Sheila Pantry, OBE
According to the Health and Safety Executive - the United Kingdom (UK) Government Agency responsible for securing good health and safety in all workplaces, about 4 million working days are lost in the UK each year because of dermatitis (skin disease).
The total annual cost to industry runs into millions of pounds. Evidence indicates that many workers are likely to be affected by skin conditions caused or aggravated by the work they do, and which are bad enough to be referred to consultant dermatologists. Many people suffer the avoidable discomfort of unsightly skin conditions without complaining.
The substances commonly encountered by workers in some industries are irritants and can degrease or otherwise attack the skin's natural defences. Others can cause skin allergy. Their use can give rise to the two most common forms of skin disease encountered, irritant contact dermatitis and allergic contact dermatitis.
Signs and symptoms of dermatitis include redness, soreness and cracked, bleeding or blistered skin. Once injured, the skin is more prone to infection and can also be more permeable to other potentially toxic substances. Chronic dermatitis can make work impossible.
The labels on products being used will give an indication of potential problems. Look for phrases such as 'Irritating to the skin' and 'May cause sensitisation by skin contact'. Look at the supplier's safety data sheets for further information about the effects on the skin, and the precautions to be taken.
Remember also that skin problems can be caused by constant exposure of the skin to water in wet work.
Duties of Employers
In the UK employers have a duty under the Control of Substances Hazardous to Health Regulations 1994 (COSHH) to assess work involving substances hazardous to health which can cause dermatitis, and prevent employees from coming into contact with such substances so far as is reasonable practicable.
Exposure can be prevented by removing the hazard: for example by changing to a safer substance (your supplier should be able to help). If this is not reasonable practicable, employers must do what they can to control exposure, for example by using automated handling systems and automatic dispensing of hazardous substances. If a risk still exists, personal protective equipment (PPE) may be appropriate.
Ensure that employees receive adequate training and have access to information so they are aware of the hazards and the precautions which need to be taken.
If there is significant potential for skin exposure, set up a system of health surveillance under COSHH. For example, this may include a visual check for skin problems by a suitably trained person appointed by the employer.
Advise your employees that if they do develop dermatitis, they should consult their doctor so it can be dealt with at an early stage. If it appears that something at work is either causing the condition or making it worse, they should inform you (or the occupational health doctor or nurse if there is one).
Examples of substances that can cause dermatitis
- Chemicals (eg photographic processing solutions) and deletion fluids
- Most inks, thinners and reducers
- Cleaning solvents (eg white spirit) and other products (eg strong alkali solution)
Key steps for maintaining a healthy skin
- Read the safety data sheet for the product being used and take steps to reduce exposure.
- Keep contact with chemical substances to a minimum. If the skin is accidentally contaminated, wash straight away, but remember that frequent washing is not an alternative for proper protection.
- Remember the importance of selecting the right PPE: gloves used need to be close fitting and resistant to the substance or cleaning agent in use.
- Make sure that PPE is clean and intact. If gloves are to be used for long periods, consider the additional use of absorbent (e.g. cotton or silk) undergloves which will reduce the effect of sweating. Bear in mind that allergies may be caused by the materials used in the manufacture of some gloves, such as latex.
- Always ensure that hands are clean before applying gloves, creams etc.
- If pre-work creams are used, take particular care to ensure that fingernails, fingertips and the skin between fingers are covered. Remove rings, watches, bracelets etc, where possible. Remember that these creams will not give the same protection as properly selected gloves.
- Wash gloves before removing to prevent contaminating clean skin.
- Wash hands before eating, drinking, smoking or going to the toilet.
- When washing skin always use the least aggressive cleaner which will do the job. Never use cleaning solvent to clean the hands - it may do a good job, but is far too aggressive, leading to dehydration of the skin and causing subsequent dermatitis.
- Remember to use a moisturising cream after washing and drying the hands.
- If going back to work, remember to reapply any pre-work creams, gloves etc. When work is finished, use an after work (moisturising) cream.
- Employees have a duty to use control measures and equipment such as gloves provided to protect them. They should also report lost or defective protective equipment such as gloves, and ask for replacements!
Reporting cases of dermatitis
In the UK The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) came into force on 1 April 1996. One of the new requirements is for the reporting, by employers, of diagnosed cases of occupational dermatitis.
Check SilverPlatter OSH-ROM Compact disc which contains databases such as HSELINE, CISDOC, NIOSHTIC which contain a wealth of information on skin diseases and many more subjects from worldwide sources.
Borrow or buy the Rash Decisions HSE video on work-related dermatitis. L49.50 from CFL Vision, PO Box 35, Wetherby, West Yorkshire LS23 7EX. Tel: 01937 541010. Also available to hire at L13.50 for 5 days.
Obtain the leaflets HSE 31 Everyone's guide to RIDDOR 95 and Preventing dermatitis at work IND(G)223(L) (single copies available free from HSE, or check the OSH-CD compact disc which gives the full text of this leaflet, the legislation and many other documents produced by the Health and Safety Executive and the Health and Safety Commission.
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