Sjuksköterskor har flera arbetsuppgifter som innebär en möjlig kontakt med patienters blod och risk för en blodsmitta. Enligt föreskrifter från Arbetsstyrelsen ska handskar användas av vårdpersonal för att förebygga smitta. Trots dessa föreskrifter varierar användningen av handskar bland sjuksköterskor. Syftet med denna studie var att undersöka sjuksköterskors attityder till att använda handskar i vården där risk för blodsmitta kan förekomma. En empirisk studie med kvalitativ ansats genomfördes. Datainsamlingen skedde med hjälp av sju enskilda intervjuer med legitimerade sjuksköterskor. Analysmetod som användes var inspirerad av innehållsanalys. Genom analys identifierades fyra kategorier: Intryck av bakomliggande omständigheter, Intryck av medvetenhet, Intryck av förförståelse samt Intryck av trygghet. Kategorierna bildade tillsammans huvudkategorin Influenser till attityder. Resultatet visade att sjuksköterskors attityder till att använda handskar är något som utvecklas med tiden och påverkas av åtskilliga faktorer. / Nurses’ have several worktasks that put them in contact with patient’s blood and a possible risk of infection. According to guidelines from the Occupation committee, health care personnel should use gloves to prevent spreading infection. Despite the guidelines, nurses’ use of gloves varies. The aim of this study was to investigate nurses’ attitudes to using gloves where there is a risk of blood infection. An empirical study with a qualitative approach was conducted; collection of data was done by interviews with seven registered nurses. The method for analyzing was inspired by content analysis. Through analyzing, four categories where identified: Impression of causes from before, Impressions of awareness, Impressions of judgments and Impressions of safety. These categories all formed one main category: Influences for attitudes. The results showed that nurse’s attitudes to using gloves are something that develop over time and are influenced by many factors.

This thesis explores innovative methodologies to assess finger strain during the assembly process atVolvo Trucks in Tuve. With the increased complexity and frequency of tasks in truck assembly, particularly with the shift to electric truck production, ergonomic concerns have risen, notably around the strain on operators’ fingers. Our project aims to identify a reliable and precise tool to measure the forces exerted on the fingers during these assembly tasks, addressing the limitations of current dynamometers which struggle in confined spaces, on non-flat surfaces and with different types of grips. Using a combination of empirical studies, expert consultations, and ergonomic tool evaluations, we evaluated various measurement tools and technologies. The study involved detailed observations and interviews at the assembly plant to identify critical ergonomic challenges. We then tested selected devices under real-world conditions to evaluate their effectiveness in capturing accurate force measurements. Our findings suggest that the integration of advanced sensor technologies can improve ergonomic assessment of assembly tasks by providing more accurate real-time data. This would allow for a better design of tools and work processes, ultimately improving worker safety and productivity. / Det här examensarbetet utforskar innovativa metoder för att bedöma fingerbelastning under monteringsprocessen hos Volvo Trucks i Tuve. Med en ökad komplexitet och mängd av arbetsuppgifter vid montering av lastbilar, särskilt med övergången till produktionen av eldrivna lastbilar, har de ergonomiska problemen ökat. Särskilt vad gäller belastningen på operatörernas fingrar. Vårt projekt syftar till att identifera ett tillförlitlig och exakt verktyg för att mäta de krafter som utövas från fingrarna under dessa monteringsmoment, och att adressera begränsningarna hos nuvarande kraftmätningsverktyg som har svårt att användas i trånga utrymmen, på ojämna ytor och vid olika typer av grepp. Genom en kombination av empiriska studier, expertkonsultationer och utvärderingar av ergonomiska verktyg, utvärderade vi olika mätverktyg och mättekniker. Projektet involverade detaljerade observationer och intervjuer i Tuvefabriken för att identifiera kritiska ergonomiska utmaningar. Vi testade sedan utvalda produkter under verkliga förhållanden för att utvärdera deras effektivitet i att fånga krafter från fingrarna. Våra resultat tyder på att integrationen av avancerade sensorteknologier kan förbättra den ergonomiska bedömningen av monteringsmoment genom att tillhandahålla mer exakt realtidsdata. Detta skulle möjliggöra en bättre utformning av verktyg och arbetsprocesser, vilket slutligen förbättrar säkerhet och produktivitet.

