02/01/2006

The Skinny On Contact Dermatitis

The skin is amazingly resilient - a strong protector. When assaulted from the
outside by irritants, or from the inside by disease, skin raises a red danger
flag in the form of a rash. The rash could be irritation, a virus, a bacterial
infection or an allergy - it could even be caused by something related to your
job.

Occupational skin disease (OSD) is not uncommon, accounting for up to a quarter
of all reported occupational diseases. OSD can be long-lasting, in other words,
a chronic condition. It can affect workers in a variety of occupations like
metalworkers, bakers, cabinetmakers, automobile and agricultural workers,
artists, and 'wet' workers like dishwashers, cleaners, cooks, nurses, and other
hospital workers.

Of all the occupational skin diseases, contact dermatitis is by far the most
common. Symptoms can include redness, swelling, itching, scaling and blistering
of the skin. The condition can be painful. And one thing is for sure, the
eczema-like rash will linger and worsen unless the source is discovered and
removed.

Contact dermatitis comes in two forms: irritant and allergic.

Irritant contact dermatitis is the most common and occurs when the skin is
exposed to a wide variety of chemicals - everything from water and detergents
to dilute solutions of chemicals that are moderate to severe irritants or
corrosives. Some chemicals may not irritate the skin following short-term
contact, but repeated or prolonged contact can result in contact dermatitis.
The severity of the reaction depends on the kind of chemicals contained in the
product used, the concentration of chemical, and the length and frequency of
the exposure.

Allergic contact dermatitis is a different type of reaction although both
irritant and allergic contact dermatitis can occur together.

Allergenic chemicals or "skin sensitizers" are capable of causing an allergic
response in a relatively large number of people following repeated exposure.
This means that some people can actually work with a skin sensitizer and never
have an allergic reaction. Other people will develop an allergic reaction, but,
at first, there may be no symptoms of exposure - no warning signs of what is to
come. In a matter of days, though, the skin becomes irritated, swollen, itchy
and blistering.

Workplace allergens can be very difficult to identify, because

  • some people develop a reaction and others do not;
  • the allergic response can take days or weeks to show up;
  • some allergens also cause irritation - further confusing the picture.

Allergic contact dermatitis is usually diagnosed with a patch test.

When exposure to the allergen stops, the rash normally clears up. However,
sensitivity to the allergen continues indefinitely. In general, the more often
someone is exposed to an allergen, the more sensitized they become - which
means they react to smaller and smaller amounts of the chemical - reacting more
quickly and severely each time.

Managing the problem

Prevention is the smartest way of minimizing contact dermatitis. Minimizing
skin contact with irritants is recommended. This can be done by changing the
process or with the use of personal protective equipment, usually gloves and
aprons. Appropriate personal protective equipment is helpful in creating a
barrier to irritants, but it must be chosen carefully, used properly and
maintained in good condition. When dealing with the more serious corrosives or
skin sensitizers more stringent controls like engineering controls should be
considered if a safer substitute cannot be found. Qualified staff should design
and install engineering controls like enclosures equipped with local exhaust
ventilation systems to remove toxic products so workers have no direct contact
with the allergenic or corrosive agents.

Occupational health experts estimate that allergic and irritant contact
dermatitis are on the rise in the workplace, largely due to the introduction of
new chemicals and chemical mixtures, latex allergies and, with newfound concern
over infectious disease control, increased hand washing with anti-microbial
cleansers. What's more, underreporting of skin problems is common - suggesting
that the problem is much worse than what it appears to be. All the more reason
a strong information program is fundamental in educating both managers and
workers to save their skins.

More info


AplusA-online.de - Source: Canadian Centre for Occupational Health and Safety