Mekonnen et al.

Environmental Health and Preventive Medicine (2019) 24:11

https://doi.org/10.1186/s12199-019-0765-0
Environmental Health and
Preventive Medicine

RESEARCH ARTICLE Open Access

Self-report occupational-related contact

dermatitis: prevalence and risk factors
among healthcare workers in Gondar town,
Northwest Ethiopia, 2018—a cross-sectional
study
Tesfaye Hambisa Mekonnen*, Dawit Getachew Yenealem and Beyene Mindaye Tolosa

Abstract
Background: Occupational skin diseases are the second most common occupational diseases and are responsible
for an estimated 25% of all lost work days. Occupational contact dermatitis (OCD) comprises 70–90% of all
occupational skin diseases. In Ethiopia, information about the prevalence and factors which determine
developments of contact dermatitis is not recognized. The objective of this study was to investigate prevalence and
factors influencing the occurrences of occupational-related contact dermatitis among healthcare workers in Gondar
town, Northwest Ethiopia.
Methods: We employed a healthcare-based cross-sectional study from March to April 2018. A stratified sampling
method followed by simple random sampling method was used to select 422 participants. The standardized Nordic
Occupational Skin Questionnaire was pretested and interviewer-administered for data collection. We used SPSS
version 20 to conduct a binary logistic regression analysis. We set ≤ 0.05 p value to ascertain significance and 95%
CI with odds ratios to evaluate the strength of associations.
Results: Response rate was 100%. The majority, 52.4% (N = 221), were males. The mean age was 22.6 (SD ± 6.3)
years. The overall prevalence of self-report occupational contact dermatitis in the previous 12 months was 31.5%
(N = 133) [95% CI (27, 36.2)]. The highest symptoms indicated was redness, 28.5% (n = 38), followed by burning,
17.3% (n = 23). The hand is the most commonly affected body sites, 22% (N = 93). Hand washing frequency [AOR 1.80,
95% CI (1.10, 3.20)], pairs of hand gloves used per day [AOR 3.22, 95% CI (2.05, 5.87)], personal history of allergy
[AOR 2.37, 95% CI (1.32, 4.61)], and lack of health and safety training [AOR 2.12, 95% CI (1.12, 2.25)] were factors
considerably associated with contact dermatitis.
Conclusions: The prevalence of occupational-induced contact dermatitis is common among healthcare workers
in Ethiopia. Therefore, our finding indicates that intervention aiming at workers’ health and safety training
demands urgent public health responses to tackle the ailment. The result also demonstrates that healthcare
workers should be aware of when and how hands should be washed. The number of pairs of gloves used per
day should also be taken into consideration while devising prevention strategies.
Keywords: Occupational-related contact dermatitis, Healthcare workers, Self-report, Ethiopia

* Correspondence: [email protected]
Department of Environmental and Occupational Health and Safety, Institute
of Public Health, College of Medicine and Health Sciences, University of
Gondar, P.O. Box 196, Gondar, Ethiopia

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Mekonnen et al. Environmental Health and Preventive Medicine (2019) 24:11 Page 2 of 9

