Occupational skin disease

Author: Susan Ford BSc (Hons) Occupational Health, Practice Nurse, New Zealand, 2011.

Introduction

Occupational skin diseases are among the most common occupational diseases reported. For a skin disease to be considered occupational in origin, there must be a causal relationship between the occupation or work and the skin disease.

There are three broad groups of occupational skin disease:

  1. Irritant contact dermatitis
  2. Allergic contact dermatitis
  3. Other occupational skin disease

More than 90% of cases are classified as one or other form of contact dermatitis.

What occupations are most likely to be affected by skin disease?

The following occupations account for 80% of reported occupational skin disease in developed countries in Europe; most involve wet working conditions, which commonly results in contact dermatitis.

Other occupations reviewed on DermNetNZ include:

The sites affected by occupational skin disease depend on exposure. About 80% of patients with occupational skin disease present with hand dermatitis.

Younger workers have a slightly higher risk that older workers, but who is affected will depend on:

Irritant contact dermatitis

Irritant contact dermatitis occurs when contact with chemical or physical agents injure the skin’s surface faster than it is able to repair the damage. Occupational irritant contact dermatitis:

Clinical features of irritant contact dermatitis are varied.

Allergic contact dermatitis

Allergic contact dermatitis is an immunological response (allergy) to a contact allergen. Only people who are allergic to a specific agent (the allergen) will show symptoms. The appearance can be exactly the same as irritant contact dermatitis. Allergic contact dermatitis:

There are some specific features of allergic contact dermatitis:

Other occupational skin diseases

Skin conditions other than dermatitis may occur as a result of occupational exposures. These comprise <10% of occupational skin disease.

What are the main types of occupational exposure?

Occupational skin disease may follow exposure to chemical, biological or physical agents.

Chemical exposure

Biological exposure

Physical exposure

How can occupational skin disease be prevented?

Recognition of cause
  • Employers and workers should be involved in identifying workplace hazards. This shouldn’t just occur once – it should be an on-going process that can respond to changes in the workplace, and changes in knowledge.
  • Evaluate the exposure to hazards, and assess the risk of harm.
  • Maintain a register of accidents/incidents/occupational disease
Eliminate or enclose
  • Sometimes skin contact with the hazard can be avoided by using encapsulated machines or automated equipment, e.g. dishwashers and food mixer.
Minimise
  • Where a hazard cannot be eliminated, it should be minimised.
  • Where possible, choose less harmful chemicals to do the same job
  • Rotate tasks to reduce individual exposure
  • Ensure appropriate ventilation and other engineering controls to minimise exposure to hazardous chemicals
  • Provide personal protective equipment: gloves, aprons, faceshields etc.
  • Optimise skin barrier function with suitable emollients, barrier and moisturising creams
  • Provide safety data sheets
  • Train workers on causes of occupational skin disease
  • Train workers how to protect their skin from injury and dermatitis
  • Move at-risk individuals to alternative work
Monitor
  • Where a hazard is minimised, monitor workers’ health in respect of that hazard.
Appropriate treatment

Related information

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