Health & Safety Update (February 2009)

Managing Skin Exposure Risks at Work

Many employers are unaware that they have a legal obligation to assess the risks to health arising from exposure of the skin to hazardous substances.

There are many materials in use in workplaces that have the potential to either irritate the skin, or be absorbed through the skin and cause adverse health effects elsewhere in the body.  Responsible employers should be familiar with the use of substances within the workplace and if they have the potential to cause ill health through skin exposure. They should also be aware of how to manage skin exposure to prevent disease. This issue is of concern to a wide range of industries but you should pay particular attention if you are engaged in chemical handling, construction, printing, metal working, catering, all health and social care businesses, hair and beauty businesses and motor vehicle repair.

The majority of work-related skin diseases are dermatitis. Some helpful clues to recognise a work-related cause are:

• it is primarily on the hands, arms and face;
• the condition improves away from work and relapses on return;
• more than one person is affected in the same work area or handling the same materials.

There are two main types of work-related contact dermatitis, irritant contact dermatitis and allergic contact dermatitis.

Irritant contact dermatitis

An irritant directly damages cells if in contact with the skin in sufficient concentration and for sufficient time. Most irritants cause dermatitis by gradually overwhelming the skin's barrier and repair mechanisms. Mild irritants such as detergents will literally wash out lipids from the skin. If exposure exceeds the capacity of the skin to regenerate those lipids, dermatitis will result. Powerful irritants ‑ such as caustic soda ‑ produce an immediate effect. These cause direct damage to cells. Other examples of substances causing dermatitis are most cleaning products, cement, diesel, lubricants, solvents, dyes and other hair products and acids / alkalis.

People vary in their susceptibility to irritants. Certain groups of people are more susceptible to irritants:

• those already suffering dermatitis/eczema (known as 'atopics');
• those with very dry skins;
• those with very fair complexions.

In general, irritant contact dermatitis is more common occupationally than allergic contact dermatitis.

Allergic contact dermatitis

Allergic contact dermatitis is caused by contact with a sensitiser, a substance that can induce an 'over-reaction' of the body's immune system. This leads to allergic skin involvement and often to other health problems.

Sensitisation is:

• Substance specific;
• Unpredictable-5-25% of the population is  affected;
• Latent-sensitisation can occur after the first exposure or after many years;
• Irreversible;
• Not dose related- minute quantities of the substance can trigger a response once sensitised.
• Examples of sensitisers are flour, animal dander/protein and feed, chromium, nickel, latex, formaldeyde, cutting fluid preservatives, epoxy resins, pesticides, dyes, isocyanates and many organic dusts.

What should I as a responsible employer do?

Avoid direct contact between unprotected hands and substances where practical:

• Get rid of the substance;
• Substitute the product/substance for something less harmful;
• Introduce controls (such as tools or equipment) to separate skin and substances.

Protect the skin. Avoiding contact will not always be possible so:

• Provide suitable personal protective equipment such as gloves. This can be complex- call the advice line or your Consultant for advice;
• Provide mild skin cleaners;
• Tell workers to wash their hands before eating and drinking, and before wearing gloves;
• Remind workers to wash any contamination from their skin promptly;
• Provide a means of drying the skin. Tell workers about the importance of thorough drying after washing;
• Protect the skin by moisturising as often as possible and particularly at the end of the day – this replaces the natural oils that help keep the skin's protective barrier working properly;
• Use suitable pre-work creams.

Check hands regularly for the first signs of itchy, dry or red skin. When skin problems are spotted early, they can be treated more easily. Your employees need to be informed and trained about the risks to their health and the steps you have taken in order to protect them. Our advice line can answer any questions you may have regarding management of skin exposure risks.