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1 Occupatinal Cntact Dermatitis and Urticaria A British Occupatinal Health Guide fr Emplyers, Wrkers Research Fundatin and their Representatives March 2010 British Occupatinal Health Research Fundat in

2 This leaflet summarises the key evidence based advice fr plicy and practice n the risk management f ccupatinal cntact dermatitis and urticaria. The full guidelines, reprt, and analysis f relevant research is available frm the British Occupatinal Health Research Fundatin. It can als be accessed n the website at is an award-winning, innvative niche charity specialising in the prvisin f evidence based slutins t practical questins asked by emplyers and their advisers in bth private and public sectrs. Our missin is: 'Bringing emplyers and researchers tgether t prduce research that will cntribute t gd emplyee health and perfrmance at wrk'. Registered Charity N: The cst f prducing the summary leaflets fr the evidence review n ccupatinal cntact dermatitis has been generusly prvided by Pfizer Ltd. Neither Pfizer nr any f their emplyees has been invlved in deciding which research is within scpe f the review, nr have they been invlved in the analysis r presentatin f either the review r the summary leaflets.

3 Intrductin OCCUPATIONAL CONTACT DERMATITIS & URTICARIA A British Occupatinal Health Research Fundatin Guide fr Emplyers, Wrkers and their Representatives Skin disease is a very cmmn ccupatinal disease. Wrkers with this type f disease ften say it affects their quality f life a great deal. Because ccupatinal skin diseases are s cmmn and the impact s severe, a review f published scientific literature has been undertaken. The aim f this review is t imprve hw these diseases are prevented, identified and managed. The wrk was carried ut by a grup f peple that included ccupatinal health prfessinals, dermatlgists, health and safety and envirnmental health inspectrs, GPs, emplyers, unins and emplyees. The infrmatin in this leaflet summarises the findings f the review fr emplyers and emplyees. What is ccupatinal cntact dermatitis? There are tw types f ccupatinal cntact dermatitis; irritant cntact dermatitis, where agents directly affect the skin leading t inflammatin. Dry, red and itchy skin is a cmmn first sign. Swelling, flaking, blistering, cracking and pain may fllw. It can ccur quickly after cntact with a strng irritant, r ver a lnger perid frm repeated cntact with weaker irritants. Irritants can be chemical, bilgical, mechanical r physical. Repeated and/r prlnged cntact with water can als cause irritant dermatitis. This is ften referred t as wet wrk. allergic ccupatinal cntact dermatitis (r skin sensitisatin) is where the sufferer develps an allergy (becmes sensitised) t an allergen (sensitising substance). The signs and symptms are difficult t distinguish frm irritant cntact dermatitis. Sensitisatin can develp ver time and it may be weeks, mnths r even years befre it becmes apparent. Hwever, nce a persn has develped an allergy, cntact with tiny amunts f the allergen will trigger allergic cntact dermatitis. What is ccupatinal cntact urticaria? Urticaria is a skin cnditin that typically shws as a wheal (swelling) and flare (red mark) reactin. Skin irritants r allergens may cause it. It is different frm irritant cntact dermatitis and allergic cntact dermatitis in that it quickly fllws skin cntact and disappears again within hurs.

4 What are the causes? The mst frequently and cnsistently reprted agents include: irritant ccupatinal cntact dermatitis alchls petrleum prducts cutting ils and clants saps and cleaners degreasers slvents and wet wrk disinfectants. allergic ccupatinal cntact dermatitis cbalt nickel chrmates plants csmetics and fragrances preservatives epxies resins and acrylics. ccupatinal cntact urticaria cw dander flur and grains fd natural rubber latex. animal prducts Wh is mst at risk? These diseases can happen in mst wrkplaces althugh wrkers reprted t be at increased risk f develping ccupatinal cntact dermatitis include: hairdressers cks and caterers beauticians mechanics health care wrkers metalwrkers and vehicle assemblers cleaners chemical/petrleum plant peratives cnstructin wrkers agricultural wrkers. Thse at greatest risk f develping ccupatinal cntact urticaria include: bakers health care wrkers farmers wrkers preparing fd.