Background Methods
Occupational skin disease is the second most common Study design and period
occupational diseases [1, 2]. According to the Health We conducted a cross-sectional study from March to
and Safety Executive (HSE) report, there are around April 2018 to assess prevalence and identify the factors
16,000 cases every year in the UK [3]. In 2010, approxi- affecting work-related contact dermatitis among health-
mately, there had been 850,000 cases of work-related care workers.
dermatitis among workers in the USA [4]. Occupational
skin diseases are responsible for an estimated 25% of all Study setting and area
lost work days [5]. Occupational contact dermatitis This study was conducted among healthcare workers in
(OCD) accounts for 70–90% of all occupational skin Gondar town, Northwest Ethiopia. Gondar town is lo-
diseases, which deteriorates functional capacity and the cated 748 km to the northwest of Addis Ababa, the cap-
quality of life [6]. It is an inflammation of the skin caused ital of Ethiopia. There are two hospitals (a public and
by exposure to substances in the workplace [3, 7–9]. The private) in the town employing more than 700 health-
most common symptoms include swelling, itching, care workers. We included the two hospitals purposively
flaking or cracking of the skin, blisters, and weeping to attain the required sample size.
sore of skin [3].
Occupational contact dermatitis is the most Source population
common form of work-related skin diseases usually All healthcare workers working in the hospitals in
experienced by health professions [10, 11]. Working Gondar town were our source population.
in healthcare is regarded as a risk factor for
occupational-related skin diseases [2, 12–14]. Workers
Inclusion and exclusion criteria
are often exposed to cleaning materials, like disinfec-
Inclusion criteria
tants, soaps, detergents, latex, and thorough and fre-
We included all healthcare workers who had been work-
quent hand washing [11, 12]. The use of alcohol gel,
ing in the hospitals for at least 12 months prior to the
contact with allergens, and the occlusive effect of
study period.
gloves also lead to contact dermatitis in healthcare
professions [6]. A study demonstrated that using latex
gloves can predispose to the developments of contact Exclusion criteria
dermatitis among healthcare workers [13]. Administrative, supportive, and nonclinical (no direct
The prevalence of contact dermatitis is usually seen contact with patients) staffs were excluded.
between 10 and 40%, in general [2]. A study from
Greece delineated that 39.9% of the sampled em- Sample size and sampling procedures
ployees suffered from occupational dermatitis [15]. A We employed a stratified sampling technique to select
study conducted in Poland showed that prevalence of the participants. A single population proportion was
skin disorders among healthcare workers ranges from used to calculate the required sample size. A 50% as-
41 to 86% [13]. sumption for prevalence and an absolute precision of 5%
In Ethiopia, together with the recent advent of health- were considered. We also assumed 95% confidence level
care system developments, employment rate of health- to obtain adequate power for analysis. After considering
care workers is rapidly growing but with little/or no an additional 10% for nonresponse rates, 422 partici-
protection of their health and safety. Exposure to various pants were included in the study.
healthcare-related hazards that increase the likelihood of
experiencing symptoms of occupational-related contact Operational definitions
dermatitis is, therefore, usually remarkable. Despite the Work-related contact dermatitis: A noninfectious disease
problem pervasiveness, the magnitude and risk factors caused by skin contact (either allergic or irritant contact)
influencing work-related contact dermatitis among with substances used at work, with any of the symptoms
healthcare workers is often unnoticed. The objective of of contact dermatitis, including redness, burning, blis-
the current study was, therefore, to investigate the ters, itching, dry skin, fissures, aching or pain, and crust-
prevalence and risk factors associated with the occur- ing that appeared in any part of the body in the previous
rences of occupational-related contact dermatitis among 12 months [16]
healthcare workers in Gondar town, Northwest Ethiopia. Healthcare workers (HCWs): Included health officers,
An investigation of prevalence and risk factors for nurses, midwives, medical laboratory technologists,
occupational-induced dermatitis is imperative to under- medical doctors, pharmacists, psychiatrists, and optome-
stand the etiology of disease and inform better prevent- trists who work in clinical departments (have direct con-
ive strategies. tact with patients) in the hospitals
Mekonnen et al. Environmental Health and Preventive Medicine (2019) 24:11 Page 3 of 9

