Introduction:
Occupational skin disorders, also known as occupational dermatoses, are among the top three reported occupational disorders. Occupational disorders are those that arise due to exposure in the workplace or that aggravate an already pre-existing condition. Skin disorders are the most prevalent occupational diseases, accounting for almost 90 % of them. These pose a threat to the normal working capacity of an individual and thereby cause a reduction in work efficacy. Occupational skin disorders is an umbrella term consisting of problems ranging from rash and allergic responses to even neoplasms. Finding the cause and efforts to prevent and treat it is of utmost importance for the general welfare of society as well as that of the employees.
What Are the Causes of Occupational Skin Disorders?
Exposure to physical, chemical, and biological factors can give rise to skin disorders. Some genetic factors may act as a predisposition and thereby aggravate the disorders in certain individuals. There may be direct and indirect causes for it. Whatever the cause, the prevention involves a comprehensive approach involving the dermatologist, physician, and health expert.
The major cause of it is chemicals and high amounts of ultraviolet radiation from the Sun.
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Physical hazards include rubbing, friction, mechanical pressure, temperature, and radiation.
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Chemical hazards the most prevalent to the skin include irritants, photosensitizing, and acnegenic agents.
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Biological hazards include bacteria, fungi, viruses, and even skin parasites.
What Is Dermal Absorption?
This involves the absorption of chemicals or pathogens through the skin. The extent of which determines the severity and prevalence of the disorder. It happens when a chemical penetrates the skin and travels into the body. Many chemicals can negatively affect the internal organs. Pesticides and organic solvents are the common chemicals that cause systemic problems.
How Does the Skin Prevent Absorption?
Skin being the primary protective layer or organ of the body, is generally inert or impermeable to external agents. It acts as a barrier to the body's protection while also helping in thermoregulation, vitamin D synthesis, and water preservation. Dermal absorption mostly depends on this barrier function of the skin. Especially that of the stratum corneum, which is the outermost layer, which has hair follicles and sebaceous glands.
If the skin's integrity is intact, there is better protection against dermal absorption and thereby preventing disorders. This integrity is regulated by the thickness of the stratum corneum, the physical-chemical structure of the external agent, the density of hair follicles, and hydration. It ideally protects the body by keeping molecules from being absorbed into the bloodstream. But repeated exposure to chemicals and other assaults can compromise the skin's integrity which causes increased dermal absorption.
The speed of absorption, therefore, depends on the following factors.
1. Nature of Skin: Whether it is damaged or intact.
If the skin is damaged, it is easier for chemicals to penetrate it, thereby increasing the risk of systemic complications.
2. Site of the Stratum Corneum: If it is in thickness of the layer at that site.
If the stratum corneum is thick, there is less absorption of the material. Areas like the palms and soles of the feet are less susceptible to dermal absorption.
3. Physical and Chemical Properties of the Agent:
Some occupations are exposed to more dangerous chemicals than others. The first step in preventing occupational skin problems is identifying the nature of the substances an employee is exposed to. It is for this purpose that RISKOFDERM was formulated to determine if a chemical is hazardous or not. If it is found to be hazardous, it should be substituted with another material, or if substitution is not possible, proper safety precautions must be enforced.
4. The Concentration of the Chemical on the Skin:
If the skin is exposed to a higher material concentration, there is a higher chance of dermal absorption.
5. Duration of Exposure to the Chemical:
The longer a person is exposed to the chemical, the more susceptible he is to dermal absorption. The RISKOFDERM toolkit demonstrates that hazardous chemicals for a small duration and nonhazardous chemicals for a more extended time can cause similar damage.
Therefore, the lower the molecular weight of the chemical, the higher its solubility, and the lower the barrier, the higher the solubility. Increased exposure leads to disruption of the skin barrier leading to increased absorption.
What Are the Problems Caused by Dermal Absorption?
Occupational exposure can result in various diseases, which can affect work efficiency, resulting in reduced performance and overall economic losses due to decreased productivity and medical expenses.
What Are Types of Occupational Skin Disorders?
Occupational skin disorders can present themselves in various forms, such as:
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Rash- caused by skin irritation and allergic reactions.
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Thermal injuries.
Chemical-to-skin interaction may have direct effects on the skin, auto-immune mediated, or systemic effects. The direct effect occurs when exposure to the chemical produces a local effect, such as irritation, necrosis, or even corrosion.
Some of the common disorders include:
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Irritant contact dermatitis.
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Allergic contact dermatitis.
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Oil acne.
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Skin neoplasms.
