Occupational contact dermatitis in the UK: a surveillance report from EPIDERM and OPRA

Since February 1993 the EPIDERM surveillance scheme has collected data on o ccupational skin disease from consultant dermatologists in the UK. Reportin g by occupational physicians to the scheme began in May 1994 and was supers eded in January 1996 by the Occupational Physicians Reporting Activity (OPR A). The schemes currently receive reports on incident cases from 244 dermat ologists and 790 occupational physicians. An estimated total of 9937 cases of contact dermatitis reported by dermatologists was calculated from survei llance data; 8129 contact dermatitis cases were estimated from reports by o ccupational physicians. The annual incidence of occupational contact dermat itis from dermatologist reports was 6.4 cases per 100,000 workers and 6.5 p er 100,000 from reports by occupational physicians, an overall rate of 12.9 cases per 100,000 workers. Manufacturing industries account for the greate st number of cases seen by both sets of reporting physicians, with health c are employment second. Reports from dermatologists also indicate high rates of dermatitis in the personal service industries (mainly hairdressers and barbers) and in agriculture. With the exception of an increase in cases see n in nurses in both schemes, the numbers and proportions of cases of contac t dermatitis within occupations have remained fairly constant over the 6-ye ar reporting period. Agents accounting for the highest number of allergic c ontact dermatitis cases were rubber (23.4% of allergic cases reported by de rmatologists), nickel (18.2), epoxies and other resins (15.6), aromatic ami nes (8.6), chromium and chromates (8.1), fragrances and cosmetics (8.0), an d preservatives (7.3). Soaps (22.0% of cases), wet work (19.8), petroleum p roducts (8.7), solvents (8.0), and cutting oils and coolants (7.8) were the most frequently cited agents in cases of irritant dermatitis. The national scope of the data, together with the parallel structure by which both derm atologists and occupational physicians report incident cases, is useful in determining the extent of skin hazards in UK industry and may help in bette r targeting efforts to reduce the burden of skin disease at work.