Occupational Contact Dermatitis (OCD) proves to be an expensive process (Meyer et al. 2000). It is responsible for notable medical costs and a subsequent demand on the UK economy. Further secondary costs to organisations and individuals are inevitable, such as production loss relating to sickness and absents and other related business costs, not forgetting the general pain and disruption to those suffering, including career disturbance and distressed loved ones (Fahs et al, 1989).
For these reasons, employers must be able to control and prevent OCD within the work place, not only to comply with law and legislation but also moral reasons for protected your staff.
OCD is an inflammatory skin condition caused by contact with an irritant or sensitizer and this paper looks at how the disease presents itself, what the causes are, the professions that are at highest risk and the types of substances that have been identified to cause OCD (CCOHS 2008). It will also examine UK strategies in place for employers to successfully identify a disease and whether control and prevention in winning in the reduction of ill health within the work place.
With the understanding that OCD is a complicated and in-depth matter (Wilcock 2006), it is clear why it is not an easy task for employers to successfully define and manage work related causes. This paper looks at the importance of training, the role of a competent person within an organisation, good leadership skills and the essentials that are required by an employer to be able to instigate a good positive culture within their organisation. Lastly, the role of staff engagement and two way communication as research has highlighted a relationship between risk management and staff involvement and how this can be encouraged by two-way communication (Douglas 1985).
Contact Dermatitis
Work related skin diseases are widespread (Meyer et al. 2000) and Occupational Contact Dermatitis (OCD) over the past thirty years has been classed as one of the most significant occupational disease in a number of countries (Helt et al., 2002) secondly only to musculo-skeletal disorders. The principle types of OCD's are irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD).
Both ICD and ACD are a well recognised disease that effects peoples quality of life and reduces their capabilities in the work place. Not only can it result in the suffering of employees, it inflates costs to the UK's economy (Liden 2009) and with the present compensation culture and subsequent civil claims and medical costs there is a financial burden on our country (Leigh, Robbins 2004). The chief expense to the employer as a result of OCD is work related absence and a study carried out in 2002 by Adisesh and Meyer into the 'prognosis and work absence due to OCD' suggested that this disease remains to hold a significant bearing on employers and organisations ( 2002).
Contact dermatitis is an inflammatory reaction of the skin that probably occurred as a consequence of contact with an irritant, allergen or sensitizer. It usually presents itself as an itchy red patch and in more serious chronic cases the area becomes thick, scaly, with possible colour changes and hair loss. Countless people suffer from skin conditions however many of these are not work related with a number of cases first occurring as a child (HSA). Nonetheless, even though OCD very really results in hospitalisation, it can effect a person's quality of life considerably (Hennessy et al 2004).
Research over the past 25 years has highlighted a number of occupations that are at higher risk of suffering this disease. Occupations such as hairdressing, catering, health care workers, construction workers, florists and cleaning staff all have an association with wet work and dermatitis (Kiec-Swierczynska 1994). Our skin cells are constantly being renewed to form a protective layer and when the rate of damage to this layer surpasses the pace of repair, dermatitis can arises. The groups of substances that can cause this damage are sensitizers and irritants and include solvents, detergents, wet cement, cutting oils, adhesives, nickel, wood dust and many others (Saint-Mezard 2004); all substances that can be found within a work place.
Dermatitis is generally apparent firstly to the employee and as a result of self examination. For this reason, the reporting structure within an organisation is vital. However, the success of self examination is determined by the employee's understanding of what to report and to whom (HSA, HSE). The importance of staff training within an organisation should not be underestimated, employees need to be able to identify the early stages of dermatitis and its prevention. Furthermore, for success in the reduction of sickness and absence good leadership is a key element (Northouse 2012). Research suggests that the promotion of a positive safety culture within a company is beneficial to a healthy work force and this needs to be driven by top management and filtered down through the organisational structure to all workers (Vecchio-Sadus A, Griffiths S 2004). As mentioned, training, supervision and information regarding the substances employees come into contact with during their working day will help to achieve this.
As set out in government legislation for the 'safe control of substances (COSHH 2002), an employer is responsible for the control and prevention of substances within their organisation and to provide a safe working environment for their employees. Any organisation must provide:
Health Surveillance where required
Risk Assessments
A Safety Statement (up to date)
Information, training and supervision for employees and
Sufficient Control Measures.
As a result of this legislation, research and its subsequent powers that aid development within policy, it has helped to create an increased awareness of hazards within the working population. HSE statistics do show that as a result of instigated systems and processes there has been a reduction in the number of reported occupational disease in 2009/2010.
However, as economies and industries mature and developed, new substances will continue to be introduced into the workplace creating uncertainty of exposure limits and secondly, substances that were thought safe over periods of time will demonstrate harm to workers and will therefore continue to create a need for ongoing research and testing in general and within organisations (Herber, et al. 2001).
