BRINGING A CONTACT DERMATITIS CLAIM

What is Contact Dermatitis? Contact dermatitis is one of the most widespread causes of ill health at work and when chronic, can make work impossible. In the UK, 0.65 million days are lost per year for men as a result of it, and 0.2 million for women. It accounts for 30 per cent of all work related health problems. It is a condition of the skin which can be caused by exposure to certain substances at work. It can be caused by the skin being exposed to an irritant (i.e. irritant contact dermatitis) or to an allergen (i.e. allergic contact dermatitis). Irritant contact dermatitis is the most prevalent form with allergic contact dermatitis affecting only a small minority.

Irritant contact dermatitis is caused by substances such as acids, alkalis, soaps, detergents, and solvents, that physically damage the skin or its protective oils and result in an outbreak or eruption of the skin which leaves the skin inflamed. Initial signs include redness, itching, scaling and blistering. As the condition progresses, the skin can crack and bleed and the dermatitis can spread further all over the body. Normally, the skin settles down once the sufferer ceases to work with the substance causing the problem.

Allergic contact dermatitis is caused by exposure to a substance to which a person has become hypersensitive or allergic. It develops in stages. The allergenic action of a substance depends on its ability to destroy the protective action of the skin so that the allergen can penetrate. Once the skin is penetrated, sensitisation begins. The process can last from 4 days to 3 weeks with no sign of skin damage at this stage. To cause sensitisation the allergenic substance combines with the skin proteins and is carried around the whole body by white blood cells called lymphocytes, which form part of the body's immune system. The immune system has a 'memory', enabling it to recognise and neutralise substances more than once. When a sensitised worker is re-exposed to the substance, the lymphocytes recognise the allergen and react with it, releasing tissue damaging chemicals called lymphokynes. This is when symptoms appear. If there is no further contact with the allergen, sensitivity may gradually decline. Common allergens include nickel or other metals, medications, latex, rubber, cosmetics, fragrances, and perfumes.

Employers Obligations

Under the Management of Health and Safety at Work Regulations 1999 (MHSW) and Control of Substances Hazardous to Health Regulations 2002 (COSHH), employers have a legal duty to assess the risks which could cause dermatitis and hence to prevent employees coming into contact with substances which can cause dermatitis. Under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR), diagnosed cases of occupational dermatitis must be reported to the Health and Safety Executive.

To prevent contact dermatitis, employers should:-

• Assess all hazardous substances under COSHH using both manufacturers safety data sheets and information on the specific workplace

• Stop using substances concerned, by either substituting a less hazardous substance, or redesigning the job to eliminate chemicals altogether

• If the substance cannot be substituted, redesign the process to prevent hazardous exposures, for example by enclosing the system

• Provide adequate welfare facilities (washing and drying close to work area) and ensure aggressive cleaning materials are not themselves a factor

• Carry out health surveillance, via occupational health nurses or doctors or competent personnel

• Provide adequate information, instruction, training and supervision to employees

• Ensure substances requiring dilution are handled correctly and diluted before being distributed

• Store and label substances correctly with the appropriate hazards warning and instructions on neutralising

• Barrier creams and personal protective equipment, such as gloves, aprons, face shields and overalls, are a last resort. If used, the employer should provide and maintain them and they must be suitable for both the job and the workers. Many substances can penetrate ordinary creams and rubber gloves, which can then hold the substance against the skin.

Occupations at Risk

Occupations which can cause or aggravate contact dermatitis include:-

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