Work-related contact dermatitis in dentistry

Work-related contact dermatitis is the most common form of skin disease in the dental team.

Size of the problem?

Dental nurses, and to a lesser extent dentists, are at a greater risk of developing work-related contact dermatitis. Compared to the all-industry average, the incidence of work-related contact dermatitis is nearly ten times greater in dental nurses and seven times greater in dentists.

What is it?

Dermatitis is an inflammatory condition of the skin caused by outside agents which can result in irritation, redness, cracking and blistering.

Much less commonly seen skin problems, such as those due to contact urticaria, may be due to occupational exposure to natural latex rubber proteins in sensitised individuals. Use the “Latex” link to see more information about latex allergies.

Who is affected?

Work-related dermatitis can affect all members of the dental team who regularly wash their hands, are exposed to chemicals used in dental work and/or are exposed to rubber materials such as those in personal protective equipment.

Causes

The main causes of work-related contact dermatitis in these workers are rubber chemicals (eg carbamates, thirurams) which may be present in both natural rubber latex and synthetic rubber materials (eg nitrile), soaps/cleaners and ‘wet-work’ (eg having wet skin through frequent hand washing, surface cleaning). The skin of workers may also be exposed to other allergenic or irritating chemicals often used in dental practice (eg an X-ray developer).

Reduce the risks of work-related dermatitis

Advice for employees

• Where practicable, use machinery and tools provided rather than hands (eg equipment cleaning machines).
• During handwashing, thoroughly rinse off residual soap/hand cleanser.
• Ensure your hands are thoroughly dry before continuing work.
• Use emollient creams regularly, especially after finishing work. Ensure all parts of the hand are covered.
• Check your skin for early signs and report concerns to your ‘responsible person’. Early detection can help prevent more serious dermatitis from developing.

Advice for employers

To comply with the laws that apply, you need to carry out a risk assessment. Depending on the risks, put in place suitable measures to manage the risks or work-related contact dermatitis which may include:

• Consider using less hazardous alternative approaches such as automation (eg an equipment washing machine), use of tools or less hazardous products.
• Provide hand hygiene products (eg gentle soaps) that are both effective and minimise the risk of skin disease.
• Train employees in use of equipment and gloves, correct hand cleaning and skin care measures (eg regular use of moisturisers). Downloadable posters for information are available on this website.
• Provide good hand-drying facilities (eg good-quality, soft paper towels).
• Provide emollients in suitable dispensers to prevent cross-contamination.

Consider using a system of skin-checking to ensure preventative measures are working.

Useful links

• Dermatitis statistics
• Information for dental practice inspection - Dermatitis Inspection Topic Pack
  
• Latex allergies
• More health and safety issues in the Health and Social Services sector