Guidelines for people with atopy
What is atopy?
Atopy refers to having a personal or family history of eczema, asthma or hay-fever.
Atopy and dermatitis
Having a history of these conditions as a baby or in childhood, even when they have gone away, increases the risk of developing work-related dermatitis, particularly affecting the hands. In fact, those who have had eczema at any age anywhere on the skin are four times more likely to develop work-related dermatitis. A history of eczema affecting the hands but not elsewhere especially increases an individual’s susceptibility to develop occupational contact dermatitis.
People with atopy are more likely to have problems with their skin being able to repair itself; therefore the barrier function is often compromised, allowing greater opportunity for the development of irritation and allergy.
Work and atopy
People with a history of atopy, and that work in certain industries are at higher risk of developing skin problems at work. These include those working in:
- Construction
- Food handling
- Hair and beauty
- Healthcare
- Mechanical and metal working
If you have an atopic background, you should minimise contact with skin irritants which are known to cause dermatitis, right from the beginning of your employment. These include:
- Wet work – including frequent hand washing
- Soaps and detergents
- Oils and greases
- Heat and sweating (which can be caused from wearing occlusive/waterproof style gloves for long periods)
- Dusts and fibre
- Solvents and thinners
Wearing appropriate gloves is also important- specific gloves are designed for specific tasks and chemicals. It is best that you avoid wearing powdered latex gloves, as people with an atopic background are at higher risk of developing an allergy to latex, and glove powder is known to facilitate the development of latex allergy.
Wearing cotton gloves under occlusive gloves can reduce sweating.
Teenagers entering the work force, even part-time, in areas such as hospitality involving frequent hand washing are vulnerable to developing hand dermatitis. This is also the case for young people who are working casually or are on work experience programs, who have not entered formal apprenticeship programs where they hopefully will learn about occupational health and safety.
Home life
It is important that you are aware of things at home that can also cause dermatitis, and flare eczema. These particularly include hand washing and dish washing, cleaning and soaps and detergents. Use of appropriate gloves is essential for these tasks. Different jobs may require different gloves. Also avoid contact with irritants when performing house renovations, car maintenance or other hobbies or activities around the house.
Skin care
People with atopy need to be vigilant about looking after their skin at work and at home. Refer to our ‘Care of your hands’ brochure for more information. Essentially, treatment includes use of appropriate gloves, soap substitutes and use of moisturising creams to the hands, especially at night. The importance of keeping the skin well moisturised cannot be under-estimated. Moisturisers have a particular role to restore skin barrier function.
People at very high risk
International studies have identified those at the highest risk of developing occupational dermatitis. These are people with
- Moderate to severe atopic eczema with hand involvement
- Chronic (long standing) hand eczema
- Previous change of work because of hand dermatitis
It is important that such individuals are counselled on appropriate skin care before starting work. It may mean that they are not suitable for some jobs.
Reference: Coenraads PJ Diepgen TL Risk for hand eczema in employees with past or present atopic dermatitis Int Arch Occup Environ Health 1998; 71: 7-13