admininflammation is dermatitis. The condition can be caused by exposure to a wide range of irritants, many of which can be found in workplaces, which is why in many cases dermatitis may be an occupational illness.
In the United Kingdom about 3 500 cases of work-related dermatitis are reported every year. In contrast to this, last year in the southern region of the country only four cases of work-related dermatitis were reported to NSSA. This would seem to indicate that many cased either went undiagnosed or unreported to NSSA. This then gives the impression that there are fewer cases in Zimbabwe than in UK.
There are three main classifications of dermatitis, namely endogenous eczema, irritant contact dermatitis and allergic contact dermatitis.
Endogenous eczema is an inherited disorder often associated with other atopic (allergic) conditions such as hay fever, rhinitis, which is inflammation of the nostrils, and asthma, which may be exacerbated by exposure to irritants at work.
Irritant contact dermatitis is the result of direct contact with irritants, such as, for example, chemicals or plants. Reversible impairment of the skin’s natural barrier properties occurs, causing skin inflammation. The effects of the irritants are dose-related, that is to say the higher the level of exposure the more severe the dermatitis.
Allergic contact dermatitis is an allergic reaction to agents that a worker becomes sensitised to. The sensitisation can occur within seven to 10 days of exposure to the offending agent but usually occurs after months or years of exposure. Once sensitised, a person can react to even low levels of the allergen. The typical acute features of contact dermatitis include redness, itchiness, dryness, cracking and oozing of clear fluid which crusts. The chronic features are cracking, thickening of the skin and in some cases a superimposed infection.
The onset of the symptoms is usually slow, with gradual progression. The symptoms may become less when not at work, such as when one is on holiday.
With irritant contact dermatitis, the area affected is usually confined to the area of contact with the irritant. Commonly this is the face and hands. Allergic contact dermatitis usually affects the eyelids and sites away from the area of exposure. Irritants can include chemical and biological agents such as weak acids and alkalis, soaps, detergents, solvents and water. Allergens include chromate, epoxy resins, fragrances, formaldehyde and rubber chemicals.
Other causes of skin disorders may include mechanical trauma, frequent hand washing (wet work), radiation and ultraviolet light (sunlight).
Dermatitis can occur in any job but some of the types of work where it commonly occurs include health care work, cleaning, engineering (cutting oils), hairdressing, catering, printing, agriculture and chemical manufacturing.
Response to the exposures varies widely from one person to another. A pre-existing skin condition increases the risk of developing dermatitis. A history of atopy, that is a tendency towards developing allergic reactions also increases the risk.
The diagnosis of work-related dermatitis is reached through clues from the worker’s history, including the history of exposure to a sensitiser. Specialised tests such as skin patch tests are also used to aid in diagnosis. Dermatitis is treated using topical emollients and steroids applied directly to the affected areas.
With irritant dermatitis, removal of the worker from exposure will result in an improvement in their condition. With allergic dermatitis one may react at even low levels of exposure. In that case redeployment might be necessary. The disease can be difficult to treat and cause a lot of distress to the worker, thereby compromising his or her quality of life.
As a means of prevention, suitable alternatives can often be substituted for sensitising agents. Engineering controls, such as computerising processes, can sometimes eliminate skin contact. Correct and consistent use of personal protective clothing, such as gloves, can help prevent exposure. Education about the risks of exposure and good hand care can help control exposure.
The following hand care measures can reduce the risk of irritant dermatitis:
l Ensure hands are not wet for more than two hours a day or more than 20 times each day.
l Avoid wearing gloves for an extended period, i.e. longer than four hours at a time.
l Use tools that avoid wet-work or contacts with irritants.
l Wash hands in warm (not cold or hot) water and dry thoroughly.
l Use protective gloves from start of wet work. If gloves are used for more than 10 minutes, wear cotton gloves underneath. Keep glove intact and dry inside. Avoid introducing irritants into the gloves.
l Do not wear rings at work — they trap water and contaminants. Use oil rich moisturising creams at work and after work.
l Talking Social Security is published weekly by the National Social Security Authority as a public service. There is also now a weekly radio programme, PaMhepo neNSSA/Emoyeni le NSSA, discussing social security issues every Thursday at 6.50pm on Radio Zimbabwe. Readers can e-mail issues they would like dealt with in this column to [email protected] or text them to 073 5041278. For individual queries contact NSSA on (04) 706517-8 or 706523-5.
dyton mupawaenda
Online Reporter