Body mass index (BMI): Workers weight (w) divided Diba, prior to the actual data collection days to test the
by height squared (h2) where: validity and consistency of the instrument used. We
< 18.5: underweight modified some words and misinterpretations, minimized
18.5–24.99: normal the number of questions, and made corrections to some
≥ 25: overweight/obesity other objections.
A satisfied worker with a job: A generic job satisfac-
tion scale score of 32 or above [17] Data management and analysis
A stressed worker with a job: A workplace stress scale Completeness of data was checked on a regular basis
score of 21 or above [18] during the data collection process. We coded data, la-
beled, verified, categorized, and entered into EpiInfo ver-
Data collection tools and techniques sion 7 software. We used SPSS version 20 to analyze
We collected data using a structured interviewer-adminis- data and computed frequencies, percentages, means, and
tered questionnaire. A self-report contact dermatitis was the standard deviation to present findings. The reliability
assessed by the standardized Nordic Occupational Skin of data collection instrument was checked and found
Questionnaire version 2002 (NOSQ-2002) [19]. Perceived that the reliability of the instrument was acceptable with
job satisfaction was assessed by a generic job satisfaction Cronbach’s alpha score of 0.988. A bivariate logistic re-
scale questionnaire [17]. We assessed perceived job stress gression analysis was performed separately for each in-
using a job stress scale questionnaire [18]. We divided the dependent variable to explore the associations with the
components of the questionnaire into four parts. The first dependent variable (occupational contact dermatitis).
part covered socio-demographic characteristics, like sex, The explanatory variables which were significant at < 0.2
age, educational status, profession, marital status, monthly p values in a bivariate analysis were exported to the mul-
salary, and work experience. The second part covers tivariable logistic regression model to control the poten-
work-related factors, including working hours per day, de- tial effects of confounders. Variables were dropped into
partment, preemployment and periodic medical examin- the multivariate logistic regression model with a forward
ation, types of glove used, pairs of gloves used per day, variable selection method. We checked the goodness of
frequencies of hand washing, shift work, health and safety fit model using Hosmer and Lemeshow and found the
training, overtime (working more than 8 h per day), assumption satisfied (p value > 0.05). A cut off ≤ 0.05 p
utilization of hand gloves in days per week, and utilization value was set to evaluate the significance and odds ratios
of hand gloves in hours per day. The third part of the (OR) with 95% confidence interval (CI) to establish the
questionnaire constitutes the detailed information about strength of associations.
self-report history of chronic diseases, such as atopic fever
(yes/no), hay fever (yes/no), asthma (yes/no), childhood Results
dermatitis (yes/no), personal and family history of allergy Socio-demographic characteristics
(yes/no), and rhinitis (yes/no). The last category of the sur- A total of 422 healthcare professionals participated
vey questionnaire covered behavioral factors, like physical with a response rate of 100%. The majority of the re-
exercise (yes/no), smoking (yes/no), and body mass index spondents, 52.4% (N = 221), were males. The mean age
(BMI) (weight divided by height squared). was 22.6 (SD ± 6.3) years. In a high proportion, 74.9%
(N = 316) were married and 39.8% (N = 168) were
Data quality control nurses (Table 1).
To ensure the quality of data collected, we gave much
emphasis to the appropriate design of data collection Work-related characteristics
tools. First, the questionnaire was designed in English Out of the participants, 78.9% (N = 333) indicated that
and translated into the local language “Amharic” and they had been working for ≤ 8 h per day. Less than half of
back to English by language experts. Second, we re- the respondents, 49.8% (n = 210), described that they
cruited three data collectors and two supervisors who worked overtime (more than 8 h per day). Thirty-five per-
had previous experience and skills in the task. We cent (N = 150) of the participants showed that they had
trained and oriented them for 2 days before the actual worked shift work (night and day shifts). The majority,
data survey. The training content included about the 71.8% (N = 303), said that they had not received any train-
clarity of questionnaire and purposes of the study, the ing on health and safety issues. Almost half of the study
confidentiality of information, informed consent, and the sample, 50.9% (N = 215), demonstrated that there was
roles and responsibilities of the data collectors as well as no periodic medical examination services in their work-
supervisors. The principal investigator supervised the place. The majority of the participants, 98.8% (N = 417),
overall data collection tasks. Third, we conducted a pre- reported that they used some types of personal protect-
test on 10% of the sample in a neighboring hospital, Kola ive equipment (PPE) for their activities. Almost all,
Mekonnen et al. Environmental Health and Preventive Medicine (2019) 24:11 Page 4 of 9

