MMed (Community Health), Faculty of Health Sciences, University of the Witwatersrand / Introduction
Occupational contact dermatitis (OCD) is the most common occupational skin disease. OCD can be either due to irritants or allergens or a combination of these two agents. Irritant contact dermatitis (ICD) tends to be more common than allergic contact dermatitis (ACD). Skin diseases affect the financial, psychosocial and occupational lives of people. Productivity in the work place is detrimentally affected. OCD is regulated under the Compensation for Occupational Injuries and Disease Act (COID Act) which is administered by the Commissioner. The OCD cases seen at the dermatology clinic at the National Institute of Occupational Health (NIOH) sees a number of cases from a wide spectrum of industries with a variety of exposures but, these are not well described.
Aims and objectives
Aims:
1.
To describe the cases seen at the occupational dermatology clinic at the National Institute for Occupational Health (NIOH).
2.
To describe the industries and exposure agents of cases diagnosed with occupational contact dermatitis (OCD).
3.
To describe the psychosocial, financial and occupational impact and compensation outcomes of cases diagnosed with OCD.
Objectives:
1.
To describe the age, sex, diagnosis, site of dermatosis and skin patch test results of cases seen at the occupational dermatology clinic from August 2005 to December 2007.
2.
To describe the jobs, the industries and suspected exposure agents of cases with OCD and dermatosis not related to vocation.
3.
To determine the duration of exposure to a suspected agent before a diagnosis was made. iv
4.
To describe the psychosocial, financial and occupational impact of the skin conditions.
5.
To describe compensation outcomes including claim status, outstanding documentation; the experience of claimants with the Commissioner’s office; the delay from submission to resolution.
Methods
Data were collected from the medical records of patients seen at the NIOH dermatology clinic from August 2005 to December 2007 (n=129). Telephone interviews were done with all participants that could be contacted (n=94). A questionnaire was administered by telephone enquiring about their current occupational status and occupational exposures; the impact of their skin disease on their finances, personal lives and vocation; and their experience with the Commissioner’s office. The status of claims submitted to the Commissioner’s office (n=64) was verified by reviewing the electronic records of the Commissioner’s office. Descriptive and analytical analysis was done using STATA 10. Multivariate analysis was done to examine factors that might determine the compensation outcome.
Results
One hundred and twenty eight medical records were reviewed. The mean age of OCD patients was 41.9 years and 48 (75%) were males. ACD was diagnosed in 35 OCD participants and ICD in 29 participants. The rash occurred on the hands in 36 (56.3%) of the 64 OCD patients. The median duration of exposure to a suspected agent was 96.8 months. The median duration from diagnosis to the visit to the Commissioner’s office was 19 months. Dermatosis on the hands had an odds ratio of 2.33 for loss of income. There was a greater chance of a claim being resolved if the skin patch test was positive. Only eight of the 64 cases were resolved at the time of the visit to the Commissioner’s office.
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Discussion
The impact of a skin dermatosis was similar in OCD and non OCD participants and impacted on their social lives and work performance. ICD and ACD were equally represented in the cohort. Workers generally reported a negative impression of the compensation process. There were many systems issues identified in the compensation process. This resulted in few cases being resolved. Many pieces of documentation required for the compensation process to be finalised were missing.
Conclusion
The financial, psychosocial and occupational impact of a skin disease was significant and similar between cases who were diagnosed with OCD and non OCD patients. The COID Act Commissioner had failed to administer the Compensation Fund effectively and to provide compensation to workers diagnosed with OCD.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/8554 |
| Date | 26 August 2010 |
| Creators | Rose, Andre Stanford |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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