Despite the search for effective and less toxic substitutes, glutaraldehyde (GA) remains one of the few substances capable of high-level instrument disinfection in modern health care. Workers commonly affected include operating room nurses, radiographers, x-ray technicians and cleaners. Widespread hospital usage combined with its well-known irritant properties, has ensured an increase in occupationally-related illnesses during recent years. Operating room nurses, laboratory workers and x-ray technicians frequently contact GA in both the liquid and vapor form. Workplace exposure is usually dependent on job tasks, ventilation levels and the use of protective equipment. GA is a relatively potent irritant and sensitizer, with a well-documented history of symptoms following occupational exposure. Although mechanisms for GA toxicity have been postulated, research on the toxicological, teratogenic, and carcinogenic potential of this chemical has shown inconsistent results. Reducing workplace exposure to its lowest possible level represents the most important hazard reduction strategy. This may be achieved by keeping GA containers tightly sealed when not in use, maintaining adequate ventilation levels and the rigid adherence to appropriate personal protective equipment. Substitution with automated cold sterilization machines may be another appropriate measure, while banning unnecessary practices such as GA fogging and its use as a surface disinfectant may also be helpful in reducing occupational exposure in the health care environment.

China's first HIV infection was officially reported in 1985 and by the end of 1996, there may have been up to 200,000 people affected nationwide. In 2001, this figure probably exceeded 600,000. By 2003, the predicted number of HIV cases had reached 1.5 million. At least 80,000 individuals now have fullblown AIDS. China may soon have the largest HIV-infected population in the world, possibly 6 million cases by 2005. With infection rates rising at about 30% per year, it is feared this figure might exceed 10 million by 2010. Although the Chinese government was initially slow to accept the problem, in the late 1990s definite changes began occurring. In 2003 Premier Wen Jiabao publicly shook the hand of an AIDS patient and his government promised to introduce a range of free HIV-related services. Large preventive education campaigns are now underway. Unfortunately, there will still be many obstacles in controlling the epidemic and preventing further spread of this disease. Without doubt, China faces a serious predicament in the new millennium, and one which will pose numerous challenges for preventive medicine.

OBJECTIVEThe aim of this study was to investigate the effects of the working environment on hand dermatitis (HD) prevalence among nurses in a Chinese teaching hospital.

METHODSWe utilised a previously validated, self-reporting survey which was translated into Chinese.

RESULTSThe prevalence of HD among nurses was 18.3%, although this rate varied between departments, ranging from 9.4% in gynaecology to 26.7% in intensive care (P for Trend=0.3167). Logistic regression indicated that wet work was the most important HD risk factor, with a 9-fold increase (OR 9.0, 95% CI 1.2-74.9, P=0.0342). Allergic disease was also related to HD, with a 4.6-fold increase noted (OR 4.6, 95% CI 1.4-15.0, P=0.0096).

CONCLUSIONSOverall, the prevalence of HD among Chinese hospital nurses appears to be less than that of their foreign counterparts. Nevertheless, the burden of this disease does seem to vary with respect to depertment of employment within the hospital.