Assessment of Campaign to Reduce Dermatitis A Local Authority Partnership Project, East Riding of...

Assessment of Campaign to Reduce Dermatitis A Local Authority Partnership Project, East Riding of Yorkshire & Hull City Council

Evaluation of Local Authority Campaign Evaluation of Local Authority Campaign Work on Dermatitis in HairdressingWork on Dermatitis in Hairdressing

East Riding of Yorkshire & Hull City CouncilsEast Riding of Yorkshire & Hull City Councils

Prepared by the Health & Safety Laboratory


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Information

Introduction & Aims ResultsMethodology

Conclusions


Introduction

Chris Dunnachie &Elizabeth SmithEast Riding of Yorkshire Council

Deborah ReadJulia DeightonHull City Council

Project delivered by:

Gareth Evans & Shamim RahmanOccupational Hygiene Unit, Health & Safety Laboratory

Introduction

At some stage in their career 35-40% of hairdressers in GB experience dermatitis

Dermatitis occurs most frequently amongst trainee hairdressers

Local authorities in GB have worked in partnership with HSE and the hairdressing industry to address this problem

East Riding of Yorkshire and Hull City Council have campaigned to advise hairdressing businesses, colleges, and training providers about the causes and risk of dermatitis in hairdressing

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Aims & Objectives Aim: To evaluate the campaign work carried out by East Riding of Yorkshire & Hull City Council on hairdressing and dermatitis

Objectives:

To use a questionnaire to assess the use and uptake of guidance provided as part of the campaign

To share with the wider LA community examples of good practice from this campaign and to take stock of those aspects that were not productive

Participants:

Hessle High School Beverley CollegeGoole College David Lister College East Riding College Hull College Newland School for Girls Prospect Training Immingham Oasis Academy Freedom Centre St Mary’s Walk

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History of project In 2006 East Riding of Yorkshire & Hull City councils started proactive work on dermatitis in hairdressing.

In June 2008, East Riding of Yorkshire Council asked HSL to deliver a training course on dermatitis in hairdressing. The meeting was attended by local authority inspectors from East Riding of Yorkshire and Hull City Councils, and by lecturers from local education colleges and training organisations.

The course encouraged staff from East Riding Council and Hull; City to carry out and evaluate the impact of their work on dermatitis amongst hairdressers.


Three questionnaires (for hairdressing salon staff, college students and college lecturers & trainers) were developed by HSL

The questionnaires consisted of ~20 'open' and 'closed' questions to assess the value of the DVD and guidance to the respondents

Paper copies of the questionnaires were circulated by East Riding of Yorkshire & Hull City Councils, and the completed questionnaires were returned to HSL for analysis

Methodology: QuestionnaireQuestionnaire

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Students: 432 students participated from local authority colleges and training providers

College lecturers & trainers: 23 staff participated from local colleges and other training providers

Hairdressing salon staff: 252 salons from East Riding of Yorkshire and Hull City Council participated

Methodology:

Study populationStudy population


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Methodology:

Collection & Collection & analysis of dataanalysis of data

Data was collated using SphinxTM survey software and checked for integrity

Summary data was analysed for significance by the Mathematical Science Unit at HSL

Frequency tables and statistical tests of the proportion being equal to 0.5 (i.e., no difference) were performed.

Probabilities greater than 1 in 20 are reported as significant

For questions that used a rating scale, negative responses and neutral responses (1 & 2 & 3) were combined and compared to positive responses (4 & 5)


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Results:Results:

Hairdressing Hairdressing salons, salons, students, students, teaching staffteaching staff

Results: Hairdressing salon staff

Results: Students

Results: Teaching staff


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Results:Results:

Feedback Feedback about DVDabout DVD

Hairdressing Salon Staff

Number of hairdressing salons participating 252Number of Councils participating 2

% response

Participants from East Riding of Yorkshire 191 69%Participants from Hull City Council 61 41%

Type of business

Hairdressers 232Barbers 20

How the DVD was usedTraining new staff Training staff Other

activity* 5% 75% 20%

* Examples included: For personal use; for self employed staff; to update knowledge; as a health & safety resource.


Hairdressing Salon StaffResults:Results:


1) How would you rate the DVD for raising awareness to dermatitis & glove use?

Yes No79% 21%

2) In your opinion has the DVD helped you understand the causes of dermatitis?

Yes Undecided No74% 6% 20%

3) How useful did you find the following sections of the DVD?

Maxine’s story

Useful Not useful58% 42%

How to select, use, and remove disposable gloves


Looking after your hands (using moisturising creams & skin checks)


= Significant difference



4) In your opinion has the DVD persuaded you to use:

Different working practices to prevent dermatitis?