A assistência em Unidade de Terapia Intensiva (UTI) é constantemente desafiada por infecções, que resultam no aumento da morbimortalidade, no tempo de internação e nos custos. Objetivos: avaliar os paciente críticos com tubo endotraqueal submetidos à ventilação mecânica na perspectiva clínica e microbiológica com a finalidade de determinar a dispersão de Staphylococcus aureus, Staphylococcus coagulase-negativa e Pseudomonas aeruginosa na assistência respiratória destes pacientes. Assim, analisou aspectos quantitativos, perfil de sensibilidade aos antibióticos, similaridade genética e formação de biofilme em tubo traqueal considerando a presença ou não de PAVM. Trata-se de um estudo observacional prospectivo realizado na UTI de um hospital de emergência no interior do Estado de São Paulo. A coleta de dados clínicos envolveu pacientes adultos com período 48 horas de intubação endotraqueal em ventilação mecânica mediante consentimento do responsável. As amostras foram procedentes da saliva, secreção traqueal e tubo traqueal dos referidos pacientes; e da luvas utilizadas na aspiração do tubo endotraqueal. Utilizou-se no processamento das amostras recursos clássicos e avançados da microbiologia como Enterobacterial Repetitive Intergenic Consensus Sequence (ERIC-PCR), Eletroforese em Campo Pulsado e a microscopia eletrônica de varredura. A análise estatística pelo SPSS foi subsidiada em medidas de tendência central, tabelas de contingências, regressão múltipla e kappa, p<0,05. Na avaliação clínica dos 44 pacientes críticos, 34 (77,32%) eram masculinos, idade média de 39,9, e o motivo de hospitalização 19 (43,2%) foi devido à traumas. O período de hospitalização foi em média 10,9 dias (DP 9,3) e de permanência do tubo endotraqueal de 6,6 dias (DP 3,3). A ocorrência de infecção hospitalar foi de 31,2%, sendo que 15 (34,1%) eram PAVM; e 34,5% representaram o percentual de óbito. O período de permanência do tubo endotraqueal 8 dias foi fator de risco para PAVM (RR 4,00, p < 0,001) e regressão múltipla. Na análise microbiológica verificou-se que a presença das cepas foi variável em termos quantitativos segundo sua procedência. Houve predominância de contaminação nas luvas direitas com as cepas de Staphylococcus coagulase-negativa. A prevalência de resistência a oxacilina foi de 16,1% para Staphylococcus aureus e 22,6% Staphylococcus coagulasenegativa. Em termos de similaridade genética observou-se apenas um caso de Pseudomonas aeruginosa isoladas da saliva e tubo traqueal de um mesmo paciente. E, em 12 cepas evidenciou-se uma forte relação genética procedentes da saliva, do tubo traqueal. Dos Staphylococcus aureus e Staphylococcus coagulase-negativa ambos resistente a oxacilina foram similares as cepas procedentes da saliva e secreção traqueal. O biofilme presente nos 30 tubos apresentou estruturas celulares e microbianas específicas como: hemácias, rede de fibrina, leucócitos, além de cocos, bacilos, filamentos e leveduras, dentre outras. Embora com número reduzido de amostras os resultados sinalizaram para a possibilidade de dispersão microbiana endógena tendo a cavidade orofaríngea como o principal reservatório. Outras investigações em diferentes UTIs, em termos de microbiota, condições clínicas e institucionais são promissoras para que se possa de fato ampliar as evidências em torno do risco de infecção respiratória do paciente crítico em ventilação mecânica. / Care in Intensive Care Units (ICU) is constantly challenged by infections, which result in the increase of morbimortality, hospitalization length of stay and costs. Objectives: to assess critical patients with endotracheal tube on mechanical ventilation in the clinical and microbiological perspective, aiming to determine the diffusion of Staphylococcus aureus, coagulase-negative Staphylococcus and Pseudomonas aeruginosa in respiratory care to these patients. Quantitative aspects, sensitivity profile to antibiotics, genetic similarity and biofilm formation in tracheal tube considering the presence of mechanical ventilator-associated pneumonia (MVAP) were analyzed. It is an observational and prospective study carried out in the ICU of an emergency hospital in the interior of the state of São Paulo. Collection of clinical data involved adult patients in a period 48 hours of endotracheal intubation in mechanical ventilation, with the consent of the responsible person. Samples were collected from saliva, tracheal secretion and tracheal tube of the mentioned patients; and from the gloves used in aspiration of the endotracheal