Investigations in Dermatitis & Other Skin Disorder Claims

GENERAL BACKGROUND TO DERMATITIS AND OTHER SKIN DISORDER CLAIMS

Dermatitis is not a single disease entity but the term used to describe a pattern of inflammatory responses originating in the second layer of the skin (the dermis). 

Occupational dermatoses are skin disorders caused or exacerbated by exposure to substances in the course of employment. 

Occupational dermatoses and in particular, hand dermatitis, are among the most prevalent occupational diseases.   They can occur in most work places although they are more likely in certain high risk jobs.   

The most common presentation of occupational dermatitis is contact dermatitis caused by direct skin contact with a particular allergen or irritant. The most common irritants are wet work, soaps, shampoos, detergents, solvents, some foods (e.g. onions), oils and greases, dust, acids and alkalis and wet cement.   

Dermatitis is very common in the general population with around estimates of around 10% suffering with some form of skin disorder.  Often, these are entirely constitutional and dermatitis is as prevalent in the general population as occupational dermatitis is in the work force.

Structure of the Skin

The skin is the largest organ of the body and accounts for 10% of the body mass.  It is made up of the following 3 layers: 

  • The Epidermis - the outermost layer of skin, provides a waterproof protective barrier.
  • The Dermis - contains tough connective tissue, hair follicles, and sweat glands.
  • The Hypodermis - The deeper subcutaneous tissue made of fat and connective tissue.

3.jpg

(Source: Wikimedia Commons)

If the skin is damaged or the barrier is breached or infiltrated then the cells within the skin respond.  The skin can be damaged by chemical, biological and physical agents and mechanical trauma.

Typical Skin Conditions

The term ‘dermatitis’ can be used to refer to several disorders, all of which are inflammation of the upper layers of the skin. 

Occupational dermatitis is usually contact (exogenous) dermatitis, caused by direct skin contact with either an irritant or an allergen (also known as a sensitiser).    Between 70 - 90% of skin disease cases are contact dermatitis. It is the third most common type of occupational disease. 

The hands and face are the most commonly affected areas, though symptoms may appear on any part of the body. 

Irritant Contact Dermatitis

Occupational contact dermatitis refers to dermatitis either caused by direct skin contact with a work chemical or substance, or where such agents have contributed and are partially responsible for a reaction on compromised skin.   Irritants are the more common cause of contact dermatitis, and are the cause of up to 80 % of cases. 

Irritant contact dermatitis occurs following direct contact between the skin and the damaging substance.  It may be caused by frequent exposure to a weak irritant, such as soap, or by a short period of contact with a stronger irritant. 

Common irritants include:

  • Soaps and detergents;
  • Antiseptics and antibacterials;
  • Nail polish remover;
  • Machine oils;
  • Anti-perspirants;
  • Disinfectants;
  • Solvents;
  • Cement;
  • Acids;
  • Alkalis;
  • Powders, dust and soil; and
  • Many plants.

Strong irritants can provoke visible skin damage, termed acute irritant contact dermatitis, or even chemical burns, after a single exposure.  This is often referred to as acute irritant contact dermatitis. Weak irritants require frequent multiple exposure over longer periods, sometimes many years before symptoms occur, the result being termed chronic (or cumulative) irritant contact dermatitis.

Allergic Contact Dermatitis

Allergic contact dermatitis is caused by contact with a ‘sensitiser’ (allergen) that causes a delayed hypersensitivity reaction.

A sensitiser is a substance that can induce an over-reaction of the body’s immune system causing it to attack healthy cells and tissues.   A sensitiser must first penetrate the skin.   Next the sensitiser is combined with skin immune cells (Langerhans) which then leave the skin and travel to nearby lymph glands. 

Here, they react with another type of immune cell (known as T-cells), which reproduce and produce ‘memory’ cells that can remember that particular sensitizer.  Future contact with the same allergen will therefore produce the same over reaction.

