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Occupational skin disease

Author: Susan Ford BSc (Hons) Occupational Health, Practice Nurse, New Zealand, 2011. DermNet NZ Update April 2021



Occupational skin disease is among the most common occupational diseases reported. For a skin disease to be considered occupational in origin, there must be a causal relationship between the occupation or work and the skin disease.

There are three broad groups of occupational skin disease:

  1. Irritant contact dermatitis
  2. Allergic contact dermatitis
  3. Another occupational skin disease.

More than 90% of cases are classified as one or other form of contact dermatitis.

What occupations are most likely to be affected by skin disease?

The following occupations account for 80% of reported occupational skin disease in developed countries in Europe; most involve wet working conditions, which commonly results in contact dermatitis.

Other occupations reviewed on DermNet include:

The sites affected by occupational skin disease depend on exposure. About 80% of patients with occupational skin disease present with hand dermatitis.

Younger workers have a slightly higher risk that older workers, but who are affected will depend on:

Irritant contact dermatitis

Irritant contact dermatitis occurs when contact with chemical or physical agents injure the skin’s surface faster than it is able to repair the damage. Occupational irritant contact dermatitis:

Clinical features of irritant contact dermatitis are varied.

  • It may be a single episode that recovers, repeated relapsing episodes, or chronic dermatitis due to repetitive injury.
  • In general, the degree of damage following irritant exposure depends on the potency of the irritant, the duration of application, the frequency of exposure, occlusion, temperature, anatomical site, and individual susceptibility.
  • Where there is repeated exposure, previous damage may render the skin more susceptible to damage from the next exposure. However, hardening may also occur.
  • Because contact irritant dermatitis is dose-dependent, it tends to be restricted to the site of primary contact, which is usually the hands. A reduction in the cumulative exposure to irritants lessens the risk of dermatitis. Conversely, occlusion of the irritating chemical(s) or particulates by gloves, jewellery (such as wedding rings), or wristwatch can aggravate dermatitis.
  • Dermatitis may be dry, flaking, and fissuring; or erythematous, swollen, blistering, weeping and eroded.
  • Broken skin leads to a risk of skin infection (impetigo), presenting as red, painful, swollen skin with ulceration, oozing or pustules.

Allergic contact dermatitis

Allergic contact dermatitis is an immunological response (allergy) to a contact allergen. Only people who are allergic to a specific agent (the allergen) will show symptoms. The appearance can be exactly the same as irritant contact dermatitis. Allergic contact dermatitis:

  • Comprises > 10% of occupational skin disease
  • Includes protein contact dermatitis e.g. in foods
  • The incidence rate is reported to be increasing.

There are some specific features of allergic contact dermatitis:

  • The allergen may have been previously tolerated for years without causing dermatitis.
  • Once sensitised the reaction may occur with minimal exposure to the allergen.
  • Dermatitis may occur not only at the site of primary contact, but also at secondary sites eg a person who is allergic to an epoxy chemical may not only get dermatitis on their hands, but also dermatitis on the face or genitals, where they transferred tiny amounts of allergen by accident with their fingertips.
  • Dermatitis occurs within hours or days of exposure to the allergen.
  • Symptoms settle down when the skin is no longer in contact with the allergen, although this may take weeks and require treatment.
  • Allergic contact dermatitis can usually be confirmed by patch tests.

Other occupational skin diseases

Skin conditions other than dermatitis may occur as a result of occupational exposures. These comprise <10% of occupational skin disease.

What are the main types of occupational exposure?

Occupational skin disease may follow exposure to chemical, biological or physical agents.

Chemical exposure

Biological exposure

Physical exposure

How can occupational skin disease be prevented?

Recognition of cause
  • Employers and workers should be involved in identifying workplace hazards. This shouldn’t just occur once – it should be an on-going process that can respond to changes in the workplace and changes in knowledge.
  • Evaluate the exposure to hazards, and assess the risk of harm.
  • Maintain a register of accidents/incidents/occupational disease.
Eliminate or enclose
  • Sometimes skin contact with the hazard can be avoided by using encapsulated machines or automated equipment, such as dishwashers and food mixer.
  • Where a hazard cannot be eliminated, it should be minimised.
  • Where possible, choose less harmful chemicals to do the same job.
  • Rotate tasks to reduce individual exposure
  • Ensure appropriate ventilation and other engineering controls to minimise exposure to hazardous chemicals
  • Provide personal protective equipment: gloves, aprons, face shields.
  • Optimise skin barrier function with suitable emollients, barrier and moisturising creams.
  • Provide safety data sheets.
  • Train workers on causes of occupational skin disease.
  • Train workers how to protect their skin from injury and dermatitis.
  • Move at-risk individuals to alternative work.
  • Where a hazard is minimised, monitor workers’ health with respect to that hazard.
Appropriate treatment



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  2. De Craecker W, Roskams N, Op de Beeck R. Occupational Skin Diseases and Dermal Exposure in the European Union - Policy and Practice Overview. European Agency for Safety and Health at Work. EASHW, 2008. ISBN 978-92-9191-161-5 Journal
  3. Department of Labour. A Guide to Occupational Skin Disease Occupational and Health Information Series. 1995. ISBN 0-477-03580-9
  4. Diepgen TL. Occupational skin diseases. J Dtsch Dermatol Ges. 2012;10(5):297–315. doi:10.1111/j.1610-0387.2012.07890.x Journal
  5. Fisher A. Contact Dermatitis Lea and Febiger Philadelphia, 1986.
  6. Lee EB, Lobl M, Ford A, DeLeo V, Adler BL, Wysong A. What is new in occupational allergic contact dermatitis in the year of the COVID pandemic?. Curr Allergy Asthma Rep. 2021;21(4):26. doi:10.1007/s11882-021-01000-3 Journal

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