tube. Classic and advanced microbiological resources such as Enterobacterial Repetitive Intergenic Consensus Sequence (ERIC-PCR), Pulsed-Field Electrophoresis and electron scanning microscopy were used to analyze samples. Statistical analysis was done using SPSS and was supported by central tendency measures, contingency tables, multiple regression and kappa, p<0.05. The clinical evaluation showed that, of the 44 critical patients, 34 (77.32%) were male, with average age of 39.9 years. Trauma was the reason for hospitalization of 19 (43.2%) patients. The average period of hospitalization was 10.9 days (SD 9.3) and the period with endotracheal was 6.6 days (SD 3.3). The occurrence of cross infection was 31.2%, of which 15 (34.1%) were MVAP; and 34.5% represented the percentage of deaths. Length of stay of endotracheal tube 8 days was risk factor for MVAP (RR 4.00, p < 0.001) and multiple regression. Microbiological analysis showed that the presence of strains varied in quantitative terms according to their origin. There was predominance of contamination in right gloves with strains of coagulase-negative Staphylococcus. The prevalence of oxacillin resistance was 16.1% for Staphylococcus aureus and 22.6% for coagulase-negative Staphylococcus. As to the genetic similarity, it was observed only one case of Pseudomonas aeruginosa isolated from the saliva and tracheal tube of a same patient. In 12 strains, strong genetic relation from saliva and tracheal tube was evidenced. Staphylococcus aureus and coagulase-negative Staphylococcus, both oxacillin resistant, were similar to strains from saliva and tracheal secretion. Biofilm present in 30 tubes presented specific cellular and microbial structures, such as: red cells, fibrin network, leukocytes, besides cocci, rods, threads and yeasts, among others. Although with a reduced number of samples, results show the possibility of endogenous microbial diffusion, with the oropharynx cavity as the main reservoir. Further research in different ICUs, in terms of microbiota, clinical and institutional conditions, can broaden evidences regarding the risk of respiratory infection of critical patients on mechanical ventilation.

So Ting Pong. / Summary in Chinese. / Thesis (M.B.A.)--Chinese University of Hong Kong. / Bibliography: leaves 150-151.

A assistência em Unidade de Terapia Intensiva (UTI) é constantemente desafiada por infecções, que resultam no aumento da morbimortalidade, no tempo de internação e nos custos. Objetivos: avaliar os paciente críticos com tubo endotraqueal submetidos à ventilação mecânica na perspectiva clínica e microbiológica com a finalidade de determinar a dispersão de Staphylococcus aureus, Staphylococcus coagulase-negativa e Pseudomonas aeruginosa na assistência respiratória destes pacientes. Assim, analisou aspectos quantitativos, perfil de sensibilidade aos antibióticos, similaridade genética e formação de biofilme em tubo traqueal considerando a presença ou não de PAVM. Trata-se de um estudo observacional prospectivo realizado na UTI de um hospital de emergência no interior do Estado de São Paulo. A coleta de dados clínicos envolveu pacientes adultos com período 48 horas de intubação endotraqueal em ventilação mecânica mediante consentimento do responsável. As amostras foram procedentes da saliva, secreção traqueal e tubo traqueal dos referidos pacientes; e da luvas utilizadas na aspiração do tubo endotraqueal. Utilizou-se no processamento das amostras recursos clássicos e avançados da microbiologia como Enterobacterial Repetitive Intergenic Consensus Sequence (ERIC-PCR), Eletroforese em Campo Pulsado e a microscopia eletrônica de varredura. A análise estatística pelo SPSS foi subsidiada em medidas de tendência central, tabelas de contingências, regressão múltipla e kappa, p<0,05. Na avaliação clínica dos 44 pacientes críticos, 34 (77,32%) eram masculinos, idade média de 39,9, e o motivo de hospitalização 19 (43,2%) foi devido à traumas. O período de hospitalização foi em média 10,9 dias (DP 9,3) e de permanência do tubo endotraqueal de 6,6 dias (DP 3,3). A ocorrência de infecção hospitalar foi de 31,2%, sendo que 15 (34,1%) eram PAVM; e 34,5% representaram o percentual de óbito. O período de permanência do tubo endotraqueal 8 dias foi fator de risco para PAVM (RR 4,00, p < 0,001) e regressão múltipla. Na análise microbiológica verificou-se que a presença das cepas foi variável em termos quantitativos segundo sua procedência. Houve predominância de contaminação nas luvas direitas com as cepas de Staphylococcus coagulase-negativa. A