4.jpg

(Source: Wikimedia Commons)

Allergens that commonly cause contact dermatitis include:

  • Hair dye;
  • Nail varnish hardeners;
  • Metals, such as nickel or cobalt;
  • Perfumes;
  • Some topical medicines;
  • Rubbers, including latex;
  • Textiles, particularly dyes and resins;
  • Strong glues, such as epoxy resin adhesives; and
  • Some plants and flowers.

Phototoxic Contact Dermatitis

A phototoxic substance is a substance with absorbs ultra-violet light and causes skin inflammation.  Examples of such substances in the industrial context include industrial chemicals such as tar, and plant resins. 

Photoallergic Contact Dermatitis

Like allergic contact dermatitis is mediated through an immunological mechanism.   The allergen becomes activated only in the presence of ultraviolet light.

Contact Uctaria

Contact urticaria (hives) is a wheal-and-flare reaction response occurring rapidly on exposure to particular substances. 

5.png

(Source: Wikimedia Commons)

Other less common skin conditions that may be encountered together with their primary causes are:

  • Mechanical Injury, e.g. frictional callosity or abrasions caused by repetitive tasks;
  • Ultraviolet light, e.g. photodermatitis;
  • Ionising radiation, e.g. radiation burns;
  • Skin infections and infestations, e.g. viral, bacterial, fungal or parasitic;
  • Acne and folliculitis – inflammation of the skin and hair follicles often caused by exposure to oil and grease; and
  • Scleroderma, e.g. exposure to silica;

Atopic Dermatitis

Atopic Dermatitis is not work related but is outlined briefly here because atopy and childhood eczema are factors sometimes associated with the susceptibility to occupational dermatitis. 

More than 20% of children are affected by atopic dermatitis in developed nations.  Most people with atopic eczema have skin that cannot retain much moisture, making the skin very dry.  Whether or not a particular individual will have atopic eczema is largely influenced by genetics; those affected are more likely to have parents or siblings also affected. 

Dryness may cause skin to be more likely to react to certain triggers, which can aggravate symptoms.

6.jpg

(Source: Wikimedia Commons)

Symptoms

Symptoms of dermatitis can include the following:

  • Skin redness;
  • Inflammation;
  • Dryness, flaking, scaling;
  • Thickening;
  • Cracking;
  • Itching;
  • Soreness and pain;
  • Weeping;
  • Blistering;
  • Infection; and
  • Fissures;

Duration, Prognosis, Treatment and Effects on Work

Once symptoms are present, if the patient is able to avoid further exposure to the causal irritant or allergen, skin affected by contact dermatitis will usually heal within a few days or weeks.  Complete clearance of symptoms has been reported in up to 72% of patients, and improvement in up to 84%.

Prognosis has been found to depend on age, atopy, allergic versus irritant dermatitis, job change and patient knowledge of their condition

Medical Causation

A wide range of common non-occupational conditions such as psoriasis or constitutional eczema are indistinguishable in their presentation from occupational dermatitis and causation is often a complex issue in dermatitis claims. 

The Industrial Injuries Disablement Benefits (IIDB) scheme allows individuals with work related conditions and diseases to be receive state benefits.  Around 75 diseases are acknowledged by the scheme as being caused by work.  In order for a condition to be added to the list of ‘prescribed diseases’ in the IIDB scheme it needs to have diagnostic features that are defined and can be clearly demonstrated. 

Dermatitis appears twice on the Department of Work and Pensions Industrial Injuries Disablement Benefit (IIDB) scheme list of prescribed diseases.  Its entries are shown below:

7.png

Occupational dermatitis is often influenced by many factors.  There can be constitutional pre-disposition such as childhood eczema or previous sensitisation to an allergen. Symptoms can be exacerbated by heat, cold, humidity or contact with a rough or abrasive surface. 

The diagnosis will require careful history taking, physical examination and patch testing.   Some cases of acute contact dermatitis will be straightforward but often, particularly in cases of chronic contact dermatitis it will be difficult to attribute causation with any certainty.

It is important to note that the Courts have held that in order to succeed the claimant need only prove that the negligence on the part of the employer has materially contributed to the risk of developing the injury.

Incident Rates and Occupations

Nationally, across all industries, an estimated 84,000 people have dermatitis caused or made worse by their work.  The food and catering industries account for around 10 % of this figure. 

The most common irritants are wet work, soaps, shampoos, detergents, solvents, some foods (e.g. onions), oils and greases, dust, acids and alkalis and wet cement.   

Commonly affected occupations include:

  • Catering and cooking;
  • Agriculture;
  • Beauty and hairdressing;
  • Work with flowers;
  • Chemical work;
  • Cleaning work;
  • Construction work;
  • Metal and electronics work;
  • Health and social care;
  • Machine operation; and
  • Mechanic and vehicle assembly.

‘Wet work’ is a general term used to describe an employment that requires an  individuals have their skin exposed to liquids for longer than 2 hours per day, use occlusive (waterproof) gloves, or clean their hands very often (e.g. over 20 times per day).

Frequent exposure to water causes swelling and shrinking of the outermost layer of the skin which is thought to case the dermatitis and it is thought that frequent hand-washing and drying episodes is more likely than longer periods of immersion in water to cause dermatitis.

8.jpg

(Source: Pixnio)

Common Irritants and Allergens by Occupation

Agriculture and Horticulture:

9.png

Chemical and Pharmaceutical Industry:

10.png

Construction and Building Industry:

11.png

Electronics and Electrical Industry:

12.png

Metal and Engineering Industries:

13.png

Food and Catering Industry:

14.png

Hairdressing and Beauty Therapy Industry:

15.png

Healthcare Industry:

16.png

While harmful substances and wet work are a major cause of skin disease, constantly working in uncomfortably hot or cold surroundings or excessively dry or wet conditions can also cause skin disorders.

GUIDANCE FOR EMPLOYERS ON CONTROL OF SUBSTANCES HAZARDOUS TO HEALTH REGULATIONS AND DERMATITIS

Legal requirements when dealing with substances hazardous to health are set out in The Control of Substances Hazardous to Health (COSHH) Regulations 2002, as amended in 2004. 

These Regulations were most recently updated in 2012 but came into force in October 1989 so apply to exposures occurring after that date.  The COSSH regulations are the primary piece of legislation in dermatitis claims.  Where one might have expected the Personal Protective Equipment Regulations 1992 and the Provision and Use of Work Equipment Regulations 1998 to apply, COSHH takes precedence and most claims for dermatitis refer to the COSHH regulations.

Claims after 1st October 2013 will be pleaded in common negligence. However, many of the duties owed by employers at common law mirror those under health and safety regulations.   Equally, failure to adhere to the regulations and associated guidance will be relied upon as evidence of negligence. Within the context of most dermatitis claims the ERR Act will not make a material difference.

Firstly it must be considered whether COSHH applies.

COSHH Regulations apply to work involving substances hazardous to health. The definition of a substance hazardous to health under COSHH is wide and far reaching.

  • Paragraph 2 (a) of the COSHH regulations states: “substance hazardous to health” means a substance —
    • (i) 10 mg/m3, as a time-weighted average over an 8-hour period, of inhalable dust, or
    • (ii) 4 mg/m3, as a time-weighted average over an 8-hour period, of respirable dust;
    • (a) which is listed in Part I of the approved supply list as dangerous for supply within the meaning of the CHIP Regulations and for which an indication of danger specified for the substance is very toxic, toxic, harmful, corrosive or irritant;  [note: CHIP has been revoked as of June 2015]
    • (b) for which the Health and Safety Commission has approved a maximum exposure limit or an occupational exposure standard;
    • (c) which is a biological agent;
    • (d) which is dust of any kind, except dust which is a substance within paragraph (a) or (b) above, when present at a concentration in air equal to or greater than—
    • (e) which, not being a substance falling within sub-paragraphs (a) to (d), because of its chemical or toxicological properties and the way it is used or is present at the workplace creates a risk to health.

