Work Related Conditions
Dermatitis
Occupational Skin Disorders (OSD) are a costly workplace hazard. OSD includes a broad range of skin conditions. More than 60,000 new OSD compensation claims occur every year, affecting nearly every industry.
For example, food processing workers may suffer from dermatitis as a result of their constant exposure to water. Meat processing workers will suffer the same because of their exposure to water as well as blood. And constant exposure to cold temperatures makes workers more vulnerable to skin disease. Symptoms vary from slight reddening and itching to a rash with intense itching. Surface damage makes workers’ skin more vulnerable to bacterial and fungal infections.
Occupational dermatitis, also known as industrial dermatitis, is a skin condition similar to eczema caused by direct and usually repeated exposure to harmful objects or chemicals. Chemicals are virtually everywhere in industry and are responsible for 70-80% of all cases.
In almost any case, proper selection and use of gloves can prevent costly and troublesome occupational skin disease.
What is dermatitis?
Occupational dermatitis is a common condition responsible for much suffering, quite apart from financial loss to employees, employers and the National Health Service.
The term dermatitis strictly covers all inflammations of the skin. Occupational dermatitis covers those aspects relating to work. The most common type is known as contact eczematous dermatitis. The term ‘contact’ indicates contact of the skin with the causative agent.
What are the signs?
Eczematous dermatitis consists of general redness of the skin and small blisters. It is irritating, and rubbing and scratching results in weeping from broken blisters and possible secondary infection. If the lesions continue for more than a short time they tend to become dry, thickened and cracked.
What can cause occupational dermatitis?
There are two broad types of occupational dermatitis:
- irritant - this is the most common form and is due to the general physical and chemical properties of the causative agent, e.g. detergents, alkalis and acids.
- allergic - this depends upon a sensitisation process with the consequent development of allergy to the causative agent. The sensitising period is a minimum of several days, but may be many years. Subsequent exposure may then result in an outbreak of the dermatitis occurring after a small delay of hours or days, although if the contact is minimal this may not always occur. As a consequence this type is sometimes referred to as the delayed type of contact dermatitis, as distinct from the irritant types which occur shortly after the exposure.
Am I at Risk?
If you are in contact with potentially sensitising substances, and do not take adequate steps to minimise or prevent such contact, you are at risk. Some materials are more powerful sensitisers than others (e.g. nickel and chrome), whereas other substances may only affect a few individuals, even after prolonged contact.
Diagnosis should always be the responsibility of medical advisors (e.g. occupational health unit, GP). Diagnosis depends upon an accurate history, including hobbies, DIY and sporting activities, and careful examination and inspection of exposed and non-exposed areas of the skin. Further special investigations may be necessary. Patch testing is one such test: the diluted substance is applied to the skin, and in a few days the skin is examined for any reaction. While the test is reasonably easy to apply, the interpretation of the result and its relevance to the dermatitis are more difficult to assess and should only be carried out by those with adequate experience.
Treatment
Treatment consists essentially of the determination of the causative chemical involved and avoidance of further contact. Avoidance can be achieved by:
- changing the chemical to a safer product.
- providing adequate guarding to machinery or otherwise modifying the system of work.
- by the wearing of protective devices such as gloves and masks. In this context it should be emphasised that chemicals may penetrate gloves, so it is important to select gloves appropriate for the specific chemical involved.
Medicinal treatment such as normal saline soaks may be necessary to control the acute stages. In very severe cases steroids may be indicated for short periods, and antibiotics may be required if there is evidence of secondary infection. Treatment should always be carried out under medical supervision.
The most important aspect of treatment is to avoid exposure to the causative agent.
What can I do?
The individual sufferer should always seek medical advice at an early stage so that a firm diagnosis can be established. This is best done by consulting a GP and informing your occupational health unit. Self-medication should be avoided as it may obscure the total picture and could even aggravate the basic condition.
There are preventive measures which can be taken:
- the skin should always be washed adequately after work, at rest periods and when there is accidental contamination.
- the skin cleanser used should be the mildest form which works to remove any contamination. Soap and water may be sufficient, but where there is heavier soiling (e.g. heavy contamination with used engine oil), stronger cleansers may be necessary.
- a suitable ‘after work cream’ to control any water loss from the skin and the application of this, or a similar preparation at night, is useful. Barrier creams are of limited value because although they may assist in the cleansing of the skin, they can sometimes aggravate the condition.
