Occupations at risk for work-related skin diseases

Usually, contact eczemas are caused by skin exposure to chemicals; this is often combined with exposure to water. On intact skin, prolonged contact with water enhances skin permeability and susceptibility to irritants.

What is wet work?

Wet work is defined as either skin exposure to liquids, wearing occlusive gloves more than two hours daily, or handwashing or other disinfection measures more than 20 times daily.

Food handling and preparation, healthcare-related occupations, cleaning, and hairdressing are examples of wet work. Soaps, detergents, industrial cleaners, disinfectants and organic solvents can dissolve the natural layer of fat that forms a skin barrier and thereby cause damage to the cell membranes.

In addition, this makes the skin more vulnerable to exposure to other chemicals.

Let’s have a look at the irritants and the occupations at risk.

Cleaning work often involves prolonged contact with water and soap. This enhances skin permeability and susceptibility to both irritants and allergy-provoking agents.
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Organic solvents are used in many different industries. They dissolve the natural layer of fat that forms a skin barrier and make the skin more vulnerable to other chemicals.
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All industries that cut, grind, or machine metals use large quantities of metalworking fluids/cutting oils. Cutting oils act as skin irritants, but also contain potential sensitizers such as biocides and emulsifiers. ^{© Colourbox}

Construction workers

Construction workers experience some of the highest levels of sensitizing chemicals, both in terms of the number of different allergy provoking agents they are exposed to and by the extent of the exposure level for each agent.

Cement can for instance cause allergic contact eczema due to its chromate content, but it can also cause irritant eczema.

Work-related contact eczema usually affects the hands and forearms while areas of skin covered by clothing are seldom primary sites. In some jobs, however, workers are also at risk of developing contact eczema on their feet and legs.
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Different types of thermoset plastics are commonly used in many industries, in the form of (industrial) paint, coatings, adhesives and laminates. The term “thermoset” plastics refers to the fact that these plastics contain polymers that cross-link together during the curing process to form irreversible chemical bonds enabling them to “set”, and become hard solids.

When they are in their liquid or un-polymerized state they are very potent skin sensitizers, but they lose their allergenic properties when they are in their solid phase unless substantial amounts of free, un-polymerized resins remain present.

Exposure to un-polymerized epoxy resins can induce allergic contact eczema. Once sensitized, a person may experience a reaction with minimal exposure to the allergen.
^{© G. Tjalvin}

Acrylates, such as “super glues”, are a group of strong, fast-acting adhesives with industrial, medical/dental, and household uses. Here “super glue” is used to mend a shoe. Acrylates may act as skin irritants, but can also cause allergic contact eczema.
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Hairdressers

Hairdressers are at great risk of developing occupational eczema, both irritant and allergic, since they, in addition to much-wet work, use many highly sensitizing chemicals in their work.

They are even at the risk of being sensitised to such things as the metals nickel and chromium. The use of appropriate gloves may help to protect the hands of such workers from harmful chemicals.
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Paraphenylenediamine (PPD) in hair dye, glycerylmonothioglycolate in permanents, ammonium persulphate in bleach, surfactants in shampoos, nickel, perfume, essential oils, preservatives in cosmetics are all examples of sensitizing agents commonly used by hairdressers.
^{© G. Tjalvin}

Here is a table showing examples of skin irritants and sensitizers, as well as the kinds of occupations where contact can occur (Reference: ILO: Encyclopaedia of Occupational Health and Safety).