Occupational dermatitis

In partnership with Occupational Safety and Health Council of Ontario (OSHCO)
Occupational Dermatitis

Dermatitis in the Workplace – What You Should Know

Occupational dermatitis is a non-infectious inflammatory skin condition resulting from direct skin
contact skin with chemicals or other substances used in the workplace. Occupational dermatitis may
take two forms: a) allergic contact dermatitis, or b) irritant contact dermatitis.
Allergic contact dermatitis occurs when a person becomes sensitized to a particular substance or
chemical (allergen). Following the initial allergic response the person will continue to react to the
allergen upon coming in contact with it, no matter how minute the exposure. Sensitization may occur
within days of the exposure, but typically follows months or years of repeated exposure.
Irritant contact dermatitis occurs when the skin is exposed to a mild irritant (such as detergent or
solvents) repeatedly over a long period of time, or to a strong irritant (such as acids, alkalis, solvents,
strong soaps, or cleansing compounds) that can cause immediate skin damage. Only the part of skin
that comes in direct contact with the substance will be affected.
Dermatitis is a common and potentially serious skin condition that can be prevented.
Legal Responsibilities

Under the Workplace Hazardous Materials Information System (WHMIS) Regulation, R.R.O.1990,
Reg. 860, employers are required to ensure supplier labels and material safety data sheets (MSDSs) are
available for controlled products and workers are educated and trained in their use.
The Occupational Health and Safety Act, section 25(2) (h), states that an employer must “take every
precaution reasonable in the circumstances for the protection of a worker”. These precautions include
providing workers with education and hazard awareness training, safe handling procedures, and
personal protective equipment. Additionally, section 3 of the Control of Exposure to Biological or
Chemical Agents, Regulation 833/90 requires the employer to take all reasonable measures to protect
workers from exposure (including skin absorption) to a chemical or biological substance. Workplace
exposures can occur during the storage, handling, processing, dispensing or clean-up of these
substances in the workplace. Furthermore, in Regulation 833/90, substances capable of being absorbed
through the skin have been assigned with a "skin" notation. This means if the substance is absorbed
through the skin, it may result in significant systemic toxicity.
Employers are required to assess dermatitis hazards in the workplace and develop policies and
programs for preventing occupational dermatitis in the workplace. Supervisors must provide written
instructions for the safe handling and use of hazardous agents and ensure workers follow instructions,
work safely and use personal protective equipment where required.
The Health Care and Residential Facilities Regulation made under the Ontario Occupational Health
and Safety Act requires that workers be appropriately protected when they are at risk injury from
exposure of the skin to an irritant or allergen. Appropriate protection may involve specific protective
equipment, hygiene practices, and readily available and accessible emergency eyewash fountains and
shower equipment.
Table 1: Occupations at Risk and Irritants Involved Irritant
Source
Occupations
Dietary, housekeeping and laundry workers term and community care settings Dentists, dental assistants and dental hygienists Day care workers Cleaning and disinfecting toolsLaboratory technologists and equipment Medical/dental clinics X-ray technicians Table 1 indicates a number of skin irritants and sensitizers, their sources, and the health care workers who may
be affected. Other irritants from the same or different sources may cause dermatitis among health care workers.
(Source: European Agency for Safety and Health at Work http://agency.osha.eu.int)

Symptoms
Employees will differ in their reactions to exposure. Some people may react severely to a substance,
while others may not react at all.
Both types of dermatitis most often affect the hands. The face is also a common site for dermatitis
through exposure to airborne allergens such as volatile chemicals, sprays, aerosols, and dusts.