Paragraph (e) is something of a ‘catch-all’ and the definition of a substance harmful to health to which the regulations apply is therefore far reaching. 

Duties Under COSHH

Under COSHH there is a hierarchy of duties requiring employers to do the following:

  • The first requirement is to prevent exposure to all substances hazardous to health.
  • Where exposure cannot be prevented then any exposure must be adequately controlled.
  1. Can exposure be prevented?

Employers first need to have considered whether exposure to the substance can be prevented.

  • Can you avoid using a hazardous substance or use a safer process – preventing exposure, e.g. using water-based rather than solvent-based products, applying by brush rather than spraying?
  • Can you substitute it for something safer – e.g. swap an irritant cleaning product for something milder, or using a vacuum cleaner rather than a brush?
  • Can you use a safer form, e.g. can you use a solid rather than liquid to avoid splashes or a waxy solid instead of a dry powder to avoid dust?

    2. Are the risk assessments adequate?

The purpose of carrying out a ‘suitable and sufficient’ risk assessment is to identify areas of concern and control measures that can be put in place to reduce the risk.

A competent person should assess the risk of exposure to hazardous substances at regular intervals.   The risk assessment should consider whether it is reasonably practicable to prevent exposure.   If prevention is not practicable then the assessment should identify how to ensure adequate control.  

The risk assessment should take account of the following:   Hazardous properties of the substance, possible health effects, frequency and duration of exposure, type of work, effectiveness of controls to minimise risk, results of any monitoring data or health surveillance.

    3. Is the exposure adequately controlled?

Where exposure cannot be prevented then any exposure must be adequately controlled.

Regulation 7(1) of COSHH requires employers to ensure that employees’ exposure to substances hazardous to health is either prevented or, where this is not reasonably practicable, adequately controlled.  This duty requires the employer to be active in investigating the risks to its employees inherent in its operations, to stay up to date with industry guidance and take appropriate action where necessary.

The control measures to be adopted will be specific to the operations carried out. 

The HSE’s Guidance paper on working with substances hazardous to health lists gives guidance on choosing appropriate control measures in order of priority as follows:

  • Eliminate the use of a harmful product or substance and use a safer one.
  • Use a safer form of the product, e.g. paste rather than powder.
  • Change the process to emit less of the substance.
  • Enclose the process so that the product does not escape.
  • Extract emissions of the substance near the source.
  • Have as few workers in harm’s way as possible.
  • Provide personal protective equipment (PPE) such as gloves, coveralls and a respirator. PPE must fit the wearer.

Personal Protective Equipment

For example, gloves, to help prevent dermatitis of the hands.  PPE should be regularly checked and maintained, and replaced if damaged.  It should be removed without contamination of the operator, and stored in a suitable place, where it cannot be contaminated.  Appropriate gloves must be chosen for the material being handled. 

17.jpg

(Source: Pixnio)

Some suitable types are:

18.png

Other control measures specific to dermatitis risk may include:

Pre-Employment Screening:  Those with a history of atopy may be more susceptible to occupational dermatitis, and should be identified and counselled to change to dry work tasks.

Barrier Creams:  Though there is some evidence that barrier creams may provide protection, their use should not replace other prevention methods, and should not be over-promoted, as this may confer on workers a false sense of security.

After-Work Creams:  Provision of moisturisers for employees may help reduce their susceptibility to dermatitis.  They should be encouraged and made readily available in the workplace.

