Occupational contact dermatitis II: risk assessment and prognosis

Contact dermatitis is a common and important condition in the occupational setting. In a companion paper, I describe changes in the incidence of recorded occupational skin disease from 1972 to 1999. Despite substantial improvements in workplace hygiene, the incidence of occupational skin disease remains half of that recorded in 1972. In the companion paper, it is argued that a more sophisticated approach to prevention and management may be required to substantially reduce the burden of occupational skin disease further. In this paper, I address the present state of risk assessment (including components of hazard identification, measuring or estimating dermal exposure, percutaneous absorption, dose-response relationships, and risk characterization) and the poor prognosis of serious occupational contact dermatitis, with a view to potential improvements in practice and outcomes.