prevalência de resistência a oxacilina foi de 16,1% para Staphylococcus aureus e 22,6% Staphylococcus coagulasenegativa. Em termos de similaridade genética observou-se apenas um caso de Pseudomonas aeruginosa isoladas da saliva e tubo traqueal de um mesmo paciente. E, em 12 cepas evidenciou-se uma forte relação genética procedentes da saliva, do tubo traqueal. Dos Staphylococcus aureus e Staphylococcus coagulase-negativa ambos resistente a oxacilina foram similares as cepas procedentes da saliva e secreção traqueal. O biofilme presente nos 30 tubos apresentou estruturas celulares e microbianas específicas como: hemácias, rede de fibrina, leucócitos, além de cocos, bacilos, filamentos e leveduras, dentre outras. Embora com número reduzido de amostras os resultados sinalizaram para a possibilidade de dispersão microbiana endógena tendo a cavidade orofaríngea como o principal reservatório. Outras investigações em diferentes UTIs, em termos de microbiota, condições clínicas e institucionais são promissoras para que se possa de fato ampliar as evidências em torno do risco de infecção respiratória do paciente crítico em ventilação mecânica. / Care in Intensive Care Units (ICU) is constantly challenged by infections, which result in the increase of morbimortality, hospitalization length of stay and costs. Objectives: to assess critical patients with endotracheal tube on mechanical ventilation in the clinical and microbiological perspective, aiming to determine the diffusion of Staphylococcus aureus, coagulase-negative Staphylococcus and Pseudomonas aeruginosa in respiratory care to these patients. Quantitative aspects, sensitivity profile to antibiotics, genetic similarity and biofilm formation in tracheal tube considering the presence of mechanical ventilator-associated pneumonia (MVAP) were analyzed. It is an observational and prospective study carried out in the ICU of an emergency hospital in the interior of the state of São Paulo. Collection of clinical data involved adult patients in a period 48 hours of endotracheal intubation in mechanical ventilation, with the consent of the responsible person. Samples were collected from saliva, tracheal secretion and tracheal tube of the mentioned patients; and from the gloves used in aspiration of the endotracheal tube. Classic and advanced microbiological resources such as Enterobacterial Repetitive Intergenic Consensus Sequence (ERIC-PCR), Pulsed-Field Electrophoresis and electron scanning microscopy were used to analyze samples. Statistical analysis was done using SPSS and was supported by central tendency measures, contingency tables, multiple regression and kappa, p<0.05. The clinical evaluation showed that, of the 44 critical patients, 34 (77.32%) were male, with average age of 39.9 years. Trauma was the reason for hospitalization of 19 (43.2%) patients. The average period of hospitalization was 10.9 days (SD 9.3) and the period with endotracheal was 6.6 days (SD 3.3). The occurrence of cross infection was 31.2%, of which 15 (34.1%) were MVAP; and 34.5% represented the percentage of deaths. Length of stay of endotracheal tube 8 days was risk factor for MVAP (RR 4.00, p < 0.001) and multiple regression. Microbiological analysis showed that the presence of strains varied in quantitative terms according to their origin. There was predominance of contamination in right gloves with strains of coagulase-negative Staphylococcus. The prevalence of oxacillin resistance was 16.1% for Staphylococcus aureus and 22.6% for coagulase-negative Staphylococcus. As to the genetic similarity, it was observed only one case of Pseudomonas aeruginosa isolated from the saliva and tracheal tube of a same patient. In 12 strains, strong genetic relation from saliva and tracheal tube was evidenced. Staphylococcus aureus and coagulase-negative Staphylococcus, both oxacillin resistant, were similar to strains from saliva and tracheal secretion. Biofilm present in 30 tubes presented specific cellular and microbial structures, such as: red cells, fibrin network, leukocytes, besides cocci, rods, threads and yeasts, among others. Although with a reduced number of samples, results show the possibility of endogenous microbial diffusion, with the oropharynx cavity as the main reservoir. Further research in different ICUs, in terms of microbiota, clinical and institutional conditions, can broaden evidences regarding the risk of respiratory infection of critical patients on mechanical ventilation.