Hygiene and the Use of Cleansers:  Cleanliness should also be considered in the prevention of dermatitis.  Adequate washing facilities with hot and cold water and approved skin cleansers should be provided.  An approved skin cleanser should be soluble in all types of water, remove foreign matter without damaging the skin, and should not dry or de-fat the skin.  Instruct workers to wash any contamination from their skin immediately.  Provide soft cotton or disposable paper towels for thorough drying after washing.

Regulation 7 (7) and Workplace Exposure Limits

Regulation 7(7) was introduced by SI 2004/3386, which launched the Workplace Exposure Limits (WELs).  Approximately 500 substances have been assigned WELs and are listed in the HSE publication EH40 Workplace Exposure Limits. 

These are occupational exposure limits set for substances that have the most serious health effects, such as dermatitis and occupational asthma.  For control to be adequate, a WEL must not be exceeded. 

In relation to certain substances, such as carcinogens, exposure must not exceed the relevant WEL, but must also be reduced as far as is reasonably practicable.            

Regulation 11

In relation the Regulation 11, health surveillance is necessary when asthma associated with the substance in use.  The HSE website states that health surveillance should be a regular planned assessment of one or more aspects of worker’s health (i.e. lung function or skin condition or both).         

Regulation 12

The HSE provides guidance in relation to Regulation 12 and the provision of information, instruction and training.  Employees must understand the outcome of any risk assessments carried out and what it means for them.  The HSE website says that employees must be told:

  • What the hazards and risks are;
  • About any workplace exposure limit;
  • The results of any monitoring of exposure;
  • The general results of health surveillance;
  • What to do if there is an accident or emergency.

Employees must have access to safety data sheets and kept informed about planned future changes in processes or substances used.  An employer should keep basic training records

Other Relevant Legislation

In addition to COSHH there are other Regulations which may be relevant. The relevant duties on employers in this respect are set out below:

  • Management of Health and Safety at Work Regulations 1999
    • Assess all significant risks, and keep a written record of the risk assessment where there are 5 or more employees;
    • Identify preventive or protective measures in the risk assessment;
    • Take particular account of risks to new/expectant mothers and young people;
    • Arrange for effective planning, organisation, control, maintenance and review of Health and safety, to include health surveillance where identified by an assessment as appropriate; and
    • Provide comprehensive and relevant training to all employees on health and safety, including information on the risks involved and preventive / protective measures.
  • Provision and Use of Work Equipment Regulations 1998
    • Ensure that the work equipment provided is suitable for use, and for the purpose and conditions in which it is to be used;
    • Maintain work equipment in a safe condition for use so that health and safety is not at risk; and
    • Inspect equipment in certain circumstances to ensure that it continues to be safe for use.
  • Personal Protective Equipment (PPE) at Work Regulations 1992
    • Provide suitable PPE when the risk cannot be controlled by other means, which must be appropriate to the risks involved, the work done, ergonomic factors and the state of health of the user, and must fit the user;
    • Take steps to ensure that the PPE is properly used;
    • Ensure that PPE is maintained in good repair, cleaned / replaced as often as necessary, and stored effectively when not in use; and
    • Provide staff with information, instruction and trainingon the risks the PPE is intended to avoid, the use of the PPE and steps the employees are expected to take to use it as directed, maintain it and report any loss/damage.

TEMPLATE SCHEDULE OF INVESTIGATIONS IN A DERMATITIS CLAIM

Detail any preliminary enquiries made with the insured, setting out what information the insured has provided to date. Then concisely summarise what else needs to be investigated / clarified by identifying the main issues in dispute which require further investigation. For example:  

Lay Evidence

The Claimant

  • What was / is the claimant’s (C) job role and periods of employments?
  • What site(s), departments, lines, operations & processes does / did the C work at with relevant dates for the same?
  • What was C’s days and hours of work, including any regular overtime?
  • Obtain a broad timeline of what happened. When did C first:
    • Start the work complained of?
    • Raise any problems concerns regarding his work?
    • Develop symptoms?
    • Go absent from work (if at all)?

