Wet W Wet Work in ork in Austra Australian lian work workplace - PowerPoint PPT Presentation

Wet W Wet Work in ork in Austra Australian lian work workplace places Dr Tessa Keegel Miss Kristen Benke A/Prof Rosemary Nixon A/ Prof Tony LaMontagne Prof Malcolm Sim

Bac Backg kground ound Wet work is one of the main exposures for occupational contact dermatitis (OCD)

Background Background Information regarding patterns of exposure to wet work is required by workers, unions, employers & policy-makers for the development of work health and safety policy

Pr Project summar oject summary The Wet Work project will look at: 1. Wet work exposure 2. Diagnosed disease 3. Successful workers’ compensation claims

Occupational contact dermatitis: wet work exposure and disease pyramid.

Study question Study question What are the patterns of exposure to wet work, occupational contact dermatitis, and accepted workers’ compensation claims amongst Australian workers?

Methods Methods • The first dataset has information about self-reported Australian wet work exposure data • The second dataset consists of de-identified diagnosed disease data from a Victorian dermatology clinic • The final dataset consists of de-identified Victorian Workers’ Compensation claims data We will compare the patterns across these three datasets

Preliminary findings Preliminary findings

Study Study design & design & sample sample In 2008, Safe Work Australia conducted the National Hazard Exposure Worker Surveillance (NHEWS) study

Wet work Wet work exposu exposure re Two separate outcomes: 1) frequency of hand washing at work 2) time spent with hands in liquids at work

Wet work Wet work exposu exposure re Workers were also asked what types of liquids they were exposed to at work Workers could nominate more than one liquid

Wet work exposure Wet work exposure For hand washing: Less than/=20 times= unexposed/ low More than 20, less than/= 100 = high More than 100 = v high

Wet wo Wet work rk exposure exposure For duration of hands in liquids: Less than 1 hr = low 1 hr up to 2 hrs = medium More than 2 hrs = high

Co Co-variates variates Employment arrangements Number of employees at workplace Occupational skill level (5 levels) Industrial sector Self-reported chemical exp Age group Gender

Results Results

Overall the NHEWS survey had: 4500 Australian workers Across 17 industries (5 priority) 42.3% response rate

When asked to nominate the types of liquids: Water 64% Detergents, disinfectants, cleaning products Oils, solvents, thinners, degreasers Concrete/cement Paint Fuel, petrol, kerosene Bodily fluids

Handwashing Overall, 9.8% (95% CI: 8.9-10.7%) washed their hands more than 20 times/day at work

… Handwashing 5.7 Agriculture, forestry & fishing (317) 1.3 4.2 Cultural, recreational & personal … 2.1 Mining (38) 2.6 23.8 Health & community services (956) 6.3 17.6 Accommodation, cafes & restaurants … 6.6 0 5 10 15 20 25 % workers exposed to hand-washing

Handwashing Odds ratio (95% CI) Gender Females 1.97 (1.49-2.61) Number of emps at wrkplce Less than 5 (ref) -- 20 to 199 1.49 (1.05-2.11) 200 or more 1.44 (1.00-2.08) Chemical Exposure High exposure 3.68 (2.91-4.66) Occupational skill level Level one (highest) (ref) -- Level five (lowest) 0.58 (0.37-0.92) Industry Transport & storage (ref) -- Health & Comm service 6.02 (3.38-10.70) Accommodation, cafes & 5.70 (2.71-12.02) restaurants Observations 4309

Hands in liquids Overall, 7.3% (95% CI: 6.5-8.0%) hands in liquids more than 1 hr 4.5 % (95% CI: 3.9-5.1%) more than 2 hrs

Hands in liquids 4.1 2 Manufacturing (714) 4.9 3.5 Agriculture, forestry & fishing (317) 5 7.4 Cultural, recreational & personal services (95) 6.3 4.5 Health & community services (956) 7.7 9.9 Accommodation, cafes & restaurants (91) 14.3 0 2 4 6 8 10 12 14 16 % workers exposed to hands in liquids

Hands in liquids Odds ratio (95% CI) Occupational skill level Level one (highest) -- Level two 2.03 (1.07-3.88) Level three 4.07 (2.37-7.00) Level four 2.40 (1.48-3.89) Level five (lowest) 6.41 (3.78-10.88) Industry -- Transport & storage (ref) Health & community 2.92 (1.46-5.84) services Accommodation, cafes & 2.97 (1.24-7.15) restaurants Chemical exposure High exposure 4.09 (2.92-5.74) Observations 4337

This study is one of the first to suggest differences in the profiles for: frequency of hand washing and hands immersed in liquids

Exposure to chemicals & exposure to wet work was highly correlated: 3 and a half times for hand washing Four times for immersion of hands in liquids

Pr Preliminar eliminary findings y findings

Study Study design & design & sample sample Compensation Research Database Victorian workers’ compensation data from 1986-2009

Results Results • 14, 709 unique claims, from 13,980 workers • Includes 729 repeat claims • Many more males than females, 76% vs 24%

Employer Employer segmen segment Females Males Government 17 % 11% Large 40% 25% Medium 33% 50% Small 10% 14%

Selected Selected occupations occupations • Meat processing 524 • Poultry processing 27 • Smallgoods 52 • Seafood 3 • Printing 62

Selected Selected occupations occupations • Motor vehicle manufacturing 354 • Automotive repair 166 • Construction 781 • Plumbing 75

Selected Selected occupations occupations • Psych hospitals 95 • Dental services 55 • Ambulance 215 • Building and industrial cleaners 77 • Hospitals 760

Selected Selected occupations occupations • Aged care 204 • Other res care 50 • Other social assistance 145

Discussion Discussion

Policy implications Success of the German policy Technical standards 1 and Technical Rules 530 Hairdressing 2 1. BAuA German Federal Institute for Occupational Safety and Health. Technical standard for hazardous substances: Skin damage from work in wet environments (TRGS 531: wet work). Translation jointly prepared by NIOSH and BAuA,1996. Available at: http://www.cdc.gov/niosh/topics/skin/recommendations.html (last accessed 08 April 2011) 2. Dickel H, Kuss O, Schmidt A, Diepgen TL. Impact of preventive strategies on trend of occupational skin disease in hairdressers: population based register study. BMJ 2002 15 June 2002:324:1422-3.

Annual incidence (± 95% confidence intervals) of hairdressers with a stated occupational skin disease 1990-1999. From BMJ 2002; 324:1422-1423 (Dickel et al. 2002)

Questions Questions 1. Is wet work an issue for your members? 2. Do employers think wet work is a potential OHS problem? 3. What liquids are workers exposed to in the workplace?

Questions Questions 4. Do your members have access to MSDS in the workplace? 5. Are your members consulted before new liquids are used in the workplace? 6. Are there any workplace interventions for wet work that you would like to see in your workplace?

Questions Questions 7. What sort of policy interventions for wet work would you like to see in your workplace? 8. Are your members involved in OHS decision making?

Acknowledg Acknowledgements ements & & publications publications details details Safe Work Australia, Dr Fleur Champion de Crespigny, Prof Thomas Diepgen, Prof Tove Agner, Ms Stella Gwini NHMRC Post-Doctoral Fellowship to TGK (#540114) Keegel T, Nixon R, LaMontagne AD. Exposure to wet work in working Australians. Accepted for publication 2/8/2011 Contact Dermatitis