Health and Safety

Executive

Occupational Dermatitis
What … ?

Graeme Waller
Regulatory Inspector (HID CI 1A)
CONTENT

• What … is dermatitis?

• What … causes dermatitis?

are the common causes?

• What …

has HSE investigated?

• What …
CONTENT … continued

• What … does it look like?

• What … does it feel like?

legislation applies?
• What …

does this mean for me?

• What …
CONTENT … continued

• What … in particular?

• What … about my employees?

• What … leading indicators can I use?

lagging indicators can I use?

• What …
CONTENT … continued

• What … is the hierarchy of control?

• What .. is health surveillance?

is it required?
• When …

is it appropriate and how?

• When …
Any questions before we start?
What ... is dermatitis?

• Dermatitis is a skin condition caused by

contact with something that irritates the
skin or causes an allergic reaction. It
usually occurs where the irritant touches
the skin, but not always.

• There are two types:

• allergic contact dermatitis; and,
• irritant contact dermatitis.
What … causes dermatitis?

Allergic Contact Dermatitis (ACD)

• This can occur when the sufferer develops an allergy to a

substance.

• Once someone is ‘sensitised’, it is likely to be permanent

and any skin contact with that substance will cause allergic
contact dermatitis.

• Often skin sensitisers are also irritants.

What … causes dermatitis?

Irritant Contact Dermatitis (ICD)

• It can occur quickly after contact with a strong irritant, or

over a longer period from repeated contact with weaker
irritants.

• Repeated and prolonged contact with water (eg more than

20 hand washes or having wet hands for more than 2
hours per shift) can also cause irritant dermatitis.
What … are the common causes?

ACD ICD
• Some hair dyes • Wet work
• UV cured printing inks • Soaps, shampoos and
detergents
• Adhesives
• Some food • Solvents
(eg shellfish, flour) • Some food
(eg onions)
• Wet cement
• Some plants • Oils and greases
(eg chrysanthemums) • Dusts
• Acids and alkalis
 What … has HSE investigated?

• Face • Hands
• Eyelids • Thighs
• Neck • Shins
• Trunk • Legs
• Abdomen • Feet
• Forearms • Back
• Morphine based • Zidovudine
• Dichromates • Z-valacyclovir
• Codeine based • TMA
• Petroleum • Nabumetone
• TheBaine • Dicyclohexylcarbodimide (DCCI)
• Active Steroids • Pholcodine
• Cleaning agents • Dihydro Codeine
• Butanol • Morphine Sulphate
• CET-3 • Carprofen
• Hydrocarbons • Dichloropyrimidine
• Hydromorphone • Potassium carbonate
• Naltrexone • Naloxone
• Ibuprofen • Acetone
• Peroxide • Methanol
• Sodium hydroxide • Hydrochloric Acid
• Latex gloves (replaced with Nitrile) • Aloes
• Nitrile Gloves (replaced with Neoprene) • Diethyl-4-methyl-Bromobenzene
• Diethyl-4-methyl-phenyl-Malononitrile
What … does it look like?

You could see one or all of these signs

• Redness
• Scaling / flaking
• Blistering
• Weeping
• Swelling
• Cracking
• Crusting
What … does it feel like?

• Someone who has dermatitis may

experience symptoms of itching and pain.

• The signs and symptoms of this condition

can be so bad that the sufferer is unable
to carry on at work.

• Case studies involving people those with

experience are available on the Health and
Safety Executive website – see the links page in
your pack.
Any questions so far?
What … legislation applies?

• Health and Safety at Work etc Act 1974 (HSWA);

• The Management of Health and Safety at Work

Regulations 1999 (MHSW);

• The Control of Substances Hazardous to Health

Regulations 2002 (as amended) (COSHH) ; and

• The Reporting of Injuries, Diseases and

Dangerous Occurrences Regulations 1995.
What … does the mean for me?

