Health and Safety

Executive

G403 Health surveillance for

occupational dermatitis
COSHH Essentials:
General guidance

Control approach 4: Special

This information will help Introduction

employers (including the ■ Exposure to skin sensitisers or repeated exposure to skin irritants can
self-employed) comply with lead to occupational dermatitis (OD). It is an important and common
the Control of Substances type of work-related ill-health.
Hazardous to Health
Regulations 2002 (COSHH), as
■ If skin becomes sensitised, exposure to a small amount of the relevant
amended, to control exposure substance can trigger a severe reaction.
and protect workers’ health. It ■ If you detect the signs of OD early and modify a worker’s exposure, the
is also useful for trade union risk of developing long-term (irreversible) skin problems is reduced.
safety representatives.
Main causes
The sheet describes specialist ■ Epoxy resins, latex, solvents, chemicals used in rubber manufacture,
advice on health surveillance for soaps and cleaning products, metalworking fluids, cement, enzymes,
occupational dermatitis. wood and irritating chemicals.
It sets out what you should ■ Hand immersion (‘wet work’), particularly multiple washing of hands
expect from a health using soap or detergent.
surveillance provider. ■ Prolonged glove use.
Health surveillance should
High risk occupational groups
identify if your workers have any
of the following skin symptoms: These include construction work, health service work, rubber
processing, printing, paint spraying, agriculture, horticulture,
■ Itching electroplating, cleaning, catering, hairdressing and floristry.
■ Scaling/flaking
What is health surveillance?
■ Dry or cracking skin
■ Health surveillance is a risk-based scheme of repeated health checks
■ Skin colour changes
for the early identification of ill-health caused by work (eg OD).
■ Blistering ■ You should not use health surveillance instead of doing a risk
■ Weeping assessment or using effective exposure controls.
■ Soreness ■ You should feed results from health surveillance into your risk
Workers should also understand management system.
the importance of reporting ■ Where OD is identified in a worker you must review your risk
these symptoms if they occur. assessment and controls, taking into account any advice given, for
A clear system should be in example, by an occupational health professional.
place for who they report these ■ Health surveillance is not the same as health promotion or health
symptoms to. screening.

Planning and preparation

Plan what you are going to do if a worker reports symptoms of OD.
This includes:
■ referring workers for further assessment of their symptoms by a
suitable health professional eg in occupational health;
■ how workers diagnosed with OD will be managed at work, such as
reducing exposure to the relevant cause or working in an alternative
role;
■ ensuring your workers are aware of your plans.
COSHH essentials: General guidance – G403 – Health surveillance for occupational Health and Safety
dermatitis Executive

When health surveillance is required

Health surveillance should be considered where there is:
■ exposure to the main causes of OD (above) or substances and
processes where OD is a known problem;
■ exposure to substances labelled:
– H315 ‘Causes skin irritation.’
– H317 ‘May cause an allergic skin reaction.’
■ reliance on Personal Protective Equipment (PPE) in workers exposed
to substances which may cause OD; or
■ a confirmed case of OD in your workers.

What a suitable health surveillance scheme should

look like
■ You will need to involve an occupational health professional (doctor or
nurse) who has the relevant competence, skills and experience for the
health risks in your business. They will help you develop your health
surveillance scheme and they can train responsible persons (see
below) to help deliver it.
■ Workers’ skin health should be assessed before exposure, but if not,
as soon as possible after exposure starts (for example within six
weeks) to provide a baseline.
■ You must have ongoing assessments at appropriate frequencies; for
example, annually. Your occupational health professional can advise
you on how frequently you should do this.
■ Health surveillance involves an appropriate questionnaire and a
relevant skin inspection (for example of the hands, forearms, face and,
if these can be contaminated, lower legs).
■ In circumstances where there is:
– only occasional exposure to a known cause of OD; or
– adequate control of exposure with no evidence of health problems
at health surveillance (questionnaire and skin checks) over a
representative time period;
an annual skin questionnaire and keeping a health record may be
adequate.
■ Occupational health professionals should interpret the heath
surveillance results for both individuals and groups of similarly
exposed workers, taking into account any previously available results.
This allows you to identify any need to revise your risk assessment,
review exposure controls, and where necessary move workers to
alternative roles.
■ You should ensure that your risk management system allows workers
to report any symptoms that occur between assessments. This
could be either to your responsible person or occupational health
professional.
■ A ‘responsible person’ is a worker you appoint who is trained and
supported by an occupational health professional. You should always
consult with your occupational health professional if you decide to use
a responsible person as part of your health surveillance scheme.
COSHH essentials: General guidance – G403 – Health surveillance for occupational Health and Safety
dermatitis Executive

■ You must keep a health record for each worker under health
surveillance and also encourage them to keep a copy of their results in
case they change jobs.
■ Your risk management system should ensure that concerns raised by
employees are investigated and that any relevant sick leave data is are
taken into account. This can help highlight cases of occupational skin
disease and any issues with working practices.

Record keeping for Health Surveillance

■ You must keep a health record for each worker under health
surveillance which includes:
– the worker’s name and address;
– national insurance number;
– products or process(es) they work on;
– date exposure started and its frequency and duration;
– what personal protective equipment (PPE) is used; and
– the results of any health surveillance.
■ These health records should be kept securely for at least 40 years from
the date of the last entry.

Further information
For further information visit www.hse.gov.uk/ and search for ‘health
surveillance’ and ‘occupational health’ and ‘Work-related skin disease
statistics in Great Britain.’
Further information on medical aspects of occupational skin disease
can be found via https://www.hse.gov.uk/pubns/priced/ms24.pdf
For information about health and safety visit https://books.hse.gov.uk
or http://www.hse.gov.uk
You can view HSE guidance online and order priced publications
from the website. HSE priced publications are also available
from bookshops.
To report inconsistencies or inaccuracies in this guidance email:
[email protected]

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Published for the Health and Safety Executive under licence from the Controller of Her Majesty’s Stationery Office.