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Skin disorders

An occupational skin disorder is a skin condition wholly or partially caused by a person's work activity.

Types of skin disorders: definitions and symptoms

The skin plays a very important role as a barrier to chemicals and other contaminants entering the body. Skin disorders may disrupt this barrier function.

Occupational skin disease is a skin disorder wholly or partially caused by a person's work activity. It’s important to remember that skin diseases can also have non-occupational and genetic causes.

What causes occupational skin diseases?

Occupational skin diseases are caused by direct contact with one or more hazardous substances. The skin can come into contact with substances through:
immersion
contact with contaminated tools or surfaces, for example a workbench, tools or clothing
splashing
the substance landing on the skin
For more information, visit the HSE’s webpage How does skin come into contact with chemicals?

Types of skin disorders: definitions and symptoms

Occupational skin disorders include:
contact dermatitis or eczema
contact urticaria
acne and folliculitis
pigmentation changes
skin cancer
skin infections
You can get more information on these skin diseases on the HSE’s webpage Types of skin diseases.

Most occupational skin diseases are confined to the hands and forearms, since they are the parts of the body most often in contact with hazardous agents. The most common skin condition is contact dermatitis (also known as contact eczema). Dermatitis is caused by an inflammation of the skin. Symptoms include redness, dryness, itching, swelling, cracking, blistering, flaking and bleeding.

There are two types of contact dermatitis: irritant dermatitis and allergic dermatitis. These have the same appearance but different causes.

Irritant dermatitis can be caused by a physical or chemical agent that damages the cells. Irritant dermatitis makes the skin more vulnerable to other hazards such as bacteria and chemicals. When there’s no more contact with what’s causing the irritation, the condition stops.

Allergic dermatitis is caused by exposure to an allergen or sensitiser, normally a hazardous substance. When the sufferer’s immune system reacts to it, they become sensitised. Once sensitised, the problem is usually lifelong and any further exposure will lead to an attack.

Both irritant and allergic dermatitis can be present together and it’s not uncommon for allergic dermatitis to develop following irritant dermatitis.

Causes of irritant dermatitis include cleaning products, organic solvents, metalworking fluids, cement and other chemicals, some plants and shrubs, and water.

Although we need water to wash our hands, too much exposure to water can cause irritant dermatitis. This is particularly important in wet work. Those involved in wet work include hairdressers, workers in the food industry and people who work with metalworking fluids.

Allergic contact dermatitis can be caused by allergens such as cement, metals (eg nickel and chromium) and resins. Latex is a common cause of allergic dermatitis. It’s commonly found in the healthcare industry, where latex gloves are worn routinely. For more information, visit the HSE’s webpage on latex allergies.

To find out more about the most common causes of contact dermatitis, visit the HSE’s webpage on causative agents.

Common risk factors for dermatitis are atopy, wet work and the use of gloves. Although gloves can provide workers with protection, they can also present a risk. Gloves must be appropriate to the task being carried out and be used properly. Using damaged gloves can give a false sense of security. Impervious gloves form a non-permeable barrier that may result in the build up of sweat, which means the wearer is effectively carrying out wet work.

Contact urticaria is a skin condition characterised by redness (erythema) and swellings. The swellings appear where the hazardous substance has come into contact with the skin. Swellings normally occur within an hour of exposure and disappear after 24 hours. Latex is a common cause of the condition.

Acne is caused by a blockage and inflammation of the glands in the skin. It can be caused by exposure to oil, halogenated aromatic hydrocarbons and coal tar. It can also be caused by long term contact with oily clothes.

Folliculitis is an inflammation of the hair follicles. This condition is common in people in the metal industry who are exposed to mineral and soluble oils.

Pigmentary disorders include depigmentation (a loss of skin colour) and hyperpigmentation (an accumulation of skin colour). Depigmentation can be caused by chemicals such as hydroquinine, phenol (and its derivatives), arsenic and mercury compounds. It can also be caused by ionising and ultraviolet radiation, as well as thermal or physical trauma. Hyperpigmentation can be caused by mineral oils, halogenated hydrocarbons, arsenic and various pharmaceutical agents.

Skin cancer can be caused by ultraviolet light (either sunlight or artificial), ionising radiation, polycyclic aromatic hydrocarbons, tar and tar products.

Occupational skin infections are often caused by contact with animals or plants. Visit the Haz-Map webpage for information on jobs associated with occupational skin infections.

Statistics and occupations most at risk

Skin diseases account for approximately 2.9 per cent of total days sickness absence certified due to all occupational illnesses as reported in 2007-09 THOR GP Scheme survey. According to the Labour Force Survey, an estimated 22,000 workers suffered skin problems which they believed to be work-related in 2009/10. In 2009, 2455 cases of occupational skin disease were reported by dermatologists and occupational physicians in Great Britain. 1,735 (71 per cent) of these reported cases were related to contact dermatitis whilst most of the remainder were related to skin cancers.

During the last few years, the most common agents cited by dermatologists and occupational physicians as causes of skin disease were "soaps and cleaners", "wet work", and "rubber chemicals and materials".

Work-related dermatitis is very common and affects people in many industries. These include:

agriculture/horticulture
catering and food processing
chemicals
construction
engineering
hairdressing
healthcare
offshore
printing
rubber.

Two tables accessed through the HSE’s Dermatitis and other skin disorders web page show the average number of cases reported by THOR per year in 2006-2008, by occupation and industry.

The HSE’s Skin Disease Project focuses on a small number of occupations that have the highest risk of dermatitis and/or account for the high numbers of cases each year. The HSE lists hazardous agents commonly encountered in these occupations. Hairdressing heads the list, with up to 70 per cent of hairdressers suffering from some form of skin disease. The HSE has a campaign specifically aimed at preventing dermatitis in hairdressers.