Ill health from metalworking and water-mix wash fluids and what to do about it

Advice to employees:

Fluids can get onto the skin by direct contact or into the body by breathing them in as mist.

They can cause irritation of the skin or dermatitis as well as breathing difficulties including occupational asthma, bronchitis, irritation of the upper respiratory tract, or extrinsic allergic alveolitis.

What should you look out for?

Skin:

• redness or swelling of the fingers
• cracking or blistering of the skin on fingers or hands
• flaking, scaling or irritation of the skin on fingers or hands

Lungs:

• wheeziness or chest tightness
• improving away from work
• night cough or chest tightness
• development of chest tightness or breathlessness after exercise
• irritation of the eyes
• stuffy nose
• unexplained weight loss
• cough with sputum
• flu-like illness developing recurrently during the working week

What should you do if you have health problems?

If you think you have health problems related to fluids then consult the works’ doctor or nurse. If your company does not have them, tell a responsible person such as the safety officer or your line manager and consult your GP. You may need to be referred to a specialist in work - related skin or chest problems.

Advice to occupational health professionals

As an occupational health professional (OHP) you should be aware of the potential for:

• skin problems where there is repeated or prolonged skin contact with fluids; and
• respiratory problems where there is exposure to mist.
  

Health surveillance

Where exposure to fluids or mist cannot be prevented a programme of health surveillance should be in place.

Skin:

A responsible person or OHP should carry out regular checks of the skin of the hand and forearm.

Positive responses identified should lead to OHP involvement and:

• clinical examination;
• review of the workplace and working practices;
• discussions with local management concerning fluid management;
• consideration of removal of the affected individual from exposure temporarily or permanently; and
• specialist referral for further investigations e.g. patch testing.

Respiratory:

Regular administration of a short respiratory questionnaire is advisable either by a responsible person or OHP.

Positive responses identified should lead to OHP involvement and:

• administration of a detailed questionnaire, clinical examination and additional investigations, which may include peak flow recordings;
• a review of the workplace and working practices;
• discussions with local management concerning mist containment and management;
• consideration of removal of the affected individual from exposure temporarily or permanently; and
• specialist referral for further investigation e.g. detailed respiratory assessment.