5 Hw can emplyers help prevent these diseases? The law requires emplyers t assess the risks and adequately cntrl expsure t materials in the wrkplace that cause ill health such as ccupatinal cntact dermatitis and urticaria. The risk is the likelihd that wrkers skin will cme int cntact with substances that can cause these cnditins. Assessment means deciding wh might be harmed and hw. Fr example: Hw much f the substance is used? Hw ften is it used, and by hw many wrkers? Hw is the substance handled? Which parts f the skin are expsed and fr hw lng? If a skin cntaminatin prblem is identified, emplyers need t develp measures t adequately prevent r cntrl the risk. The key recmmendatins frm this review fcus n things that can be dne in the wrkplace t limit the risks. 1. Reducing expsure reduces the likelihd f disease. Des the substance have t be used? Can a safer alternative be used? If it des have t be used then the mst effective way t reduce expsure is t try and cntain it at surce (e.g. by enclsing the prcess r using lcal exhaust ventilatin). Handle the materials in ways that limit cntact. Gd husekeeping and gd strage f materials prevents the spread f cntaminatin. 2. PPE is the least effective cntrl measure and shuld be the last measure t be cnsidered. PPE nly prtects well when it is selected crrectly, wrn prperly, remved safely and either replaced r maintained regularly. Wearing glves fr lng perids can make the hands ht and sweaty, leading t skin prblems. Using separate cttn liner glves can help prevent this. 3. Dn t prmte the use f pre-wrk creams as barrier creams. They can keep the skin misturised and may help with the remval f dirt but, they d nt create an effective physical barrier. Prmting their use as barrier creams may cnfer n wrkers a false sense f security. 4. After-wrk r cnditining creams help t prevent ccupatinal cntact dermatitis develping. They shuld be readily available in the wrkplace and their use encuraged. 5. A number f the studies reviewed have shwn the imprtance f training wrkers abut their risks t health frm skin expsure and the precautins needed t prevent disease. This training shuld include the crrect use f any persnal prtective equipment, gd skin care and what t d if they suspect they might have a skin prblem. Hw can emplyees help prevent these diseases? Wrkers have a legal duty t take care f their wn health and safety. This means c-perating with emplyers by fllwing their health and safety training and by using any preventative measures prvided. This includes using any persnal prtective equipment supplied and fllwing any skin care prcedures. They shuld als reprt any prblems prmptly.

6 Hw can safety representatives help? It is imprtant that emplyers invlve wrkers, safety representatives and trade unins in health and safety matters. Nt nly is it gd practice but cnsultatin is a legal duty. It is imprtant t remember that cnsultatin is abut invlving all parties and taking n bard their views, nt just giving wrkers infrmatin. Safety representatives can help with wrkplace inspectins, which include checking engineering cntrls such as ventilatin r persnal prtectin. They can als help t investigate shuld things g wrng. Safety representatives can help secure a gd safety culture. What if a case f ccupatinal skin disease is suspected? Individuals with suspected skin prblems shuld visit their General Practitiner fr advice and treatment if needed. If a case f ccupatinal cntact dermatitis is cnfirmed then under the Reprting f Incidents, Diseases and Dangerus Occurrences Regulatins 1995, emplyers shuld reprt this t the apprpriate regulatry authrity (either the Health and Safety Executive r lcal Envirnmental Health Authrity). Emplyers shuld als review their risk assessment and make any necessary changes. Further infrmatin Useful infrmatin n ccupatinal skin prblems and n health and safety legislatin is available frm the Health and Safety Executive web site: Fr the full versin f the guidelines n ccupatinal cntact dermatitis and urticaria g t:

7 British Occupatinal Health Research Fundatin is an award-winning, innvative niche charity specialising in the prvisin f evidence based slutins t practical questins asked by emplyers and their advisers in bth private and public sectrs. Our missin is: 'Bringing emplyers and researchers tgether t prduce research that will cntribute t gd emplyee health and perfrmance at wrk'. British Occupatinal Health Research Fundatin 6 St Andrews Place Regent s Park Lndn NW1 4LB Registered Charity N: