Validation of a questionnaire on hand hygiene in the construction industry

Abstract

INTRODUCTION: Construction workers are at risk of developing occupational contact dermatitis. Gloves, when used properly, may protect against chemicals and coarse materials. We investigated the prevalence and determinants of contact dermatitis in a population of Dutch construction workers and aimed at validating questionnaire items on hand hygiene. METHODS: A cross-sectional study was conducted at 13 construction sites, yielding data of 177 subjects (95% response rate). A questionnaire covering questions on hand hygiene and contact dermatitis symptoms was used. Agreement between workplace observations and a number of questionnaire items was assessed by calculating Cohen's kappa. Log-binomial regression analysis was used to assess the association between contact dermatitis and various hand hygiene-related determinants. RESULTS: The 1-year prevalence of self-reported contact dermatitis in our study sample was 46.9%. Multiple regression analysis showed a positive association with difficulties with hand cleaning (prevalence ratio [PR]: 1.26, 95% confidence interval [CI]: 1.05-1.52), hand contamination at the end of the working day (PR: 2.30, 95% CI: 1.14-4.65), and intensive hand cream use (PR: 2.07, 95% CI: 1.42-3.01). Observations of hand contamination, glove use, and glove types were found to agree well with the self-reported data from the questionnaire (Cohen's kappa's 0.75, 0.97, and 0.88). CONCLUSIONS: Self-reported contact dermatitis prevalence in construction workers was high and related to hand hygiene. A strong agreement was found between workplace observations and self-reported questionnaire data.