According to World Health Organization (2020), occupational disease is demarcated as the disease which is caused during the course of employment and by the work the person is involved in to. It has been observed that there are certain activities which tend to put health of workers at risk in the form of occupational disease also known as work related disease. If the risks and hazards related to the occupational disease, it can harm the physical and mental health of the patient.
This discussion primarily empathises upon the occurrence of dermatitis in case of painters. The study done by Health management.co.uk (2020), there are certain occupational disease which are characterised under the RIDDOR (Reporting of injuries, Disease and Dangerous Regulations 2013) and dermatitis in painters is one of them.
Dermatitis is defined as a skin disease or skin inflammation. The person suffering with dermatitis have dry, red and swollen skin based on the type of dermatitis the person is suffering from. This discussion includes physiological data where the normal physiology of the disease is elaborated along with the changes caused by the disease that alters the normal physiology. In addition to that, statistical data of the disease is also included. It has been observed that general health and lifestyle factors also contribute in the development of the selected work-related disease and hence is included in the discussion along with the determinants of health. Workforce safeguarding strategies which can help in reducing the risk of disease with respect of risk assessment, RIDDOR and COSHH are also discussed along with the measures which can lessen the impact of condition of painters.
The occupation which has been selected in the discussion is painters and the disease which has been selected is dermatitis, which is one of the most common occupational disease in case of painters. Dermatitis is a skin related disease, where the skin of the person infected gets swollen, red and dry. According to the study performed by Boguniewicz, Fonacier and Leung (2019), dermatitis or contact dermatitis in case of painters are one of the most common disease as compared to that of the other occupation. The study suggests that person working as a painter possess an increased risk of getting infected with occupational dermatitis. It is because of the epoxy resins and isothialinones, which are considered as the two most sensitizers in the paints which harms the skin of the individual.
According to the conducted by Kerscher et al. (2019), skin is the largest organ in the human body, which aids in protecting from the microbes and such elements. In addition to that, it also helps in regulating the body temperature and also allows the sensation of heat, cold and touch. The skin is composed of three different layers, named epidermis, dermis and subcutaneous.
The study suggests that epidermis is the outermost layer of the skin which helps in provide a waterproof barrier and also helps in creating the skin tone. The dermis is the second layer which is located beneath the epidermis layer. This layer of the skin contains the tough connective tissue, sweat glands and hair follicles. The last layer is the deeper subcutaneous tissue or hypodermis which is made up connective and fat tissue.
Figure: Physiology of Skin
The most common type of dermatitis that has been observed in the case of painters is contract dermatitis. Rendering to the study done by Nosbaum, Nicolas and Lachapelle (2020), the pathophysiology of the contact dermatitis begins when the individual gets in contact with the allergen of the skin. This allergen then penetrates that stratum corneum and then is secreted into the Langerhans cells. This antigen then undergoes processing by such cells and as a result it gets displayed on the surface of the skin. As per the normal immunity of the skin, the Langerhans cells gets in close contact with the T-lymphocyte cells adjacently placed. Due to the process of clonal expansion and cytokine-induced proliferation, antigen-specific T lymphocyte is created. The T lymphocyte cells then passes through blood and reaches the epidermis (Zack, Arrandale and Holness, 2017). This whole process is known as sensitization phase or step of the allergic contact dermatitis. After the re-exposure of the antigen, elicitation phase takes place. The Langerhans cells which contains the antigen gets in interaction with the antigen-specific T lymphocyte for antigen. This interaction triggers a proliferation process which is induced by cytokine. This proliferation is the possible reason which creates a localised inflammatory response.
According to the survey conducted by Health Management.co.uk (2020), it has been estimated that around 1.3 million people who worked during the period of 2015-2016, is suffering from work-related illness. The survey further states that about ½ million cases of work-related illness reported each year. The study further suggests that work-related skin disease such as dermatitis in painters is also one of the most commonly observed occupational disease. The possible reason behind the increasing occurrence rates of work-related skin disease is due to the excessive contact with the chemicals and also due to working with the wet hands (Zack, Arrandale and Holness, 2017).
According to the study done by Health Management.co.uk (2020), the annual prevalence rate of contact dermatitis is around 12.9 cases of the total 100,000 population and due to improper work hazards measures, the rate is exponentially increasing year-by-year.
Figure: Statistical data of work-related skin disease by Occupational physicians and dermatologists
From the above data, it can be clearly stated that, work related disease is one of the most common occupational disease. Painting comes under the social and personal services, and as stated in the graph, that according to dermatologists the rate of contact dermatitis in case of person involved into social and personal services is more as compared in case of other occupations.
According to the research performed by Health and Safety Executive (2020), contact dermatitis is one of the most commonly observed work-related skin disease and as stated above, it is due to the excessive exposure with the allergen. The study suggests that the general health and life style factor of an individual plays an important role in the occurrence of the disease.
There are a number of general health and life style factor or also known as social determinants which can lead to contact dermatitis.
