Occupational Dermatology

The National Institute of Occupational Safety and Health (NIOSH) included dermatologic disorders on its list of the top 10 work-related diseases and injuries in the United States;

• 10% - 15% of health hazard evaluations by NIOSH involve skin complaints.
• The economic impact of work-related dermatologic conditions is in the hundreds of millions of dollars per year.
• Dermatologic injuries from trauma or brief exposure to toxic agents constitute approximately 30% of all injuries.
• The most common injuries are due to lacerations, punctures, abrasions, and burns.
• 30% of occupational injury and 40% of occupational disease are dermatologic.

Contact dermatitis accounts for 90% of occupational skin disease, with the majority of cases being irritant. The clinical course for occupationally induced contact dermatitis is relatively poor:

• 25% have clearance of the dermatitis
• 50% have improvement but with periodic recurrence,
• 25% have persistent and severe dermatitis despite a change in jobs and therapeutic intervention.

The negative impact on the workplace and society results in:

• Lost worker productivity, medical care, and disability payments.

According to the Bureau of Labor Statistics 1984 Annual Survey:

• The highest number of occupational skin diseases occurred in the manufacturing sector
• The highest incidence was in the agricultural, forestry, and fishing industry.
• In 1993 the Annual Survey of Occupational Injuries and Illnesses reported an estimated rate of occupational dermatitis of 1.12/10,000 workers.
  • The largest number of cases occurred in health services
  • The highest rate was in agricultural crops.
  • The occupation with the largest number of cases was non-construction laborers.
  • Cleaning and polishing agents caused the largest number of cases.

Occupational skin disease has a guarded prognosis. Despite proper treatment, only 25% of patients have clearance of the dermatitis, even with a change in jobs.

Marks JG, Elsner P, DeLeo VA: Etiology of Occupational Skin Disease. Chapter in Contact and Occupational Dermatology Third Edition, Chapter 12, Mosby St. Louis, pp 303-313, 2002.