Health and Safety
Executive / Commission
Statistics
Causative agents recorded by the physicians reporting to EPIDERM or OPRA during 2004-06 are shown in Table THORS06, and those agents accounting for more than 5% of diagnoses during that period are shown in Figure 2. The most common agents were "soaps and cleaners", "rubber chemicals and materials", "wet work", and "personal protective equipment (PPE)". There may be some degree of overlap between agent categories with some diagnoses being assigned more than one agent code. For example, some cases caused by the use of latex gloves may appear in both the "rubber chemicals and materials" and "personal protective equipment" categories.
A recent analysis of THOR data for 2002-2005 found that 43% of cases of contact dermatitis reported to EPIDERM were allergic in nature, 40% were irritant and the remainder mixed or unspecified. Of contact dermatitis reports to OPRA over the same period there were nearly three times as many irritant cases as allergic cases – though about half of all cases were unspecified2.
Industrial and occupational analyses of EPIDERM/OPRA cases can give some insight into the types of workplaces and activities that are currently causing occupational dermatitis in the British workforce. Table THORS04 and Table THORS05 show the average number of EPIDERM and OPRA cases reported per year during the period 2004-2006, by occupation and industry respectively, together with estimated rates per 100 000 workers. These latter rates are calculated by using a denominator based on the number of workers identified in the Labour Force Survey in the relevant occupational or industrial sector. Thus the denominator is representative of the whole sector whereas the number of cases reported is limited by underreporting (see above). As a consequence the rates identified should be seen as minimal estimates.
EPIDERM data in Table THORS04 shows that the occupations with the highest estimated rates of contact dermatitis reported to dermatologists (EPIDERM) were: "floral arrangers and florists" (121 per 100 000 workers per year), "hairdressers and barbers" (116 per 100 000); "rubber process operatives" (103 per 100 000); "glass and ceramics process operatives" (85 per 100 000) and "beauticians and related occupations" (75 per 100 000). Using information from both schemes, however, would give somewhat higher estimates for some occupations, for example 177 per 100 000 for "glass and ceramics process operatives", compared with the figure of 85 per 100 000 based on EPIDERM alone. However, this rate - which should not be used as a means of comparing with other occupations* - is still an underestimate of the true rate of new cases of work related dermatitis for this occupation.
EPIDERM data in Table THORS05 shows that the industrial sector with the highest estimated rates of contact dermatitis reported to dermatologists (EPIDERM) was the "other service activities" sector in the "Other Community, Social and Personal Service Activities" industrial grouping (60 per 100 000 workers per year).
The 2001/02 Self-reported Work-related Illness (SWI)3 survey is the most recent for which there were sufficient numbers of sample cases to estimate the number of working days lost due to occupational skin disease. Between an estimated 96,000 and 367,000 full time equivalent working days were lost due to skin disease in 2001/02 (Table TYPESEX3). This compares with 31.8 million days lost due to all self-reported work-related illness in the same year (95% CI: 29.1-34.4 million). The average number of days lost per case was between 3.9 and 12.5 days for skin disease compared with 22.8 days for all self-reported work-related illness (95% CI: 21.1-24.5 days).
Based on reports made during the first year of the THOR GP scheme, skin diseases accounted for 1% of working days lost due to all occupational illnesses. For skin diseases, a sickness certificate was issued in 14% of cases and the average length of sickness absence was 17 days per case (Table THORGP01).
* & † Because the coverage of British industry by occupational physicians varies by type of industry and occupation the dermatologist (EPIDERM) data alone should be used for making comparative statements between different agents, industries and occupations. Given that there is not thought to be a great deal of overlap in cases reported in the two schemes, data from both chest physicians (EPIDERM) and occupational physicians (OPRA) can be combined to give the most complete available estimate for any particular subgroup.