Occupational dermatitis in the catering and food industries

CONTENTS

Food Sheet No 17

HSE information sheet

Introduction

Occupational dermatitis is one of the most widespread causes of ill health and affects people working in many industry sectors, including food processing and especially catering.

Nationally, across all industries, an estimated 84 000 people have dermatitis caused or made worse by their work. This results in 132 000 lost working days each year and costs employers some £20 million. Nearly 3000 cases of contact dermatitis are reported by occupational physicians and dermatologists each year. Many additional cases are seen by other medical professionals.

The food and catering industries account for about 10% of all occupational dermatitis: it is one of the main occupational health risks.

Occupations at risk

Workers of all ages in the catering industry represent a high risk group with regard to occupational dermatitis.

Those most at risk are:

  1. chefs;
  2. cooks;
  3. kitchen and catering assistants;
  4. counter hands.

Others at risk include:

  1. waiters and waitresses;
  2. bar staff;
  3. cleaners.

In food manufacture those at risk include:

  1. bakers;
  2. confectioners;
  3. meat, poultry and fish handlers;
  4. fruit and vegetable handlers.

What is occupational dermatitis?

Occupational dermatitis is caused by the skin coming into contact with substances at work. Because of this it is sometimes called 'occupational contact dermatitis'.

Symptoms of the condition can be redness, itching, scaling and blistering of the skin.

In food preparation and catering it is usually the hands and forearms which are affected. If the condition gets worse, the skin can crack and bleed. It can be extremely painful - bad enough to keep people off work and serious enough to force them to change jobs.

How quickly you get it depends on the substance, its strength or potency and how long and how often it touches the skin. Sometimes it can be caused by a combination of things - for instance, using detergents at work means you are likely to have hands in water a lot of the time. Over a period of time the combination of the wetness and the detergents can cause dermatitis.

If dermatitis is spotted early enough and adequate. precautions are taken, most people will make a full recovery. But some people will never recover due to sensitisation. So it makes sense to prevent dermatitis occurring in the first place.

Causes of occupational dermatitis

Water, soaps and detergents

In catering and food occupations, the prolonged contact with water, soaps and detergents - essential for food safety purposes - causes about 55% of dermatitis cases. This represents about 5% of all industry's occupational dermatitis and results in over 200 cases per year being reported by occupational physicians and dermatologists. Many additional cases will be seen by other medical professionals.

Foods

About 40% of dermatitis cases in the industry are caused by contact with foods. A wide variety of foods have been shown to cause dermatitis problems, including:

  1. sugar;
  2. flour/dough;
  3. citrus fruits and their peel;
  4. other fruits;
  5. vegetables;
  6. spices, herbs and seasonings (eg horseradish, mustard, garlic);
  7. fish and seafoods;
  8. meat and poultry.

Other causes

The remaining cases of dermatitis are mainly due to contact with:

  1. nickel (coins etc);
  2. rubber (including rubber gloves);
  3. chemicals and cleaners.

Some alcohol-based hand sanitisers/rubs may also cause dermatitis. Such sanitisers/rubs, which are applied to and rubbed between the hands after washing, can contain 30-70% concentration of isopropyl alcohol. The Department of Health advises there is currently no legal requirement for alcohol rubs in high-risk food premises and that soap or suitable detergent, used in conjunction with suitable washing and drying facilities, should be sufficient.

Prevention is easy

Occupational dermatitis can be prevented by following a few simple precautions. Dermatitis is more easily prevented than cured and the costs of prevention are much less than those of a cure.

Find out if there is a problem

  • Do workers come into contact with agents which could cause dermatitis?
  • Monitor sickness absence due to skin problems (if there is one case of dermatitis there could be more).
  • Investigate workers' complaints.
  • Consult safety representatives and employees.

Decide what to do

  • What is the cause of any problem and how many are affected?
  • Can the cause of the problem (ie the substance/item) be removed, for example not using alcohol hand cleansers?
  • Can the cause of the problem be substituted for something better, for example replacing a high concentration soap/detergent by a milder one?
  • Can contact with the substance or item be prevented in another way, for example not touching a foodstuff or wearing gloves (but remember some people are sensitive to rubber and latex glove materials and may require cotton-lined gloves).
  • Consider providing an after-work moisturising cream to help replace the natural oils the skin can lose when washed or in contact with detergents etc.
  • Decide what other control measures are required to prevent workers getting dermatitis, for example job rotation or alternative duties.
  • Implement the control measures.

