Your Career is in Your Hands!
Preventing work-related skin conditions in young people

 Young people are at risk of developing work related skin problems such as occupational contact dermatitis.  This can develop whether they are on work experience, undertaking an apprenticeship and working part- or full-time.  If young people develop occupational contact dermatitis it may be necessary for them to change their duties at work or even leave their chosen career.

What is Occupational Contact Dermatitis?

Occupational contact dermatitis is a skin condition caused by substances that touch the skin.  The hands are most commonly affected. Signs and symptoms of this condition include the skin becoming red, dry, itchy, blistered and painful.

Occupational contact dermatitis may affect a person’s life, making them feel embarrassed by the condition of their skin.  The two main types of occupational contact dermatitis include irritant contact dermatitis and allergic contact dermatitis.

Irritant contact dermatitis

Irritant contact dermatitis is the most common cause of occupational contact dermatitis.  It occurs when the natural barrier of the skin is damaged and often starts in the web spaces between the fingers.  This condition can take months to heal, which is why is it important to protect the skin from being damaged in the first place.

High-risk occupations are considered to include those where the workers’ hands are wet and then dried repeatedly – especially where hand washing occurs more than 20 times a day or for more than ¼ of the shift.  This is known to be extremely irritating to the skin.   In Germany, legislation exists to limit the amount of “wet work” performed per shift to a maximum of 4 hours.  The Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation have also written some guidelines for the Australian setting and these are available at: http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/153/GuidanceOnPreventionOfDermatitisCausedByWetWork_2005_PDF.pdf

Other irritants that can cause damage to the skin include:

  • Solvents
  • Soaps and detergents
  • Oils and lubricants
  • Acids and alkalis
  • Heat and sweating
  • Dusts and fibres
Allergic contact dermatitis

Allergic contact dermatitis can develop at any time during a person’s career and often happens after irritant contact dermatitis has already damaged the skin.  Allergic contact dermatitis is a delayed reaction caused by a chemical or substance that may be used at work.  Once a person develops an allergy to something, a rash will develop whenever they touch or come into contact with that particular substance.  It is possible to develop an allergy to a product at any stage, even after years of exposure without obvious evidence of skin problems.

Some substances that may cause allergy include:

  • Epoxy resins, used in coating chemically-resistant surfaces
  • Hair dyes, perm solution and bleach
  • Rubber chemicals in both synthetic and normal rubber gloves
  • Preservatives and biocides in oils, hand washes and some creams
  • Metals such as nickel, or chromate in cement and leather
High-risk occupations

Occupational contact dermatitis often affects young people who have recently entered the work force.  Occupations commonly affected include:

  • Hairdressing
  • Healthcare
  • Food handling
  • Cleaning
  • Printing
  • Automotive maintenance
  • Construction
Risk Factors

Having a personal or family history of asthma, eczema or hay fever, even as a baby, increases the risk of developing this often-debilitating condition.  In fact, those who have had eczema at any age have a 4 times higher possibility of developing work-related dermatitis.

Atopic adolescents, especially those planning a high risk career, need information to enable them to minimise disease by utilizing an appropriate skin care routine from the beginning of their working life.

Skin Care for Those at Risk

 Avoid irritants and allergens

  • Reduce the amount of wet work whenever possible
  • Chemicals known to cause allergies should be substituted where possible
  • Minimise direct contact with irritants and allergens with use of appropriate gloves
  • Use a soap substitute at home and at work to avoid harsh soaps and cleaning agents

Moisturise regularly

  • Use a greasy moisturiser, especially after work and before bed. Greasier ointments and creams are more effective moisturisers than lotions in a pump pack
  • Use of a moisturising lotion is convenient for quick use when at work, but daily (nocturnal) use of a greasy moisturizing cream or ointment is best

 Wear the right gloves for the job

  • Different gloves are required for different exposures. Lined gloves, or cotton gloves under reusable gloves reduce skin irritation from heat and sweating.
  • Vinyl gloves are recommended for food handlers. Food handlers should never wear latex gloves at work
  • Powdered latex gloves are associated with an increased risk of latex allergy and should never be used.
  • Healthcare workers should use non-powdered latex gloves unless they have risk factors for latex allergy. Risk factors for latex allergy include: atopy, pre-existing irritant contact dermatitis and use of powdered latex gloves.
  • For those who must avoid latex, nitrile gloves are recommended for healthcare workers as vinyl gloves do not protect against bodily fluids.

Medication

  • Topical corticosteroids are generally more effective in a greasier ointment formulation compared to a cream.
  • Oral corticosteroids may be suitable for short term use in severe cases. Repeated requirements for oral corticosteroids should indicate the need for specialist referral.
The Impact

Unfortunately there is no ‘cure’ for occupational contact dermatitis, except for avoidance of irritants and allergens.   Studies have shown that good skin care can reduce the risk of developing this career threatening condition.   Preventative measures should be encouraged to help prevent the development and recurrence of occupational contact dermatitis. Without preventative measures, a number of young people will be required to modify their work duties, change work areas and some may even have to stop working in that industry.

Support and consultation

Preventing occupational contact dermatitis in young people will be more successful and effective through collaboration between parents, general practitioners, career counsellors and training institutions.

Career counsellors are often unaware of the association between childhood atopy and occupational contact dermatitis.  It is for this reason that educational information has been developed to specifically target career counsellors and students.   Please refer to the Skin@Work Careers Counsellor booklet for more information.

General practitioners may be aware of an atopic history and be able to offer appropriate advice.

Empowering young people by the provision of appropriate advice gives maximum chance of minimising disease.

For more information please ph. 03 9623 9402 or email admin@occderm.asn.au