It is good to see some scientific rigour applied in this important area. It is interesting to note however that there is no definition of occupational dermatitis. It is a reportable and prescribed disease in the UK, and can cause major impact on workers who suffer from it, but the question is whether healthcare workers who have perhaps a period of dry skin managed with ease, should be regarded has suffering from an occupational disease. The answer to such a question is important to the context of this paper and to the subject as a whole. The title of the paper is on 'management' therefore relates to those who have the condition, but there are of course in addition, major issues of risk reduction and control, which must run in parallel. While the paper makes mention of sensitisation in its background section, this important group does not feature in the review. In its later sections the term occupational dermatitis, is often reduced just to 'dermatitis'. Does this mean that the recommendations apply equally to workers with non occupational skin problems, such as psoriasis or eczema, both in the pre-employment and in service situations?
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