Monitoring

  • Monitor the situation to ensure the control measures are effective.
  • Consider the need to provide simple health surveillance by a responsible person to enquire about symptoms of dermatitis. Suitable arrangements are described in HSE Guidance Note MS24 (see Further Guidance).

Training and information to workers

Another important element in prevention of dermatitis involves explaining to employees:

  • the causes of contact dermatitis;
  • how to minimise the risks by using the control measures you have identified;
  • how to recognise early symptoms of dermatitis and the need to examine their skin regularly;
  • the importance of reporting symptoms immediately.

Case studies

  • A number of employees in a food production area developed dermatitis. This was traced to water disinfecting tablets which were used to wash vegetables. The employer stopped those who had developed dermatitis working in this area and issued gloves to all the food handlers who were subsequently involved in this work. This satisfactorily resolved the problem.
  • A young female employee handling curry spices in the development kitchen of a food factory developed dermatitis on her hands, arms, face and neck. The condition improved when she took a week off work but worsened immediately upon her return, necessitating redeployment.
  • A male catering kitchen assistant developed severe dermatitis from frequent immersion of his hands in soapy water and contact with detergents. The situation was resolved by a series of measures including job rotation, reducing the concentration of soaps, providing suitable gloves and providing an after-work moisturising cream.
  • A 40-year-old female employee wore latex gloves when handling garlic and ginger in the production of soups and sauces. The skin on her hands occasionally became cracked and bled, necessitating time off work. Investigations into the cause of her dermatitis found that it was due to the latex gloves and not the ingredients she handled. She now wears cotton-lined gloves and continues to work in the same department.

Law

The Management of Health and Safety at Work Regulations 1992 and the Control of Substances Hazardous to Health Regulations 1994 require employers to assess whether dermatitis is a risk. If it is, employers must institute effective arrangements for the preventive and precautionary measures needed.

If a doctor confirms that an employee is suffering from occupational dermatitis, this must be reported to the enforcing authority (either the local authority Environmental Health Department or HSE as appropriate) as an occupational disease, under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995.

Further help and guidance

Priced publications

  1. Preventing dermatitis at work: Advice for employers and employees INDG233L (available in priced packs of 15) ISBN 0 7176 1246 5 Single free copies also available from HSE Books
  2. Control of Substances Hazardous to Health Regulations 1994: Approved Codes of Practice L5 ISBN 0 7176 1308 9
  3. The Management of Health and Safety at Work Regulations 1992: Approved Code of Practice ISBN 0 7176 0412 8
  4. Health surveillance of occupational skin disease HSE Guidance Note MS24 ISBN 0 11 885583 2
  5. A guide to RIDDOR. The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 ISBN 0 7176 1012 8

Video

Rash decisions (video on work-related dermatitis - its causes, effects and prevention - not specific to food/catering) 17 minutes. Available from CFL Vision, PO Box 35, Wetherby, West Yorkshire LS23 7EX Tel: 01937 541010

Free publications

  1. Preventing dermatitis at work: Advice for employers and employees INDG233L (also available in priced packs of 15 from HSE Books - see above)
  2. Everyone's guide to RIDDOR 95 (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995) HSE 31
  3. RIDDOR 95: Information for doctors HSE 32

HSE priced and free publications are available by mail order from HSE Books, PO Box 1999, Sudbury, Suffolk CO10 6FS. Tel: 01787 881165 Fax: 01787 313995.

HSE priced publications are also available from good booksellers.

For other enquiries ring HSE's InfoLine Tel: 0541 545500, or write to HSE's Information Centre, Broad Lane, Sheffield S3 7HQ.

HSE home page on the World Wide Web: http://www.open.gov.uk/hse/hsehome.htm

This guidance is issued by the Health and Safety Executive. Following the guidance is not compulsory and you are free to take other action. But if you do follow the guidance you will normally be doing enough to comply with the law. Health and Safety Inspectors seek to secure compliance with the law and may refer to this guidance as illustrating good practice.

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