Table 3.

Summary: standards of care for occupational contact dermatitis (OCD) and occupational contact urticaria (OCU)

Standards of care: employer
1	There should be no use of prework creams labelled or promoted as ‘barrier creams’
2	Skin-conditioning creams should be available at hand-washing areas and in other appropriate places. Training and guidance in the application of skin-conditioning creams should be provided
3	Arrangements for access to a physician who has expertise in occupational skin disease should be in place for initial diagnosis and recommendations regarding appropriate workplace adjustments, together with subsequent investigation by patch or prick testing if appropriate
4	Employers have legal duties to assess the health risks from skin exposure to hazardous substances at work. They should prevent or, where this is not reasonably practicable, adequately control exposure to the hazards by using and maintaining suitable controls
5	Where adequate control of exposure cannot be achieved by other means, suitable personal protective equipment should be provided in combination with other measures. The use of gloves must take into account appropriate selection and training on glove usage, including the provision of cotton liners
6	Information and training aimed at improving and maintaining skin health should be provided to employees at risk of developing OCD or OCU at the time of employment and regularly thereafter
Standards of care: health professional
7	Whenever someone of working age presents with a skin rash the clinical records should contain a full clinical and occupational history asking about their job, the materials with which they work, the location of the rash and any temporal relationship with work
8	The diagnosis of suspected occupational skin disease (OCD or OCU) should include objective patch or prick testing where (i) the condition has not improved 3 months after initial advice, and (ii) a contact allergy is suspected or there are implications for fitness to work, such as altered employment, loss of job or complete change of employment
9	Where a worker has been offered a job that will expose them to causes of OCD, the clinical records should indicate if they have a personal history of dermatitis, particularly in adulthood, and record advice given to them of their increased risk, and how to care for and protect their skin
10	Where a worker has been offered a job that will expose them to causes of OCU, the clinical records should indicate if they have a personal history of atopy, and record advice given to them of their increased risk, and how to care for and protect their skin