Risk assessment are fundamental in the safe use of chemicals and so is the expertise of the individual carrying out the assessment. An unsuitably trained person carrying out an assessment is likely to produce one that is flawed or inadequate (Stranks 2006) . A suitable and sufficient assessment would identify those who could be harmed, the work areas that are affected, hazards including the types of machines used, i.e. if they cause friction and skin damage etc. and the daily safe exposure levels stated in the regulations. Others factors such as environmental issues such as humidity, working temperatures, seasonal influence, would also be addressed (Felter et al 2002).
With proper controls OCD can be averted with control measures or at least minimised with a decrease in skin contact with a substance. If a risk assessment indicates that an employee is at risk of developing dermatitis as a result of contact with a substance then controls are required to reduce these risks to the minimum.
An employer must adequately control the exposure of any material or substance that could possibly cause ill health (COSHH regulations 2002) and this can be achieved by changing working practices and processes (HSE 2007) such as:
The removal where possible of the substance
Substitution of the substance for a less harmful product
If possible, introduce a closed working system to reduce contact to a minimum
Use vacuum, drainage or LEV systems to remove fumed and excess materials
Introduction of good welfare facilities for hand washing, drying and for applying hand creams and barrier cream (Bourke 2001).
Many companies do claim to have health and safety systems in place, however on closer inspection there is often a failure to meet essential factors due to the implementation of the systems or difficult scenarios such as part time workers and temporary staff (Gallagher et al, 2003). Therefore, for any management process to be a success, training and communication with employees is extremely important (Michie, Williams 2003) . Workers need to be aware of the harmful substances they are working with and they are also entitle to the necessary training and information required for them to safely carry out their duties. Training should include access to safety data sheets, risk assessments, control measures, the known substances that cause contact dermatitis and the seriousness of the disease and how it may affect them, and the purpose of health surveillance. Staff also need to understand the importance of the correct use and storage of PPE; the correct selection and use of gloves in the workplace is imperative (Kwon 2006) and they also need to be encouraged to carry out self examinations and understand what they are looking for and who to report to if they identify any symptoms. In addition, wet workers require an understanding of the benefits of barrier creams and skin care programmes, research does suggest that skin care programmes have a positive effect in the prevention of OCD (Held et al 2002). Again, this is where training is important.
Health Surveillance is employed to identify the symptoms of dermatitis at the earliest onset and risk assessments, along with the safety data sheet for a substance will clearly identify if there is a need for it. Health Surveillance is however a lesser prevention control and should be carried out in conjunction will the primary control measures. This secondary control can be conducted by an experienced individual who understands the workplace and has a knowledge of the chemicals used. However, it is advisable to include a health and safety practitioner in any health program. Their role would involve the training of staff , have an involvement maybe in individual employee assessments with new starters and initiate any regular testing required as a result of information collated via risk assessment, staff questionnaires, health surveillance etc. They will also be required to interoperate results to indentify new problems or changes and be able to use such information to address any need for assessments to be revised or work processes to be adapted.
Behaviour change within an organisation to promote a positive safety culture and subsequent reduction in OCD can be a challenge, however research does indicate that where behaviour change and risk awareness within workplaces have been promoted, it has resulted in a reduction of reported cases of occupational ill health (Whysall et al 2006). Research has also suggested that to achieve this cultural change, motivational techniques encourage the support of safer work conditions and practices (Mathias 1990). Unfortunately, smaller organisations may not have the understanding or guidance required to access the information necessary or the essential expertise to promote a safe workplace (Pingquit 2006). For compliance to be accomplished, a safety consultant may be required and therefore adding hugely to the operational costs of the company and in today's economy this may not seem feasible. Hence, it is not only employees that require the necessary education to bring about positive change, without knowledge and understanding an employer, of a smaller business in particular, may not have the understanding or confidence to make an informed decision as to whether the expense of an health consultant could outweigh the possible cost to his organisation as a result of accidents, incidents and ill health that are occurring due to insufficient or nonexistent controls (Walker 2004). There is more of a chance that larger organisations have the required recourses available to promote a positive safety culture to both director level and the workforce (Mcleod 2007).
Another hurdle to consider is conformity, as most workforces consist of teams the desire to conform is usually present. As a rule, people want to be accepted by their work colleagues and that drive to 'fit in' and 'to do what the others are doing' needs to be acknowledged by the individual who has the difficult job of bringing about change and introducing new working practices to achieve a safer working environment. A good health and safety practitioner within an organisation should be able to deliver the training, information and supervision to all levels of the company, achieve staff engagement and motivation, bring about positive change, and gain employee commitment to be part of the process (Mcleod 2007).
A recent success story in this field being the 'Olympic build project's ill-health prevention programme. Research by the Olympic Delivery Authority identified that the employment of an occupational hygienist on site during the full three year build, avoided costs to the sum of 7m by minimising sickness and absence. Results showed that for every £1 spent on the project £7 was saved: A very good example that occupational health can be a good investment (IOSH 2012).
Conclusion
