Working with a physical, chemical, or biological agent or a repeating force can cause permanent skin diseases such as dermatitis or eczema and forms 80% of all work-related skin diseases. Many different types of substances harm the skin – some irritate, and others cause permanent damage. Construction has its particular risks.
Skin and Construction
On construction sites, the main skin hazard is cement dust mixed with sand or other substances to make mortar or concrete. Cement dust released during bag dumping or concrete cutting can also irritate the skin. Moisture from sweat or wet clothing reacts with the cement dust to form a caustic solution. Some workers can become allergic to the dust, with symptoms ranging from a mild rash to severe skin ulcers.
In addition to skin reactions, components of the dust can cause a respiratory allergy called occupational asthma. Symptoms include wheezing and difficulty breathing.
It’s possible to work with cement for years without any allergic skin reaction and then suddenly develop a problem. The condition gets worse until exposure to even minute quantities triggers a severe response. The allergy usually lasts a lifetime and prevents any future work with wet concrete or powder cement.
When a skin condition first appears, the worker can apply creams to the affected area or avoid the substance altogether, but if exposure continues it may go on to cause a more severe skin condition – allergic dermatitis. Here, large areas of skin become severely inflamed from just tiny exposures and the worker has to work away from the substance, which, if you are a bricklayer or plasterer, is hard to do.
Exposure to airborne dust may cause immediate or delayed irritation of the eyes. Depending on the level of exposure, effects may range from redness to chemical burns and blindness.
Assess the risk
A risk assessment needs to establish known substances that can cause skin allergy and identify measures to protect all workers.
Look at safety data sheets for phrases such as:
- R42 or 43: May cause sensitisation by skin contact
- Skin sensitiser
Identify where concrete is used and see if you can reduce the amount used or even if it is necessary. Minimise the likelihood of direct contact with concrete and educate workers, so they know how dangerous it is to have concrete slurry remain on your skin.
The hazards of wet cement are due to its caustic, abrasive, and drying properties. Continuous contact between skin and concrete allows alkaline compounds to penetrate and burn the skin. When wet concrete or mortar falls inside a worker’s boots or gloves, the result may be first, second, or third-degree burns or skin ulcers. These injuries can take several months to heal and may involve hospitalisation and skin grafts.
Make sure your First Aiders know what to do when concrete accidents occur and call them for their opinion in cases of accidents.
Avoid skin burns
- Wear the right PPE for any task involving wet concrete
- Gloves should be waterproof and suitable for use with high alkaline substances. They should be extended and tight fitting at the end to prevent concrete trapping between the glove and skin
- Provide footwear such as wellington boots with no leaks or splits
- Wear waterproof trousers over boots and not tucked in
- Coveralls with long sleeves and full-length trousers (pull sleeves down over gloves and tuck pants inside boots and tape at the top to keep mortar and concrete out)
- Use knee pads or a waterproof mat for kneeling
- Provide washing facilities to wash off concrete quickly
- When laying concrete block, have different sizes on hand to avoid cutting or hammering to make them fit
- Work in ways that minimise the amount of cement dust released
- Where possible, wet-cut rather than dry-cut masonry products
- Mix dry cement in well-ventilated areas
- Work upwind from dust sources
- Where possible, use ready-mixed concrete instead of mixing on site
- When kneeling on fresh concrete, use a dry board or waterproof kneepads to protect knees from water that can soak through fabric
- Remove jewellery such as rings and watches because wet cement can collect beneath
- Quickly remove clothing contaminated by cement. Wash affected skin immediately with large amounts of cool, clean water
- Don’t wash hands with water from buckets used for cleaning tools
- Provide adequate washing facilities for workers to wash hands and face at the end of a job and before eating, drinking, smoking, or using the toilet. Facilities for cleaning boots and changing clothes should also be available
The most common type of health check is a visual inspection by someone trained to look for such problems (occupational health services or responsible persons) on a regular basis. Health questionnaires that ask workers to self-report possible skin problems, in my experience, are not reliable. Workers either hide their health problems, fearing their jobs may be at risk or just tick all the boxes.
Dermatitis, when diagnosed by Doctor is a reportable disease under RIDDOR
Treatment for Those Affected
Steroid creams or ointments are commonly used to relieve scaling and extreme itching. Topical corticosteroid creams and ointments are available with or without a prescription but may cause harmful side effects if not applied correctly. Talk to your local pharmacy or GP before using.
Antibiotics are only available from a GP and used to treat bacterial infections, open sores, or cracking in the skin caused by frequent scratching.
Antihistamine tablets are ideal for those suffering from severe itching. Certain types of medications make you sleepy, helping not only to eliminate itching itself but also helping anyone whose sleep is affected by the continuous sensation to scratch. Be aware that these may affect driving or if you use plant on construction sites.
Oral or Injected Corticosteroids
Corticosteroids are used for extreme cases of itching and prescribed by a Doctor. Although this treatment is effective for eczema, it is a short-term solution due to potential long-term usage side effects.
Patch testing identifies the causes of eczema. Here, doctors place patches of possible irritants on the skin to look for allergic reactions. (see image) Its important to include workplace suspects and I have often sent samples of along with the worker.
Another option to help find the cause of your eczema is through RAST (radioallergosorbent) Testing. A blood test determines environmental and food allergies that can be contributing to skin sensitivity.