Contact dermatitis is an inflammation of the skin resulting from a worker coming into contact with a substance. There are two forms of contact dermatitis:
- Irritant contact dermatitis arises from contact with chemical, physical or biological agents that damage the skin by direct action in the area of contact
- Allergic contact dermatitis occurs when a person becomes allergic, or ‘sensitised’, to small amounts of a substance, where the reaction is delayed hours to a day or so after contact
- Contact urticaria falls under allergic contact dermatitis, but the allergic reaction happens soon (minutes) after contact
Irritant dermatitis can lead to the development of allergic dermatitis as the continual damage to the skin barrier can allow increased penetration of substances through the skin.
Many chemicals used in industry can cause a sudden and very strong reaction when they come into contact with bare skin and may even be absorbed and cause disease in other areas of the body. Examples include:
| Contaminant | Area affected |
|---|---|
Aromatic amines | Bladder (cancer) |
Mineral oils | Scrotum (cancer) |
Benzene | Blood (leukaemia) |
Organophosphates | Nervous system (muscle weakness) |
Common industries with a high risk of skin exposure include :
- Food services
- Construction
- Cleaning and maintenance
- Hairdressing and beauty therapy
- Health and community care
- Metal working
- Motor vehicle repair
- Printing
Common examples of work-related skin diseases
| Irritant contact dermatitis from excess washingIrritant contact dermatitis can occur quickly from exposure to a strong irritant or develop more slowly after repeated exposure to a mild irritant. It can also be caused by wet work. Irritant contact dermatitis happens at the area of skin where contact occurred. Examples of contaminants that cause this skin condition are solvents, oils, acids and detergents. |
| Allergic contact dermatitis from garlicAllergic contact dermatitis occurs when the body becomes sensitive to a contaminant over time. This can happen over weeks, months or years of exposure. After sensitisation has occurred even very small exposures can cause allergic skin reactions within 24 hours. This allergy will stay with the affected person for the rest of their life and the only way to control symptoms is to prevent further exposure. Common examples of allergy causing contaminants are nickel, hair dye, cement, leather, and certain food stuffs. |
| Allergic contact dermatitis on a hairdresser's handsContact urticaria may occur immediately after contact with a substance that is an irritant or sensitiser. Contact urticaria is caused by an irritant or allergic reaction to a substance and may present as red flaring, itching, swelling and welts (hives) of the skin that occurs soon after exposure. If the urticaria is caused by an allergic reaction, other symptoms such as sneezing, a runny nose or wheezing may also occur. In severe cases there may be difficulty with breathing and anaphylactic shock, which is life-threatening. Common examples of substances that can cause contact urticaria include natural latex rubber found in latex gloves, hairdressing bleach and seafood . |
Which substances can cause contact dermatitis?
- Acids
- Alkalis
- Oils
- Solvents
- Petroleum products
- Soaps and detergents.
- Cement
- Powdered latex gloves
- Synthetic rubber
- Plastics
- Fibreglass
- Resins (flooring, marine paint, and adhesives )
- Acrylates (dentistry or artificial nails )
- Isocyanates
- Glue
- Hand wash
- Preservatives (formalin, methylchloroisothiazolinone, methylisothiazolinone, chloroacetamide, iodopropynyl butylcarbamate )
- Shellfish
- Metal objects with nickel or chromium content (e.g. jewellery when worn close to the skin may cause contact dermatitis)
- Metal working fluids
- Hair dyes, perm solution, henna tattoos, bleach.
- Sawdust and wood splinters (from some wood varieties)
- Natural oils (used in perfumes)
- Dyes (used on leather, fur, wool, and cotton)
- Preservatives (used in cosmetics, creams, and ointments)
However, these substances will not affect everyone who comes into contact with them.