Table 2: Symptoms of Allergic Contact Dermatitis and Irritant Contact Dermatitis
Allergic Contact Dermatitis
Irritant Contact Dermatitis
Localized reactions (area where contact with skin occurred) Reactions can spread beyond the area where contact with skin occurred Table 2 - The main differences between irritant and allergic contact dermatitis. (Source: Cleveland Health Clinic Information Centre) Skin Defenses

Our skin is made of multiple layers that act as a protective barrier. Some substances change or remove
skin oils, cause the skin to become more vulnerable, and allow chemicals to penetrate into the deeper
layers. Once this damage has occurred, the substance or chemicals can interact with body cells and
tissues. At this point, the skin may show visible signs of chapping, scaling, and blistering. These
reactions can take place within a few hours of exposure or up to 24 hours after exposure.
Risk Factors
Various risk factors may facilitate the onset of dermatitis. The three main factors are:
Properties of Substance

Solubility - the more soluble the substance, the more likely it is to penetrate the skin.
Form: gas, liquid, solid - agents that affect the skin can come in all forms; however, liquids are the
most common skin irritants and sensitizers.
Concentration - generally, the higher the concentration, the greater the skin hazard.
Duration of exposure - the greater the exposure duration, the greater the skin hazard.
Properties of the substance - Acids and alkalis are more likely to cause skin irritation than neutral
products such as those containing water.
Environmental Conditions

Temperature, humidity, moisture - hot, humid workplaces can cause sweating. Sweat can dissolve
certain types of chemicals, making them more toxic or irritating.
Contamination in the air - as the concentration of the chemical in the air increases, so does the potential
for dermatitis.
Health of Employee

Skin region (hands, arms, face) - certain chemicals penetrate the face and back quicker than the arms.
Skin condition (cuts, rashes, abrasions) - cuts and skin abrasion permit irritants or sensitizers to
penetrate the skin more easily.
Dry skin - dry skin can become cracked and allow irritants or sensitizers to penetrate the skin more
easily.
Sweating - sweat can dissolve certain types of chemicals, making them more toxic or irritating.
Alternatively, sweating may protect the skin by washing away or diluting substances
Age and genetic background - People may react differently when exposed to the same substance.
Prevention
Workers should:

• Read and understand the information contained in Material Safety Data Sheets (MSDS). They provide information on health hazards associated with the material and precautions to take. Phrases such as “may cause skin sensitization” or “skin irritant” indicates the substance can cause dermatitis. • If using a chemical that can cause dermatitis, check whether there is a safer alternative. • Remove any contaminated clothing quickly. Immediately wash skin that has been in contact with skin irritants or sensitizers with large amounts of warm clean water and a mild moisturizing soap. • Never wash hands with solvents such as Varsol or gasoline. • If any changes in the skin are noticed while at work or after using substances, seek medical attention as soon as possible. Early diagnosis and treatment is essential in preventing occupational dermatitis. • Report occupationally acquired dermatitis to your supervisor and occupational health nurse (if • Dry your hands completely after washing them and apply hand lotion frequently • Use non-latex gloves, unless contraindicated. When latex gloves are required, use low protein, Employers should:

• Ensure the workplace is in compliance with all WHMIS legislation. MSDSs must be readily
available for all controlled products being used. • If possible, change the way processes are done to effectively reduce skin contact with dermatitic agents. For example, automated mixing instead of hand mixing substantially reduces the risk of skin contact. • In the case of an emergency, have approved emergency eyewash and shower equipment for flushing the eyes, face and skin after contact with skin irritants or sensitizers. • Provide adequate on-site hygiene facilities for workers to wash their hands and face at the end of the job, before eating, drinking or smoking and after using the toilet. • Develop, implement and monitor safe work practices. • Provide training and education on safe work practices to new staff at orientation and to all • Ensure personal protective equipment or clothing is made of a material appropriate for the chemical(s) being handled. Provide non-latex gloves. For procedures requiring the use of latex gloves, provide low protein, no powder gloves. Joint Health and Safety Committee should:

• Review the WHMIS program annually;
• Review incident and accident statistics; • Make recommendations to the employer for the improvement of the health and safety of

Source: http://osach.ca/products/resrcdoc/bskne350.pdf