Yes Already aware No24% 75% 1%

Longer non-latex disposable gloves (e.g., for washing hair)?


Moisturising cream to protect skin?


Regular checks for signs of damaged skin?


Results:Results:






Results:Results:

Impact of Impact of guidance, guidance, information & information & trainingtraining

5) Have you read the leaflet “Looking after your hands: wearing disposable gloves”?

Yes No72% 28%

If yes has the information in the leaflet persuaded you of the benefit of using non-latex disposable gloves (vinyl or nitrile)?


Has your business obtained the HABIA Health & Safety Award?

Yes No27% 73%

Do you use the HABIA guidance booklet “Dermatitis and glove use for hairdressers”?

Yes No41% 59%

As part of future training activity will you use the DVD with new starters?






Results:Results:


Students

% responseNumber of students participating 432 ~90%Number of colleges participating 6Number of training providers participating 5

% Students currently working in salons:

Yes 57%No 43%

List of colleges & training organisations

Beverley College, East Riding College, Goole College, Hessle High School, Hull College, Newland School for Girls, St Mary’s Walk, David Lister School, Freedom Centre, Oasis Academy, Prospect Training



StudentsResults:Results:


1) Have you watched the DVD?

Yes No95% 5%


Maxine’s story









3) Has the DVD helped you to understand?

The causes of dermatitis in hairdressing work?


How to prevent dermatitis?

Yes Already aware No80% 19.5% 0.5%

How to safely use non-latex gloves?


How to protect your skin?


How to check your skin for signs of damage?


Results:Results:


Students




Results:Results:


5) Have you read the leaflet “Looking after your hands: wearing disposable gloves”?

Yes No56% 44%

6) Has your college given you a copy of the HABIA guidance booklet?

Yes No50% 50%

7) Has your employer explained to you how to prevent dermatitis?

Yes No79% 21%

8) Has your employer checked your hands for signs of dermatitis?

Yes No75% 25%

Students




Results:Results:


9) Has your employer provided you with non-latex gloves for washing hair? Yes No

86% 14%

10) Has the leaflet helped you understand the advantages of using non latex disposable gloves? Yes Already aware No

87% 9% 4%

Students




Results:Results:


Teaching staff

Number of staff participating 23Number of colleges participating 4Number training organisations participating 1

Had the students that watched the DVD?

Yes No 95% 5%

For what activity was the DVD usedTraining students Training staff Other activity* 91% 17% 17%

*Examples included: Informing employers; for group tutorials; for induction training



Teaching staffResults:Results:


1) How would you rate the DVD for raising awareness to dermatitis & glove use?

Yes No92% 8%


Maxine’s story









Results:Results:


Teaching staff3) Has the DVD helped you to understand?

The causes of dermatitis in hairdressing work?


How to prevent dermatitis?


How to safely use non-latex gloves?


How to protect your skin?


How to check your skin for signs of damage?





Results:Results:


5) Have the students read the leaflet “Looking after your hands: wearing disposable gloves”?

Yes No86% 14%

6) Has the glove trial leaflet helped the students to understand the advantages of using non-latex gloves?


7) Has your college obtained the HABIA Health & Safety Award?

Yes No84% 16%

8) Do you provide your students with a copy of the HABIA guidance booklet “Dermatitis and glove use for hairdressers”?

Yes No59% 41%

Teaching staff




How useful did you find the DVD?

Not No Useful Useful difference

Hairdressing salon staff

Students

Teachers

Overall result:Overall result:

Value of DVD to Value of DVD to different groupsdifferent groups

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Conclusions:Conclusions: The survey was very well supported with questionnaires completed by 252 hairdressing salons, 432 students and 23 teaching staff from training providers across East Riding of Yorkshire and Hull City Council

This survey demonstrated that a significant proportion (more than 75%) of the teaching staff and students considered that the DVD, glove trial leaflet and the HABIA guidance book had helped them to understand the causes and prevention of dermatitis

A significant proportion of the hairdressing salons (79%) said that the DVD had raised awareness about dermatitis and its causes and they would use it to train staff

The survey demonstrated that the DVD was valued most by trainers and students.

