The first thing that comes into contact with a surface, a person, feels the warmth of the sun, or the cold wind is our skin. Or rather the sensitive nerve endings that are part of one of the marvels of the skin feels all those aspects.
The skin is one of the largest organs in the body, and has to work very hard to keep us healthy. Doctors and nurses are trained to check the skin first, looking for signs and symptoms of disease.
The skin works in the following ways to keep us healthy:
- Protection: it is the barrier between our internal structures and the environment we live and work in.
- Sensation: The nerve endings in the skin react to hot and cold, pressure, and pain
- Heat regulation: we have our own air conditioner – we perspire when hot or shiver when cold, we lose water when perspiring which cools us down. The blood vessels you can see under your skin dilate when it is hot to cool us, or ‘shrink’ to keep the warmth in.
- Absorption and excretion: perspiration includes waste material we don't need, and we absorb what is added to our skins in creams, chemicals and medicines.
- Aesthetics and communication: one of the most important perhaps in terms of how others see us – mood, poor skin condition as we age or are ill, and physical attractiveness
The hue, or depth of colour of our skin is determined by the amount of melanin we carry. We also have other pigments that determine colour or adds depth to the colour we see when looking at someone. Carotene is yellow, haemoglobin is red (found in blood cells). We also carry a range of microorganisms such as yeasts and bacteria, that might sound a little strange, but without which we could become quite ill.
We know that age affects the skin, which becomes more fragile and easily damaged as we grow older. The protective aspects also reduce as we age.
The skin at work
What do we need to know about keeping the skin healthy at work? It makes sense if you have read the introduction to know that there could be issues when working in very hot, cold or high-risk areas. The modern working environment can be very difficult, and risks hard to recognize. There are new types of industries, chemicals and technology being developed daily, each with its own risk, hazards and health effects. So if we don't know what we are working with, how do we know how to protect those working there?
The skin absorbs easily, while it does protect, it can’t protect us from everything, and cant itself identify all the toxins it is exposed to. While healthy and in good condition, it will manage, but if there is a large exposure, it will be a problem, resulting in injury or disease.
When do we know if skin disease is work related?
All diseases that are work-related are well defined by the Compensation Commissioner. The simplest way to define this is to show the link between the symptoms or disease and the exposure. Some aspects could happen at home, but the critical issue is to show the relationship.
The following table shows this as an example:
High-risk occupations causing skin diseases
The range of high-risk jobs is very wide, from hairdressing to printing.
Three occupations will be discussed:
Printing is still in use with, newspapers, magazine and even in-house printing departments. Equipment can be highly automated, or manually operated and cleaned.
The most common substances used that could affect the skin in the printing sector are:
Wash-up solutions, Inks, varnishes, developers and the solvents used for cleaning. The most common processes causing skin diseases include platemaking, cleaning of rollers and cylinders, guillotining and working in press rooms (HSE, 2014).
Employees working with lathes, machining and grinding among many are exposed to fluids and oils used to protect the machinery, and general wear and tear. Skin contact occurs when working with the metal to shape, cleaning and clearing.
Construction does not only include indoor work, but extensive time in the sun. Workers are highly exposed to ultraviolet radiation (sunburn)) and chemicals used. Chemicals range but cements, grouts, paints, petroleum based chemicals will have a major effect on the skin too (HSE, 2014).
Protecting the worker from skin diseases
The hierarchy of control is the preferred method of limiting exposure and disease. There are a number of ways in which risk can be managed or limited, which are:
- Hazard identification of workplace risk;
- Assessment of the level of risk;
- Measurement of the risk;
- Reducing, eliminating, and
- Management of the risk.
Early identification of disease is essential, a worker with a severe irritating contact dermatitis could result in not able to work, losing a job from something that could have been prevented. Medical surveillance is one of the ways the OH team will identify those at risk, and those who have been exposed. Claims to the Compensation Commissioner for skin diseases are very tedious, and likely to have limited success.
Hazard identification of workplace risk
A detailed understanding of the working environment is required in order to identify the risk of each activity related to the business. Each activity needs to be broken down into sub activities. Who does what and when, what equipment is used, and how is it used and what noise levels are emitted. Then one needs to know how bad or serious the health effects are of each of the sub activities. The Health and Safety (H&S) Officer therefore needs to understand the nature of the business, how everything works and where the hazards are.
Management of exposure
The standard approaches in terms of hierarchy are as follows:
- Good design – there wont be an issue if all the potential hazards and risks are designed out of a process;
- Engineering – identify plant and equipment to be purchased, installed or used that has require chemicals or processes to limit risk. Enclosing areas, limiting access, using ‘closed’ chemical supplies;
- Substitution – investigate alternative chemicals or products, equipment and processes;
- Eliminate – is the process/plant/equipment needed or used or can the work be automated, and
- Reducing exposure – limiting the number of employees able to access the area, using specially trained teams.
Where the management is not able to use the upper levels of the hierarchy of control, costs increase, as monitoring, medical surveillance, training and management is required.
Good hygiene, clean clothing and regular cleaning and clearing further assist with limiting exposure. Often a worker will absorb a chemical if it has been soaking through an overall or seeped through shoes. Clearly the appropriate personal protective equipment (PPE) is required, but as shown in the hierarchy and management, PPE is a last resort. It is also expensive, needs to be managed and cared for.
The H&S Officer can advise you regarding the types of PPE appropriate, and should where possible work with the OH staff to identify the health issues and ensure workers stay healthy. There is some resistance to providing workers with sunscreens, specifically in South Africa. While the following reference is not from here, it gives an international look at what the latest issues are http://www.skcin.org
The prevention of exposure to the skin is imperative, and is a team effort. The risks and hazards are identified, areas, processes and products investigated, and ultimately will protect workers in the field or any environment there they work. Workers too can assist with notifying the OH team of problems and issues quickly to protect themselves and others.