• Keep your workplace safe and without risks to

health;

• draw up a health and safety policy statement if

there are five or more employees;

• ensure articles and hazardous substances are

moved, stored and used safely;

• provide adequate welfare facilities;

• give employees the information, instruction,
training and supervision necessary for
maintaining health and safety;

• appoint a competent person(s) to assist with

health and safety responsibilities and consult
employees or their safety representative/s about
this appointment;

• prevent or adequately control exposure to

hazardous substances that may cause damage
to the health of employees and others affected
by the undertaking;
• provide free any protective clothing or
equipment, where risks are not adequately
controlled by other means;

• ensure that appropriate safety signs are provided

and maintained; and,

• report certain injuries, diseases and dangerous

occurrences to the appropriate health and safety
enforcing authority.
What … in particular?

• assess the risks to employees’ health and safety.

If there are five or more employees, record the
significant findings of the assessment;

• identify measures for controlling the risks;

• make arrangements for putting those measures

into effect; and

• ensure those measures continue to work and are

correctly used.
What … about my employees?

• Take reasonable care for their own health and safety and
that of others who may be affected by what they do or do
not do;

• co-operate with their employer on health and safety;

• correctly use work items provided by their employer,

including personal protective equipment;

• use all safe systems of work in accordance with training or

instructions;

• To not interfere with or misuse anything provided for their

health, safety or welfare.
Any questions so far?
What … leading indicators can I use?
examples

• Have we identified potential sources of exposure?

• Have we eliminated or controlled the potential

exposure?

• Have we assessed the risks and reduced levels to

ALARP?

• Is Local Exhaust Ventilation plant being

thoroughly examined and maintained?
What … lagging indicators can I use?
examples

• Is dust building up in areas?

• Is there a change in attendance for particular

areas or individuals?

• Are related incidents or concerns being

reported?

• Are claims being submitted against the

company?
What … is the hierarchy of control?

• Regulation 7 of COSHH states that an

employer’s overriding duty is to prevent
employees being exposed to substances
hazardous to health.

• Where this is not reasonably practical,

employers must achieve adequate control of
exposure. To achieve adequate control the
hierarchy listed in Schedule 2A of COSHH must
be applied.
• Most work situations will require several levels of
the hierarchy to be used to adequately control the
risks associated with skin exposure.

– Design and use appropriate work processes, systems

and engineering controls and use suitable work
equipment and materials.

– Control the exposure of the substance at source (eg

enclosures, adequate exhaust ventilation systems and
appropriate organisational measures).

– Where adequate control cannot be achieved by other

means, provide adequate protective equipment (such as
suitable chemical protective gloves).
Any questions so far?
What … is health surveillance?

• Health surveillance is for the protection of individuals, to

identify as early as possible any indications of disease or
adverse changes related to exposure, so that steps can be
taken to treat their condition and to advise them about the
future.

• It may also provide early warning of lapses in control and

indicate the need for a reassessment of the risk.

• Predictive tests are never likely to be totally reliable, and

because certain known toxic agents still need to be used,
dermatological health surveillance must NEVER be
regarded as reducing the need for control of exposure and
effective decontamination after exposure.
When … is it required?

Health surveillance is required when:

• an employee is exposed to a hazardous agent;

and

• the agent is known to be associated with an

identifiable disease or an adverse effect; and

• there is a reasonable likelihood that the disease

or the adverse effect may occur under the
particular conditions of the work; and
• a valid technique is available that is safe to use
in the workplace and is capable of detecting the
early signs of the disease or the adverse effect
caused by a hazardous agent; and

• the technique used is unlikely to place

employees at an increased risk or to cause
unacceptable harm to the employees; and

• it is likely to benefit the employee.

When … is it appropriate and how?

• Substances known to cause severe dermatitis

Skin inspection (SI) by a responsible person

• Substances known to cause skin sensitisation

SI. In some cases, medical surveillance (MS)

• Substances known to cause de-pigmentation

SI.
• Substances known to cause oil acne
SI

• Substance which may cause skin cancer

MS

• Substances that can be taken up via skin

Biological monitoring and biological effect
monitoring
• Manufacture, production, reclamation,
storage, discharge, transport, use or
polymerisation of vinyl chloride monomer.
MS
Thank you for listening

Any questions?