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Conclusions:Conclusions: Approximately 3 out of every 4 of the hairdressing salon staff said that they were already aware of the issues raised in the DVD and the guidance

Approximately 4 out of every 10 of the hairdressing salon staff said that they had used copies of the HABIA guidance

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Conclusions:Conclusions:

Examples of Examples of feedbackfeedback

Student comments about the DVD:

“It was good, it helped me learn more about my hands and how to keep them healthy”

“ After watching the DVD we tested ourselves with the gloves and learnt how to take them off properly”

“Put more stories in about people with dermatitis”

“Show more pictures of what can cause dermatitis”

Hairdressing salon staff comments about the DVD:

“Bit slow and patronising. Unrealistic scenarios for busy salon”

“ Very informative”

“Valuable for younger members of the team”

“Need more info, clearly explaining dermatitis – a good introduction”

“Longer length gloves not so easy to get hold of”


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AcknowledgementsAcknowledgements We would like to thank the following for contributing to the evaluation of the guidance and DVD:

The hairdressing salon staff from Hull City and East Riding of Yorkshire.

The students and teaching staff from Beverley College, Hessle High School, Goole College, East Riding College, Hull College, St Mary’s Walk, David Lister College, Newland School for Girls, Prospect Training, Oasis Academy, Freedom Centre

Local authority colleagues from Hull City Council and East Riding of Yorkshire who carried out the surveys

Anton Gordon (VPS at HSL) for design of the presentation

Eileen Holmes (Mathematical Science Unit HSL) for carrying out the statistical analysis and Jo Bowen (CWH HSL) for supporting delivery of training events


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Information:Information:1) Feedback from LA staff about using DVD for campaigns2) Summary of feedback provided by survey respondents

3) Previous LA Partnership work- HABIA GuidanceQuestionnaires used in study

Questionnaires

4) Materials distributed prior to surveyDermatitis leafletGlove trial fact sheetDermatitis DVD (version for web sites)HABIA guidance booklet

5) Other resourcesLooking after and checking your skinContamination of skin & taking off contaminated glovesHSE postersHSE website


Background:Background:

Inspector’s Inspector’s suggestions suggestions encouraging use encouraging use of DVDof DVD

Use questionnaire on visit to assess compliance & knowledge

Encourage discussion & refer to HSE skin check form

Salon owner unsure of control measures to be implemented

Make available portable DVD player-& encourage viewing as part of staff meeting to clarify salon rules

Salon has no facility to watch DVD

Have extra copies available & ask salon to ring after receipt (follow up if no contact)

Salon had lost DVD / not received letter

Ring to make appointment reminding that DVD & information has been sent

Mail left un-opened in salon

Letter explaining that salon will be inspected (including assessment of dermatitis controls) & that DVD will assist in preparing for the inspection

“Far too busy” to engage with LA Inspector

Solutions implemented to improve dialogue / contact

Issues identified during evaluation exercise

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Previous LA Previous LA partnership work: partnership work: HABIA guidanceHABIA guidance

The booklet summarises the following:

Five steps to healthy hands

What is dermatitis?

Signs and symptoms of dermatitis

What causes dermatitis?

Avoiding dermatitis – wearing gloves

Avoiding dermatitis – looking after your skin

Avoiding dermatitis – checking your skin

What does the law require?



Disposable glove Disposable glove trialtrial

Previous studies have found that many hairdressers:

Used unsuitable disposable gloves (powdered latex)

Used chemicals that can damage the skin but without wearing gloves

Worked for long periods doing wet work without wearing gloves

Considered that disposable gloves were unsuitable for hairdressing work

Comments that were made before the trial was conducted

“Gloves break easily”

“Gloves snag on the clients hair”

“Gloves are not comfortable to wear”

“Gloves make it difficult to sense the temperature of the

water”




Glove trial Glove trial methodologymethodology

Laboratory tests of six different vinyl and nitrile disposable gloves included:

Touch and thermal sensitivity

Elasticity and durability (tear resistance)

Dexterity

Gloves were evaluated by an independent panel to assess:

Comfort and ease of fitting and removal

Consumable cost for replacing latex gloves




Glove trial resultsGlove trial results

Once hairdressers had tried disposable vinyl and nitrile gloves that fitted well, most of them were willing to use them

The hairdressers preferred longer length gloves that protected their wrists

The majority preferred the close fit of nitrile disposable gloves

After the trial most hairdressers were positive about using these gloves for wet work (hair washing) and handling chemicals (bleaches, perming solutions and colours)

Very few gloves (<1%) were found to have broken or torn during their use

What hairdressers said about the gloves they tried




Glove trial resultsGlove trial results

An opinion that did not change after the trial: Most hairdressers said that disposable gloves cannot be worn for cutting and styling hair

Examples of changes of opinion after the trial concluded




Development of Development of dermatitis DVDdermatitis DVD

A short educational DVD for Environmental Health Officers was produced

The DVD contains

A personal story of the impact of dermatitis

Instructions on selecting disposable gloves and their safe removal after use

Looking after your skin and checking your skin for damage

HSE Five steps to healthy hands




What is What is dermatitis?dermatitis?

