Work-related contact dermatitis in the health services

Size of the problem

Nurses are reported to have an incidence of diagnosable work-related contact dermatitis[60] which is 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[61] 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[62], 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[63] 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.
  • Use a system of skin-checking[64] or other appropriate health surveillance to ensure.

Links

Link URLs in this page

  1. Skin at workhttps://www.hse.gov.uk/skin/index.htm
  2. Overview - Employers, employees and traineeshttps://www.hse.gov.uk/skin/employ/index.htm
  3. Overview - What are work-related skin diseases?https://www.hse.gov.uk/skin/employ/whatare.htm
  4. Dermatitishttps://www.hse.gov.uk/skin/employ/dermatitis.htm
  5. Urticariahttps://www.hse.gov.uk/skin/employ/urticaria.htm
  6. Skin cancerhttps://www.hse.gov.uk/skin/employ/cancer.htm
  7. Sun exposurehttps://www.hse.gov.uk/skin/employ/sunprotect.htm
  8. Overview - Latex allergieshttps://www.hse.gov.uk/skin/employ/latex.htm
  9. Selecting latex gloveshttps://www.hse.gov.uk/skin/employ/latex-gloves.htm
  10. How does exposure happen?https://www.hse.gov.uk/skin/employ/exposure.htm
  11. Overview - How can they be prevented?https://www.hse.gov.uk/skin/employ/prevention.htm
  12. Gloveshttps://www.hse.gov.uk/skin/employ/gloves.htm
  13. High-risk jobshttps://www.hse.gov.uk/skin/employ/highrisk/index.htm
  14. What does the law say?https://www.hse.gov.uk/skin/employ/law.htm
  15. Overview - H&S and medical professionalshttps://www.hse.gov.uk/skin/professional/index.htm
  16. Overview - Causes of skin diseasehttps://www.hse.gov.uk/skin/professional/causes/index.htm
  17. Causes of Contact dermatitishttps://www.hse.gov.uk/skin/professional/causes/dermatitis.htm
  18. Causes of Contact urticariahttps://www.hse.gov.uk/skin/professional/causes/urticaria.htm
  19. Causes of Acneshttps://www.hse.gov.uk/skin/professional/causes/acnes.htm
  20. Causes of Cancershttps://www.hse.gov.uk/skin/professional/causes/cancers.htm
  21. Causes of Leucoderma (Vitiligo)https://www.hse.gov.uk/skin/professional/causes/leucoderma.htm
  22. Structure and functions of the skinhttps://www.hse.gov.uk/skin/professional/causes/structure.htm
  23. Skin infectionshttps://www.hse.gov.uk/skin/professional/causes/infections.htm
  24. Overview - Causative agentshttps://www.hse.gov.uk/skin/professional/causes/agents.htm
  25. Skin irritants and sensitisershttps://www.hse.gov.uk/skin/professional/causes/agentstable1.htm
  26. Causes of contact urticariahttps://www.hse.gov.uk/skin/professional/causes/agentstable2.htm
  27. Agents that cause skin cancerhttps://www.hse.gov.uk/skin/professional/causes/agentstable3.htm
  28. Managing exposure riskshttps://www.hse.gov.uk/skin/professional/managerisk.htm
  29. Legal requirementshttps://www.hse.gov.uk/skin/professional/legal.htm
  30. Information for inspectorshttps://www.hse.gov.uk/skin/professional/inspectors.htm
  31. Training resourceshttps://www.hse.gov.uk/skin/professional/trainingresources.htm
  32. Overview - Resourceshttps://www.hse.gov.uk/skin/information.htm
  33. Publicationshttps://www.hse.gov.uk/skin/professional/publications.htm
