Occupational dermatitis is one of the most common health problems affecting workers. It affects people in many sectors but is especially prevalent in catering and food processing.

Across all UK industries, around 84,000 people have work-related dermatitis. One in ten of these people work in the catering and food industries.

Ten percent of cases under the Department or Work and Pensions Industrial Injuries Scheme are attributed to occupational dermatitis, and 13% of occupational diseases reported under RIDDOR to the Health and Safety Executive are attributed to it.

What causes occupational dermatitis?

Soaps, detergents, and water exposure

Many workers have prolonged contact with soaps, detergents, and water in the food and catering industries. Statistically, each year there are more than 200 cases reported by dermatologists and occupational physicians. In addition, there are likely to be many more cases reported to other medics.

Foodstuffs

Around 40% of cases of occupational dermatitis are attributed to food contacting the skin. This is because there are lots of foodstuffs that cause dermatitis. These include flour, dough, sugar, fruits (particularly citrus fruits), spices, vegetables, meats and fish.

Other causes of occupational dermatitis

Occupational dermatitis can also have other causes: rubber gloves, latex gloves, cleaners, chemicals, alcohol-based hand sanitisers, machining oils, acids, alkalis, plants, solvents, and abrasives.

Preventing occupational dermatitis

It is possible to prevent occupational dermatitis, and it is much easier to prevent it than it is to cure it – and the costs of preventing it are cheaper than curing it too.

What can employers do?

Employers need to find out if there is a problem. Do their employees come into contact with dermatitis-causing agents, for example? Are they monitoring absences caused by skin problems? Are they investigating any worker complaints and consulting with employees and safety representatives?

Using the APC approach

APC stands for: Avoid, Protect, Check.

Avoid

Where practical and sensible, workers should avoid unprotected hands contacting products, substances and wet work. If possible, employers should get rid of the product, substance or wet work that is causing issues. If this is not possible, they should substitute the product or substance with something that is less of an irritant.

Finally, employers should implement control measures like equipment or tools so that there is a safe working distance between the product, substance or wet work and the skin.

Protect

When it is not possible to avoid contact entirely, protection is vital.

Employers should provide suitable PPE (personal protective equipment) like gloves. Any skin cleaning product should be as mild as possible, and there should be handwashing facilities that have both cold and hot water available.

Workers should ensure they wash their hands before drinking or eating and also before they put on gloves. Mobile workers should make sure there are suitable washing facilities available where they are working. Whenever the skin is contaminated with something, it should be washed off promptly.

Drying your hands is a vital step that shouldn’t be missed as it is key to preventing occupational dermatitis. Dry hands thoroughly on paper or cotton towels.

Moisturising frequently is also another way workers can protect their skin. Moisturising replaces the skin’s natural oils and maintains its natural protective barrier. If possible, pre-work creams should be applied.

Check

Hands need to be checked regularly. This is so that you can spot the very first signs of dry, red, or itchy skin.

When dermatitis is found early, it is much easier to treat, and it’s much more likely that the skin will recover fully.

When a skin problem is suspected, advice should be sought from a GP.

Urticaria (hives)

Urticaria – or hives – is an itchy, raised rash. It can appear on a single part of the body or be spread across more areas. The rash typically ranges in size; the welts can be as small as a few millimetres in diameter but can be much larger too.

Urticaria is either acute or chronic. If the rash has completely disappeared within six weeks, it is described as acute. For longer persisting rashes, the condition is described as chronic.

Urticaria is caused by a trigger. It causes the body to release histamine into the skin. This, as well as other chemical messengers, causes blood vessels to open up, which results in pinkness or redness of the skin. In addition, the extra fluid in the skin’s tissues causes itchiness and swelling.

Histamine release occurs due to different reasons like:

• Allergic reactions (e.g. a food or latex allergy)
• Stings or bites
• Exposure to heat or cold
• Infection
• Medication

In the workplace, urticaria can occur when a person comes into contact with a trigger or irritant.

Triggers in the workplace often include:

• Cosmetics (like preservatives, hair dyes, fragrances, nail varnish resins)
• Metals (e.g. cobalt, nickel, and chromate)
• Textiles (e.g. formaldehyde resins)
• Adhesives and plastic resins
• Plants (the most common are sunflowers, chrysanthemum, tulips, primula, and daffodils)

Diagnosing occupational dermatitis and urticaria

Doctors diagnose urticaria and occupational dermatitis by history taking, conducting a clinical examination, performing patch tests, blood tests, or skin prick tests.

When specialists take a history, they will ask about occupational history, including whether there is a possible link between the patient’s work and their rash. They will also ask about whether the patient is exposed to hazardous substances at work.

Treating urticaria and occupational dermatitis

Often there is no treatment necessary for urticaria because rashes usually get better on their own after a few days. Antihistamines can ease any discomfort caused by itchiness. These are available over the counter, and a prescription is not needed. Occasionally, if the urticaria is severe, a person might need a short course of oral corticosteroids.

For occupational dermatitis, there are many treatments. These include:

• Soap substitutes
• Topical steroids
• Using moisturising cream
• Antibiotics (for resulting secondary infections)
• Systemic therapy
• Phototherapy
• Immunosuppressant therapy

Occupational dermatitis can take a long time to improve, so it’s vital that appropriate protection is taken. In addition, once cleared, it is essential to keep on top of preventing a reoccurrence.