Primary prevention of XXXX in the German health care system through education and intervention.

@entity566 @entity56 @entity2144 @entity565
BACKGROUND: The development of @entity56 caused by natural rubber latex (NRL) @entity566 are risks for health care workers. There are few published studies to suggest that intervention programs to reduce exposure will lead to primary prevention of sensitization. OBJECTIVE: This study assesses the effects of intervention to reduce the incidence of @entity2144 in personnel working in health care facilities insured by the German statutory accident insurance company for health care workers, Berufsgenossenschaft f  r Gesundheitsdienst und Wohlfahrtspflege, with approximately 3 million insured employees, by switching to powder-free NRL gloves. METHODS: The timing of introduction of intervention strategies, such as education of both physicians and administrators, together with regulations demanding that health care facilities only purchase low-protein, powder-free NRL gloves are reported. We reviewed the annual numbers of reported suspected cases of NRL-caused @entity566 and the amount and type of gloves used in German acute-care hospitals since 1986. RESULTS: The purchase of powder-free NRL examination gloves exceeded that of powdered gloves for the first time in 1998. This only became true for powder-free NRL sterile gloves 2 years later in 2000. The incidence of suspected occupational @entity2144 cases rose until 1998 and has declined steadily since. There was a 2-year lag between the beginning of the decline in the purchase of powdered NRL examination gloves and the beginning of a decline in suspected NRL-caused occupational @entity565 cases. CONCLUSIONS: Despite the effect of increased recognition of NRL @entity566 , education about NRL @entity566 in health care facilities combined with the introduction of powder-free gloves with reduced protein levels has been associated with a decline in the number of suspected cases of @entity566 caused by NRL in Germany on a nationwide scale. These results clearly indicate that primary prevention of occupational NRL @entity566 can be achieved if these straightforward and practical interventions are properly carried out and maintained.