[Further details on complaints and absences etc. requested below]

Control of Substances Hazardous to Health

  • Is it accepted that the work carried out by C involved Hazardous Substance(s)?
  • What substance(s) did C use during the course of employment?
  • What was the substance used for?
  • What was the chemical name (if appropriate)?
  • In what quantities was the substance use?
  • Is it accepted that COSHH would apply?

Preventing Exposure as Far as Reasonably Practicable

  • Have the insured considered whether contact with the hazardous substance can be avoided?
  • If so when and how was this considered and by whom?
  • What was the conclusion reached and why?
  • Why was it not reasonably practicable to avoid the use of the substance?

Risk Assessment

  • Have the insured carried out risk assessments regarding the operations / process?
  • Is there a specific COSHH assessment relating to use of the particular substance(s)?
  • When and how were these risk assessments carried out and by whom?  Where they carried out by a ‘competent person’?
  • Where the risk assessments suitable and sufficient?
  • If the risk assessments were not suitable explore reasons / why not?
  • Has the risk assessment considered whether it is reasonably practicable to prevent exposure?
  • If prevention is not practicable then has the risk assessment identified how to ensure exposure is adequate controlled?
  • How often were risk assessments reviewed and why?
  • Details of insured’s general Health and Safety structure and policies and procedures.

Control Measures

  • What control measures were identified by the risk assessments to adequately control exposure to the hazardous substance?
  • Have these been implemented? If not, why not?
  • If they have been implemented, then when where they implemented and how and by whom?
  • Where they in place at the time of C’s alleged exposure?
  • Obtain details of the existing control measures in place and throughout the C’s employment and reasons for any changes e.g. access control, containment of the substance, use of gloves, googles or other appropriate PPE, health monitoring, washing facilities, barrier creams etc.

The Work

[Note: Some of these questions may overlap with the above.]

  • Please take a video of the work carried out by C.
  • If possible please take photographs of the labelling of any substance container or warning labels.
  • Obtain full details of the nature and extent of the work as follows:

The Substances to Which C Was Exposed

  • What substances did C use/ come into contact with?
  • What are they used for?
  • In what quantities are they used?
    • Are there any safer alternatives?
    • Does the risk assessment require access control i.e. restricted to competent personnel?
    • Was C competent to handle the substances?
    • Where there any special operating procedures in place?

Duration and Frequency

  • The frequency of the exposure to the substances per minute / hour / over the course of a working day;
  • The duration of each individual exposure;
  • The cumulative duration of exposure in a working day;
  • How many days per week -daily and regular task / weekly and irregular etc.

For ‘Wet Work’

  • How long was C exposed to liquids during a typical working day?
  • Which liquids?
  • Does C use occlusive (waterproof) gloves?
  • How often does C wash their hands per day?

Engineering Control Measures

  • Are there any engineering control measures in place? i.e. containment, blast screen, fume cupboard?
  • Where all control measures periodically inspected and adequately maintained.

Environment

  • Is the work environment particularly hot or humid?
  • Are there any extremes of temperature (hot or cold)?
  • Has the insured provided washing facilities? i.e. basins, soap, showers, on site laundry.

PPE

  • Is any PPE required? Was it worn?
    • What type? E.g. gloves, eye protection, overalls, other (specify type).
    • Specify model/type of PPE provided.
    • If required, was the use enforced?

Training

  • Please detail the training provided to the C in relation to the work generally and the tasks carried out in department;
  • Details of any induction and/or refresher training provided to the claimant in relation to the risks of exposure to hazardous substances. What exactly did the training cover-for example:
    • Nature of substance and hazardous properties;
    • Handling and storage requirements;
    • Emergency procedures;
    • How injuries can occur;
    • How to avoid injuries;
    • How to use substances safely;
    • How to use engineering control equipment safely;
    • How to use PPE safely;
    • When and how to report any accidents and health problems and seek medical advice & assistance?
  • When, how and who carried out the training and what qualifications/experience did they have?

