Guidelines to a standard of care on occupational dermatitis and urticaria will be published in full in a future issue of Occupational Health. OH nurse adviser Diane Romano-Woodward provides a guide to reviewing the service.
In 2006, the House of Lords Science and Technology Committee appointed a subcommittee to discuss the impact of allergy on the population. This included patients, society and the economy. The scope was wide reaching, covering allergies to substances commonly found in the community, in workplaces and in the general environment.The report, "Allergy", was part of the 6th Report of Session 2006/07. This is an informative document with an excellent description of the nature of allergies, both IgE-mediated (atopy) and non-IgE-mediated (House of Lords, 2007).
The report also contains specific information on occupational allergies. Mention was made of asthma, rhinitis and extrinsic allergic alveolitis, as well as allergic contact dermatitis. The committee recognised a lack of consistency in the diagnosis and care of those with allergies in both primary and secondary care. It made recommendations to the Health and Safety Executive (HSE) for further action (see box 1).
As a result of this report, the HSE supported the British Occupational Health Research Foundation (BOHRF) in assembling stakeholders from the fields of occupational health, dermatology, general practice, trade unions and patients' groups. In 2010, they produced evidence-based guidance on occupational dermatitis and urticaria (Romano-Woodward, 2010).
The HSE then formed a standards of care working group to develop standards, including a representative from the Association of Occupational Health Nurse Practitioners. The 10 standards have been published (see box 2) and cover the whole of the "patient's journey", dealing with the responsibilities of employers and also of the healthcare professionals with whom the employee will come into contact.
Many employees do not have access to OH services and the initial diagnosis and onward referral may be made by a GP.
If there is an OH service, it may be nurse led, so that the initial history taking and advice about health and control of hazards will be from an OH professional who is not a physician.
However, all health surveillance programmes should be overseen by a physician with expertise in OH, to whom the nurse can refer those affected