Canadian Occupational Safety

34 Canadian Occupational Safety | www.cos-mag.com of hands. The cream should be fully absorbed and feel dry before engaging in any activities. It's also very important for the soaps and creams to be fragrance-free and ideally, they should be preservative- free too, says Martinez Cabriales. Also, lotions with a low pH are the best option, she adds. Employers might need to have some specialty products on hand for workers with underlying skin conditions like psoriasis or eczema, says Croutch. When it comes to selecting the right cleansers and creams for your work- force, treat it the same as you would when selecting any other personal pro- tective equipment. Croutch says it's a collaborative process that includes purchasing, front-line workers, sup- port services and occupational health and safety. "(Skin care) products need to be compatible with existing products, such as gloves, accepted by staff and meet any applicable industry recom- mendations," she says. Coppotelli suggests starting with a plant survey to determine the potential skin hazards and irritants that could lead to contact dermatitis, speaking to workers and looking at their hands. It's important to determine a baseline of skin health and worker education. "They might think their hands are normal; but normal to them is not normal to us. Normal to us is a QVC model on TV — that's actually really healthy," Coppotelli says. "Normal hands on a work site might look a lot different, but that isn't healthy." The study in the European journal found that worker compliance with hand care programs is low. One way to improve this is to ensure the product dispensers are located in convenient areas. In health care, the hand sanitizer is placed in front of a patient's room, so the worker applies it when he is entering and leaving the room, says Croutch. This concept can be applied to industrial environments as well, such as having creams at the entrance of work areas. "If they have, for instance, to get cream that's only available in tubes at a tool crib, they're not going to walk to that tool crib; it's just out of the way," says Coppotelli. "It has to be a good workflow for them to use the product." Change rooms, rest areas, washrooms, lunchrooms or cafeterias are other good locations. The Deb Group white paper recommends involving workers when deciding where to place the dispensers. The product also has to be well-stocked and clearly labelled. Workers need to be educated on the importance of the hand care program. They should learn about what contact dermatitis is, how it can negatively affect their work and personal lives, how to properly use the skin care products and what to do if they are experiencing symptoms of skin dis- ease. They should also be shown what healthy hands should look like. Many organizations have seen benefits from implementing hand care programs. A 2006 pilot program in Austria's oil industry was able to decrease the rate of irritant contact der- matitis from 55.4 per cent to 19.7 per cent by introducing workplace-adapted skin products, strategically placed and labelled dispensers and a series of standardized educational courses. According to the European journal study, the success of a hand care pro- gram can be evaluated by drawing on an established model of hand-hygiene compliance monitoring, which includes the following components: • establishing a denominator for the total number of hand cream appli- cation events that are possible in a given period • developing a sustainable method for measuring the number of events fulfilled in a given period (the numerator) • calculating a baseline from which to gauge improvements over time. Smart soap dispensers are connect- ing to digital platforms to make this monitoring process even easier. They digitally track how much soap or cream is being used and when, and they provide a report and statistics on this usage. The authors of the European study recommend reporting data back to employees as it becomes available. This not only shows that the organi- zation is taking hand health seriously, but it holds individuals accountable and reinforces expectations. Employees should be surveyed again after the program has been in place for about six months, and the results should be compared to the original employee survey. Safety managers should also evalu- ate the number of missed work days due to contact dermatitis, as well as how many workers are on modified duties due to the disease, says Marti- nez Cabriales. Fortunately, if caught early, the impact of contact dermatitis can be minimal for both the employee and employer. If the worker is showing any symptoms, a hand assessment should be performed and she should be seen by a physician, says Croutch. "It all depends on the severity of the issue but for regular contact dermatitis, it's usually resolved fairly quickly once you figure out what the root cause is and why it's happening." m Have you conducted an audit of the contaminants in your workplace that get onto employees' skin? m Do you analyze skin issues to ensure your skin care program is effective? m Have you confirmed that the hand cleansers provided are suitable for the specific contaminants in your workplace? m Do any employees use their own products from home? m Are employees using the correct amount of hand cleanser? m Have all employees received training on why they need to use the skin care products provided? m Have all employees received training on how checking their skin regularly can help reduce the risk of serious skin disease? m Is point-of-use signage used to reinforce the skin care training messages? m Are creams available alongside hand cleansers for use after hand washing? Source: "The Three Moments of Skin Cream Application: An Evidence- Based Proposal for Use of Skin Creams in the Prevention of Irritant Contact Dermatitis in the Workplace," Journal of the European Academy of Dermatology and Venereology Skin-health audit checklist Regular skin health checks can help with early detection of dermatitis, which can prevent more serious disease development. Checks can also help identify any gaps in preventive measures and the need to reassess skin protection as appropriate.

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