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Trots att det har utvecklats skyddsutrustning som skyddar hjärnan mot farlig roterande kinematik inom flera områden, finns ännu ingen utrustning som skyddar boxare mot den typen av våld. Syftet med arbetet var att göra olympisk boxning och träning säkrare. Målet var att utveckla en handske som reducerar töjningen i hjärnan med minst 20 %. I det här arbetet utvecklades och testades ett antal boxningshandskar med implementerade glidskikt som skulle reducera töjningen i hjärnan som uppstår när huvudet utsätts för roterande kinematik. Testerna genomfördes med en linear impactor som slog handskarna mot ett testhuvud. Testhuvudet samlade mätdata med hjälp av nio accelerometrar. Två av prototyperna reducerade töjningen med mer än 20 % vid ett eller flera tester men de hade brister i användningsbarhet. Ingen av prototyperna uppfyllde alla mål och därför kan ingen prototyp rekommenderas för vidareutveckling men det kan konstateras att det finns potential i grundidén. / Although protective equipment has been developed that protects the brain against dangerous rotating kinematics in several areas, no equipment is yet available to protect boxers against this type of violence. The purpose of this work was to make Olympic boxing and training safer. The goal was to develop a glove that reduces the strain in the brain by at least 20 %. In this work, a number of boxing gloves with implemented sliding layers were developed and tested, which would reduce the strain in the brain that occurs when the head is subjected to rotational kinematics. In the tests a linear impactor was used, which hit the gloves against a test head. The test head collected data using nine accelerometers. Two of the prototypes reduced the strain by more than 20% in one or more tests, but they lacked in usability. None of the prototypes met all objectives and therefore no prototype can be recommended for further development, but it can be stated that there is potential in the basic idea. / <p>Betyg 2020-07-11</p>

En cirugía abierta, piel y el tejido se cortan lograr tener proximidad a un órgano o estructura, extirpar la lesión y mantener intacta a través de una barrera protectora. Los guantes pueden reducir el peligro de exhibición del personal de la salud durante la cirugía abierta a microorganismos patógenos, como el virus de la inmunodeficiencia humana (VIH) y los virus de la hepatitis, que pacientes portadores pueden transmitir a los trabajadores de la salud. Sin embargo, las perforaciones en los guantes son bastante comunes. El propósito de este análisis secundario es verificar si da seguridad el uso de dos guantes al equipo médico durante varios procedimientos quirúrgicos. El método utilizado es la enfermería basada en la evidencia; la pregunta de investigación fue: ¿es efectivo el uso del doble guante para el equipo médico en quirófano? Se buscó información en las siguientes bases de datos: Biblioteca Virtual en Salud, PUBMED y ELSEIVER, se encontraron 359 artículos de revistas, donde solo 13 fueron escogidos, todos estos artículos fueron remitidos a Gálvez. Toro Finalmente, el artículo fue seleccionado y analizado utilizando las guías PRISMA, por tratarse de un tipo de estudio científico. Para cuestiones clínicas, verificar que usar dos guantes tiene mayor efectividad que uno solo, siempre dependiendo de la especialidad y el tiempo de la cirugía. / In open surgery, skin and tissue are cut to achieve proximity to an organ or structure, excising the lesion and keeping it intact through a protective barrier. Gloves can reduce the danger of exposure of healthcare personnel during open surgery to pathogenic microorganisms, such as the human immunodeficiency virus (HIV) and hepatitis viruses, which patient carriers can transmit to healthcare workers. However, glove perforations are quite common. The purpose of this secondary analysis is to verify whether it is safe for the medical team to wear two gloves during various surgical procedures. The method used is evidence-based nursing; The research question was: is the use of double gloves effective for the medical team in the operating room? Information was searched in the following databases: Virtual Health Library, PUBMED and ELSEIVER, 359 journal articles were found, where only 13 were chosen, all these articles were sent to Gálvez. Bull Finally, the article was selected and analyzed using the PRISMA guidelines, as it is a type of scientific study. For clinical issues, verify that using two gloves is more effective than one, always depending on the specialty and the time of surgery.

