Dermatitis prevention program for workplaces

Occupational contact dermatitis can considerably affect an individual's work situation and quality of life. It can be severe enough for workers to have to give up their chosen career. Data from the Occupational Dermatology Research & Education Centre (ODREC) indicates this condition affects approximately 34 per 100,000 Australian workers annually. The good news is this condition is preventable.

RASH (Resources About Skin Health) is an occupational contact dermatitis prevention program recently developed for Australian workplaces and training centres.

About occupational contact dermatitis

Occupational contact dermatitis is an inflammatory skin condition usually caused by substances touching the skin at work, mostly affecting hands, but the face, arms and legs can also be involved. It's not contagious, so it can't be passed from one person to another.

Less commonly, environmental conditions may contribute to occupational dermatitis, such as heat causing sweating or low humidity.

There are three types of dermatitis: irritant contact dermatitis, allergic contact dermatitis and contact urticaria.

Irritant contact dermatitis is the most common. It is a condition that everyone is susceptible to develop and it often builds up over time. Skin dryness is usually the first sign and often starts in the web spaces between the fingers. The skin may take months to heal, even once it looks like it has returned to normal. This is typically caused by repetitive exposure to water, which is termed 'wet work'. This occurs when the hands are wet then dry, or in water for long periods. Wetting and drying is very irritating to the skin.

Wet work is defined as where any part of the body is:

• In water or other liquids for longer than two hours a shift,
• In waterproof or other occlusive personal protective clothing for longer than two hours a shift,
• Handling wet things for longer than two hours a shift, or
• Hands are washed more than 20 times a shift.

Other causes include exposure to soaps, detergents, solvents, thinners, oils, greases, dust, fibres and environmental factors such as heat which causes sweating.

The second type is allergic contact dermatitis, which is a delayed allergy, which can occur at any time, whether using a product for many years or just a few weeks. A rash appears 8-24 hours after contact and lasts for days, weeks or months. It is commonly caused by substances such as metal objects, glues, coatings, leather and preservatives in water-based skincare products. Once an allergy starts, it is lifelong and even the smallest amount of contact will cause the rash to appear again.

The third type is contact urticaria, different from the other types of dermatitis as it occurs within minutes of things such as natural rubber latex and certain foods touching the skin. This condition can cause hay fever-like symptoms or asthma, as well as skin reactions.

Dermatitis prevention for the workplace

To prevent occupational contact dermatitis, it is important to avoid contact with potential allergens and irritants, often achieved through changes being made to the workplace, wearing appropriate personal protective equipment and following a good skincare regime.

Changes to the workplace:

• Remove or replace strong irritating and allergenic substances where possible,
• Remove solvents and gritty-based hand cleansers,
• Implement a skincare plan.

Appropriate PPE:

• Suitable gloves for the job should be supplied and worn as many gloves are task or chemical specific.
• Waterproof gloves should be used for wet work.
• Powdered latex gloves should be avoided as they may cause latex allergy. Wear alternatives such as nitrile and neoprene gloves. If you need to wear latex gloves, wear non-powdered versions.
• If gloves need to be worn for long periods of time, wear cotton gloves underneath to reduce sweating.

Skincare:

• Moisturiser should be supplied for workers who contact skin irritants in their job.
• Workers should be encouraged to moisturise the skin regularly with a greasy fragrance-free moisturiser.
• Use commercial cleansers to clean up, rather than solvents or abrasive hand cleansers.
• Workers with damaged skin should use a soap substitute to clean up.

Other important tips:

• Never work with wet feet for long periods of time. Wear waterproof boots, or if sweating is a problem, socks should be changed midway through the shift.
• Workers should report skin problems to management and see their local doctor as soon as possible.

RASH training program

RASH is a 'train-the-trainer' education package aiming to raise awareness about ways occupational contact dermatitis can be prevented. RASH is designed to be used as a training tool in workplaces eg, short 15-minute 'toolbox talks' or training sessions up to 30 minutes for induction training, self-paced learning or included in OHS units at training institutions.

The package contains information suitable for all workplaces and training institutions, but has specific sections for those working in construction, food handling, healthcare and mechanical and metalworking industries. According to ODREC, people working in these industries are at a high risk of developing occupational contact dermatitis.

The RASH program was developed by ODREC (a unit of the Skin and Cancer Foundation), the Department of Health and Ageing and the ASCC.