Preventive Measures for Occupationally Induced Immediate Contact Reactions

  • Jose Hernán AlfonsoEmail author
Part of the Updates in Clinical Dermatology book series (UCD)


By definition, work-related and occupational immediate contact reactions can be prevented by measures that eliminate or reduce occupational exposures. Thus, effective prevention starts at the legislation level, which creates a framework for not only the elimination, substitution, and reduction of skin urticariogens and allergens at the workplace, but also for the recognition of occupational skin diseases. In addition, preventive measures must contribute to maintain the natural protective function of the skin and to restore a damaged skin barrier when it is disrupted by occupational exposures. This chapter provides evidence-based standards for the prevention of work-related and occupational immediate contact reactions from the legislation level to everyday medical practice.


Preventive measures Standards Gloves Moisturizers Education Primary prevention Secondary prevention Tertiary prevention 


  1. 1.
    European Agency for Safety and Health at Work. Occupational skin diseases diseases and dermal exposure in the European Union (EU-25): Policy and practice review. 2008. Available at: Accessed 20 Nov 2017.
  2. 2.
    Gordon RS Jr. An operational classification of disease prevention. Public Health Rep. 1983;98:107–9.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Allmers H, Schmengler J, John SM. Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German health care workers. J Allergy Clin Immunol. 2004;114:347–51.CrossRefPubMedGoogle Scholar
  4. 4.
    Bensefa-Colas L, Telle-Lamberton M, Faye S, Bourrain JL, Crépy MN, Lasfargues G, et al. Occupational contact urticaria: lessons from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P). Br J Dermatol. 2015;173:1453–61.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Turner S, McNamee R, Agius R, Wilkinson SM, Carder M, Stocks SJ. Evaluating interventions aimed at reducing occupational exposure to latex and rubber glove allergens. Occup Environ Med. 2012;69:925–31.CrossRefPubMedGoogle Scholar
  6. 6.
    Nicholson PJ, Llewellyn D, English JS, On behalf of the Guidelines Development Group. Evidence-based guidelines for the prevention, identification and management of occupational contact dermatitis and urticaria. Contact Dermatitis. 2010;63:177–86.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Alfonso JH, Bauer A, Bensefa-Colas L, Boman A, Bubas M, Constandt L, Crepy MN, Goncalo M, Macan J, Mahler V, Mijakoski D, Ramada Rodilla JM, Rustemeyer T, Spring P, John SM, Uter W, Wilkinson M, Giménez-Arnau AM. Minimum standards on prevention, diagnosis and treatment of occupational and work-related skin diseases in Europe – position paper of the COST Action StanDerm (TD 1206). J Eur Acad Dermatol Venereol. 2017;31(Suppl. 4):31–43.Google Scholar
  8. 8.
    Health and Safety Executive. Work-related skin disease in Great Britain 2014. 2016. Accessed 25 Nov 2017.
  9. 9.
    Voß H, Gediga G, Gediga K, Maier B, Mentzel F, Skudlik C, et al. Secondary prevention of occupational dermatoses: first systematic evaluation of optimized dermatologist’s procedure and hierarchical multi-step intervention. J Dtsch Dermatol Ges J Ger Soc Dermatol. 2013;11:662–71.Google Scholar
  10. 10.
  11. 11.
    Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work.Google Scholar
  12. 12.
    Wulfhorts R, John SM, Strunk M. Worker’s protection: gloves and cream. In: Duus Johansen J, Lepoittevin JP, Thyssen JP, editors. Quick guide to contact dermatitis. Berlin: Springer; 2016. p. 275–87.CrossRefGoogle Scholar
  13. 13.
    Diepgen TL, Andersen KE, Chosidow O, Coenraads PJ, Elsner P, English J, et al. guidelines for diagnosis, prevention and treatment of hand eczema--short version. J Dtsch Dermatol Ges J Ger Soc Dermatol JDDG. 2015;13:77–85.Google Scholar
  14. 14.
    DGUV. Healthy skin Campaign. Available at: Accessed 27 Nov 2017.
  15. 15.
    Geier J, Krautheim A, Uter W, Lessmann H, Schnuch A. Occupational contact allergy in the building trade in Germany: influence of preventive measures and changing exposure. Int Arch Occup Environ Health. 2001;84:403–11.CrossRefGoogle Scholar
  16. 16.
    Uter W, Geier J, Lessmann H, Schnuch A. Is contact allergy to glyceryl monothioglycolate still a problem in Germany? Contact Dermatitis. 2006;55:54–6.CrossRefPubMedGoogle Scholar
  17. 17.
    Douglas JD, McSharry C, Blaikie L, Morrow T, Miles S, Franklin D. Occupational asthma caused by automated salmon processing. Lancet. 1995;346:737–40.CrossRefPubMedGoogle Scholar
  18. 18.
    Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Hand dermatitis in a prospectively followed cohort of hairdressing apprentices: final results of the POSH study. Prevention of occupational skin disease in hairdressers. Contact Dermatitis. 1999;41:280–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Bundesanstalt für Arbeitsschutz und Arbeitsmedizin. [TRGS 401: risks resulting from skin contact – determination, evaluation, measures]. 2008. Available at: Accessed 26 Jan 2016.
  20. 20.
    Agner T, Held E. Skin protection programmes. Contact Dermatitis. 2002;47:253–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Brown T. Strategies for prevention: occupational contact dermatitis. Occup Med (London). 2004;54:450–7.CrossRefGoogle Scholar
