Dermatitis is a common skin condition that is caused by direct contact with a substance that will either irritate the area of contact or cause an allergic reaction. This article provides information around the two main types of dermatitis and how to reduce exposures resulting in the condition.
It is estimated that 84,000 people in the UK have dermatitis that is either caused or made worse by their workplace. It is worth noting that 10% of the figure accounts for food and catering industries.
Once the affecting substance has direct contact with the skin, usually the area becomes itchy and dry, which then becomes reddened, inflamed, blistered, thickened and cracked. Symptoms can appear anywhere on the body but are most commonly found to occur on hands and face. The effects often begin to show between 6 -48 hours after exposure. However, milder irritants may need repeated exposure before they begin to show.
The vast majority of work industries will include substances that can cause dermatitis. For instance, in the food and catering industry exposure to sugar, flour, Dough, fruits, vegetables, spices, fish and meats are most common.
What are the Different Types of Dermatitis?
There are two main types of contact dermatitis, irritant and allergic. Both effect different individuals. Irritant reactions care caused by the direct damage to the outer layer of skin and the effects are usually seen early after exposure. However, allergic reactions are the immune system reacting that causes hypersensitivity to the skin.
Irritant Dermatitis
Irritant dermatitis is found in industries that involve the repeated wetting of hands or exposure to certain chemicals. Some examples of professions that result in occupational dermatitis are agricultural workers, beauticians and hairdressers, chemical workers, cleaners, construction workers, cooks and caterers, metal and electronics workers, health and social care workers, machine operators, mechanics and vehicle assemblers.
Typical skin irritants include detergents, organic solvents, acid and alkaline (cement), oxidising agents, oils, greases, dust and some plants. The skin reacts by becoming dry, chapped, red and after a while can become cracked. If the process is then repeated without treatment it will lead to further irritation, more intensified itching and excoriation. The level of response from exposure is depended on the level of dosage.
The way in which irritant response differs from allergic is that the stratum corneum, (protective outer layer of skin) that acts as a protective barrier against external agents from entering the skin and water from escaping is damaged.
Acute response is the impairment of the skin, Chronic effects due to repeated exposure cause increasing and more intensified damage. Repeated exposure will lead to that particular area of skin to be susceptible even after apparent healing. Substances that are most likely to cause damage are organic solvents, alkaline soaps and chemicals.
Allergic Contact Dermatitis
This type of dermatitis occurs once the individual has developed an allergy and become sensitised to a certain substance. Common sensitised substances are nickel, epoxy resin adhesives, latex (gloves), hair dyes, UV cured printing inks, coins, rubber, plants, colophony and wood dust.
Allergic dermatitis differs from irritant because once a person as becoming ‘sensitised’ to a certain substance it is most likely that they are permanently allergic. Repeated exposure to the sensitised substance will lead to an allergic reaction.
The visual response to the skin is similar in the sense that the affected area will become itchy, red and cause burning/ stinging. However, this is the response of the immune system and may take longer to appear than a skin irritant.
The usual response time is 48 hours after exposure. This is due to the time it takes for the substance to be conveyed from the skin to the lymph node, this will then result in the specific lymphocytes stimulated. The area of skin is then hypersensitised with an inflammatory reaction.
What Can Be Done to Prevent Dermatitis?
In the workplace, it is important that information and training are provided in order for your workforce to be protected. Providing education on the potential risk and good occupational hygiene precautions are an effective way to reduced exposure.
As an employer, simple steps need to be made to learn about your workforce.
what are the potential causes?
How many people are affected by this?
Once the substance and employees are identified, can the substance/ process be removed or substituted?
Would job rotation help to see fewer people affected for shorter periods?
Have you provided the appropriate PPE? Such as gloves, or providing moisturising cream?
Are workers adequately trained to use the PPE provided?
One thing to note here, PPE can be the cause of dermatitis. For example, allergic contact dermatitis can occur if the wearer is allergic to the glove material. Latex allergies are common.
An allergic reaction is caused due to the proteins in the natural rubber. Prevention involves non-powdered, low protein or synthetic rubber alternative gloves.
If an individual is allergic to a certain substance that is being used in the workplace it is important to identify and avoid direct contact to ensure protection. When attempting to identify the specific substance in an individual it is important to consider medical history (childhood eczema), physical examination and patch testing. A qualified and competent Occupational Health professional should be consulted.
Infrequent drying of the sweated hands can lead to irritant dermatitis and swelling of the skin through excessive moisture contact. These are things to consider when providing protective gloves.
A hazardous substance should, where practicable, be substituted for a less hazardous alternative. An example could be that commonly, alkaline soaps are substituted for less harmful, more natural alternatives. Emulsion skin cleansers are also used, this can ensure protection against drying skin and help to keep it hydrated.
Patch Testing
Patch testing is seen as the best way to test individuals and can confirm a positive allergic response to direct contact with the skin.
Once the substance is identified, the symptoms can then improve or even clear up completely.
The test involves using different substances and applying them on the upper part of the persons back under adhesive tape. Time is used to determine whether the substance is an irritant or an allergic reaction.
The tape is examined at 48 hours and then again after another 48 hours. If there has been a reaction immediately after the tape has been removed, an irritant reaction has occurred, this is then usually cleared up in a few days. However, an allergic reaction is most likely to occur a few days after the removal and last longer.
Patch testing should only be provided by those with the appropriate training and with the consent of the individual partaking.
In summary, dermatitis is a condition capable of causing severe discomfort and can impact greatly on a person's life. There are substances that can cause server allergic reactions resulting in painful blistering, swelling, cracking and drying of the skin. On the other hand, irritants are also capable of defeating, burning and damaging the skin leading to irritant dermatitis. Substances should be managed appropriately and a suitable and sufficient COSHH Risk Assessment should highlight the need for further controls to be implemented in light of a foreseeable risk being highlighted. Considering the steps outlined briefly in this article is a great way of beginning to reduce the risk of exposure to prevent skin contact.
Do You Need Support with COSHH?
It is hoped that this article goes some way to providing a brief overview of COSHH. If you wish to know more on this subject or need support with your COSHH assessments, exposure monitoring or the testing of your LEV systems, RPE Fit Testing then please feel free to get in touch with us through social media or our website (www.workplacescientifics.com), by email at support@workplacescientifics.com or simply give us a call on 01709 931299.
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