Table 1 Socio-demographic characteristics of HCWs in Gondar said that they used gloves for 2–6 h per day, whereas
town, Ethiopia, 2018 20.4% (N = 86) for > 6 h per day. Of the participants,
Variables (N = 422) Frequency Percent (%) 47.6% (N = 201) reported that they wash their hands
Sex one to five times per day (Fig. 1).
Male 221 52.4
Prevalence of self-report occupational contact dermatitis
Female 201 47.6
The overall prevalence of self-report work-related
Age
contact dermatitis in the previous 12 months was 31.5%
18–24 14 3.3 (N = 133) [95% CI (27, 36.2)]. Nurses indicated a high
25–35 192 45.5 proportion of contact dermatitis, 12.1% (N = 51),
≥ 36 216 51.2 followed by midwifery professionals, 11.8% (N = 50)
Religion (Fig. 2). Redness was showed to be the highest symp-
toms of self-report contact dermatitis, 28.6% (n = 38),
Orthodox 236 55.9
followed by burning, 17.3% (n = 23) (Fig. 3). A high pro-
Muslim 125 29.6
portion of the symptom of self-report dermatitis was ob-
Protestant 49 11.6 served on the hands (hand dermatitis), 22.0% (N = 93).
Others+ 12 2.8 Five percent (N = 19) of the participants reported having
Marital status had experienced contact dermatitis on their faces. The
Single 92 21.8 prevalence of contact dermatitis among healthcare
workers was 2.1% (N = 9) and 2.8% (N = 12) on the eyes
Married 316 74.9
and other body parts, respectively. Of the victims, 17.3%
Separated/divorced/widowed 14 3.3
(n = 23) indicated that they had experienced work-related
Educational level contact dermatitis in more than one body sites.
First degree (BSc, MD) 174 41.2
Masters (not medical) and specialists 248 58.8 Occupational characteristics of the problem
Monthly salary in BIRR Of the reported contact dermatitis, 75.9% (n = 101) in-
dicated that their symptoms last for more than 3 weeks.
≤ 4000 140 33.2
Regarding the occupational relatedness of the problem,
4001–4999 148 35
92.5% (n = 123) said that their symptoms become made
≥ 5000 134 31.8 worse when they contact with certain materials, chemi-
Profession cals, and anything else at their workplaces. Twenty-six
Nurse 168 39.8 percent (n = 34) of the participants who reported con-
Midwives 138 32.7 tact dermatitis indicated that contact with certain mate-
rials outside their work aggravated their symptoms.
Laboratory technologists 64 15.2
Most of the participants who indicated the problem,
Dentists 3 .7
96.2% (n = 128) said that their symptoms improve on
Surgeon 16 3.8 days away from work.
Others* 33 7.8
Work experience Factors affecting the occurrences of contact dermatitis
< 5 years 194 46 A bivariate logistic regression analysis showed that edu-
cation, monthly salary, work experience, working hours
5–10 years 104 24.6
per day, frequency of hand washing per day, job satisfac-
> 10 years 124 29.4
tion, pairs of hand gloves used per day, periodic employ-
Others+ Catholic, Juba; Others* pediatricians, anesthesia, optometrists,
psychiatrists; pharmacists; health officers; medical doctors; HCWs healthcare
ment medical examination, hours of hand gloves used
workers; BSc Bachelor of Science; MD medical doctor; BIRR Ethiopian currency per day, health and safety training, and having personal
previous history of allergy were significantly associated
99.3% (N = 419), of the workers had illustrated that they with occupational contact dermatitis.
always used gloves for their jobs. Regarding the type of In the multivariable logistic regression analysis, how-
gloves used, 58.8% (N = 248) described that they used ever, the frequency of hand washing per day, pairs of
natural rubber/latex glove, whereas 37.2% (N = 157) hand glove used per day, health and safety training, and
and 4% (N = 17) indicated that they used synthetic rub- previous history of allergy remained to significantly
ber and plastic types of gloves, respectively. Among the affect the occurrences of contact dermatitis. Our finding
respondents, 38.6% (N = 163) reported that they used demonstrated that hand washing frequency significantly
gloves for < 2 h per day. Forty-one percent (N = 173) affected the development of contact dermatitis. The
Mekonnen et al. Environmental Health and Preventive Medicine (2019) 24:11 Page 5 of 9