Figure: Irritants that can lead to contact dermatitis at workplace
As per the study done by Hines et al. (2020), during painting individuals comes in contact with paints or epoxy resin which possess negative impact on the health of the individual. The study suggests that hardener or epoxy can lead to acute contact dermatitis, which can lead to discomfort. It may severe, however it disappears if the person discontinues coming in contact with such harmful chemicals. Recurrent skin contact with the hardener or resin can lead to chronic contact dermatitis.
Another one of the major general and lifestyle factors that can lead to the increasing incidence rate of contact in case of painters is working under hot and humid climate. Rendering to the study done by Kudla et al. (2017), contact dermatitis is more common when the ambient temperature of the working area is higher as compared to the normal temperature. As painters need to work under hot and humid climate, therefore the rate of contact dermatitis among the painters is more common.
Sweating is also counted among one of the major irritants that can lead to contact dermatitis. As stated above, that painters have to work under hot and humid climate, therefore sweating is common and hence the occurrence of contact dermatitis is common. Rendering to the study done by Bimbi and Martini (2018), apart from the above discussed factors, working continuously within wet environment. As painters continuously work with paints, hardener and resins, frequent exposure to cleaners, soaps and wet work is common which acts as allergen for the skin and hence lead to contact dermatitis. According to Budd, Kudla and Holness (2020), prolonged glove use lead to about 10%-15% of the total contact dermatitis case. In addition to that, unable to wear gloves is also one of the possible reasons which can also lead to contact dermatitis.
According to the survey conducted by Safe Work Australia (2020), work force safeguarding in an organization is one of the most effective tools that helps in reducing the rate of injury to the employee working in the organization. It is the responsibility of the organization to evaluate or implement strategies of workforce safeguarding in order to make the workplace safe for the employees.
As stated above that it is the responsibility of the organization to provide a safe workplace fir the employee working in the organization by the help of certain workplace safeguarding strategies., in order to do that, risk assessment of the place needs to be done. It helps in evaluating the risks of hazards associated with the workplace with the help of COSHH and RIDDOR.
According to National Health Service (2020), The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) helps in reducing the rate of accidents at workplace. Under this regulation, all the employee should record all workplace injuries and accidents to the authorities. If any employee is dangerously injured at work place, it should be reported immediately, however in other case the incident should be reported within 10 days. It helps in conducting a risk assessment test.
COSHH is a systemic assessment tool of a process that involved using of hazardous substance (HS Direct, 2020) The main purpose of the tool is to identify the hazardous substance that can lead to illness or dermatitis in this case. It is divided into 8 primary steps:
1. Assessing the risk: The risks which are actually associated with the painter’s workplace is working under the hot and humid climate for a prolong period, wearing gloves for longer period of time, wearing no gloves and excessive contact with the wet surface and resin and hardener.
2. Deciding the precautions: At this step, precautionary step which helps in reducing the risk are evaluated, such as reducing contact with the resin and hardener as it acts as primary allergen for the dermatitis.
3. Prevention or control the exposure: As in the case of painters, it is not possible to prevent the exposure with the resin and hardener, as their whole work is involved around that, however in such case the employee should set a limit of exposure.
4. Control measures: Apart from the resin and hardener, there are other factors also which acts as allergen and can cause dermatitis and hence needs to be controlled. For example, the working environment should be less hot and humid. It will also reduce sweating.
5. Monitor the exposure: The exposure of the employee to the irritants should be closely monitored.
6. Health surveillance: As per the study directed by (HS Direct, 2020), some individuals are more vulnerable to the resin and hardener and as a result gets easily impacted. Therefore, health assessment should be done prior to assess the vulnerability.
7. Preparing an emergency plan: Emergency plan related to spillages should be prepared for emergency condition.
8. Training: It is one of the most important steps. The employer should make sure that all the employee working in the organization are well aware about the resin and hardener harmful nature, they should be well trained and supervised.
Measures help in reducing the impact of the condition on the working population. The measures for reducing the contact dermatitis are as follows:
1. Proper health surveillance should be conducted.
2. Each and every employee should be provided with personal protective equipment such as gloves, mild cleaner which they can use while working.
3. Employee should be properly trained about the workplace hazards in painters and also about the strategies that can reduce such hazards.
Bimbi, C. and Martini, L., 2018. Occupational Hand Dermatitis: Clinical Features. Prevention and Treatment. J Dermat Cosmetol, 2(1), p.00047.
Boguniewicz, M., Fonacier, L. and Leung, D.Y., 2019. Atopic and Contact Dermatitis. In Clinical Immunology (pp. 611-624). Content Repository Only!.
Budd, D., Kudla, I. and Holness, D.L., 2020. Workplace survey: guiding principles from occupational dermatology. Kanerva’s Occupational Dermatology, pp.1263-1272.
Health and Safety Executive, 2020. Work-Related Contact Dermatitis - Health And Safety Topics In Cleaning. [online] Hse.gov.uk.
Health Management.co.uk, 2020. The Impact Of Work On Health. [online] Healthmanagement.co.uk.
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