Occupational skin disease is one of the most prevalent occupational diseases reported. By definition, for skin disease to be classified as an occupational one, there must be a causal relationship between the occupation and the skin disease.
Occupational skin diseases is broadly categorized into three groups: irritant contact dermatitis, allergic contact dermatitis, and another occupational skin disease.
The majority of all reported cases are classified as one or another form of contact dermatitis.
Quite often, wet working conditions are associated as triggering agents for contact dermatitis. The following occupations account for 80% of the reported cases of occupational skin disease: food industry, hairdressing/beauty therapy, healthcare, laboratory workers, cleaning, printing, motor vehicle repair, construction work, and agriculture
Not to mention 80% of patients diagnosed with occupational skin disease also have hand dermatitis.
Younger workers are slightly at greater risk in comparison with older workers. However, factors like individual predisposition (i.e. presence of atopic dermatitis/eczema or sensitive skin), personal hygiene, and/or circumstances of exposure.
Irritant contact dermatitis occurs when contact chemical or physical agents lead to the injury of the skin’s surface faster than it is able to repair the resulted damage. Occupational irritant contact dermatitis makes up 80% of all occupational skin diseases. It includes chemical burns and the majority of cases of contact urticaria.
Clinical features of irritant contact dermatitis tend to vary. It may be a single episode that eventually recovers, maybe series of repeated relapsing episodes, or maybe chronic dermatitis resulted from a repetitive injury. The degree of damage is multifactorial: it is determined based on the duration of application, the potency of the irritant, occlusion, the frequency of exposure, anatomical site, temperature, and individual susceptibility.
Dermatitis itself may be dry, flaking, swollen, blistering, and eroded. Broken skin leads to a risk of skin infection. It appears as red, painful, and swollen skin with ulceration or pustules.
Allergic contact dermatitis is defined as an immunological response (allergy) to a contact allergen. Individuals who are allergic to a particular agent (the allergen) will be the only ones projecting symptoms. Allergic contact dermatitis makes up about 10% of occupational skin diseases. It also includes protein contact dermatitis which is found in different foods.
Overall, the clinical features in terms of appearance are very similar to the ones presented by irritant contact dermatitis. However, there are some specific features. It is common for an allergen to be previously tolerated and not result in dermatitis. Dermatitis may occur not only at the site of primary contact but also at secondary sites. Dermatitis occurs within hours or days after exposure to a potential allergen. Symptoms tend to settle down when the skin is no longer in contact with the allergen, but it may take several weeks and treatment will be required. Allergic contact dermatitis is generally confirmed by patch testing.
Other occupational skin diseases refer to skin conditions other than dermatitis and they occur as a result of occupational exposures. They make up less than 10% of occupational skin diseases. Skin cancer may arise in certain occupations. According to a recent report, 11% of deaths are caused by melanoma and squamous cell carcinoma that arose from work exposures, such as bricklayers and roof tilers. Some cases of basal cell carcinoma appeared at sites of injury like welding burns.
Occupational skin disease is usually treated with topical or oral steroids, emollients, and/or antibiotics.
Centre for Medical and Surgical Dermatology offers various occupational skin disease treatment methods that are individual for each patient.