Fig. 1 Hand washing frequencies among healthcare workers in Gondar town, Ethiopia, 2018 (N = 422)

participants who washed their hands 11 and more times who did not indicate as having a previous history of al-
per day were 1.80 times more likely to develop contact lergy [AOR 2.37, 95% CI (1.32, 4.61)]. Having health and
dermatitis than those who washed 5 and fewer times a safety training was the other factors which importantly
day [AOR 1.801, 95% CI (1.10, 3.20)]. The pairs of hand affected the experiences of occupational contact derma-
glove used per day indicated to significantly affect con- titis. The participants who received no training about
tact dermatitis. The odds of having contact dermatitis workplace health and safety were 2.12 times more likely
were 3.22 times high among respondents who used five to develop contact dermatitis than those who received
and more pairs of gloves per day than those who used a training on health and safety [AOR 2.18, 95% CI (1.12,
pair of gloves per day [AOR 3.22, 95% CI (2.05, 5.87)]. 2.25)] (Table 2).
Having a previous history of allergy also importantly in-
fluenced the development of contact dermatitis. Respon- Discussion
dents who indicated to have been diagnosed with allergy Occupational contact dermatitis is a priority
in the previous time were 2.37 times more likely to de- occupational-related health problem markedly affecting
velop occupational-related contact dermatitis than those employees’ quality of life and performance efficiency.

Fig. 2 Distribution of occupational contact dermatitis by profession, Gondar town, Ethiopia, 2018 (N = 422)
Mekonnen et al. Environmental Health and Preventive Medicine (2019) 24:11 Page 6 of 9

Fig. 3 Perceived symptoms of contact dermatitis among healthcare workers in Gondar town, Ethiopia, 2018 (n = 133)

This study employed a healthcare-based cross-sectional occurrences of occupational-related contact dermatitis.

study to investigate the prevalence and risk factors influ- This finding was in line with other reports [5, 22, 24, 27,
encing the occurrences of work-related contact derma- 29]. The possible explanation might be due to that having
titis among healthcare workers in Gondar town, a personal previous history of allergy might exacerbate the
Northwest Ethiopia. The prevalence of self-report occurrence of contact dermatitis. A more plausible reason
occupational-related contact dermatitis in the previous is that having a previous history of allergy may lead to the
12 months was 31.5% (N = 133) [95% CI (27.0, 36.2)]. developments of contact dermatitis, particularly allergic
This result was comparable with a study in Namibia contact dermatitis due to stimulation of the body’s mecha-
(31.3%) [20]. This might be due to similarities in socio- nisms, for example, IL-4/Th2 pathway [31, 32], increasing
economic characteristics and poor implementation of the individual susceptibility to elicitation response to
workplace health and safety services in these regions, as environmental triggers.
developing countries. We found a lower prevalence of In the current study, frequency of hand washing per
occupational-related contact dermatitis than a study re- shift considerably affected the experience of occupa-
port in Lithuania (47.3%) [21], Turkey (61.7%) [22], tional contact dermatitis. This result was equivalent to
Bulgaria (58.5%) [23], and Greece (39.9%) [15]. The dif- other study findings [6, 15, 24, 27]. This may be due to
ferences might be due to the differences in workplace ill- that repeated hand washing may expose workers to an
ness management and reporting cultures and procedures extraordinary amount of contact with water (wet work)
available between the countries. and soap/cleansing agents that can affect the normal
Our finding was, however, higher compared to a study outer layer of skin. Repetitive hand washing exposes to
finding in China (28.5%) [24], Bulgaria (28.2%) [25], and constant wetting and drying, removing protective sub-
Taiwan (8%) [26]. This may be due to disparities in the stances from the skin that makes it less pliable and more
characteristics of study participants and setting among the prone to contact dermatitis related to occupation.
countries. Hand dermatitis (hand eczema), 22% (N = 93), Our study also indicated that pair of hand gloves used
was the most commonly indicated occupational-induced per day was an important risk factor for work-related
contact dermatitis in the current study. This magnitude contact dermatitis. This finding agreed with other studies
was lower than that of previous reports in Japan [27] and [13, 21, 33]. A possible explanation might be that the bar-
India [28] (36.2% prevalence in both) and higher than that rier and exposure protection function of the skin may be
of a study in Saudi Arabia (7.73%) [29]. The difference impaired by occlusion effects of wearing pairs of gloves.
may be due to differences in sample size and method of Lack of health and safety training was the other signifi-
data collection employed. Redness, 28.5% (n = 38), was the cant factor for occupational-related contact dermatitis.
most common symptoms of all occupational-related con- There is scant research that indicates the association
tact dermatitis observed in our investigation. This was between occupational-related contact dermatitis and
lower than literature report in the UK (49%) [30]. The dif- workers’ training status on workplace health and safety is-
ference could be due to the differences in illness reporting sues. A study conducted in India corroborated with this
cultures and data collection methods used. finding [28]. The possible suggestion for our finding is due
This study revealed that having previous history of to the fact that health and safety training plays an import-
personal allergy significantly influenced the likely ant preventive role from different occupational related ill
Mekonnen et al. Environmental Health and Preventive Medicine (2019) 24:11 Page 7 of 9

