Occupational Dermatitis: Skin Hazards in the Workplace and How to Prevent Them

The Scale of Occupational Skin Disease in Australia

Occupational skin disease — predominantly dermatitis (inflammation of the skin) — is the second most common work-related disease in Australia after musculoskeletal disorders. It affects workers across a wide range of industries and causes significant suffering, lost productivity, and in severe cases, permanent career-ending disability.

High-risk industries include hairdressing and beauty therapy, food processing and catering, healthcare and aged care, cleaning and janitorial services, construction (particularly wet trades), motor vehicle repair, printing, metal working, and floristry. Common to all these industries is regular contact with water, cleaning products, solvents, or specific sensitising agents.

Types of Occupational Dermatitis

Irritant Contact Dermatitis (ICD)

ICD is caused by direct chemical damage to the skin’s barrier function. It does not require prior sensitisation — anyone exposed to sufficient concentrations of an irritant for sufficient time will develop ICD. Common irritants include:

• Water and wet work (prolonged skin wetness removes natural skin lipids and disrupts barrier function)
• Soaps, detergents, and cleaning products
• Acids and alkalis
• Organic solvents
• Cutting fluids and metalworking fluids
• Cement (highly alkaline; causes severe ICD in concrete workers)

ICD typically presents on the hands and forearms as dryness, cracking, redness, and scaling. In acute severe cases, blistering and weeping lesions develop. ICD generally improves with removal from exposure and barrier repair, but repeated exposure and inadequate skin care can lead to chronic, persistent disease.

Allergic Contact Dermatitis (ACD)

ACD is an immune-mediated delayed hypersensitivity reaction (Type IV) to a specific chemical sensitiser. It requires an initial sensitisation phase (often without visible symptoms) followed by an elicitation phase on re-exposure. Key features of ACD that distinguish it from ICD:

• Once sensitised, very low concentrations of the allergen can trigger reactions
• Sensitisation is permanent — complete avoidance of the allergen is required
• Reactions typically appear 24–72 hours after contact (delayed hypersensitivity)
• The rash may spread beyond the site of contact

Important occupational ACD allergens include:

• Chromate (hexavalent chromium): Cement, chrome-plated metals, chrome-tanned leather
• Isocyanates: Two-pack polyurethane products, foam
• Epoxy resin components: Bisphenol A diglycidyl ether (DGEBA) and hardeners, used in adhesives, coatings, flooring
• Acrylates and methacrylates: Dental materials, adhesives, nail products, UV-curing inks
• Rubber accelerators: Thiurams, carbamates, and mercaptobenzothiazole in latex and synthetic rubber gloves
• Nickel: Ubiquitous in metalworking, jewellery, and some plated components
• Preservatives: Formaldehyde-releasing preservatives, methylisothiazolinone (MI) in cutting fluids and cosmetics
• Plant allergens: Grevillea, chrysanthemum, primin in primula — relevant for horticultural and florist workers

Glove Selection for Chemical Protection

Gloves are the primary PPE for skin protection in chemical handling, but incorrect glove selection provides false security. Key principles:

• Glove material must be matched to the chemical: Nitrile resists petroleum hydrocarbons and oils; butyl excels against ketones and esters; neoprene provides broad-spectrum protection; latex (increasingly replaced due to latex allergy concerns) has poor resistance to most organic solvents.
• Breakthrough time: Every glove material has a breakthrough time — the time before the chemical permeates through to the inner surface. Check the glove manufacturer’s chemical resistance chart and compare breakthrough time against your task duration.
• Thin “examination” gloves: Thin nitrile or latex examination gloves used in healthcare provide minimal chemical protection — they are fluid barriers, not chemical resistance barriers. For chemical handling, thicker industrial-grade gloves are required.
• Glove change frequency: Gloves must be changed before breakthrough time is reached, inspected before donning (check for pinholes and degradation), and removed without contaminating the hands.
• Glove allergy: Rubber accelerators in synthetic gloves are a common cause of ACD. Workers who develop glove-related dermatitis should be patch-tested to identify the specific allergen, and alternative glove materials sourced.

Skin Management and Pre-work / Post-work Care

A comprehensive skin protection program should include:

• Pre-work skin protection creams: Create a hydrophobic or hydrophilic barrier depending on the expected contaminant type. Not a replacement for gloves, but complement glove use by protecting the areas between the glove and forearm.
• Adequate hand-washing facilities: Gentle, pH-neutral soap, warm water (not hot), and soft paper towels. Avoid abrasive cleansers, solvents for hand cleaning, and harsh antibacterial soaps.
• Post-work moisturisers: Barrier repair creams replenish skin lipids stripped by wet work and chemical contact. Most effective when applied immediately after washing.
• Wet work reduction: Administrative measures to limit continuous wet work to less than 2 hours per shift (the threshold above which significant skin barrier disruption begins to occur).

Frequently Asked Questions

Can a worker return to work with the causative chemical after their dermatitis heals?

For ICD: generally yes, with improved skin protection measures. For ACD: the worker must avoid the specific sensitiser permanently. If the sensitiser is endemic to the role (e.g., isocyanates in a spray painter), the worker may need to be redeployed to a non-exposed role. Re-exposure to the sensitiser will trigger recurrence, typically more severe with each exposure.

How do I know if a chemical is a skin sensitiser?

Check the SDS Section 2 (GHS hazard classification) for “skin sensitisation category 1” and Section 11 for sensitisation data. The WHS Regulations also require the SDS to identify sensitisers. When in doubt, consult an occupational hygienist or dermatologist with occupational medicine experience.