Contact dermatitis, which is a type of eczema that is triggered by contact with a particular substance, can develop on any area of the body (although this article focuses specifically on the hands). This can be an irritant, such as a substance that directly damages the skin, or an allergen, such as a substance that causes the immune system to respond in a way that affects the skin, according to NHS England (www.is.gd/bunefe).
The former can be caused by a range of substances, from water, soaps, detergents, solvents and oils, to acids and alkalis, cement, powders, dust and soil. “You may be more at risk of irritant contact dermatitis if you work with irritants as part of your job, or if your job involves a lot of wet work,” it explains. “If you develop the condition because of a substance you work with, it may [also] be referred to as occupational irritant dermatitis.”
Chemical, agricultural and construction workers, metal and electronics workers, and machine operators are just a few examples of occupations that may be affected. And it can be a very unpleasant experience for the affected person. Symptoms can range from redness, weeping, cracking and swelling, to scaling and flaking and blistering, while the skin can become itchy and painful.
“Where skin contact with substances that are corrosive, irritant, harmful, sensitising or toxic is not prevented, employees are at risk,” warns Dr Karen McDonnell, occupational safety and health policy adviser at the Royal Society for the Prevention of Accidents (RoSPA). “These risks can arise as a result of direct contact with the causal agent [and] it is important to remember that not all common hazards to your skin come with a hazard warning label.”
APC APPROACH
Contact dermatitis usually improves or clears up completely if the substance causing the problem is identified and avoided. It is recommended that anyone showing symptoms see their GP, who should be able to diagnose the problem from the appearance of the skin, prescribe a treatment or perform further tests. Over-the-counter remedies may also be available from a pharmacy.
However, in reality, safe systems of work should already be in place to prevent irritant contact dermatitis from occurring. McDonnell says: “Dermatitis can be prevented through undertaking a risk assessment of the work and putting some simple control measures in place that prevent exposure. As employers, you have this duty of care, and as employees, [you should] take five to follow the safe system and look after your skin.”
The most effective and reliable way to prevent skin problems in the workplace is to implement processes to avoid contact with harmful substances, according to the Health and Safety Executive (HSE). The APC approach is one suggested method (www.is.gd/anekos):
● Avoid direct contact between unprotected hands and substances, products and wet work where this is sensible and practical. For example, get rid of the substance/product/wet work altogether or introduce controls (such as tools or equipment) to keep a safe working distance between skin and substances/products/wet work.
● Protect the skin (as avoiding contact will not always be possible). For example, use suitable pre-work creams or mild skin cleaning creams; moisturise; wash and dry hands properly; or use suitable personal protective equipment, such as gloves.
● Check hands regularly for the first signs of itchy, dry or red skin. Regular skin checks will help spot the early signs of dermatitis or other skin problems caused by skin exposure.
NHS England offers similar advice, including cleaning the skin if it encounters an irritant, using gloves to protect hands, and applying emollients (creams, ointments, lotions or gels for protecting, moisturising, and lubricating the skin) frequently.
CHOOSING PPE
While gloves are recommended when contact with substances is unavoidable, the HSE says that this subject can be ‘complex’. It, therefore, advises that employers consider five factors when selecting PPE gloves (www.is.gd/usihaz):
● Identify the substances handled – gloves differ in design, material and thickness, and no glove material will protect against all substances
● Identify all other hazards – for example, is there a risk of abrasion, cuts, puncture or high temperature?
● Consider the type and duration of contact – what duration period will gloves be worn for and will contact be from splashes or total immersion?
● Consider the user (size and comfort) – gloves should fit the wearer. It can help to use sizing charts
● Consider the task – gloves should not hamper the task. Those selected should, however, meet any standards required for the task.
As already established, irritant contact dermatitis can be brought on by a range of substances. Khurram Akhtar, director of sales and product at PPE maker and supplier Supertouch, says that hand protection, therefore, “plays a key part” in mitigating the development of dermatitis among workers in the engineering sector.
“Material safety datasheets may refer to the need for protective gloves but ensuring that the right glove is specified is critical,” Akhtar adds. “For example, occupations that expose workers to oil-based products, such as lubricants and fuel, will require a nitrile-based barrier, with full hand coating to provide the most protection. In the past, full-dip nitrile gloves have been cumbersome and uncomfortable to wear, restricting dexterity to the point where operators may remove their hand protection altogether in order to complete their task.”
Akhtar continues: “Frequent contact with liquids, such as industrial parts and process cleaning applications, as well as maintenance and repair work, can also put operators at risk of developing dermatitis. Again, for applications where sustained contact with liquids is unavoidable, it is crucial that the correct PPE is specified. All too often, water-repellent gloves are provided to employees, without consideration of the wider impact on operational efficiency.”
PPE GLOVE EXAMPLES
The PPE market is flooded with gloves for industrial work and operator protection, with new designs being added regularly. Hand protection products maker Taste International launched its Aquila glove brand in 2012, for example, and in January 2020, launched the Aquila LX300 latex glove. The LX300 is said to give high grip while also being waterproof and keeping hands dry, warm and safe. It also includes a fully-dipped 30cm long cuff and claims to be suited to handling wet, slippery items, such as those found in the outdoors materials handling or building construction sectors, highways work and the agricultural industry.
Supertouch also offers glove products for a range of different applications. One example is its Pawa PG202 dual layer nitrile coated gloves (pictured) that are aimed at sectors including construction, general maintenance, automotive and rail and refuse collection. The primary layer is said to provide an effective barrier in oily environments, while the second layer offers grip.
Akhtar concludes: “Ultimately, the onus is on employers to ensure that operators are protected from conditions such as dermatitis. In instances where frequent contact with water is unavoidable, the most effective solution is to equip employees with PPE that is specifically suited to that application and will enable them to carry out work unimpeded.”