Canadian Occupational Safety

32 Canadian Occupational Safety | www.cos-mag.com A worker at Bell Camp Manufacturing in Inger- soll, Ont., had developed a severe rash on his hands that became infected. He went to the hospital and was pre- scribed a medicated cream, but after one week, there was no improvement. The company decided to implement a comprehensive hand care program that included a pre-work skin cream, industry-specific hand cleaners and after-work conditioning cream. After this process was in place for about one week, the employee's infected rash was completely gone. Hand creams, cleansers, soaps and lotions should not be overlooked in industrial workplaces. Sure, they are at the bottom of the pyramid when it comes to the hierarchy of controls, but any skin irritation on the hands can pose significant problems for workers and consequently, employers. Skin disease is the most common occupational disease in many jurisdictions. In Canada, the inci- dence rate across all sectors for occupational skin disease is on aver- age 4.63 cases per 10,000 full-time employees. But experts agree many cases go unreported and untreated. According to the Centers for Disease Control and Prevention in Atlanta, up to 40 per cent of industrial workers will suffer a skin issue at some point in their working life. Occupational contact dermatitis accounts for up for 95 per cent of all workplace skin disease, according to a 2017 study published in the Journal of the European Academy of Dermatology and Venereology. Contact dermatitis is a skin condi- tion caused by coming into contact with something that either irritates the skin or that causes an allergic reaction. Individuals may experience redness, scaling, blistering, cracking, crusting or swelling of the skin, as well as itching and pain. The con- dition is often long-lasting and chronically relapsing. "When you have skin break downs, if your hands become dry and cracked, there is a risk you could have foreign substances enter into your body," says Cheryl Croutch, manager of occupa- tional health and safety services at St. Joseph's Health Centre in Toronto. Irritant contact dermatitis is the most common form (seen in about 80 per cent of cases). Upon contact with the substance, the skin may be imme- diately damaged or become damaged after repetitive exposure. This type of contact dermatitis can be caused by wet work (work that involves repeated con- tact with water), cleansers, detergents, alkalis and acids, oils and greases, cut- ting fluids and solvents, plants and animals and fibreglass, according to Ontario's Public Services Health and Safety Association (PSHSA). Contact dermatitis can also be caused by wearing gloves for long periods of time and not letting the skin breathe. The disease is especially prevalent in the winter. "In the wintertime, you can have more cracks in your skin, your skin is just dryer, there's less moisture in the air and you can get cracks along the cuticles and it's lifting up the skin," says Croutch. Allergic contact dermatitis is seen in about 20 per cent of cases. Work- ers may be exposed to a substance for years before the allergy develops, and symptoms can spread to other parts of the body. At Sunnybrook Health Sciences Cen- tre's dermatology clinic in Toronto, the dermatologists see many cases of work-related contact dermatitis every day, says Sylvia Aide Martinez Cabria- les, a dermatology fellow who works at the clinic under certified dermatolo- gist Joel Dekoven. The patients range from construction workers, mechan- ics and plumbers to dentists, surgeons, bakers and hair dressers. "Anyone who spends a lot of time working with their hands, is in contact with a lot of chemicals or substances, lots of people that need to clean their hands a lot, they are usually the people that will be at risk to develop contact dermatitis," says Martinez Cabriales. Contact dermatitis can severely negatively affect an individual. It can restrict hand mobility and make it difficult to carry out every day work- place activities, such as gripping a tool or operating machinery. It also affects the worker's home life because simple tasks, such as making a cup of coffee, opening jars and turning taps, can become an impossible or stress- ful challenge, according to the white paper Preventing Occupational Skin Dis- orders: Skin Care Best Practice, released by Deb Group. Workers' mental well-being may also be affected as they can suffer from anxiety, depression, social isolation, low self-esteem and embarrassment due to their contact dermatitis. "It makes them feel sad and frus- trated because the hands are a very important thing from a social point of view and shaking hands, for instance, they might be embarrassed and don't want to do that," says Martinez Cabria- les. "We have seen in our clinic most patients will have damage in their self- confidence because of that." Contact dermatitis affects a worker's ability to perform her job, so she may need to take time off work to recover or be assigned modified duties, depend- ing on the severity of the disease. "Sometimes it's really painful and patients have blisters and they cannot do anything," says Martinez Cabriales. The Occupational Safety and Health Administration (OSHA) in Washing- ton, D.C., has an online calculator for determining the cost of occupational injuries and illnesses, and the esti- mated impact on an organization. The calculator shows that for one case of contact dermatitis, an employer will need to make US$792,000 in additional sales to overcome both the direct and indirect costs associated with the disease, such as health care, By Amanda Silliker Proper skin care in the workplace can drastically reduce instances of contact dermatitis TOUCH A gentle

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