The impact of contact dermatitis : a case series from the National Institute for Occupational Health (NIOH) : original research

Abstract

Background: Occupational contact dermatitis (OCD), a commonly diagnosed occupational disease, has the potential to have negative psychosocial, vocational and financial outcomes. Workers' compensation can ameliorate some of the financial loss. Little is known about these outcomes in South African cases of OCD.
Methods: This was a cross sectional study, using qualitative and quantitative methods, of patients diagnosed at the Dermatology Clinic of the National Institute for Occupational Health (NIOH) in Johannesburg. All patients' records for the period October 2006 to March 2008 were reviewed and the patients were asked to participate in a telephone interview. The cases were followed up at the Compensation Commissioner's office to evaluate the status of their claims.
Results: One hundred and twenty-nine patients were seen at the Clinic during the study period and 128 were included in the review. Ninety-three patients participated in the telephone interview, 47 of whom had been diagnosed with occupational contact dermatitis. There was a recurring theme that people felt embarrassed by the condition and that it "affected [their] lives too much." Vocational impact included "job insecurity", "difficulty completing work" and "stigmatisation from fellow workers and the employer." Nine of the 47 participants (19.1%) interviewed and diagnosed with occupational skin disease had lost income. Twenty-four of the 47 (51.1%) patients with occupational skin disease had made out-of-pocket medical payments. The median out-of-pocket payment per month for all participants was R260 (range R20-R900) over a median duration of 15.9 months (range 1-36 months). Sixty-four patients (50%) were diagnosed with occupational contact dermatitis and hence were potentially eligible for workers' compensation. An important finding was that only eight had been resolved: six of the 64 had received compensation; a further two cases had been repudiated.
Conclusion: Contact dermatitis was associated with negative psychosocial and vocational impacts and financial loss. Fewer than expected compensation claims had been resolved