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Skin deep

By Linda Johnson
| www.cos-mag.com

Workers in manufacturing face serious skin conditions due to contact with hazardous substances

In August 1996, Karen Wetterhahn, a chemistry professor at Dartmouth College in Hanover, N.H., was conducting lab tests when a drop or two of a highly toxic compound spilled onto one of the latex gloves she was wearing. The substance, dimethylmercury, penetrated the glove and within 15 seconds entered her skin. In less than one year, she had died of mercury poisoning.

Her death points in a stark way to the crucial importance of protecting the skin against hazardous substances. And while chemicals may present the most obvious risk, many other substances, agents and processes in the workplace can damage the skin and lead to long-term, debilitating disorders.

The most common occupational skin disease is contact dermatitis, a rash or inflammation of the skin caused by contact with a substance.

Dermatitis appears in various degrees of severity, from mild rash to blistering. Dermatitis can be painful and may affect a person’s quality of life.

“Usually, it’s an itchy, scaly, flaky, persistent rash,” says Irena Kudla, clinical occupational hygienist at Toronto’s St. Michael’s Hospital. “It can be red, swollen and lead to the development of tiny blisters, tiny water bubbles, that will weep and then form a crust. And that cycle repeats itself, so the skin becomes thick, and it will start to crack.”

Contact dermatitis has two forms: irritant contact and allergic contact.

Irritant contact dermatitis, which accounts for 80 per cent of all cases of contact dermatitis, results from direct damage to the skin caused by exposure to a hazardous substance and usually affects only those areas of skin exposed to the irritant. Damage may be caused by chronic, cumulative exposures to mild irritants (such as water, detergents and soaps) or acute exposures to highly irritating substances (such as acids and caustic soda).

A major cause of irritant contact dermatitis is “wet work,” says Kudla.

“Wet work is a big issue. It includes not only having your hands wet, whether you’re in the service industry or food service, and you’re washing dishes or you’re a cleaner, it also includes prolonged use of gloves because the hands can perspire in the gloves,” she says.

Allergic contact dermatitis results when a worker comes in contact with a skin allergen. The worker must first be sensitized to the allergen before the reaction can occur. The reaction may not be limited to the area of contact with the allergen but may spread over large areas of the body.

The effects can be long-lasting and hinder a person’s ability to continue working. Common sensitizers are epoxy resins, formaldehyde, nickel, wood dust, flour, printing plates, chemicals, adhesives and cement.

Health effects to the skin are often divided into localized problems — such as chemical burns and physical trauma, including bruises and punctures — and systemic problems, which result when a contaminant is absorbed into the skin and goes to a target organ or the nervous system, according to Dhananjai Borwankar, technical specialist at the Canadian Centre for Occupational Health and Safety in Hamilton.

Some solvents can cause harmful effects on the heart, others on the kidneys. For example, the industrial use of benzene has been proven to cause cancer in humans.

Lorne Kleppe, executive director of the Manufacturers’ Health and Safety Association, based in Rocky View, Alta., says the manufacturing sector uses products — including solvents, acids, caustic soda, paints, lacquers and paint thinners — that contain chemicals that can be hazardous to skin.

In the industrial sector generally, mechanical irritation presents another hazard. Friction from handling parts, minor cuts and abrasions can break down the skin’s outer layer, allowing substances to penetrate the skin, says Kudla.

Keeping skin protected

To protect against hazards to the skin, many manufacturers supply specialty gloves, made from different materials and in various thicknesses.

“The gloves might protect hands from sharp edges or from different types of solvents,” says Kleppe. “Workers should be analyzing the health hazards and using the right protective glove for the tasks they’re working on.”

Occupational hygiene, as well, is paramount in the manufacturing sector, Kleppe says, and many employers supply specialized hand sanitizers and cleansers for workers to use before breaks and after work. Keeping hands clean not only helps protect workers’ hands, it also reduces the likelihood they will transfer contaminants from their hands to their faces — and to their family members.

“Someone doesn’t clean their hands, hops in the car and drives home. Then someone else wants to go shopping, gets in the car, touches the same steering wheel, and you have cross contamination. You could bring that type of harm back home with you by that simple scenario,” he says.

Employers are responsible for identifying hazards and controlling for them, Borwankar says. A good practice is to do an inventory of all chemicals and materials used on site.

“Once you’ve established, ‘I have these chemicals, these workers are exposed to them and this is how they use them,’ then you can look at how to minimize their exposures,” he says.

Following the hierarchy of controls safety model, employers should then look at each hazardous substance and try to reduce risk through elimination, substitution, engineering and administrative controls and, lastly, through the use of personal protective equipment (PPE). For skin safety, PPE may be limited to gloves but may also extend to safety goggles, a face shield and laboratory coat.

Changing employee attitude

Inappropriate handling of hazardous materials often leads to skin ailments, says Wagish Yajaman, occupational hygienist with Workplace Safety and Prevention Services, based in Mississauga, Ont. Sometimes, workers continue practices that, though potentially dangerous, have proven safe so far, or they pick up new practices that become bad habits.

In one incident, he recalls, workers stopped wearing gloves after the gloves began to stick to the spray guns they used to put glue onto foam parts. Then, to remove the glue from their hands when work was done, they used a solvent — which effectively dissolved the glue but also removed protective oils from the surface of their skin.

“Their hands were getting dry. Then, winter comes around, and they started getting fissures on the hands and wounds that wouldn’t heal,” he says.

Along with the usual way of doing something, workers may also get used to the discomfort a substance causes, while easily dismissing any signs of harm, Yajaman says.

“They’ll say, ‘I get a tingling on my hands when I use that stuff, but I get used to it.’ There’s a little machismo to it — not saying or doing anything about that bit of pain associated with work and not realizing that it’s actually causing damage to the skin that may be irreversible,” he says.

When initial symptoms appear, employees should understand they can, and should, be telling their supervisor about it, he adds.

They also need to ask questions if they are not sure about a substance’s health effects or how to protect themselves, says Borwankar. They should be trained in WHMIS, know where the MSDS sheets are and read through them.

“And if they need clarification, they can go to the employer and say, ‘I don’t understand. What is the potential for exposure, and what are you doing to help me protect?’ It’s their right to know that,” he says.

Paying attention

Occupational risks to skin health are underestimated, says Kudla. Employers and workers need to be more aware that contact dermatitis can be debilitating.

“(Work-related skin disease) is not really on the radar in workplaces. And unfortunately, it doesn’t come onto the radar until someone develops a problem,” she says, adding family physicians, too, should be more educated about occupational skin hazards.

“Often, we encourage workers to tell their family physician where they work, and what substances they’re using.”

By simply paying attention, Kudla adds, employers take a major step towards preventing occupational skin disease. When they see a worker is developing a rash, they should examine what the person is doing.

“Particularly when you have clusters of rash,” she says. “That’s a red flag to stop and pay attention to what chemicals are being used in the process and how the tasks are being done.”

Linda Johnson is a freelance writer based in Toronto.

 

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