Introduction
Occupational risks
Understanding occupational skin disease
Skin conditions seen in farmers
Workplace risk assessment
Personal protective equipment
Recommended hand care for farmers
Treatment
Farming is a widespread, worldwide occupation. It is estimated that between 50% and 60% of farmers will develop some form of skin condition within 5 years of beginning their occupation.
Factors that contribute to skin conditions in farmers include:
Intact, healthy skin is an important part of the immune system and provides defense against physical, biological or chemical agents. Farming work may jeopardise the integrity of the skin.
The most common skin conditions associated with farming are contact dermatitis and sun damage / skin cancer.
Irritant contact dermatitis is common in agricultural workers.
Irritants include plants, acids and alkalis, frictional damage, animal waste, water and many other items.
Allergic contact dermatitis is due to an immunological response to a sensitiser. This form of dermatitis may spread to affect areas that were not directly exposed to the sensitiser.
In farmers, common contact allergens include:
Allergic reactions to bee and wasp stings result in local swelling, and in severe cases, in urticaria and anaphylaxis. Adrenaline for injection should be kept on hand in case of severe allergic reaction.
Sun damage is due to prolonged exposure to solar radiation and is a serious problem for fair-skinned farmers. Damage is due both to sunburn and cumulative exposure to sunlight.
The damage is mainly due to ultraviolet radiation (UVA and UVB). UV levels depend on:
In New Zealand, follow the recommendations of the Sun Protection Alert, published as part of weather forecasting.
Other risk factors for significant sun damage in farmers include:
Prolonged exposure to the sun leads to premature skin aging such as wrinkling, pigmentary changes and telangiectasia. Precancerous changes include actinic keratoses, actinic cheilitis and intraepidermal carcinoma.
Agricultural work also increases the risk for skin cancer, mainly because of prolonged sunlight exposure.
Farmers may be prone to specific infections associated with agriculture and animal husbandry. Examples include:
Assessing the workplace and promoting worker safety should include:
Personal protective equipment, including gloves, goggles and aprons, can help to decrease the level of exposure to irritants or sensitisers by keeping the skin covered. These devices have to be used consistently, taken on and off in the proper manner, and the right glove must be selected for the specific type of work undertaken.
To take care of their hands/skin properly, it is recommended that farmers:
Begin with a thorough assessment of presenting complaints, relevant medical history, specific occupation, chemicals and other substances in regular use, and a full physical examination.
Treatment will vary depending on the nature of the complaint.
Dermatitis is treated by avoiding the cause (if possible), and:
Photoageing and skin cancers will require individualised treatment, which may include creams, cryotherapy and skin surgery.
The presence of precancerous lesions and skin cancers should lead to lifelong daily protection from further sun exposure:
