Skin Protection for Tradespeople: Cement Dermatitis, Barrier Creams and COSHH Compliance

Summary

Occupational skin disease is the most common work-related illness in the UK after musculoskeletal disorders. In construction, it is primarily driven by contact with wet cement, epoxy resins, and other skin-sensitising chemicals. The consequences of occupational contact dermatitis go far beyond reddened hands: once a worker is sensitised to chromate or epoxy resin, they may never be able to return to work with those substances, ending careers prematurely.

The COSHH Regulations 2002 impose a specific legal duty on employers to prevent skin exposure to hazardous substances or, where this is not reasonably practicable, to adequately control it. The hierarchy of control for skin protection mirrors that for inhalation risks: eliminate, substitute, engineer (enclose the process), then personal protective equipment (PPE) as the last resort — not the first response.

For individual tradespeople, the practical requirements are clear: understand which substances pose a skin risk, use appropriate gloves consistently, apply barrier cream correctly, and moisturise regularly. These are simple habits that prevent serious, lifelong disease.

Key Facts

• Occupational contact dermatitis (OCD) — two types: irritant contact dermatitis (ICD) from chemical damage; allergic contact dermatitis (ACD) from sensitisation; both are RIDDOR reportable once diagnosed by a physician
• 5,000+ new cases per year — estimated annual new OCD cases in UK construction; significant under-reporting likely
• Hexavalent chromium (Cr(VI)) — the skin sensitiser in Portland cement; limited to ≤2mg/kg by EN 196-10 in cement sold in the UK and EU since 2005; ferrous sulphate reducing agent is added during grinding to convert soluble Cr(VI) to insoluble Cr(III)
• Cement burns — fresh wet concrete has a pH of 12–13 (strongly alkaline); can cause full-thickness burns after prolonged skin contact; kneeling in wet concrete is the most common mechanism — wet concrete inside Wellington boots or kneepads causes burns before the victim is aware
• Wet work definition — work where skin is in contact with wet, dilute, or moist substances (including water, cement, cleaning agents) for ≥2 hours per day; wet work is a major driver of ICD
• COSHH Regulations 2002 — require risk assessment, control measures, and monitoring for all substances hazardous to health including skin sensitisers
• Pre-work barrier cream — applied to clean, dry skin before work; creates a physical barrier that is harder for irritants to penetrate; reduces skin contact with cement, oils, and solvents
• Nitrile gloves — the standard glove for construction work with chemicals; provides good resistance to cement, oils, and solvents; available in different thicknesses (0.1mm disposable to 0.5mm heavy-duty); latex gloves are a skin sensitiser in themselves — switch to nitrile
• Latex allergy — type I hypersensitivity to natural rubber latex proteins; can cause anaphylaxis; all construction gloves should be latex-free (nitrile or vinyl)
• After-work moisturiser — restores the skin's natural lipid barrier damaged by wet work and chemical contact; apply after washing at end of day and after every wash during the working day
• MSDS/SDS requirement — manufacturers of hazardous substances must provide Safety Data Sheets (SDS) under REACH Regulation; Section 8 contains PPE requirements; Section 11 contains toxicological information
• Skin surveillance — annual medical skin check for workers regularly exposed to skin sensitisers; look for early signs of dermatitis before sensitisation occurs
• Ferrous sulphate additive — added to cement during manufacture to reduce Cr(VI); has a shelf life; cement stored for more than 6 months may have depleted additive and higher Cr(VI) levels — check bag date codes
• Epoxy resin — a potent skin sensitiser; mixed components (resin + hardener) and uncured epoxy are both sensitising; once sensitised, the worker may react to minute traces indefinitely

Quick Reference Table

Detailed Guidance

Understanding the Two Types of Dermatitis

Irritant Contact Dermatitis (ICD): ICD is caused by direct chemical damage to the skin — not an immune response. Common irritants in construction include wet cement (alkaline), solvents (degreasing), and abrasive cleaning agents. ICD can affect any worker on first exposure; no prior sensitisation is required. Symptoms include redness, dryness, cracking, and scaling. ICD can be resolved by removing the irritant exposure, though chronic ICD may take months to settle.

Allergic Contact Dermatitis (ACD): ACD is an immune-mediated response to a skin sensitiser. It requires an initial sensitisation phase (often symptom-free) followed by an elicitation phase — on subsequent contact with even minute amounts of the allergen, a severe inflammatory response occurs. Common sensitisers in construction: hexavalent chromium in cement, epoxy resin hardeners, rubber accelerators in gloves, and colophony (in some adhesives and fluxes).

ACD is irreversible — once sensitised, the worker will react to the allergen indefinitely. The consequences are career-limiting: a concretor sensitised to cement chromate cannot continue in that trade. This makes prevention — not just treatment — the only effective approach.

Hexavalent Chromium and Cement

Cement contains a small amount of soluble hexavalent chromium as an impurity from the raw materials. Cr(VI) is both an irritant and a potent skin sensitiser; it can also cause lung cancer with inhalation exposure (though inhalation of cement dust is a separate COSHH issue).

The EN 196-10:2005 limit of 2mg Cr(VI)/kg cement is achieved by adding ferrous sulphate to the cement during grinding, which reduces soluble Cr(VI) to insoluble Cr(III). Cr(III) does not penetrate the skin and is not a sensitiser.

Important practical implications:

1. Shelf life of cement: ferrous sulphate oxidises over time; bags stored beyond the 'use by' date may have elevated Cr(VI) levels. Always check bag date codes; do not use cement more than 6 months old if the bags are opened (check product-specific guidance as shelf life varies).
2. Wet cement is more dangerous than dry: Cr(VI) is only bioavailable when dissolved in water; dry cement contact is much less likely to cause sensitisation than prolonged contact with wet cement.
3. Concrete additives: accelerators, retarders, and plasticisers may contain additional sensitisers; check the SDS for all admixtures.

Cement Burns: Mechanism and Prevention

Portland cement in contact with water generates calcium hydroxide, raising the pH to 12–13. At this pH, the skin's natural acid mantle (pH 5.5) is overwhelmed and the alkali begins to saponify (break down) the skin's fatty acids and eventually the dermis. Full-thickness chemical burns can occur within 30 minutes of constant contact.

The kneeling mechanism: workers in poured concrete who are not wearing fully waterproof kneepads or waders allow wet concrete to pool inside their footwear. Because the alkali burns slowly — without the acute pain of a thermal burn — the worker may not notice until the burns are already severe. Cement burns inside boots and kneepads are a recognised construction emergency.

Prevention:

• Wear fully waterproof kneepads with a sealed edge — not simply foam kneepads
• Wear rubber wellington boots or rubber overshoes in poured concrete
• Check regularly for wet concrete inside boots and kneepads
• If skin is contaminated, wash off immediately with copious water for at least 15 minutes

Glove Selection

Nitrile gloves are the standard for most construction skin hazard situations. Nitrile (acrylonitrile butadiene) provides:

• Good resistance to cement alkali and Cr(VI) penetration
• Good resistance to oil-based substances, solvents (moderate), and most cleaning agents
• No natural rubber latex (avoids latex sensitisation)

Glove thickness selection:

• 0.1–0.2mm disposable nitrile: low-dexterity tasks where hands need protection but grip is not critical; change frequently
• 0.3–0.4mm medium-duty nitrile: most construction tasks with chemical hazard
• 0.4–0.5mm heavy-duty nitrile: epoxy work, prolonged cement contact, solvent-intensive tasks
• Double-gloving (nitrile liner + heavy outer): epoxy resin mixing and application; provides redundancy if outer glove is punctured

Check for degradation: nitrile gloves exposed to some solvents (MEK, acetone, some hydrocarbons) can swell and lose integrity. Check compatibility charts from glove manufacturers when using organic solvents.

Wearing time: change gloves regularly; perspiration inside a glove creates a warm, moist environment that accelerates skin irritation (ironically, prolonged glove wear without changing can itself cause ICD). Rinse and dry hands when changing gloves.

Barrier Cream Protocol

Pre-work barrier cream is a secondary control — it should supplement, not replace, appropriate gloves. Barrier creams create a thin hydrophobic film on the skin surface that:

• Reduces the rate of skin penetration by irritants
• Makes post-work cleaning easier (less scrubbing required)
• Reduces the drying effect of soap and water washing

Application: apply to clean, dry hands before work begins. Cover all areas of the hands and lower forearms (up to the elbow for bricklayers). Cream should be reapplied after washing and at mid-shift.

Brands: Swarfega Orange (barrier formulation, not the cleaning gel), Deb Stoko Protect, and Uvex Washing Cream Protect are widely used in construction. Check that the barrier cream is appropriate for the substance hazard — most creams provide general barrier properties; specialist creams are available for epoxy and other specific sensitisers.

After-Work Skin Care

Washing removes surface contamination but also removes the skin's natural oil and lipid barrier. Without replacement, the skin becomes dry, cracked, and more susceptible to irritant penetration. Post-work moisturiser is not cosmetic — it is an occupational health control.

Apply an unperfumed, non-sensitising emollient moisturiser after washing at end of day. Examples: E45 cream, Neutrogena Norwegian Formula, Cetraben. The moisturiser should be applied generously to all washed areas.

Workers developing signs of dryness, cracking, or early dermatitis should see a GP as early as possible — patch testing can identify sensitising allergens before irreversible sensitisation is established.

COSHH Requirements for Employers

Under COSHH Regulations 2002, employers with workers exposed to skin-sensitising substances (including cement, epoxy resin, and cleaning agents) must:

1. Carry out a skin risk assessment — identify which substances pose a skin risk, assess the routes of exposure, and identify the control measures needed
2. Implement control measures — engineering controls first (enclosed processes, ventilation); then gloves, barrier cream, and hand-washing facilities
3. Provide information and training — workers must understand the risks, the symptoms to look for, and how to use PPE correctly
4. Provide health surveillance — annual skin surveillance for workers regularly exposed to Category A skin sensitisers; review the surveillance with an occupational health professional
5. Keep records — health surveillance records for 40 years; exposure assessment records for the duration of the work activity

Competent person for skin surveillance: the regulations allow employers to appoint an appropriately trained and experienced person (not necessarily an occupational health nurse or physician) to carry out initial skin surveillance by inspection and questionnaire. Where surveillance reveals concerns, referral to an OH physician is required.

Frequently Asked Questions

Does cement barrier cream prevent Cr(VI) sensitisation?

No barrier cream provides reliable protection against Cr(VI) penetration — this is why gloves are the primary control and barrier cream is supplementary. The Dermatological Centre at Salford Royal found that barrier creams with chelating agents (binding Cr ions) may reduce penetration, but these are specialist products. For cement work, the combination of nitrile gloves + barrier cream provides much better protection than either alone.

Are latex gloves acceptable for construction?

No. Natural rubber latex contains proteins (Hev b antigens) that are potent sensitisers — prolonged occupational latex glove use can cause Type I hypersensitivity, which can progress to anaphylaxis. All construction PPE specifications should require latex-free gloves. Nitrile is the standard alternative.

My worker has developed itchy, cracked hands — what should I do?

Refer them to a GP promptly. Do not delay because the symptoms are mild — early diagnosis allows for patch testing to identify specific allergens before sensitisation is established. While awaiting the appointment, provide emollient moisturiser, keep the affected areas clean and dry (but moisturised), and reduce chemical skin contact where possible. If dermatitis is occupationally diagnosed, it is RIDDOR-reportable.

Can I use household hand cream as an after-work moisturiser?

In principle, yes. The key requirements are that it is non-irritating, unperfumed (fragrance is a common contact sensitiser), and a proper emollient rather than a surface gloss. Avoid products with lanolin (can sensitise some individuals), strong fragrances, or alcohol bases. E45 cream or an equivalent unperfumed emollient is ideal.

How does cement age affect Cr(VI) content?

Ferrous sulphate oxidises over time, converting Cr-reducing capacity to inert ferric sulphate. In opened bags stored in damp conditions, the ferrous sulphate can be consumed in weeks. In sealed bags in dry conditions, the shelf life is typically 6–12 months from manufacture. Batch date codes are printed on cement bags — check these and do not use cement beyond its recommended shelf life for skin-contact work.

Regulations & Standards

• COSHH Regulations 2002 (SI 2002/2677) — control of substances hazardous to health; primary skin protection legislation

• EN 196-10:2005 — test methods for cement; determination of water-soluble chromate in cement; ≤2mg/kg Cr(VI) requirement

• REACH Regulation 1907/2006 — EU regulation on chemicals; requires Safety Data Sheets (SDS) for hazardous substances

• RIDDOR 2013 — reportable occupational diseases including OCD

• EH26 (HSE guidance) — at risk? Skin at work

• BS EN ISO 374-1:2016 — protective gloves against chemicals; terminology and performance requirements

• HSE: Skin at Work — comprehensive guidance including skin risk assessment tools

• HSE COSHH Essentials — COSHH risk assessment guidance and e-tools

• Deb Stoko: Skin Care Guide for Construction — three-step skin care protocol: protect, cleanse, restore

• British Association of Dermatologists: Occupational Dermatitis — clinical guidance on OCD

• CITB: Health and Safety Guidance — construction-specific skin protection training resources

• vibration havs — occupational health surveillance and COSHH in construction

• hot works — PPE requirements for hot works

• excavation safety — PPE and health and safety on site