Protection from occupational allergens

Occupational skin disease (OSD) is an important and costly problem within occupational medicine. Ten to 15% of all occupational illness is caused by skin disease with contact dermatitis being the cause of up to 95% of all OSD. While irritant contact dermatitis is the most frequent cause of OSD, allergic contact dermatitis (ACD) is an important cause of chronic skin disease. In this chapter, various methods of protecting a worker from work-related allergy, including immediate and delayed-type hypersensitivities, are considered and reviewed. Concepts such as elimination of harmful exposures and allergen identification are considered. Personal protective equipment is an important component of prevention, including barrier creams, gloves and protective clothing. Methods for preventing allergy are discussed including prevention of sensitization, prevention of skin barrier breakdown, postexposure skin care and the role of educational programs. Protecting a worker from initial sensitization is the primary goal in prevention, but this is challenging considering the small amounts of an allergen needed to initiate and potentiate dermatitis. Patients diagnosed as having ACD can have symptoms that are more persistent, despite accurate diagnosis and therapy. With the high prevalence of contact dermatitis in the occupational setting, prevention is a key to healthy skin.