Cement Irritant Contact Dermatitis in a Construction Helper, An occupational & environmental medicine case report (original) (raw)

Background: Irritant contact dermatitis is a non-specific response of the skin to chemicals or irritants due to chemical mediators produced mainly by the epidermis of the skin, while allergic contact dermatitis is a hypersensitive reaction (type 4)/delayed type to an antigen/allergen. Cement is widely used in the construction industry and causes both irritant contact dermatitis and allergic contact dermatitis. More cases of irritant contact dermatitis than allergic contact dermatitis have been reported in construction workers. There is study thats show demographic characteristics of cement workers. The job of a construction helper is to help builders in work, prepare tools, mix cement to sand, and deliver the mortar to the masons who work and fix the tools that have been used (Monday to Saturday). Materials used are cement, sand, shoe, shovel, cement spoon, bucket, sandpaper, bricks with a work period of 2 years. Case Presentation: A man, 23 years old, who works as a construction helper, comes to the skin clinic with complaints since about 1 year ago that he has itching, dryness and cracks on his right and left hands after contact with cement while working. Chemical hazards in Cement are Potassium dichromate, Crystalin silica (bricks), Iron Sand dust, Calcium silicates, Aluminate, Ferrites and Calcium sulfate. Other research finding chemical material at cement. Discussion: There is case report of irritant contact dermatitis in construction workers causing skin damage, which in the process involves a lot of cement in the work. Wet cement contains potassium dichromate which causes a corrosive effect resulting in irritant contact dermatitis on repeated use of cement. It can even cause deep cement burn in lime mortar, especially for workers who do not use adequate personal protective equipment. Deep cement burn, also known as chromium ulcer, is seen in 32% of construction workers. Necrotic changes in the skin occur after 8-12 hours after repeated exposure to semen and may occur after a month to a year of repeated exposure. The clinical presentation of the lesions chronically may include xerosis, macular erythema and vesicles, especially hyperkeratosis and lichenification. Based on other research about thats symptom. Therefore many of worker feel same complaint with patient and enough time up by months to years beside on the reference upside. The feasibility assessment is temporary UNFIT by temporarily avoiding contact with irritants until the inflammatory process and pain have subsided, seeking immediate treatment to relieve inflammation and pain and prevent infection. Conclusion: Occupational Specialist Recommendation include For workers: Go to the doctor immediately to cure inflammation and pain, Carry out supporting examinations (provocative tests and KOH), Apply handbody before gloves. For employers: Biomonitoring of chromate, silica, iron and aluminate dust exposure, Screening other workers for the same case, PPE Leather Gloves.