Dermatitis and other skin conditions

Dermatitis is a skin disease sometimes called eczema. Inflammation of the skin is the most common sign. It can cause itching, cracking, blistering and ulceration, and make the skin red, sore, flaky and scaly. In the worst cases, occupational dermatitis can lead to severe health problems.

There are two main kinds of dermatitis:

• irritant contact dermatitis, caused by substances that physically damage the skin such as wet work, dyes, and shampoos; and

• allergic contact dermatitis, caused when the body’s immune system becomes “sensitised” to a particular substance, like the latex in some rubber gloves.

Sensitisation can happen suddenly even when a worker has been exposed to a substance for years. A worker who has been sensitised will have an allergic reaction to even tiny amounts of the substance, and may also become allergic to related substances.

The most commonly reported agents causing dermatitis include:

• rubber chemicals and materials, such as rubber gloves;

• wet work; and

• shampoos, soaps and cleaners.

Dermatitis can develop immediately or over a period of weeks or months, depending mainly on the agent and its strength. Occupational dermatitis is one of the most widespread causes of ill-health at work, with around 40,000 new cases each year, according to the HSE.

Some sectors present a particular risk, including hairdressing, catering, cleaning, printing, health services, chemicals, engineering and construction.

Public services union UNISON advises workers to take simple precautions:

• avoid direct contact with cleaning products, for example by using a dishwasher rather than washing up;

• protect the skin, for example by wearing suitable gloves (remembering that latex can itself cause occupational dermatitis and allergy); and

• check hands regularly for early signs, such as itchy, dry or red skin.

The employer’s duty to protect workers from the risk of dermatitis is based on the Control of Substances Hazardous to Health Regulations (COSHH). The employer must:

• conduct a risk assessment;

• follow a hierarchy of control measures to respond to the risk:

• eliminate the chemical altogether, for example by changing the work process, and only if this is not possible;

• substitute the chemical for a safer one, and only if this is not possible;

• enclose the process;

• provide adequate ventilation;

• only when having already worked through all the alternatives for eliminating or reducing the risk, can the employer as a last resort rely on PPE (such as gloves and face masks), which the employer must ensure fit properly and are being used correctly.

Where necessary, the employer must introduce a system of health surveillance.

The employer must provide information and training to all staff about the risks of dermatitis and how to prevent it.

Occupational dermatitis should be reported under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) (see Chapter 10: Reporting).

Latex allergy

There are many cases of workers suffering an allergic reaction to latex-lined gloves. Employers must ensure their workers are protected from exposure to harmful substances like latex. See, for example, the groundbreaking case of UNISON member Alison Dugmore (page 93).