Work-related contact dermatitis in the health services

Size of the problem

It is estimated that each year, 1000 nurses develop work-related contact dermatitis. Nurses are reported to have an incidence of diagnosable work-related contact dermatitis which is nearly seven times higher than the average for all professions.

What is it?

Contact dermatitis is the most common form of work-related skin disease in nurses and other healthcare professionals.

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

Much less commonly reported skin problems such as contact urticaria may be seen in individuals who have latex allergies and are sensitive to natural latex rubber proteins. .

Who is affected?

Those who are most affected are nurses, midwives, medical radiographers, nursing auxiliaries and assistants, medical practitioners (doctors, SHOs etc) and physiotherapists.

Other professionals in this sector that can suffer from work-related contact dermatitis are those who need to wash their hands regularly or those whose skin is frequently exposed to chemicals or rubber materials used in personal protective equipment.

Causes

Frequent exposure to soaps and cleaners, and ‘wet work’ (work involving wet hands or hand washing) account for over a quarter of all cases of work-related contact dermatitis. Other hazardous agents include rubber chemicals (eg carbamates, thirurams) which may be present in both natural rubber latex and synthetic rubber materials), bleach and sterilisers, preservatives, fragrances and aldehydes.

Reducing the risks of work-related dermatitis

Advice for employees

• Where practicable, use machinery and tools provided rather than hands (eg equipment cleaning machines).
• During hand washing, 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.

Links

• Industry statistics
• Dermatitis statistics
• Latex allergies
• More on health and safety issues in the health and social services sector