Table 2 Factors affecting occupational contact dermatitis (OCD) among HCWs, Gondar town, 2018, Ethiopia
Variables (N = 422) Contact dermatitis COR (95% CI) AOR (95% CI) p value
Yes No
Educational level
First degree (BSc, MD) 39 135 2.11 (1.6, 3.28) 1.41 (0.84, 2.30) 0.06+
Masters (not medical) and specialists 94 154 1 1
Monthly salary in BIRR
≤ 4000 30 110 2.79 (1.65, 4.75) 1.11 (0.03, 2.10) 0.041+
4001–4999 45 103 1.60 (0.94, 2.73) 1.01 (0.08, 1.49)
≥ 5000 58 76 1 1
Work experience
< 5 years 45 149 1 1 0.079+
5–10 years 31 73 1.41 (0.82, 2.40) 1.40 (0.02, 2.19)
> 10 years 57 67 2.82 (1.73, 4.58) 1.40 (0.04, 1.59)
Working hours per day
≤8 73 260 1 1 0.057+
>8 60 29 7.37 (4.41, 12.32) 3.80 (0.11, 4.82)
Hand washing frequency per day
≤ 5 times 35 150 1 1 0.001*
6–10 times 29 109 1.14 (0.66, 1.98) 1.11 (0.85, 1.22)
> 10 times 69 30 9.86 (5.60, 17.34) 1.80 (1.102, 3.20)
Job satisfaction
Satisfied 73 278 1 1 0.061+
Not satisfied 60 11 20.77 (10.39, 41.52) 5.36 (0.18, 8.19)
Pairs of hand gloves used per day
< 1 pair 15 104 1 1 0.002*
1–5 pairs 43 172 1.73(.92, 3.28) 1.53 (0.43, 3.12)
> 5 pairs 75 13 40.0 (17.98, 89.01) 3.22 (2.05, 5.87)
Periodic medical examination
Yes 78 137 1 1 0.048+
No 55 152 1.56 (1.03, 2.37) 1.23 (0.87, 1.09)
Personal history of allergy
Yes 46 10 14.75 (7.15, 30.46) 2.37 (1.32, 4.61) 0.001*
No 87 279 1 1
OSH training
No 114 209 2.31 (1.59, 3.89) 2.12 (1.12, 2.25) 0.001*
Yes 19 80 1 1
Hours of hand gloves used per day
< 2 h/day 47 116 1 1
2–6 h/day 51 122 1.03 (0.31, 2.11) 1.01 (0.15, 1.93) 0.079+
> 6 h/day 35 51 1.70 (0.18, 3.25) 1.51 (0.39, 2.65) 0.053+
1 represents a reference group. All variables we presented in this table were included in the multivariable model
AOR adjusted odds ratios, CI confidence interval, COR crude odds ratio, HCWs healthcare workers, BSc Bachelor of Science, MD medical doctor, N number,
OSH occupational safety and health
+
Significant in a bivariate analysis
*Significant in a multivariable analysis
Mekonnen et al. Environmental Health and Preventive Medicine (2019) 24:11 Page 8 of 9