1. Contact Dermatitis:
It is the most common occupational skin disorder. It can further be classified into:
a. Irritant: Involves a chemical directly damaging the skin or causing an inflammatory response. Occurs when the chemical or physical agent injures the skin faster than its ability to heal. It may be a single occurrence, relapsing episodes, or a chronic condition.
b. Allergic: Occurs when a chemical that the body absorbs causes the body to produce an allergic reaction. Only people with an allergy to a specific agent will develop symptoms.
The appearance of both is the same. Whereas in incidence, irritant contact dermatitis comprises 80 % of all occupational skin disorders, while allergic dermatitis only comprises ten percent of them.
Dermatitis may be dry, flaking, red in appearance, and swollen with blisters.
This leads to a break in the skin barrier and further makes it prone to infection and ulceration.
Allergic contact dermatitis and urticaria happen in two phases:
a. Induction Phase: Which exposes the body to an allergic response
b. Elicitation Phase: Which triggers the immunological memory response.
2. Oil Acne:
It occurs as a result of irritation of the hair follicle by mineral oil remaining on the skin surface. It is intensified by poor hygiene and is found in the forearms and thighs of mechanical operatives.
Chloracne is a type caused by aromatic hydrocarbons such as chloro dibenzo dioxins.
3. Skin Neoplasms:
These include melanoma, squamous cell carcinoma, basal cell carcinoma, scleroderma, and leucoderma. 11 % of deaths by melanoma and squamous cell carcinoma may be traced to work exposure. It can be caused by polycyclic hydrocarbons, inorganic metals, and arsenic.
What Occupations Are at Risk of Exposure?
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Healthcare Workers: They are among the most affected, as the chemicals used for disinfection and sterilization can be a contributing factor. Also, latex gloves may act as an allergen; medical gloves may contain rubber accelerators.
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Cosmetologists and Hairdressers: They, too, are among the ones affected as they are exposed to irritants, colors, fragrances, surfactants in shampoos, detergents, and bleaching agents. Bleaching agents may contain dyes, and they are also exposed to acrylates used for nail art.
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Agriculture, Forestry, and Fishing Industries: They make up 50 % of the world's labor force. They are exposed to chemicals from pesticides and fertilizers. These contain organophosphates which can cause nerve damage.
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Kitchen Staff: They may be exposed to photoallergic substances, and the allergic response may even continue after the exposure has been prevented.
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Construction Laborers: They are exposed to petroleum and rubber products, which are toxic.
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Printing Industry: The use of solvents, oils, and other chemicals can act as both chemical and physical hazards.
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Scientific Workers: They are exposed to a plethora of chemicals used for laboratory observation, stains, and other mounting chemicals that can give rise to skin disorders. Hence proper physical protection is necessary while performing experiments.
What Are the Chemicals That Cause Skin Disorders?
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Latex, hair dyes, and epoxy resins can cause dermatitis.
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Tar, arsenic, and asbestos are associated with cancers.
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Cement under occlusion can cause chemical burns.
Some chemicals, once exposed, can give rise to allergic reactions such as urticaria or asthma. Some may even affect the respiratory tract. Systemic toxicity or organ toxicities can also develop. Recent evidence suggests that dermal exposure to certain chemicals which were earlier considered safe is now found to cause developmental and immunological effects, as well as cancers, obesity, and diabetes. This is due to their endocrine-disrupting properties. Endocrine-disrupting compounds (EDCs) are chemicals that have the potential to mimic or block hormones causing detrimental effects on the body's normal functioning.
How to Prevent Occupational Skin Disorders?
They can be prevented by:
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Recognition of the cause.
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Elimination or minimization of exposure.
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Monitoring the individual.
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The use of proper hygiene practices such as hand washing or use of sanitizers helps kill pathogens and reduce exposure time or contact. Healthcare workers can implement these steps to prevent chemical as well as biological exposures.
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Construction workers can use safety wear such as leather gloves and face shields.
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Cleaning staff must use rubber gloves, hypoallergenic gloves, and aprons that are impervious to oils and chemicals.
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The use of sunscreen helps protect against UV radiation.
Conclusion:
As newer advances in technology are made each day, they also open the gates to more risks and exposures in the workplace. Infections may be combated, but care should be taken in living and working environments. Knowing the enemy and taking precautions to overcome them is the best way to reduce occupational disorders and thereby increase productivity and economic results. Workers should be aware and made aware of the hazards the chemicals in their environment possess. Both the employers as well as employees should also be given training and equipment that prevent exposure should be provided.
