Evaluation of Health Education Based on Pictograms and Video Sequences in the Prevention of Hand Eczema Among Hospital Cleaners: A Cluster-Randomised Controlled Trial With 24 Weeks Follow-Up

Abstract

Background: Hand eczema (HE) is common among hospital cleaners, yet no specific prevention programme exists for this group in Denmark.

Objectives: To evaluate the effectiveness of visual aids (pictograms and video scenes) based on evidence-based skin care and protection recommendations on HE outcomes, focusing on disease severity, point prevalence and skin care and protection knowledge.

Methods: A cluster-randomised controlled trial was conducted in professional cleaners from three Danish hospitals. Intervention Group A received pictograms, video clips and a short group-based educational session. Intervention Group B received only pictograms and video clips. The control group received treatment as usual. HE severity and prevalence were assessed clinically, while knowledge was measured using self-reported data.

Results: Out of 234 invited cleaners, 224 (96%) participated (Intervention Group A: 73, Intervention Group B: 78, Control Group: 73). After 24 weeks, both intervention groups showed significant reductions in HE severity and prevalence compared to the control group. Knowledge of skin care and protection also improved significantly in both intervention groups.

Conclusion: Visual aids effectively reduced HE prevalence and severity in hospital cleaners. Pictograms are a cost-effective strategy that can be widely implemented, addressing the substantial burden of HE in the cleaning industry across diverse settings.

Keywords: contact dermatitis; pictogram; prevention.