Dermatitis is caused by exposure to physical, chemical and biological hazards that cause damage and provoke inflammation or allergy in the skin

Dermatitis typically occurs at the site of contact (e.g., hands) with the hazard but in more severe cases can spread to involve wider areas of the body (e.g., arms, neck, and face)

There are two major forms of occupational dermatitis (irritant and allergic dermatitis)

Whilst the agents that cause irritant ad allergic dermatitis may be different the symptoms for both conditions are often similar

Dermatitis symptoms may decline when exposure ceases but some types of dermatitis (e.g., allergic disease) persist and can be activated at a future time by exposure to small amounts of the hazard

Typical symptoms Dry skinItchingRednessSwellingFlaking of skinBleedingBlisteringCracking of skin




How does How does dermatitis occur?dermatitis occur?




What does What does dermatitis look dermatitis look like?like?




Prevalence of Prevalence of dermatitis dermatitis amongst amongst hairdressershairdressers

A recent survey of the UK hairdressers found that 39% reported having had dermatitis on their hands at some point during their career

This compares to a prevalence of approximately 8% in the general adult population

More than two thirds of hairdressing apprentices suffer some form of skin damage, and a third experience more severe changes to their skin during their first few years in hairdressing work.




Risk factors for Risk factors for dermatitis dermatitis amongst amongst hairdressershairdressers

Prolonged contact of the skin with water (called ‘wet work’)

Frequent contact with hazardous chemicals (particularly corrosive substances e.g., peroxides)

The duration and amount of exposure

For allergic dermatitis a family history of atopy (I.e, a predisposition to develop allergies to common environmental allergens e.g., pet dander, pollens, house dust mite)

Females and younger age groups are more at risk



Irritants

Lightening / bleaching agents

Colorants

Developers

Removers

Perm solutions

Straightening products

Neutralisers & relaxers

Wet work & shampoos


Hazards causing Hazards causing dermatitis in dermatitis in hairdressinghairdressing

Allergens

Persulphate salts (in bleaching agents)

Paraphenylenediamine (PPD) in colorants

Resorcinol in colorants

Glyceryl thioglycolate / thioglycolate

Salt (perms & straightening solutions)

Perfumes

Preservatives

Nickel

Latex in high protein content

disposable gloves



A layer of moisturiser will help protect skin and reduce the chance of drying

It is important to apply moisturiser after tasks like ‘wet work’

Hand lotion need not be expensive, e.g. ‘own brand’ moisturising hand lotions containing emollient, liquid paraffin, glycerine can be equally effective

Products sold as barrier creams/protective creams/gloves in a bottle do not provide a genuine barrier against chemicals and water!


Looking after skinLooking after skin




Checking skinChecking skin

Checking for early signs of dermatitis

Who checks?The employer A responsible trained person delegated by the employerThe employee – once trained

What next if you see signs?• Investigate the work carried out• Check regularly to see if symptoms progress• Record your findings• Take action to protect skin and prevent further exposure




Removing Removing contaminated contaminated glovesgloves

When gloves become contaminated with chemicals (e.g., bleaches) it may not always be easy to see this

The photograph below uses a special dye to show how skin (e.g., finger tips) can become easily contaminated if you do not remove gloves properly

Follow this link for a chart that explains how to remove disposable gloves without contaminating skin. Or view the demonstration on the DVD.





Guidance on Guidance on chemical hazardschemical hazards

A more detailed list of ingredients found in salon hair products can be found in the booklet ‘A Guide To The Health & Safety of Salon Hair Products’ 8th Edition 2007 (written by the Cosmetic, Toiletry and Perfumery Association (CTPA). This guide to the health and safety requirements for salon products is available to order from the Hairdressing and Beauty Suppliers Association (cost: ~£1.00 plus postage; Tel: 01707 649499)




Guidance on skin Guidance on skin diseasedisease

The HSE skin disease website contains a lot of very useful information, advice and case studies providing information for LA inspectors as well as employers, employees and trainees. This can be found by following the link: www.hse.gov.uk/skin


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Link to DVDLink to DVD

This page links you to a website compatible video format of the DVD ‘Preventing Dermatitis: A guide for hairdressers’. Each section of the DVD can viewed by clicking the links below.

Introduction

About dermatitis in hair dressing

Dermatitis: a personal Story

Simple steps to protect your hands

Wearing gloves

Proper use of gloves

Proper glove removal

Looking after your hands

Summary

Assessment of Campaign to Reduce Dermatitis A Local Authority Partnership Project, East Riding of...

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