Occupational dermatitis among construction workers

Introduction

The construction industry is a growing one and a major employer worldwide. The nature of the work puts those in this sector at risk for dermatological disorders. In a study out of India, a study of 92 different construction sites found that 47.8% of workers have skin conditions and 19.6% have frictional callosities (calluses) of the palm.

Why do construction workers have skin problems?

Factors that make construction work a risk for skin health include:

• The work takes place in all weathers, including extreme heat and cold, and there is increased exposure to solar radiation
• The work is often hard manual labour, which can increase the risk for abrasions and other mechanical injuries
• Exposure to cement, which contain irritants (lime) and sensitisers (chromium).

Understanding the causes of occupational skin disease

Work-related skin conditions make up around 50% of occupational illnesses — and are responsible for about 25% of all lost work days. These figures may be conservative estimates, because researchers believe that occupational skin disease goes under-reported.

Skin acts as a barrier to microorganisms and to chemical irritants and other toxic substances, but the nature of certain kinds of work can compromise this barrier through overexposure to biological, physical or chemical agents. Occupational skin problems can affect many different kinds of workers, but the nature of construction work puts employees in this sector at significant risk.

Conditions associated with construction work

Contact dermatitis, friction callosities and infections are common in those working in the construction sector. Fissured skin and ulcerations (full thickness epidermal loss) are also frequent.

Contact dermatitis

Contact dermatitis is frequent among construction workers.

• Irritant contact dermatitis and/or allergic contact dermatitis occur
• The most frequent cause is contact with cement, which contains both corrosive irritants and sensitisers
• Patients present with redness, itching and pain of exposed areas of skin

Friction callosity

Friction callosity is also common among workers in the construction industry.

• Friction callosity is the skin’s reaction to friction and pressure from manual labour
• Patients present with thickened growths of skin on palms and soles, and over bony areas
• The calluses can be painful

Infectious skin disease

Several studies have found that infectious skin diseases are common in construction workers.

• Bacterial, viral or fungal infections may arise.
• The pathogens enter through the skin that has been compromised through friction or other mechanical injuries.

Workplace risk assessment

In order to cut down on instances of workplace dermatoses, the work area should be assessed and the following measures implemented if they are not already in place:

• Hand-washing stations and facilities stocked with adequate, safe supplies
• Showering facilities
• Laundry facilities
• Access to personal protective equipment such as gloves, aprons and shields

Personal protective equipment (PPE)

The most frequently recommended PPE is gloves, which, if properly used and maintained, can help to reduce work-related dermatoses in the construction industry.

Worldwide, many construction workers come from low socioeconomic backgrounds with low rates of literacy, making education on work safety issues such as PPE more difficult. Many construction sites worldwide lack the facilities for showering, laundry, hand-washing and basic PPE.

Hand care for construction workers

It is recommended that those engaged in the construction industry take care of their hands by:

• Hand washing with effective, non-irritating, non-allergenic cleanser or soap
• Using emollients and/or lotions after hand washing
• Frequently changing clothing and removing soiled clothes; washing soiled clothing at on-site laundry
• Moisturising skin regularly with fragrance-free creams, rubbed carefully into hands and wrists and between the fingers
• Using suitable gloves for the job, such as waterproof gloves for wet work
• Seeking advice from a health professional if dermatitis develops

Treatment of occupational skin disease

Care of occupational skin disease begins with thorough patient assessment, including general work conditions, specific job duties, a list of physical, chemical and biological agents at the work site and presence of skin conditions in fellow workers.

Treatment can include:

• Wet dressings
• Topical and oral corticosteroids
• Emollients and barrier creams
• Paring down callosities with a pumice stone 1–2 times weekly and applying creams containing salicylic acid or urea to soften them