health, including occupational-related contact dermatitis. Abbreviations

It is often evident that workplace health and safety train- AOR: Adjusted odds ratios; BMI: Body mass index; BSc: Bachelor of Science;
CD: Contact dermatitis; CI: Confidence interval; COR: Crudes odds ratio;
ing likely increase workers’ knowledge and awareness to- HCWs: Healthcare workers; HSE: Health and Safety Executive; MPH: Masters of
wards prevention and control of the risks and hazards Public Health; NOSQ: Nordic Occupational Skin Questionnaire; OR: Odds
associated with adverse health conditions, as this generally ratios; SPSS: Statistical Package for Social Sciences; UK: United Kingdom

boosts early recognition and notification of the conditions. Acknowledgements

Moreover, employees’ provision with safety training at the The authors would like to thank the Department of Environmental and
earliest possible period of employment might also improve Occupational Health and Safety, Institute of Public Health, College of Medicine
and Health Sciences, University of Gondar for providing ethical clearance. We
workplace safety cultures and practices. Previous reports would also like to extend our appreciation to all participants and data collectors.
also noted that occupational health and safety education
encourages employees to recognize and report health con- Funding
Department of Environmental and Occupational Health and Safety, Institute
ditions at the earliest possible [34, 35]. In Ethiopia, cover- of Public Health, University of Gondar, covered all the required financial cost
age in health and safety service is empirically very poor. of this study but did not involve in any of the research activities.
Health and safety training is thus rarely implemented, ur-
Availability of data and materials
ging to the likely developments of health conditions, in- The datasets generated and analyzed during this study are included in the
cluding that of work exposure-related occupational main document of this manuscript.
contact dermatitis. The authors would like to recommend
Authors’ contributions
future researchers to further examine the associations be- THM initiated the research concept, analyzed the data, presented the results
tween the lack of health and safety training and and discussions, wrote up of the draft manuscript, reviewed and finalized the
occupational-related contact dermatitis. manuscript document, and is the corresponding author. DGY wrote up of
the research proposal, involved in data analysis, interpreted results, and
This study would likely contribute considerable evidence involved in manuscript reviewing. BMT involved in writing up of the research
to literature regarding prevalence and the factors influen- proposal, writing up of the draft of the manuscript, and involved in
cing occurrences of work-related contact dermatitis. How- manuscript reviewing. All authors read and approved the final manuscript.

ever, few limitations have not been ruled out. First, the Ethics approval and consent to participate
study was based on a cross-sectional design. Therefore, it We obtained ethical clearance from the University of Gondar, Institute of
might be difficult to conclude the temporal relationship Public Health, Department of Environmental and Occupational Health and
Safety (Reference No.EOHS 463/10). We submitted letters to the two
between the outcome of interest (occupational-related hospitals. Informed consent was obtained from the participants. Involvement
contact dermatitis) and factors influencing its occurrences. in the study was based on the full consent of the participants. The
Next, the study was based on respondents’ self-report data. confidentiality of the collected data was ensured and maintained. Only
aggregate data were used for interpretation of the results.
As a result, underestimation of the condition due to recall
bias may be expected. Moreover, the finding was not sup- Consent for publication
ported by clinical diagnoses, like patch testing that help to Not applicable.

identify work-related irritant and allergic contact derma- Competing interests

titis. However, we used the standardized Nordic Occupa- The authors declare that they have no competing interests.
tional Skin Questionnaire that was validated for
estimating a self-report prevalence of skin dermatitis in a Publisher’s Note
given population. Last, while translating the data collec- Springer Nature remains neutral with regard to jurisdictional claims in
published maps and institutional affiliations.
tion tool from English to the local language (Amharic),
some technical errors may occur. But to minimize such er- Received: 28 September 2018 Accepted: 30 January 2019
rors, the translation was done by language experts.
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