Working-hands care guide
What NIOSH, OSHA, HSE and the AAD say about skin at work, quoted.
General information, not medical advice. This guide quotes NIOSH, OSHA, the UK's Health and Safety Executive, the American Academy of Dermatology and the FDA. It doesn't diagnose or treat anything and gives no first-aid instructions; for chemical exposure or injury, follow your employer's procedures and the product's own label and safety data sheet. The section on when to see a doctor quotes HSE and the AAD.
Our explanation written by Grimy Hands
The quoted sources discuss irritant and allergic contact dermatitis. NIOSH says their symptoms and appearance are similar and that clinical testing is often necessary to distinguish them. HSE identifies repeated or prolonged water contact as a cause of irritant dermatitis, and says that once someone is sensitised to a substance, that is likely to be permanent.
The official advice follows an order. Avoid contact where that is sensible and practical, protect the skin where it isn't, and check hands regularly. Within protection, HSE covers mild cleaning products, prompt washing of contamination, thorough drying and regular moisturising, and it is clear that a so-called barrier cream is not a substitute for suitable gloves.
Wet work counts as exposure too. HSE puts numbers on it: more than 20 hand washes, or wet hands for more than 2 hours per shift. Frequent washing, particularly with soaps and detergents, can therefore be part of the problem as well as part of the routine.
This page is general information drawn from the sources quoted. It doesn't diagnose or treat anything. HSE says to see a GP or an occupational health service about dermatitis caused or made worse by work, and about skin dryness and cracking, and the AAD describes when dry, painful hands may be hand eczema.
Our explanation of the official sources quoted below. It adds no facts of its own and doesn't rate or recommend any product.
Skin problems at work
Chemicals can enter the body through the skin and injure individual organs or groups of organs
Contact dermatitis is the most common form of reported occupational skin disease.
Research suggests that contact dermatitis makes up 90–95% of occupational skin disease cases in the United States.
Many studies indicate that absorption of chemicals through the skin can occur without being noticed by the worker.
Dermatitis is a skin condition caused by contact with something that irritates the skin or causes an allergic reaction.
Once someone is 'sensitised', it is likely to be permanent and any skin contact with that substance will cause allergic contact dermatitis.
The symptoms and the appearance of irritant contact dermatitis and allergic contact dermatitis are similar. Clinical testing (such as patch testing) is often necessary to tell the difference between them.
Hand eczema is common among construction workers and machinists.
How skin comes into contact with substances
Direct handling of contaminated workpieces
Contact with contaminated surfaces (eg workbench, tools, clothing and containers
Skin integrity (damaged or intact)
Wet work
Prolonged or frequent contact with water, particularly in combination with soaps and detergents, can cause dermatitis.
Repeated and prolonged contact with water (eg more than 20 hand washes or having wet hands for more than 2 hours per shift) can also cause irritant dermatitis.
Mild irritants that cause damage over time (such as water, detergents, or weak cleaning agents).
Avoid first: the order of controls
Employers can use the hierarchy of controls to prevent occupational skin disease in workers.
Elimination : Eliminating exposure to the compound or product that causes the skin condition is the most effective method of control.
Use the APC approach.
Avoid direct contact between unprotected hands and substances, products and wet work where this is sensible and practical
Contamination at work: employer guidance
Remind workers to wash any contamination from their skin promptly.
This is HSE guidance to employers about contamination; the cleaner finder is not chemical-exposure or injury guidance.
Routine cleaning and drying
Provide mild skin cleaning cream that will do the job and washing facilities with hot and cold water.
Tell workers about the importance of thorough drying after washing.
Makers' claims for routine hand cleaning are on the cleaner finder.
Moisturising
Protect the skin by moisturising as often as possible and particularly at the end of the day – this replaces the natural oils that help keep the skin's protective barrier working properly.
Unlike dry skin, you need more than a good moisturizer to get rid of hand eczema.
No moisturizer or balm is listed yet: those we found either lacked a maker's directions, cautions, ingredients or sizes, or carried drug-type claims. See the method.
Barrier and pre-work creams
Can I use a barrier cream instead of gloves? No. There are no true 'barrier' creams – chemicals will always work their way through to the skin.
However, pre-work creams can play a role in an overall skin care programme. They will help remove dirt during washing, so milder cleansing agents can be used.
No shielding or pre-work cream is listed: those we found carried drug-type claims on their makers' pages. See the method.
Gloves
The gloves need to be right for you, for the task and for the substances you are protecting yourself from.
Checking your skin
Check hands regularly for the first signs of itchy, dry or red skin
Checking your skin regularly is easy and can help to catch dermatitis early, which can make it easier to treat.
When to see a doctor
Skin dryness and cracking are early signs of dermatitis and shouldn't be ignored – you should check with your GP or if available, your occupational health service if you notice these signs.
If you believe that you have dermatitis that is either caused by or made worse by your work, go and see your GP or if available, your occupational health service .
If you have extremely dry, painful hands and using moisturizer throughout the day fails to bring relief, you may have hand eczema.
A dermatologist is a medical doctor who specializes in treating the skin, hair, and nails.
Labels: cosmetic or drug?
How the FDA tells a cosmetic from a drug, and why that matters for what a hand product can claim, is on its own page.