This thesis deals with common problem health protection at work. Namely hand protection during the work in very cold environment. It’s an analysis of materials suitable for apparatus used for measuring the thermal resistance of the gloves. There was analysed a range of materials. Every single sample was tested for heat conductivity and afterwards was assessed the suitability of materials. Heat was generated by electricity. Ocured heat fields was assessed with thermocamera. After performed experiments of carbon fiber we haven’t reached any satisfying results which we could use for manufacturing of this device. On the other hand kapton film has given very interesting results which we would recommend eventually. Kapton film needs to be modify according to the method listed in the conlusion. This thesis gives us a clear overview and inspiration for additional research of this device. It finds it’s place in research facilities and companies manufacturing protective clothing.

Hautphysiologische Untersuchungen zu repetitiven Handschuhokklusionen EINLEITUNG: Berufsbedingte Hauterkrankungen nehmen in Deutschland die führende Position unter den gemeldeten berufsbedingten Krankheiten ein (DGUV 2009). Als ein Risikofaktor für chronische, irritative Kontaktdermatitiden werden repetitive Handschuhokklusionen mit hautphysiologischen Auswirkungen auf die Epidermale Barriere (z.B. Exsikkationseffekte, Barriereschädigungen und Verschiebungen des Hautoberflächen-pH-Wertes) angeführt (FLUHR et al. 2005; FROSCH/JOHN 2006; GRAVES et al. 1995; JUNGBAUER et al. 2004a, 2004b und 2004c; RAMSING/AGNER 1996b; TSAI/MAIBACH 1999; WULFHORST et al. 2010; ZHAI/MAIBACH 2002). In der einschlägigen Literatur wird der hautschädigende Einfluss von Langzeit-Okklusionen jedoch kritisch diskutiert, da widersprüchliche Studienergebnisse vorliegen (FLUHR et al. 1999b; RAMSING/AGNER 1996a und 1996b; WETZKY et al. 2009a). Hardening-Effekte werden als ein Erklärungs-ansatz für die Kompensation hautschädigender Okklusionseffekte angegeben, die auch im Kontext von Spontanremissionen irritativer Dermatitiden trotz konstanter äußerer Risikofaktoren diskutiert werden (ELIAS et al. 2001; LAMMINTAUSTA/MAIBACH 1990; WATKINS/MAIBACH 2009; WULFHORST 1996a, 1996b, 1996c und 2000). ZIELE: Aus diesen Gründen wurden in der vorliegenden Arbeit neben den Kurzzeit- auch die Langzeit-Okkusionseffekte von 14 verschiedenen, impermeablen (Einmal- und Mehrweg-) Handschuh-Testpatches aus den Materialien Polyvinylchlorid, Naturlatex, Nitril und Polyethylen untersucht. Des Weiteren wurde erstmalig versucht, Hardening-Effekte nach repetitiven Handschuhokklusionen hautphysiologisch zu detektieren. METHODIK: An den volaren Unterarmen 40 hautgesunder Probanden wurden mittels der Laborparameter Relative Hornschichtfeuchte (RHF), Transepidermaler Wasserverlust (TEWL) bzw. Skin Surface Water Loss (SSWL), Hautoberflächen-Farbe und Hautoberflächen-pH-Wert hautphysiologische Einflüsse untersucht. Nicht nur die Kurzzeiteffekte wurden 