Validation of a monitor to measure exposure to wet-work

Wet-work exposure has been recognized as a main risk factor for developing Irritant contact dermatitis of the hand. Duration and frequency of wet-work exposure are the key risk determinants, but there is still no reliable objective method to assess these factors in the workplace. The current study aimed to further validate a newly invented wet-work exposure monitor (WWEM) among four high risk occupational groups of hairdressers, florists, caterers and nurses. The WWEM, which consists of two similar thermocouples provides a real-time indication of the wetness of the finger by measuring the temperature changes when the finger is wet and subsequent cooling when the water evaporates from the skin. A suitable data analysis routine was constructed and direct observation was employed as the gold standard. Receiver Operating Characteristic (ROC) analysis was used to compare the results. In laboratory experiments, the most suitable wet-event threshold value, as a criterion to distinguish the wet and dry exposure periods was identified as 1.6°C (Mean+5SD of the “dry” data). Using this value sensitivity and specificity were 70% and 78%, respectively. An area under the curve (AUC) of 0.78 demonstrated a “high” accuracy for WWEM in lab experiments. Field testing in real occupational fields identified varying degrees of user acceptability and different wet-event threshold values to produce maximal sensitivity and specificity of the instrument. Among hairdressers, the WWEM showed a “moderate” accuracy at the threshold value of 1.37°C with an AUC of 0.62. For florists, the most suitable threshold value in the range of examined thresholds was 1.14°C with a “good” accuracy. Among a cohort of caterers, a threshold value of 1.6°C demonstrated a “hi gh” accuracy with an AUC of 0.72. The WWEM demonstrates the minimum value of the largest AUC for nurses. This is the minimum amount of accuracy among the four occupational groups. The figure is 0.52, achieved at a threshold value of 2.5°C. The WWEM enables the frequency and duration of wet-work exposure to be assessed in an objective manner rather than the current costly and unreliable subjective methods of direct observation and questionnaire. The results indicate that the WWEM has good sensitivity and high specificity in detecting exposure to wet-work. This device provides new experimental data on wetwork exposure and may be used in future as an educational tool to highlight the importance of wet-work exposure to both employees and employers.

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