The TiVi Skin Damage Visualiser can help the occupational health practitioner to minimise the risk of any damage to health from workplace skin exposure.

This new instument, developed in Sweden, takes a photograph of the skin and shows the level of red blood cells present in the dermis. Since skin irritation, which can ultimately lead to irritant contact dermatitis, causes an increase in red blood cells, it is now possible to visualise the location and extent of the damage from contact with irritants, even if there is no visible sign of the damage that is accumulating.

This new technique opens up new possibilities for skin health surveillance and for the prevention of occupational contact dermatitis, still one of the major causes of occupational ill health.

It is now not only possible to detect skin damage at an early, and still sub-clinical stage, but the ability to identify where in the skin the damage is occurring can assist when investigating how the damage is being caused. The system can, of course, also be used to monitor the success of any action taken to eliminate the cause or to treat the actual skin problem.

The illustration shows the same hand photographed before and after exposure to a chemical that can cause vasodilation in the same way as would happen with the skin if exposed to an irritant.

The increase in red blood cells, as indicated by the red areas, shows clearly what has happened within the skin, although there was no significant indication visually on the skin surface that any change had taken place. The system also provides quantitative data on the number of red blood cells present.

Having identified sub-clinical damage and determined the cause, action can be taken to eliminate the problem. Subsequent monitoring will then indicate whether the skin is improving, so that, if necessary, additional measures can be taken to prevent an occupational skin problem.

The system stores up to 20 images per person, so that progress can be monitored and a trend created, as shown. This illustrates how damage increased until action was taken and how the skin subsequently recovered.

The statistical data obtained from the analysis of the images can be exported to a system such as Excel™ This allows for various investigations and analysis within the working environment, for example, to identify where skin damage is occurring within one group of workers, indicating a particular problem with this group or task.

Irritant contact dermatitis

Irritant contact dermatitis is the most common form of occupational skin disease. It is rarely from contact with a single chemical but due to repeated exposure of the skin to many different chemicals, usually over an extended period, possibly years. The damage from repeated exposures accumulates until the skin finally succumbs and the damage becomes visible. Even before the damage becomes visible, the effect on the skin is such that allergic reactions are also more probable. Once damage has become visible studies have shown that the prognosis is very poor. Thus early detection of sub-clinical damage is extremely important so that pre¬emptive action can be taken and monitored for effectiveness. This can significantly improve the effectiveness of any skin health surveillance programme.