Danger - Skin at work!

In the cleaning industry it is inevitable that chemicals will be used. Almost without exception all will have the potential to cause damage to health should there be any contact between the skin and the chemical. In fact, water, in the form of wet work and long term wearing of protective gloves, is the most common cause of occupational contact dermatitis. Unfortunately, this is one aspect of occupational health where there are many myths and much misinformation. 

Many people are not aware of how thin is the barrier in our skin that is essential for our very survival. This barrier is extremely complex, but consists primarily of layers of dead skin cells forming the stratum corneum, the outermost layer of our skin. Over most of our bodies this layer is no thicker than that piece of cling film that we wrap sandwiches in. It is a remarkable organ but it can easily be damaged by the very chemicals that are used in cleaning and general housekeeping. 

Chemical reaction

Detergents will remove the extremely thin layer of fatty emulsion that forms in the surface layer of our skin. This allows the skin to lose the water the cells need to function as a barrier. One problem that we encounter is that the result is what is termed ‘chronic’, that is, it is not immediately apparent. So the person goes on using detergents unaware that the damage is accumulating unseen until the skin finally succumbs and the visible dermatitis appears. Incidentally, should the GP diagnose this as occupational, it becomes immediately reportable to the Health and Safety Executive, even if it has not resulted in time away from work.

Other chemicals present their own hazards. Be aware that when we use them we can change their properties. The effect of this can be dramatic, as illustrated by the case where an employee, tasked with cleaning the changing rooms in the premises, inadvertently mixed two chemicals together. The result was a chemical reaction that produced a toxic gas which he inhaled with a fatal outcome. Unfortunately, safety data sheets do not provide information on changes in properties when chemicals are used. So contrary to the popular, and often still promoted view, safety data sheets on their own are not a safe basis for a risk assessment. The table shows some of the changes that can occur.

For an effective risk assessment one must start with the particular task, establish what is being done during the task, what chemicals are being used for the task and how they are being used. From this one can determine the real hazard, combine this with the exposure and create the risk assessment.

Health surveillance

Those responsible for the health of their workforce should also be aware of the section in COSHH dealing with health surveillance. What is contained in the regulations has been amplified in the Approved Code of Practice (ACoP) for COSHH. The sixth edition of the ACoP (which in the author’s view anyone employing workers should have seen) sets down three new situations where health surveillance is required. Two of them are particularly relevant for the cleaning industry.

The first relates to the use of PPE, such as chemical protective gloves. Where these are being worn, then the employer must implement a skin health surveillance system. The second stipulates that where in the particular industry cases of ill health, such as occupational dermatitis, are occurring, then, again, health surveillance becomes a requirement for regulatory compliance. In effect this means that all those organisations employing workers in the cleaning industry must have a formal skin health surveillance system operated by a competent person.

This short article has had to omit many important aspects of occupational skin management that anyone needing to ensure that the health of their workforce is maintained will need to be aware of. These include the correct selection and use of gloves, the type of skin care products, the elements of a risk assessment and exposure strategy for skin in the working environment, how to investigate and manage a suspected case of occupational skin disease, etc.