HSE occupational dermatitis

1. Health and Safety
Executive
Occupational Dermatitis
What … ?
Graeme Waller
Regulatory Inspector (HID CI 1A)

2. CONTENT
• What …
• What …
• What …
• What …
is dermatitis?
causes dermatitis?
are the common causes?
has HSE investigated?

3. CONTENT … continued
• What …
• What …
• What …
• What …
does it look like?
does it feel like?
legislation applies?
does this mean for me?

4. CONTENT … continued
• What …
• What …
• What …
• What …
in particular?
about my employees?
leading indicators can I use?
lagging indicators can I use?

5. CONTENT … continued
• What …
• What ..
• When …
• When …
is the hierarchy of control?
is health surveillance?
is it required?
is it appropriate and how?

6. Any questions before we start?

7. 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.

8. 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.

9. 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.

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

11. What … has HSE investigated?
• Face
• Eyelids
• Neck
• Trunk
• Abdomen
• Forearms
• Hands
• Thighs
• Shins
• Legs
• Feet
• Back

12. • Morphine based
• Dichromates
• Codeine based
• Petroleum
• TheBaine
• Active Steroids
• Cleaning agents
• Butanol
• CET-3
• Hydrocarbons
• Hydromorphone
• Naltrexone
• Ibuprofen
• Peroxide
• Sodium hydroxide
• Latex gloves (replaced with Nitrile)
• Nitrile Gloves (replaced with Neoprene)
• Zidovudine
• Z-valacyclovir
• TMA
• Nabumetone
• Dicyclohexylcarbodimide (DCCI)
• Pholcodine
• Dihydro Codeine
• Morphine Sulphate
• Carprofen
• Dichloropyrimidine
• Potassium carbonate
• Naloxone
• Acetone
• Methanol
• Hydrochloric Acid
• Aloes
• Diethyl-4-methyl-Bromobenzene
• Diethyl-4-methyl-phenyl-Malononitrile

13. You could see one or all of these signs
• Redness
• Scaling / flaking
• Blistering
• Weeping
• Swelling
• Cracking
• Crusting
What … does it look like?

14. 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.

15. Any questions so far?

16. 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.

17. 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;

18. • 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;

19. • 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.

20. 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.

21. 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.

22. Any questions so far?

23. 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?

24. 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?

25. 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.

26. • 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).

27. Any questions so far?

28. 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.

29. 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

30. • 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.

31. 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.

32. • 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

33. • Manufacture, production, reclamation,
storage, discharge, transport, use or
polymerisation of vinyl chloride monomer.
MS

34. Thank you for listening
Any questions?