Occupational Exposure
See below examples of irritants and sensitisers that workers can be exposed to among various occupations:
| Occupation | Irritants that can cause irritant contact dermatitis | Sensitisers that can cause allergic contact dermatitis |
|---|---|---|
Abattoir workers | Acids, alkalis, detergents, waste products, wet-work | Animal proteins, formaldehyde, latex gloves, nickel |
Cleaners | Detergents, other cleaning products, solvents, wet-work | Formaldehyde, germicidal agents |
Construction workers | Cement, dusts, solvents, sand, wet-work | Cement, chromium, cobalt, epoxy resins, wood dust, wood splinters, isocyanate-based products |
Cooks and caterers | Acids, alkalis, bleaching agents, detergents, vegetable juices, wet-work | Some flavours, formaldehyde, garlic, sodium metabisulphite, spices |
Hairdressers | Bleaching agents, dyes, perming solutions, shampoos, wet-work | Dyes, nickel, persulphates, perfumes, latex gloves, amine based chemicals |
Health care workers | Disinfectants, detergents, wet-work | Latex gloves, local anaesthetics, antibiotics, antiseptics, formaldehyde, glutaraldehyde |
Metal workers | Cutting fluids, solvents, metal shavings/dust, wet-work | Additives/preservatives in cutting fluids, chromium, nickel |
Motor vehicle repairers | Aggressive hand cleaners, fuels, oils, paints, solvents | Chromium, cobalt, epoxy resins, nickel |
Printers | Solvents | Colophony, formaldehyde, metals in inks & resins, hardeners, turpentine |
Fishing, trawling or seafood handling | Fish products, wet-work | Seafood |
Risk Control Measures
Recommended risk control measures include the following:
Find out precisely which substance is causing contact dermatitis in your work area.
- A safety data sheet (SDS) will provide information on whether a chemical is a skin irritant, skin sensitiser, or harmful via skin absorption
If possible, remove the irritating substance from the work area and replace it with a less hazardous substance. For example, using:
- A less concentrated substance
- A water-based product instead of a solvent-based product
- Unpowdered latex gloves or nitrile gloves
- Keep the work area clean
- Avoid spills, splashes and sprays of the substance and clean them up promptly if they occur
- Enclose the process by using a glove box
- Create a safe working distance by using tongs, hooks and scoops
Select the correct PPE for the task (eg correct gloves for the specific chemical substance used - refer to the SDS and see a Glove Chemical Resistance Guide)
- Instruct the worker on the correct use and maintenance of the PPE
Gloves
Not every glove will protect against every chemical or be suitable for every work task. When choosing the right glove, consider:
- The activity
- If dexterity is needed for the task (generally, thicker, robust gloves offer greater protection, but thinner gloves offer better dexterity )
- The type of glove needed for the task (e.g. sterile or food grade gloves )
- The length of time it takes to conduct the task
- Whether cotton liners are required
- The worker
- Provide a range of sizes to fit individual workers
- Minimise risk of latex allergies by providing powder free non-latex gloves
- The substance/s being used
- Breakthrough time of the substance through specific gloves
- Glove selection guide – Usually, manufacturers data is for pure chemicals. Generally, base your glove selection on the component in the mixture with the shortest/quickest breakthrough time
- How to safely remove single-use gloves
- Wash hands with mild soap and water, and make sure that hands are dried thoroughly
- Use a cleanser made from vegetable oil to remove grease or other substances that will not come off with soap and water
- Do not use solvents for cleaning hands (e.g. paint thinners)
- Use moisturising creams regularly, especially at the end of a shift, to repair and maintain moisture in the skin
- Treat minor cuts and abrasions promptly
- Include information about contact dermatitis in safety training programs.
It is advisable to seek medical advice, ideally from an occupational physician or dermatologist, if you experience any dermatitis symptoms.
PCBU and Worker Responsibilities
Persons conducting a business or undertaking (PCBUs) are required by work health and safety legislation to eliminate or minimise risks so far as is reasonably practicable. This can be carried out by implementing the following:
| PCBU Responsibilities | Worker Responsibilities |
|---|---|
Provide and make available safety data sheets (SDS) for hazardous chemicals, ensuring staff have read through them before starting a task | To be familiarised with the SDS’ of hazardous chemicals in the workplace, their health effects, and suitable controls |
Include information about contact dermatitis in your training programme | To be aware of, and monitor for any signs and symptoms of contact dermatitis and communicate any concerns to your doctor first, then the PCBU and/or Health and Safety representative to implement safer working conditions |
Provide PPE (e.g. gloves, overalls, face shields, goggles, respirators, gloves and/or boot covers) where appropriate | To use suitable PPE for specific hazards (see SDS), including appropriate glove selection |
Take additional precautions for workers with known allergies | Notify PCBU and other workers of any allergies to specific substances |
Provide health monitoring for workers conducting ongoing work with, generating, or storing certain hazardous chemicals (see health monitoring below) | Comply with health monitoring requirements |
Health Monitoring
Some chemicals that require health monitoring can be readily absorbed through the skin. Health monitoring is required where there is a significant risk of workers developing a disease from exposure to certain hazardous chemicals. See Safe Work Australia’s Health monitoring guides for advice on conducting health monitoring for hazardous chemicals.