  34. Postershttps://www.hse.gov.uk/skin/professional/posters.htm
  35. Overview - Case studieshttps://www.hse.gov.uk/skin/casestudies/index.htm
  36. Photographic chemicalshttps://www.hse.gov.uk/skin/casestudies/photographic.htm
  37. Tiler: Ted's storyhttps://www.hse.gov.uk/skin/casestudies/tiler.htm
  38. Hairdressing: Maxine's storyhttps://www.hse.gov.uk/skin/casestudies/hairdressers.htm
  39. Hairdressing: Julie's storyhttps://www.hse.gov.uk/skin/casestudies/julie-hair.htm
  40. Hairdressing: Marie's storyhttps://www.hse.gov.uk/skin/casestudies/marie-hair.htm
  41. Latex allergies - Nursinghttps://www.hse.gov.uk/skin/casestudies/alison-nursing.htm
  42. Latex allergies - Radiographyhttps://www.hse.gov.uk/skin/casestudies/pip-radiographer.htm
  43. Latex allergies - Dental practicehttps://www.hse.gov.uk/skin/casestudies/julie-dental.htm
  44. Catering industryhttps://www.hse.gov.uk/skin/casestudies/catering.htm
  45. Meat processinghttps://www.hse.gov.uk/skin/casestudies/meatprocessing.htm
  46. Paint manufacturinghttps://www.hse.gov.uk/skin/casestudies/paint.htm
  47. Fabric coaterhttps://www.hse.gov.uk/skin/casestudies/fabric.htm
  48. Image galleryhttps://www.hse.gov.uk/skin/imagelibrary.htm
  49. Statisticshttps://www.hse.gov.uk/skin/statistics.htm
  50. Researchhttps://www.hse.gov.uk/skin/professional/research.htm
  51. Presentationshttps://www.hse.gov.uk/skin/professional/presentations.htm
  52. Videoshttps://www.hse.gov.uk/skin/professional/videos.htm
  53. Linkshttps://www.hse.gov.uk/skin/links.htm
  54. Overview - FAQshttps://www.hse.gov.uk/skin/faq/index.htm
  55. General questionshttps://www.hse.gov.uk/skin/faq/general.htm
  56. Hairdressing FAQhttps://www.hse.gov.uk/skin/faq/hairdressing.htm
  57. Catering FAQhttps://www.hse.gov.uk/skin/faq/catering.htm
  58. Cleaning FAQhttps://www.hse.gov.uk/skin/faq/cleaning.htm
  59. Dental practice FAQhttps://www.hse.gov.uk/skin/faq/dental.htm
  60. work-related contact dermatitishttps://www.hse.gov.uk/skin/employ/dermatitis.htm
  61. contact urticariahttps://www.hse.gov.uk/skin/employ/urticaria.htm
  62. laws that applyhttps://www.hse.gov.uk/skin/employ/law.htm
  63. postershttps://www.hse.gov.uk/skin/professional/posters.htm
  64. skin-checkinghttps://www.hse.gov.uk/healthservices/faqs.htm
  65. Industry statisticshttp://www.onr.org.uk/llc/index.htm
  66. Dermatitis statistics https://www.hse.gov.uk/statistics/tables/index.htm#thor
  67. Latex allergieshttps://www.hse.gov.uk/skin/employ/latex.htm
  68. More on health and safety issues in the health and social services sectorhttps://www.hse.gov.uk/healthservices/index.htm
  69. Skin checks for dermatitis (Free poster)https://www.hse.gov.uk/skin/assets/docs/skindermatitis.pdf
  70. Keep your top on: INDG 147https://www.hse.gov.uk/pubns/indg147.pdf
  71. COSHH Essentialshttps://www.hse.gov.uk/coshh/index.htm
  72. HSE Bookshttps://books.hse.gov.uk/
  73. The National Eczema Societyhttp://www.eczema.org/
  74. Cateringhttps://www.hse.gov.uk/catering/index.htm
  75. Constructionhttps://www.hse.gov.uk/construction/index.htm
  76. COSHHhttps://www.hse.gov.uk/coshh/index.htm
  77. Health serviceshttps://www.hse.gov.uk/healthservices/index.htm
  78. Printinghttps://www.hse.gov.uk/printing/index.htm

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Updated 2021-05-04