  22. 22.
    English J, Aldridge R, Gawkrodger DJ, Kowancki S, Statham B, White JML, et al. Consensus statement on the management of chronic hand eczema. Clin Exp Dermatol. 2009;34:761–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Held E, Mygind K, Wolff C, Gyntelberg F, Agner T. Prevention of work related skin problems: an intervention study in wet work employees. Occup Environ Med. 2002;59:556–61.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    BAuA – Hazardous Substances/Topics from A to Z/Federal Institute forOccupational Safety and Health. bstances/Hazardous-Substances.html. Last accessed 20 Nov 2017.Google Scholar
  25. 25.
    Microsoft Word - 013-056l_S1_Berufliche_Hautmittel_2014-10.docx -013-056l_S1_Berufliche_Hautmittel_2014-10.pdf. Last accessed 20 Nov 2017.
  26. 26.
    Korinth G, Geh S, Schaller KH, Drexler H. In vitro evaluation of the efficacy of skin barrier creams and protective gloves on percutaneous absorption of industrial solvents. Int Arch Occup Environ Health. 2003;76:382–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Korinth G, Lüersen L, Schaller KH, Angerer J, Drexler H. Enhancement of percutaneous penetration of aniline and o-toluidine in vitro using skin barrier creams. Toxicol Vitro Int J Publ Assoc BIBRA. 2008;22:812–8.CrossRefGoogle Scholar
  28. 28.
    Korinth G, Weiss T, Penkert S, Schaller KH, Angerer J, Drexler H. Percutaneous absorption of aromatic amines in rubber industry workers: impact of impaired skin and skin barrier creams. Occup Environ Med. 2007;64:366–72.CrossRefPubMedGoogle Scholar
  29. 29.
    Hines J, Wilkinson SM, John SM, Diepgen T, English J, Rustemeyer T, et al. The three moments of skin cream application: an evidence-based proposal for use of skin creams in the prevention of irritant contact dermatitis in the workplace. J Eur Acad Dermatol Venereol. 2017;31:53–64.CrossRefPubMedGoogle Scholar
  30. 30.
    Wilke A, Bollmann U, Cazzaniga S, Hübner A, John SM, Karadzinska-Bislimovska J, et al. The implementation of knowledge dissemination in the prevention of occupational skin diseases. J Eur Acad Dermatol Venereol. 2018;3:449–458. [Epub ahead of print].
  31. 31.
    Crepy MN. Rubber: new allergens and preventive measures. Eur J Dermatol. 2016;26:523–30.PubMedGoogle Scholar
  32. 32.
    Beezhold DH, Kostyal DA, Wiseman JS. The transfer of protein allergens from latex gloves. A study of influencing factors. AORN. 1994;59:605–14.CrossRefGoogle Scholar
  33. 33.
    Palosuo T, Antoniadou I, Gottrup F, Phillips P. Latex medical gloves: time for a reappraisal. Int Arch Allergy Immunol. 2011;156:234–46.CrossRefPubMedGoogle Scholar
  34. 34.
    Bernardini R, Novembre E, Lombardi E, Pucci N, Marcucci F, Vierucci A. Anaphylaxis to latex after ingestion of a cream-filled doughnut contaminated with latex. J Allergy Clin Immunol. 2002;110:534–5.CrossRefPubMedGoogle Scholar
  35. 35.
    Lind ML, Boman A, Sollenberg J, Johnsson S, Hagelthorn G, Meding B. Occupational dermal exposure to permanent hair dyes among hairdressers. Ann Occup Hyg. 2005;49:473–80.PubMedGoogle Scholar
  36. 36.
    Oreskov KW, Søsted H, Johansen JD. Glove use among hairdressers: difficulties in the correct use of gloves among hairdressers and the effect of education. Contact Dermatitis. 2015;72:362–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Loden M, Andersson AC. Effect of topically applied lipidson surfactant-irritated skin. Br J Dermatol. 1996;134:215–20.CrossRefPubMedGoogle Scholar
  38. 38.
    Held E, Agner T. Comparison between 2 test models inevaluating the effect of a moisturizer on irritated human skin. Contact Dermatitis. 1999;40:261–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Held E, Agner T. Effect of moisturizers on skin susceptibility to irritants. Acta Derm Venereol. 2001;81:104–7.CrossRefPubMedGoogle Scholar
  40. 40.
    Held E, Johansen JD, Agner T, Menne T. Contact allergyto cosmetics: testing with patients’ own products. Contact Dermatitis. 1999;40:310–5.CrossRefPubMedGoogle Scholar
  41. 41.
    Saary J, Qureshi R, Palda V, DeKoven J, Pratt M, Skotnicki-Grant S, Holness L. A systematic review of contact dermatitis treatment and prevention. J Am Acad Dermatol. 2005;53:845–855.75.CrossRefPubMedGoogle Scholar
  42. 42.
    Arbogast JW, Fendler EJ, Hammond BS, Cartner TJ, Dolan MD, Ali Y, Maibach HI. Effectiveness of a hand care regimen with moisturizer in manufacturing facilities where workers are prone to occupational irritant dermatitis. Dermatitis. 2004;15:10–7.CrossRefPubMedGoogle Scholar
  43. 43.
    Winker R, Salameh B, Stolkovich S, Nikl M, Barth A, Ponocny E, et al. Effectiveness of skin protection creams in the prevention of occupational dermatitis: results of a randomized, controlled trial. Int Arch Occup Environ Health. 2009;82:653–62.CrossRefPubMedGoogle Scholar
  44. 44.
    Breuer K, John SM, Finkeldey F, Boehm D, Skudlik C, Wulfhorst B, et al. Tertiary individual prevention improves mental health in patients with severe occupational hand eczema. J Eur Acad Dermatol Venereol. 2015;29:1724–31.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Occupational Medicine and EpidemiologyNational Institute of Occupational HealthOsloNorway

Personalised recommendations