Skin problems among textile workers

Introduction

The textile industry is an important employer for workers across the globe, especially in developing countries. However, the occupation carries a high risk for the development of occupational dermatitis.

For instance, one study of textile workers found 29% of participants surveyed had allergic contact dermatitis, while another 38% had irritant contact dermatitis, making skin conditions a widespread problem.

Why are textile workers at risk for occupational skin disorders?

There are several factors which increase the risk of textile workers for developing occupational skin disorders, including:

• Exposure to irritants and allergens including textile dyes (particularly Disperse Blue 124, Disperse Blue 10 and Disperse Yellow 104), formaldehyde resins, rubber allergens, and textile finishers
• Poor regulation and work safety conditions in some textile factories
• A preponderance of younger, unskilled, low-paid workers with low literacy levels, which make employee education/training challenging.

Understanding occupational skin disease

The skin barrier is an important part of the body’s immune system and acts as a natural barrier to a wide variety of substances that can cause irritation, allergic reactions, and infections. The risk of skin disorders increases when the skin barrier is compromised by injury or disease. Textile workers are at high risk for skin disease due to the nature of their work.

The main occupational risk for textile workers is contact dermatitis.

Contact dermatitis

Contact dermatitis in textile workers most often results in hand dermatitis. Signs may include:

• Nonspecific eczema
• Nummular eczema
• Pustules associated with infected dermatitis
• Lichen simplex
• Postinflammatory hyperpigmentation.

Severely affected patients can present with widespread eczema and erythroderma.

How is contact dermatitis diagnosed?

Careful history indicating exposure to potential contact irritants and allergens, and examination confirming dermatitis, should be followed by careful patch testing to the baseline series of allergens and to textile dyes.

Positive patch tests demonstrate contact allergy to a specific allergen.

Workplace risk assessment

Workplace risk assessment is uneven throughout the textile industry. Assessment should ideally take into account the following:

• Workplace provision of personal protective equipment and on-site washing facilities.
• Policies regarding patient education on the use of gloves and other protective equipment, the nature of the chemicals and dyes that are being used, and knowledge of signs and symptoms of contact dermatitis.
• Company strategies put into place to reduce exposure to irritants and allergens.
• Use of different and less toxic materials, more stable dyes, and less formaldehyde in the textile manufacturing processing.
• The willingness of managers and employees to implement and be compliant with safety procedures.

Personal protective equipment

The use of personal protective equipment such as gloves and protective clothing can reduce the exposure to irritants and allergens. However, latex gloves can cause dermatitis due to the development of latex sensitivity and contact allergy to rubber accelerants, so non-latex gloves are recommended.

Diagnosis and treatment of occupational skin disorders

Diagnosis of occupational skin disorders should be based on:

• A thorough occupational assessment of the patient, including the nature of their work, any chemicals or other substances they are in frequent contact with, safety protocols in place at the worksite and the presence of similar skin problems in co-workers
• Knowledge of both classic and atypical signs and symptoms of dermatitis
• Patch testing and other tests due determine the presence of patient allergies.

Treatment of occupational skin disorders can include:

• Reduction of worker exposure to potential allergens and irritants
• Use of appropriate personal protective equipment
• Appropriate applications of moisturisers and barrier creams as needed
• Use of oral or topical steroids
• Use of second-line treatments like phototherapy, methotrexate, ciclosporin, and azathioprine.