PREVENTION OF IRRITANT CONTACT DERMATITIS: New Aspects

Abstract

Contact dermatitis is the most frequent manifestation of occupational skin disease. Apart from total elimination of cutaneous exposure to hazardous substances, no established forms of treatment exist for irritant contact dermatitis (ICD). Furthermore, ICD is an accepted risk factor for allergic contact dermatitis (ACD). Due to these circumstances, prevention should have obvious priority to reduce the incidence and prevalence of ICD and secondary ACD. Primary, secondary, and tertiary prevention should be distinguished. Primary prevention tries to prevent the development of disease in the healthy individual. Secondary prevention is targeted at the diseased individual trying to inhibit a relapse of contact dermatitis. In tertiary prevention (rehabilitation), a chronically diseased patient is treated and reintegrated into the working environment. Prevention of occupational contact dermatitis requires an integrated approach that considers both the exposure and the exposed individual. The responsibility for primary prevention rests mainly with manufacturers and producers of chemicals and products, government agencies, consumer organizations, industrial physicians and nurses, and safety engineers. 34 A multidimensional approach with eight basic elements of prevention planning has been proposed by Mathias 26 : 1Recognition of potential cutaneous irritants and allergens 2Engineering controls or chemical substitution to prevent skin exposure 3Personal protection with appropriate clothing or protective creams 4Personal and environmental hygiene 5Regulation of potential allergens and irritants within the workplace 6Educational efforts to promote awareness of potential allergens and irritants 7Motivational techniques to promote safe work conditions and practices 8Pre-employment and periodic health screening (Table 1)