[Occupational burden of the skin: the example of hands]

The target body part primarily affected by stress in an occupation are the hands. The hands are involved in 90-95 % of the nearly 18,000 cases of occupation-related skin diseases registered every year. Harmful substances and stressing procedures, such as, e. g., wet work, tensides, organic solvents, lubricating coolants, metals, and even foods, are able to cause irritation of the skin. These noxious substances penetrate the skin and either cause direct damage of the protective skin barrier (irritative contact dermatitis (CD)) or provoke an immunological reaction (allergic CD); both will become manifest in eczemas of various forms. In order to avoid such eczemas preventive measures have to be taken. Primary prevention includes the reduction of harmful substances or even their replacement (e. g., chromate in cement or powder in latex gloves). Secondary prevention comprises, among other measures, training programs to educate in methods of skin protection and skin care. If all these measures are taken in a consistent manner the occurrence of skin diseases that are subject to compensation claims can be avoided.