Skin disorders in boat builders

Author: Brian Wu, MD candidate, Keck School of Medicine, Los Angeles, USA. DermNet New Zealand Editor in Chief: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. December 2016.


Introduction

Boat building is a significant global industry, especially in countries where fishing, shipping and related maritime industries are economically important. However, the nature of boat-building work puts workers at risk for occupational dermatoses. In one study of boat builders in New Zealand, it was found that 26% of the workers had some form of skin disease. In another study, boat building was listed among the professions at highest risk for occupational skin disorders.

Why are boat builders at risk?

A high risk of occupational skin disease in boat builders is due to:

  • Work with composite materials such as fibreglass
  • Exposure to epoxy resins, paints, and adhesives, as well as solvents, such as methyl ethyl ketone peroxide, sodium hydroxide, toluene, acetone and turpentine
  • Uneven global safety regulations in the boat-building industry
  • Globally, a workforce with low education levels and socioeconomic status and a large percentage of migrant, transient or part-time workers.

Understanding occupational skin disorders

An occupational skin disorder is a skin condition that is due to, or is made worse by, the nature of one’s work or occupation. The most common forms of occupational skin disorder are contact dermatitis (both allergic contact dermatitis and contact irritant dermatitis), skin cancer, skin infections and injuries (wounds). These disorders occur when mechanical, biological or chemical agents undermine the integrity of the skin’s protective barrier and leave it more vulnerable to breakdown or infection.

While the risk of getting an occupational skin disorder is reduced with personal protective equipment, some people may need to change their occupation if they are found to be resistant to treatment.

Skin disorders related to boat building

Irritant and allergic contact dermatitis

Contact dermatitis is the most common skin disorder among boat builders.

    • Irritant contact dermatitis is primarily caused by wet work (ie, frequent exposure of the hands to water).
    • Allergic contact dermatitis among boat builders is mainly caused by exposure to epoxy resins and other epoxy-based compounds.
    • Dermatitis affects hands and sites exposed to the allergen or irritant.
    • Signs and symptoms of acute dermatitis are redness, pain or burning sensation, swelling, and blistering.
    • In the longer term, chronic dermatitis presents with itching, scaling, fissuring and thickened skin.
Reactions to epoxy resin in a boat builder

Chemical burns

Chemical burns are another risk for boat builders, due to the number of chemicals used.

  • Paints, adhesives and other strong chemicals are the main culprits.
  • Personal protective equipment is not always used by workers.
  • Employee education about safety precautions can reduce this risk.

Mechanical injuries

Mechanical injuries are also common in the boat building trade. This is partly due to the heavy manual labour required for work in this industry.

  • Tools, machines, and equipment — especially if not properly used or maintained — can also be a source of mechanical injury.
  • Secondary bacterial skin infections can develop after injury and prompt first aid is needed.

Sun exposure

Ultraviolet (UV) radiation or sunburn is another risk for boat builders.

Workplace risk assessment

Workplace risk assessments should be formulated to reduce exposure to hazards at the source whenever possible. When this cannot be done, the path of exposure should be blocked or workers should be educated to use various forms of personal protective equipment to keep themselves safe. An exposure control plan may alter the industrial process, invest in employee training and education, improve the working environment and implement a skin care programme to protect against occupational dermatoses.

Personal protective equipment

Because of its hazardous nature, the boat building industry requires the use of extensive personal protective equipment, including:

  • Gloves to protect hands
  • Laboratory or shop coats
  • Disposable aprons
  • Loose, long-sleeved clothing
  • Protective footwear
  • Safety masks and/or respirators
  • Protective headgear, hoods, or hats for work in the sun 

Personal protective equipment must be part of a larger worker safety programme. Employees need to understand the nature of the chemicals they are working with, their risk for exposure and safety measures they need to take to protect themselves.

Hand care advice for boat builders

Hand care advice for those in the boat building sectors includes:

  • The proper donning, use and disposal of gloves
  • Thoroughly washing and drying the hands as needed
  • Using a gentle soap or cleanser
  • Applying emollients and moisturisers
  • Washing hands before eating or drinking, smoking, or at the end of a shift.

Diagnosis and treatment of occupational skin disorders

Diagnosis of an occupational skin disorder or disease should be based on a meticulous physical examination, knowledge of the individual’s job (including the nature of the work, length of stay on the job and particular potential exposures), and their personal/medical history, with an emphasis being placed on a history of allergies or atopy (especially atopic eczema). Patch testing may be required.

Treatment of skin disorders can include:

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