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PRACTICE: Allison Worth, S Hasan Arshad, and Aziz Sheikh Occupational dermatitis in a hairdresser BMJ 2007; 335: 399 [Full text]

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What about "wet work"?

Dil Sen, Catherine Boyle   (28 August 2007)

Occupational Dermatitis response

Raymond Agius   (12 September 2007)

What about "wet work"? 28 August 2007
Dil Sen, Consultant Occup Physician & Senior Medical Inspector,HSE HSE Manchester, Grove Ho, Manchester M16 0RB, Catherine Boyle Send response to journal: Re: What about "wet work"?	We were pleased to read the 10 minute consultation - Occupational dermatitis in a hairdresser [1] by Sheikh et al, especially since a) current figures confirm this particular industry group to be at highest risk of acquiring contact dermatitis [2], and b) for most hairdressers their first post of call would be their GP. However, we were disappointed that no mention was made of "wet work" [3], which is well recognised as being a cause of irritant contact dermatitis, especially in trainee hairdressers who do most of the hair washing [4]. It is because of the size and nature of the problem in this industry that the Health & Safety Executive (HSE) is promoting good skin care (through its Bad Hand Day campaign), and the use of suitable, single-use, non-powdered, non- latex gloves, particularly when carrying out wet work. [1] Sheikh A, Worth A, Arshad H. 10-minute consultation. Occupational dermatitis in a hairdresser. BMJ 2007;335:399. [2] http://www.hse.gov.uk/hairdressing/index.htm [3] Held E, Mygind K, Wolff C et al. Prevention of work related skin problems: an intervention study in wet working employees. OccupEnvironMed 2002;59:556-561. [4] Lind M-L, Albin Maria, Brisman J et al. Incidence of hand eczema in Swedish hairdressers. OccupEnvironMed 2007;64:191-95. Competing interests: Members of HSE's SKIN/Hairdressing Programme Team
Occupational Dermatitis response 12 September 2007
Raymond Agius, Professor of occupational and environmental medicine University of Manchester, Ellen Wilkinson building, Oxford Road, Manchester, M13 9PL Send response to journal: Re: Occupational Dermatitis response	Letter in response to “Occupational dermatitis in a hairdresser”  BMJ 25 August 2007, 335: 399 Worth et al (1) comment on the likelihood of developing dermatitis after starting work in hairdressing. Their choice of case is well justified when considering the incidence of dermatitis amongst workers with this occupation, as compared to others. Information on the UK incidence of work-related ill-health reported by physicians is available from The Health and Occupation Reporting (THOR) network (2), mainly from dermatologists reporting to EPIDERM (3). THOR data may be used to estimate overall rates for work-related ill-health diagnoses by applying Labour Force Survey (LFS) data (4) as denominators (with THOR data as numerators). The most recently estimated average overall annual incidence rate for work-related skin disease in EPIDERM was 91.3 per million (95% CI 81.8, 101.1), mainly comprising contact dermatitis (68.0 per million; 95% CI 59.8, 76.2) (5). The accompanying table highlights the occupations in the UK with the highest reported burden of occupational dermatitis to THOR. Not only is the burden in dermatitis in hairdressers in the top five, but hairdressers suffer by far the highest incidence overall – more so than nurses for example.   Occupation    (Standard Occupational Code) Average annual  number of estimated cases in EPIDERM 2002-2005  (95% CI) Incidence rate per 100,000 employed persons 2002-2005 (95% CI) Nurse (3211) 197.3 (131.6, 262.9) 39.7 (26.5, 53.0) Hairdresser (6221) 184.0 (109.7, 258.3) 122.4 (73.0, 171.9) Cook/chef (5434) 94.8 (40.9, 148.6) 38.2 (16.5, 59.9) Catering assistant (9223) 65.3 (21.7, 108.8) 17.0 (5.7, 28.4) Cleaner (9233) 65.3 (21.7, 108.8) 10.9 (3.6, 18.2) As well as in clinical management and in education (1) physicians have an important role in bringing these data to the fore in order to promote disease prevention programmes, and to support enforcement and educational initiatives such as those of the Health and Safety Executive. Raymond Agius Professor of Occupational and Environmental Medicine, Research School of Translational Medicine, The University of Manchester Competing interests THOR is partially funded by the Centre for Occupational and Environmental Health at the University of Manchester, The British Cotton Growers’ charitable fund, the DH, and the HSE       Worth A, Arshad SH, Sheikh A. Occupational Dermatitis in a Hairdesser. BMJ 2007; 335: 399. THOR - The Health and Occupation Reporting network. Occupational and Environmental Health Research Group. The University of Manchester. Available at http://www.medicine.manchester.ac.uk/coeh/thor Cherry NM, Meyer JD, Holt DH, et al. Surveillance of work-related diseases by occupational physicians 1996-1999. Occup Med (Lond) 2000;50:496-503. Office for National Statistics. Labour Force Survey 2002-2005. Turner S, Carder M, van Tongeren M, et al. The incidence of occupational skin disease as reported to The Health and Occupation Reporting (THOR) network between 2002 and 2005. British Journal of Dermatology (In Press), online early article available at www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2133.2007.08045.x Competing interests: THOR is partially funded by the Centre for Occupational and Environmental Health at the University of Manchester, The British Cotton Growers’ charitable fund, the DH, and the HSE