Complaints / Occupational Health

  • Obtain details of the insured’s system relation to injury complaints;
  • Identify whether C made any complaints about the nature of the work and/or his injury to managers/supervisors/ other employees;
  • If complaints made then when and to whom and nature/gist of the same?
  • How C’s complaints were dealt with-when and by whom-and what was the outcome? Did C carrying on with work complained of?
  • Details of the insured’s occupational health arrangements / policy;
  • Was monitoring in place? i.e. periodic occupational health assessments and / or any monitoring of personal exposure values?
  • Was C referred to Occupational Health-if so how, when and by whom?
  • What was done following the referral including the occupational health advisor’s recommendations and whether these were followed);
  • Were there any previous complaints from others? If so when, from whom/ what action taken?

Absences and Returns to Work

  • Dates of absences from work and reasons?
  • Any assessment of capability for work on return?
  • Graduated return to work / any restrictions imposed / different work carried out?
  • Did C return to same work-if so when?
  • Were there any subsequent complaints by C after the injury / absence? If so when and to whom and nature / gist of the same? How was this dealt with and what was the outcome?
  • Identify in retrospect whether anything could have been done differently.
  • Was C’s employment terminated? If so when and for what reason(s)?
  • Was C placed on different work which effected income? Obtain full details.

Documents

This Checklist is intended only to be a guide and it is not exhaustive.

NB: IN CASES WHERE SUCH DOCUMENTS ARE NOT AVAILABLE IT IS VITAL TO CLARIFY WHETHER (I) THEY NEVER EXISTED, OR (II) IF THEY DID WHAT BECAME OF THEM AND WHEN?

The Injury

  1. Accident Book entry for the Claimant’s symptoms and any other relevant incidents.
  2. Form F2508 (submitted to the Health & Safety Executive).
  3. Any HSE investigations or correspondence in relation to this claim, any other similar incidents or the system of work in general.
  4. Any other investigation reports or forms, including any statements taken or memos sent.
  5. First Aid/Treatment Book entry.
  6. Sick Notes submitted by the Claimant.
  7. Any documents completed for the purposes of the DSS.
  8. Documents relating to any other similar claims or Accident Book entries etc.

Production Information

  1. In relation to the period about which the Claimant is complaining, documentation to show:
    1. The Claimant’s Day Work Sheets (including details of basic hours worked and any overtime);
    2. A breakdown of the Claimant’s daily activities;
    3. The Claimant’s performance targets and their actual achievement/production levels;
    4. Average speed of the process (e.g. in terms of units per minute or per hour or per shift);
    5. If the Claimant was above or below average, documents to show this (e.g. statistics or a comparator employee’s Day Work Sheets etc.).

Risk Assessments COSHH Assessments and Health & Safety Records

  1. Health & Safety Committee Meeting Minutes which refer in any way to the subject matter of this claim.
  2. The Company’s Health & Safety Policy.
  3. Any other relevant internal Health & Safety documents, including memos and e-mails, relating to dermatitis.
  4. Maintenance, inspection and/or repair records for all relevant equipment, plant or tools used by the Claimant.
  5. Risk Assessments and COSHU assessments — for the period of the Claimant’s employment and also one year before and after, in relation to:
    1. The COSHH Regulations;
    2. The Management of Health & Safety at Work Regulations;
    3. Personal Protective Equipment at Work Regulations;
    4. Any re-assessments following any changes (e.g. to the work station, to systems of work or following any accidents or health (surveillance);
    5. Any other relevant, general risk assessments.
  6. Documents showing any other sources of information obtained, such as:
    1. Manufacturers’/suppliers Product Safety Data Sheets;
    2. Independent health & safety reports commissioned; work surveys;
    3. Air monitoring surveys;
    4. Documents obtained from HSE, trade associations, health & safety industry journals.

