Occupational Dermatitis: Contact Eczema and Prevention

What is occupational dermatitis, and why does it start on the hands?

Occupational dermatitis is inflammation of the skin caused by substances or conditions encountered during work. It is the workplace equivalent of what is called "hand eczema" in everyday language: dryness, redness, scaling, cracking and sometimes small itchy blisters. The hands are the most affected area, because they are the first place to touch cutting fluid, water, detergent and solvent.

In metalworking workshops the picture usually starts silently. The operator first notices that their hands have become dry and that cracks have formed between the fingers; within a few months the sores stop healing. If it is noticed and measures are taken at this stage, most irritant dermatitis recedes. If not, the worker may become allergic, and complaints recur with every contact with the same substance.

Types of contact dermatitis at work: three pictures

To choose the prevention method, you need to know which picture you are dealing with. The physician makes the definitive diagnosis; the comparison below explains why the symptoms are managed differently.

Feature	Irritant contact dermatitis	Allergic contact dermatitis	Contact urticaria
How does it arise?	The skin's protective layer is worn down by repeated contact	The immune system becomes sensitised to a substance	An immediate-type allergic reaction develops
When does it appear?	Gradually over weeks and months	After sensitisation, hours or days after contact	Minutes after contact
Typical agents at work	Wet work, detergents, solvents, water-mixed cutting fluids	Nickel, chromium, cobalt, biocides in cutting fluid, epoxy, rubber additives	Latex glove proteins
Course	Often recedes when contact is reduced	Sensitivity is usually permanent	Recurs on renewed contact

The two pictures can also occur together in the same person. Skin damaged by irritation makes it easier for allergenic substances to penetrate; so do not dismiss irritant dermatitis as "minor dryness".

Main sources in metalworking

Fluids, metals and cleaning habits work together. Check the following sources one by one in your workshop:

Water-mixed cutting fluids (soluble oil): The emulsion dries and irritates the skin; the preservatives and additives in it and metals such as nickel, cobalt and chromium passing into the fluid from the workpiece can cause allergy.
Neat cutting oils: Prolonged contact and oil-soaked workwear can cause oil-related skin problems on the forearms and legs.
Washing hands with solvent: Removing oil with thinner or solvent also removes the skin's oil; gritty harsh cleaners deepen cracks.
Wet work: Keeping hands wet for a significant part of the day or working for long periods in occlusive gloves softens the skin and leaves it unprotected.
Resins and adhesives: Products containing epoxy and acrylates are among the strong allergens.
The glove itself: An unsuitable glove, or one that is wet inside, can make the problem worse instead of solving it.

You will find the skin warnings for the products you use in sections 2 and 11 of the safety data sheet; we explained how to read it in our article on the safety data sheet.

Cutting fluid eczema: reduce contact at source

Preventing cutting fluid eczema starts not with gloves but with managing the fluid and the machine:

Measure the concentration. Keep the emulsion at the ratio recommended by the manufacturer; do not judge by eye, measure regularly and record.
Keep the fluid clean. Swarf, tramp oil and degraded fluid irritate the skin more; change foul-smelling, discoloured fluid with a defined procedure.
Prevent splashing. Use doors and splash guards, and direct the fluid nozzles at the workpiece.
Reduce hand contact. Use a hook or holder instead of taking the part out of the fluid by hand; do not clean parts by blowing fluid around with compressed air.
Change clothing. Oil-soaked overalls and an oily rag carried in a pocket keep contact going all day.

For other measures on CNC machines, see our article on CNC operator safety.

Glove allergy and correct glove use

Gloves are the most effective barrier against contact with cutting fluid and solvent; but when chosen wrongly, they are themselves a source of problems. There are two separate mechanisms in glove allergy:

Latex proteins can cause immediate-type allergy and contact urticaria. Switching to non-latex gloves is often enough.
Rubber additives (accelerators used in manufacture) can cause allergic contact dermatitis. These substances are found not only in latex gloves but also in some nitrile gloves. For a worker with proven sensitivity, accelerator-free glove options are considered.

