Contact Dermatitis among Hospital Cleaners in Dar es Salaam: Prevalence and Associated Factors

Shufaa N. Mitawa^1,2, Ezra J. Mrema¹, Khadija A. Shebe³, Zuhura I. Kimera¹, Hussein H. Mwanga¹*

1. Department of Environmental and Occupational Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Tanzania.
2. Technical Services and Environmental Management Unit, Amana Regional Referral Hospital, Dar es Salaam, Tanzania.
3. Dermatology Unit, Department of Internal Medicine, Mwananyamala Regional Referral Hospital, Dar es Salaam, Tanzania.
   *Corresponding Author: Hussein H. Mwanga; E-mail: mwangahh@gmail.com

Abstract
Background
Cleaners are a high-risk group for contact dermatitis in healthcare settings due to frequent exposure to cleaning agents, gloves, and wet work, yet they remain understudied in Tanzania. This study investigated the prevalence of contact dermatitis and its associated factors among hospital cleaners in Dar es Salaam, Tanzania.
Methods
A cross-sectional study was conducted between March and July 2022 among hospital cleaners from three regional referral hospitals and one national hospital. Data were collected using the Standardized Nordic Occupational Questionnaire. Modified Poisson regression was applied to estimate prevalence ratios (PRs) with 95% confidence intervals (CIs). Contact dermatitis was defined as the presence of two or more skin symptoms affecting the hands, wrists, or forearms within the past 12 months.
Results
A total of 323 cleaners took part in the study. The median age was 26 years (range 18-64), and 65% were female. The prevalence of contact dermatitis was 48.9%. The most frequently reported symptoms were itching (48.6%), dry skin (44.6%), and rashes (22.0%).
Work-related factors positively associated with contact dermatitis included use of floor-cleaning products (aPR = 1.70, 95% CI:1.18–2.44), bleach (aPR = 1.64, 95% CI: 1.22–2.22), handwashing >10 times a day (aPR = 1.63, 95% CI: 1.12–2.35), and latex glove use (aPR = 1.61, 95% CI: 1.29–2.01). Prevalence varied across hospitals. Individual factors such as age, sex, smoking, and allergy history were not significantly associated with disease.
Conclusions
Contact dermatitis is highly prevalent among hospital cleaners in Dar es Salaam, with its occurrence mainly associated with occupational exposures rather than individual susceptibility. Preventive measures should prioritize safer cleaning products, improved hand hygiene practices, appropriate glove use, and tailored skin protection programs.
Keywords: Contact dermatitis, hospital cleaners, occupational exposure, bleach, handwashing, latex gloves, Tanzania