Personal Protective Equipment

  1. Manufacturers’/suppliers’ product information (e.g. catalogues, marketing information etc.) for all PPE provided (e.g. gloves, gauntlets, aprons, visors, goggles, masks etc.), including the name and make.
  2. Any manuals in respect of the use of the PPE.
  3. Purchase records to show how often and how many items are typically purchased (e.g. each month).
  4. Documents showing what PPE the Claimant received and when (e.g. signed receipt forms).
  5. Documents relating to suitability (e.g. trials, discussions with suppliers etc.).
  6. Documents relating to the maintenance, testing and repair of all PPE provided (e.g. repair and maintenance records).

Skin Hygiene

  1. Documents relating to the provision of washing facilities (e.g. hot and cold water, soap, towels, hot air driers).
  2. Documents relating to the provision of skin barriers, moisturisers or other skin care products.
  3. Purchase records to show how often and how many items are typically purchased (e.g. each month).

Other Control Measures

  1. Documents showing what other steps have been taken, if any, to prevent or adequately control exposure to hazardous substance(s) (other than PPE and skin hygiene). In particular, relating to:
    1. The implementation of any control measures by engineering means (e.g. automation or dispensing systems);
    2. Ventilation systems (e.g. extractors);
    3. The manufacturer’s specifications (e.g. catalogues, product information); and
    4. Any systems of review, maintenance and testing of the above;
    5. The rotation of employees, the variation of duties and the taking of rest breaks.
  2. Any documents which explore the possibility of the above.

Training and Enforcement

  1. Health & Safety Handbook/Manual — preferably the copy signed and dated by Claimant to acknowledge receipt.
  2. Documents showing all training, instructions and warnings (e.g. certificates, course notes, course registers, internal memos, publicly displayed warning notices, handbooks/booklets, notes of guidance and any other literature etc.) given to the Claimant in respect of relevant matters such as:
    1. The risk of occupational dermatitis;
    2. The correct use and upkeep of PPE;
    3. The importance and enforcement of the use of PPE;
    4. Recognition of symptoms;
    5. The need to report symptoms and seek medical assistance.
  3. The Claimant’s Training Records for all aspects of their work and, in particular, in respect of COSHH and PPE.
  4. Documents relating to enforcement procedures, including warnings given and disciplinary procedures taken against employees (particularly the Claimant) for failure to wear PPE and to follow the health and safety policies generally.

Health Surveillance

  1. Documents detailing any system of health surveillance (e.g. undertaken by who, when, how often and in respect of what).

Complaints or Comments and Action Taken

  1. Documents relating to any written or oral complaints or comments made by the Claimant or any other employees about symptoms or the system(s) of work.
  2. Documents detailing the Company’s response to any such complaints or comments and what action was taken, if any.
  3. All correspondence passing between the Company and the Health & Safety Executive regarding this incident or any other similar matters.

Wages, Benefits and Absences

  1. Details of the Claimant’s net weekly pre-absence earnings for a period of 13 weeks.
  2. Details of all payments made to the Claimant during any periods of absence from work due to the alleged injury.
  3. Details of any Permanent Health Insurance scheme and, where applicable, details of any payments made.
  4. The Claimant’s Absence Record (including all absences due to sickness, holidays, training etc).
  5. If the Claimant was moved to alternative work:
    1. Details of the pay in the new job compared with the old job (including differences in shift allowances and bonuses).
  6. If the Claimant’s employment was terminated:
    1. The date on which the employment ceased;
    2. All letters and documentation relating to the termination.
  7. If the Claimant was made redundant:
    1. All documents relating to the redundancy, including the selection procedure, details of payments made etc.
  8. Pension details, if applicable:
    1. Pension Handbook;
    2. Pension Statements;
    3. Copy correspondence confirming details of how the pension would be affected (if the Claimant’s employment was terminated or made redundant).

Confidential Records

  1. Works’ Medical Records/Occupational Health Records.
  2. Personnel File (including Contract of Employment and job description).