To use gloves correctly:

Choose a material suitable for the chemical according to section 8 of the safety data sheet; for selection criteria, see our article on choosing work gloves.
In prolonged use, wear cotton liner gloves inside, and take the gloves off at intervals to air the hands.
Change gloves that have let in liquid or are wet inside with sweat; a wet glove does not protect the skin, it damages it.
Put gloves on clean, dry hands, and do not touch the outer surface when taking them off.

Skin care plan: protect, cleanse, care

Instead of leaving skin care to individual habit, turn it into a written plan hung next to the washbasin:

When?	What is done?	Point to watch
On starting work and after breaks	Pre-work protective cream on clean, dry hands	Cream does not replace gloves
When hands are dirty	Washing with lukewarm water and a mild cleanser, rinsing thoroughly	No solvents, thinners or gritty harsh cleaners
After washing	Drying fully, including between the fingers	Skin left wet cracks more easily
At the end of work	Care cream (moisturiser)	Fragrance-free products preferred
Every week	Checking hands, reporting dryness and cracks	Early reporting prevents permanent damage

For the plan to work, the cream and cleanser must be next to the washbasin, accessible and full. If there are no supplies, there is no plan.

Health surveillance and occupational disease notification

Dermatitis is one of the most easily monitored outcomes of health surveillance, as long as someone looks at the hands. The workplace physician proceeds through these steps:

At pre-employment, records the skin history and condition of the hands; takes this into account when placing the worker in roles involving wet work or cutting fluid contact.
At periodic examinations, examines the hands and asks about symptoms the worker has noticed. Periodic examinations are carried out at least every 3 years in the hazardous class and every year in the very hazardous class; the physician shortens the interval if needed. You can track the dates with the OHS calendar tool.
When there are complaints, recommends work arrangements to reduce contact and, where necessary, requests a dermatology assessment and patch testing. We plan these tests with authorised healthcare institutions.
When occupational disease is suspected, starts the process. In SGK's list of occupational diseases, group B is occupational skin diseases; agents such as nickel, chromium, cobalt, alkalis and cement are listed in this group. For the structure of the list, see our article on the list of occupational diseases.

If more than one worker in the same department has hand complaints, see this not as cases to be treated one by one but as a sign whose source must be found: has the fluid changed, has a new cleaner been bought, has the glove supplier changed? At metal and machinery businesses in Bursa and the surrounding provinces, Bursa Sistemer OSGB addresses these questions together with the risk assessment in our workplace physician services.

Common mistakes

The mistakes commonly found on site walks are:

Dismissing cracked hands as "winter dryness" and not reporting them to the physician
"Cleaning" hands with thinner, solvent or the cutting fluid itself
Handing out the same gloves to everyone; not choosing according to the chemical and the task
Wearing gloves for hours without taking them off, not changing gloves that are wet inside
Keeping cream and cleanser in the store rather than next to the washbasin
Mixing cutting fluid by eye without measuring
Seeing recurring complaints in the same department as separate cases and not looking for a common source

Most of these mistakes require no extra budget; they are put right with an instruction, a measuring habit and a cabinet placed next to the washbasin.

Frequently Asked Questions

Does occupational dermatitis go away?

Irritant dermatitis often recedes when contact is reduced and skin care is applied regularly. In allergic dermatitis, sensitivity is usually permanent; for complaints to go away, contact with the substance causing the allergy must be prevented.

Does a worker with cutting fluid eczema have to leave their job?

Not always. First, contact is reduced through fluid management, splash protection and skin care. If allergy is proven, the physician assesses whether contact with the allergen can be prevented and, if necessary, recommends a change of duties.

Does barrier cream replace gloves?

No. Pre-work protective cream makes skin easier to clean and is part of the care plan, but it does not provide the protection against chemicals that gloves provide.

What does wet work mean?

Jobs in which the hands are in contact with water, wet products or cleaning solutions for a significant part of the day, or in which occlusive gloves are worn for long periods. Because it softens the skin and weakens its protective layer, it is one of the main causes of irritant dermatitis.

Do nitrile gloves cause allergy?

Nitrile gloves do not contain latex protein, so they are a good option in latex allergy. However, some nitrile gloves may contain rubber additives and can cause dermatitis in people sensitive to these substances.