A female employee working in a school kitchen had developed signs of dermatitis. Both hands were affected and there were patches of broken and weeping skin. She could not continue to work and was forced to take sick leave.
It was considered that the dermatitis may have been caused by her daily routine involving food preparation, cooking, washing dishes and wiping down surfaces. Due to food hygiene requirements, she regularly washed her hands.
The problem appeared to have arisen even though they had the following control measures in place:
The employer investigated what else could be done to prevent the dermatitis. The investigation focused on finding out:
The initial investigation was carried out with the help of a ‘skin care questionnaire’ but unfortunately they were still unable to identify the cause of the dermatitis. As an initial precautionary measure she was supplied with an alternative pair of nitrile reusable gloves but this did not lead to improvements.
At this stage expert advice from the occupational health service was sought resulting in patch testing for potential causative agents.
Patch tests confirmed that the employee had sensitivity to plant materials, in particular to lettuce. It was also felt that the washing up detergent could have played a part in the sensitisation of her hands as it emerged that she did not always wear gloves when wiping surfaces down using a cloth.
On her return to work the following procedures were put in place:
This case demonstrates the importance of the combination of early identification, careful management of skin care, adequate control measures for reducing expenditure on medical referral costs and sickness absence. There was also a commitment on the employee's part, to work with the employer to protect her health and income.
Hampshire County Council Catering Services have kindly allowed HSE to publicise this case study.