIM OF THE STUDY: Occupational contact dermatitis caused by wet work is particularly common in hairdressers. Data on the duration of wet work (DWW) in the hairdresser's trade are not well known until now. A questionnaire or self-reported/estimated skin exposure are not suitable to get accurate information about DWW. According to the guidance of the German Federal Ministry for Labour and Social Affairs, employees with DWW > 2 h per day should get a possibility for targeted occupational-medical health examinations. Targeted occupational-medical health examinations are prescribed for employees with daily duration of wet work longer than 4 h. The aim of the study was to quantify the average daily exposition to wet work in hairdressers. MATERIALS AND METHODS: In our study, we used the direct observation as a standard method to analyse the work steps and to measure DWW in hairdressers. We developed the instrument for the analyses of activities in hairdresser salons and measurement of DWW in hairdressers during their 8-h shift. At the beginning of the study, 60 observers were intensively instructed and trained in the procedure of analysis. RESULTS: The mean of duration of wet work (DWW) in 106 8-h shifts analysed was 8,234 s (approx. 2 h 17 min). The minimum of DWW was 278 s and the maximum 21,135 s (approx. 6 h); the standard deviation was 3,826 s. In 37% of the analysed 8-h shifts, DWW was shorter than 2 h, in 58% between 2 and 4 h and in 5% longer than 4 h. Eighteen per cent of the DWW was caused by wearing water-resistant protective gloves. We found positive correlations between "DWW" and "DWW > 2 h", with the predictors "number of customers total", "number of long-haired people" and "number of female customers". CONCLUSION: According to the guidance of the German Federal Ministry for Labour and Social Affairs, hairdressers should get a possibility for targeted occupational-medical health examinations.

Prevention of occupational skin disease: a workplace intervention study in geriatric nurses.

BACKGROUND: Health care workers have an increased risk of occupational dermatosis. OBJECTIVES: To determine whether a skin care programme reduces skin disease on the hands of geriatric nurses and increases protective behaviour and the provision of skin care products at the workplace. The intervention was based on a 2-h skin care training session and an occupational advisory service. METHODS: The study design was a randomized intervention study with a control group. Three hundred and eighty-eight geriatric nurses were included in the intervention group exposed to a skin care programme (IG; n = 146) and in the control group (CG; n = 242). Both groups completed questionnaires on exposure and underwent clinical examinations of their hands at the beginning and after a 12-month period. Preventive measures initiated by the employer at the workplace were documented at baseline and at 3 months after the intervention. RESULTS: At baseline, no difference between the IG and the CG was found with respect to skin changes or work-related behaviour. At follow-up, the frequency of skin disease was significantly reduced in the IG, from 26% at baseline to 17% at follow-up, whereas the frequency remained almost unchanged in the CG. Effects on behaviour in the IG included significant increases in the use of moisturizers and hand disinfection instead of hand washing. The provision of cotton gloves and barrier cream products increased at intervention workplaces. CONCLUSIONS: Effective implementation of an occupational skin care programme for geriatric nurses should include both the training of the nurses and an occupational advisory service for management.

Mutation of the tumor suppressor gene p53 in human prostate and bladder cancers--investigation by temperature gradient gel electrophoresis (TGGE).

PURPOSE: To test the value of a recently developed screening method for the detection of p53 mutations in prostate and bladder cancers. MATERIALS AND METHODS: Tumor tissue from 24 prostate cancers and 27 bladder cancers were evaluated. DNA of the critical p53 exons 5-8 were amplified and run on horizontal polyacrylamide gels under defined temperature conditions (TGGE) to yield specific gel shifts and sets of homo- and heteroduplexes in case of mutation. Sequencing with a laser-fluorescent electrophoresis unit was done directly from polymerase chain reaction (PCR) products and/or from reamplified mutant and wild type bands excised from the gels. RESULTS: The p53 genotype predicted from the TGGE analysis was always confirmed on the excised DNA fragments, in contrast to only 50% of cases tested by direct sequencing from mixed wild type and mutant DNA present in PCR products. With this screening protocol, 6 of 24 prostate cancers (25.0%) and 11 of 27 bladder cancers (40.7%) showed p53 mutations. At stage T1, none of prostate cancers and 41.2% of bladder cancers contained mutant p53. At higher stages (> or = T2), 30.0% of prostate cancer and 50.0% of bladder cancers were mutated. Histological tumor grading was > G1 in all but two prostate/bladder cancers with mutant p53. It appears that p53 mutations can occur early in bladder carcinogenesis. CONCLUSION: TGGE fulfills the clinical need of a rapid and specific screening method, and, at the molecular level, has the advantage of sorting out the wild type and mutant alleles for consecutive sequencing.