Wet work in relation to occupational dermatitis

This thesis describes the nature and the quantity of work-related skin exposure in occupations where ‘wet work’ is performed. Activities that cause one or both hands to become wet, in contact with detergents or other skin irritating substances or activities that need to be done with occlusive gloves are considered to be wet work. Employment sectors with much wet work are known to have many employees with skin complaints caused or worsened by the occupational exposures. In the first chapters the occurence of occupational dermatoses in some typical wet work occupations are described. In The Netherlands the occupational physician should recognise occupational relevant health problems, such as occupational dermatoses, and give advice on primary, secondary and tertiary prevention. Unfortunately many occupational physicians, also in industries with much wet work, are not confronted with employees with occupational dermatoses. Skin complaints lead to sick leave in a late stage of the disease, therefore occupational physicians who only focus on absenteeism will miss many of these occupational diseases. The occupational physician will have to use other methods than absence registration to detect patients with work related skin diseases. Amethod enabling an occupational physician to screen employees on work related skin diseases and on a predisposition for developing such skin diseases, was studied. The findings of these assessments were translated into an advice, aimed at avoiding hand dermatitis. The efficacy of this advice in terms of reducing skin irritation was evaluated in a laboratory situation. The focus was on the health-care sector, which is one of the sectors which have a high prevalence of work-related skin complaints (from here onwards in the text the term ‘skin complaints’ will be used for current skin problems as well as skin problems in the last year).