Occupational dermatoses are common. About four million working days are lost in the UK each year because of skin disease, the total cost to British industry running into millions of pounds. No occupation can be considered entirely free from the hazard of skin diseases and equally not all skin diseases are of occupational origin.

 

The skin provides natural protection as long as the surface layer remains intact and undamaged by wounds, solvents or irritants. For this barrier layer to function properly there must be at least 10% of water in it. Partial gaps in the barrier layer are made by sweat glands and hair follicles, which are consequently more vulnerable to penetration. The nature of the substance, the degree, duration and frequency of exposure to the substance and individual susceptibility determine how much skin damage will result from any particular substance.

 

 

Symptoms show as eczema and itching. Substances capable of causing contact dermatitis can be divided into two groups;

 

Irritants:- Can be divided into "weak" and "strong" irritants. Weak irritants require frequent multiple exposures, often over prolonged periods, the result being termed Chronic Irritant Contact Dermatitis. Chronic irritants include a wide range of substances including weak acids and alkalis, soap, detergents, organic solvents and water-based metal working fluids (soluble oils). Mechanical friction can also act as a chronic irritant.

 

Sensitisers:- are substances capable of causing the allergic type of contact dermatitis in a two stage process:-

Further skin contact with the particular sensitiser causes Allergic Contact Dermatitis. The concentration, duration and frequency of skin contact are major factors in inducing sensitisation. The sensitisation hazard of chemicals varies from none to strong. Sensitisation can be induced at any time or not induced at all, being influenced by variation in personal susceptibility. Contact sensitizing substances include formaldehyde, biocides, hardwoods, plants (e.g chrysanthemums, daffodils, tulips etc) and nickel.

 

In order to avoid occupational dermatoses it is necessary to:-

In determining the measures required to prevent ill-health, the following hierarchy should be observed:

If not:-

Considerations might include:-

 

 

This is required where there is exposure to a substance known to be associated with skin disease/ adverse effects on the skin and where, under the particular conditions of work, there is a reasonable likelihood that the disease/effects may occur.

 

General approach: Ensure arrangements are in place to identify cases of occupational dermatoses, supported by information, instruction and training for employees on health risks, precautions and information on what to be alert to.

 

Statutory Surveillance: Where health surveillance is legally required (see COSHH), cases of occupational skin disease should be actively sought in the workplace, together with the keeping of appropriate health records. Surveillance might be under the control of a competent person but the more inherently dangerous the dermatitis the more appropriate it is to be looked for directly by a suitably qualified person or medical practitioner. In cases of doubt as to whether surveillance is necessary , employers will need to obtain advice from an occupational physician or medical practitioner.