Dermatitis is a general term for skin rashes and other skin ailments. Exposure to the compounds in epoxy resin systems can cause skin problems ranging from mild irritation to severe and long-lasting sores and rashes. The two main skin conditions caused by exposure to epoxy resin systems are irritant contact dermatitis and allergic contact dermatitis.

• Irritant Contact Dermatitis (ICD) is skin damage caused by contact with irritants.  Signs of ICD include stinging, blisters, dead skin, scabs, scaling, cracks, redness, swelling, bumps, and watery discharge.  Itching is common, and there is often pain in the affected areas. Both chemical and physical actions (such as abrasion) on the skin can cause ICD. Strong chemical irritants include acids and caustics. Soap and water and solvents are weak skin irritants. Weak irritants are slower to cause skin reactions than strong irritants, but both can damage the skin with enough contact.  Epoxy resin system fillers, such as fiberglass, cause skin abrasions. These abrasions make the skin more vulnerable to other irritants in the epoxies. Anyone who has contact with skin irritants can get ICD.  In most cases, ICD clears up when the skin no longer contacts the irritant.
   
• Allergic Contact Dermatitis (ACD) is skin damage caused by contact with sensitizers. A sensitizer is a substance that causes reactions only in people who are allergic, or sensitive, to that substance.  ACD includes many of the same symptoms as ICD. The severity of the symptoms varies widely from one person to another, depending on the individual’s sensitivity to the allergen. But most people can become allergic if they are exposed to an allergen often enough.
  
  The most common sensitizer found in epoxy resin systems are amine hardeners.  In a controlled study, dermatologists used skin patch tests comparing sensitized workers and workers with no prior exposure to the epoxy resin systems.  The results show that occupational allergic dermatitis was mainly induced by an epoxy hardener (alkylamine).  
  
  Another sensitizer found in cement-based epoxies is hexavalent chromium (hexchrom or Cr[VI]).  You can find more information in the hazard analysis 'Skin Contact with Portland Cement'.
   

There are no studies that tell us how many masons have allergic dermatitis, or how many will develop it in any given year (incidence), in the United States. We do have some information from workers compensation claims, but the true rate of dermatitis is certainly higher that the number of dermatitis claims to workers compensation, for research has shown that most occupational diseases are under-reported. In Oregon between 1990 and 1997 the claim rate to workers compensation was 7/100,000 construction workers, and a study from Germany found a similar incidence. A study in Finland found that almost 9% of concrete prefabrication workers had work-related hand dermatitis. Among construction workers with skin problems 65% of the dermatitis was caused by work, with 40% being allergic to chromium, 10% to nickel, and 7.5% to epoxy resins in one study. In the German study noted above, the incidence of dermatitis among tile setters and terrazzo workers was 10 times that of a low risk construction occupation.

Consider comparing your group of workers with themselves before and after beginning a program to reduce dermatitis (see solutions).  Use written checklists. Watch your employees work and take reports from them of what they do to are compare a group before and after.  Which best practices are the employees currently doing? Which are they failing to do? Keep a written record of observations. Have employees complete a symptoms checklist of the skin problems they currently have, with no names attached.

Best Practices Checklist

Symptoms Checklist

Worksite conditions can determine whether a worksite material will cause skin problems.

• How long does the material contact the skin?
• How often does a worker use the material?
• Is there mechanical trauma or abrasion of the skin (a break in the barrier)?
• Is the material trapped or occluded to the skin with gloves, creams, lotions, petroleum jelly, or barrier creams?
• Are there adequate hygiene facilities?

Environmental factors can cause skin problems directly or they can work with other factors to increase skin problems:

• Heat causes sweating. Sweat dissolves chemicals and brings them into closer contact with the skin. Heat increases blood flow at the skin surface and increases absorption of materials into and through the skin.
• Cold dries the skin and causes microscopic cracks. Cold changes blood flow at the skin surface and leads to loss of feeling.
• Humidity increases sweating. High humidity keeps sweat from evaporating. Extremely low humidity can dry skin as sweat evaporates.
• Sun burns and damages skin. Sun can increase absorption of chemicals. Sun reacts with some chemicals to cause photosensitization.

Individual factors can affect work-related skin problems. These include:

• pre-existing dermatitis
• genetic predisposition
• knowledge
• attitude
• personal behavior/workpractice