Author(s): Fourie, A., Muvhali, M., Carman, H., Singh, T.

Source: Current Allergy & Clinical Immunology, December 2022; Vol 35, No 4

Abstract: Personal protective equipment (PPE) should be the last-used, hazard-control measure in the workplace; however, it is still the first consideration as a protective measure in many workplaces. The conundrum is that despite its crucial role in protecting workers from various exposures, adverse skin conditions can present in some individuals. As the skin condition may progress to a chronic course with an unfavourable prognosis, this case series highlights the importance of diagnosing occupational dermatitis associated with various types of PPE. This is in order to inform risk-based preventative management to protect the worker and sustain work activity. A retrospective review of patients who visited the occupational dermatology clinic from September 2005 to May 2022 was performed. Patients who used PPE were further assessed to determine the type of adverse reactions and causative agents. A total of 36 records of interest were retrieved and analysed further. Allergic (16/36, 44%) and irritant contact dermatitis (13/36, 36%) were the most common diagnoses made. Adverse reactions to gloves (various types) were the most prevalent (25/36, 69%), followed by shoes at 17% (6/36). The majority of cases were from the healthcare industry (24/36, 66%), followed by manufacturing (5/36, 14%) and mining (4/36, 11%). The data for provinces were skewed, with most patients from Gauteng (30/36, 83%), Mpumalanga (4/36, 11%) and Limpopo (2/36, 6%). This study highlights the importance of recognising and diagnosing skin conditions attributed to PPE and emphasises the value of patch-testing to identify putative agents. This informs the process of identifying appropriate alternative PPE for sensitised workers in ensuring their continued safety while on duty.

Keywords: contact dermatitis; skin rash; prevention and control; health and safety; extended use