30 Minuten nach singulärer, 4stündiger Handschuhokklusion, sondern auch die Langzeiteffekte einen Tag nach 14maligem, täglich 4stündigem Aufkleben von Handschuh-Patches ermittelt. Unter der Voraussetzung signifikanter Kurzzeit-Okklusionseffekte wurden außerdem potenzielle Hardening-Effekte auf die vier hautphysiologischen Parameter 30 Minuten nach einwöchigen sowie zweiwöchigen, täglich 4stündigen Okklusionen erfasst. Die statistische Auswertung erfolgte anhand nicht-parametrischer Testverfahren (Längsschnitt-Studien: Friedman- und Wilcoxon-Test; Querschnitt-Studien: Kruskal-Wallis- und Mann-Whitney-U-Test). ERGEBNISSE: Während Kurzzeit-Okklusionseffekte auf die Parameter RHF sowie TEWL bzw. SSWL in Form einer signifikanten Hyperhydratation des Stratum corneum (p<.013) bei der Hälfte der untersuchten Handschuhe sowie eine Verschiebung des Hautoberflächen-pH-Wertes in Richtung des alkalischen Bereichs (p=.007) bei einem von 14 Handschuh-Ausschnitten objektiviert werden konnten, wurden keine signifikanten Veränderungen der Hautoberflächen-Farbe 30 Minuten nach einmaliger, 4stündiger Okklusion ermittelt. Des Weiteren ließen sich keine signifikanten Langzeit-Okklusionseffekte – auf keinen der vier Parameter – nachweisen, d.h. keines der 14 untersuchten Handschuh-Testmaterialien bewirkte einen Tag nach täglich 4stündigen Okklusionen über zwei Wochen signifikante Exsikkationseffekte, Barriereschädigungen, Verschiebungen des Hautoberflächen-pH-Wertes in Richtung des alkalischen Bereichs oder Erytheme bzw. Blanching-Effekte. Hinsichtlich des Induktionsversuchs von Hardening-Effekten auf die vier untersuchten hautphysiologischen Parameter ist zu konstatieren, dass keine eindeutigen statistisch belegbaren Hardening-Effekte induziert wurden. Es lagen für einzelne Handschuh-Testpatches jedoch Hinweise vor. DISKUSSION: Da in der vorliegenden Arbeit bei keinem der 14 untersuchten Handschuhe ein hautschädigender Langzeit-Okklusionseffekt detektiert wurde, sind die Gleichsetzung von Feuchtarbeit mit repetitiven Okklusionen anhand impermeabler Handschuhe in der Gefahrstoffverordnung (Fassung von 2007) sowie die Festsetzungen in der Verordnung zur arbeitsmedizinischen Vorsorge (2008) zu diskutieren. Da aufgrund relativ weniger signifikanter Kurzzeit-Okklusionseffekte nur einzelne Handschuhe in die Untersuchung der Hardening-Effekte eingeschlossen werden konnten, ist die dringende Notwendigkeit weiterer Okklusionsstudien gegeben. Dennoch konnten Vorschläge für weiterführende Hardening-Okklusionsstudien abgeleitet werden. Weitere Studien hierzu sind dringend erforderlich, um Vorhersagen treffen zu können, welcher Personenkreis möglicherweise an einer chronischen Form einer irritativen Kontaktdermatitis erkranken und wessen irritative Kontaktdermatitis durch Hardening-Effekte wieder ausheilen könnte. Somit könnte ein wichtiger Beitrag zur Berufsberatung und Berufsprognose geleistet werden (LAMMINTAUSTA/MAIBACH 1990; WATKINS/MAIBACH 2009; WULFHORST 1996a, 1996b, 1996c und 2000).