Dermatitis in health and social care

Contact dermatitis is the most common form of work-related skin disease suffered by nurses and other health and social care professionals. Each year an estimated 1000 nurses develop work-related contact dermatitis.

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

HSE has a specific Skin at work website - providing information on how to prevent work-related skin diseases in your workplace – where you can get further help if you need it. The microsite contains guidance on dermatitis and specific guidance on reducing the risks of work-related dermatitis in healthcare and dentistry.

Inspection projects and programmes

Inspection project 2008/09: Prevention and management of work-related contact dermatitis in the NHS acute sector

Summary of project

In 2008/09, HSE specialist inspectors (occupational health) undertook a project to inspect acute NHS organisations' management arrangements for implementing the requirements of the Control of Substances Hazardous to Health Regulations 2002 (as amended) (COSHH).

The aim of the project was to gather both quantitative and qualitative data about the organisations' management and prevention of skin problems. 

The project, prompted by a series of anecdotal reports to HSE, indicated a rapid increase in the incidence of work-related contact dermatitis (WRCD) in some acute trusts in England.

Forty-four NHS organisations participated in the inspections, representing approximately one-third of acute trusts in England and Wales and boards in Scotland.

Summary of findings    

• 40 organisations (91%) were unable to identify actual (or approximate) incidence of dermatitis or skin problems
• 70% had an incomplete or flawed system, either for identifying cases of dermatitis or for reporting diagnosed cases under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR)
• 46% of healthcare staff questioned had problems with their skin. Symptoms ranged from dry skin to dermatitis
• 91% of organisations' risk assessments failed to differentiate between the generic risk situation, which could be assessed centrally, and those specific to job or location
• Various glove types, sterile and non-sterile, including latex, were in use. Latex glove use ranged from 3% to 95%. Twenty-two organisations had 'glove use' policies, although these policies failed to inform staff of activities where gloves were not required
• Only 10% of organisations had either considered the full impact on staff of hand-washing policies, including use of alcohols gels, or had management systems in place to assess, monitor or review the effects 
• 34% of organisations provided employees with information, instruction and training about hand washing and use of alcohol gels. However, instruction about the signs and symptoms, prevention and control of dermatitis was not generally included in this training, despite the significant level of risk

Further information on the findings of this inspection project can be found in the summary report or the full report.

Further information

This section provides useful links to guidance, research and information on the management of dermatitis in the health and social care sector.

• HSE skin at work publications webpage
• 'Healthy Workers Handbook' chapter on 'Hand care'
  Available from NHS Employers organisation