Section 3.3 Occupationally Specific Advice Food Handlers

The food industry includes a diverse group of workers including chefs and cooks, bakers and pastry cooks, kitchen hands, deli workers, waiters and bartenders. Food handlers need their hands to be in good condition to be able to prepare and cook food, and are all at risk of developing work-related contact dermatitis. Apprentices are often at the highest risk of developing contact dermatitis.

Work-related skin conditions include irritant contact dermatitis, allergic contact dermatitis and contact urticaria. Dermatitis may become complicated by secondary bacterial infection. Contact dermatitis can be caused by frequent wetting and drying of the hands as well as from handling meats, fish, fruit and vegetables. Inappropriate use of certain gloves for hygiene purposes may cause allergy, while others can cause excessive sweating. The combined effect of these factors can be very damaging to the skin.

Irritant contact dermatitis

Common irritants in the food handling industry include:

  • Water from wetting and washing hands frequently
  • Handling moist foods such as meat and seafood
  • Frequently drying hands with paper towels
  • Alcohol in beverages, which can dry out the skin
  • Flours which can dry the skin
  • Spices which can irritate the skin, such as chilli
  • Soaps, detergents and cleaning agents which dry the skin
  • Heat and sweating, which can occur when wearing occlusive gloves for long periods of time

Allergic contact dermatitis

Common allergens in the food industry include:

  • Rubber chemicals in gloves
  • Fragrances found in disinfectants and detergents
  • Garlic and onion
  • Spices such as cinnamon
  • Preservatives in hand cleaners and liquid soaps
  • Nickel, especially in old or worn cooking utensils

Contact urticaria and latex allergy

Contact urticaria is an immediate (Type 1) form of allergy. Repeated episodes of contact urticaria may lead to dermatitis, known as protein contact dermatitis. In food handlers this type of allergy is caused by particular proteins, such as those found in seafood, meat, poultry, wheat or rye flour and some fruit and vegetables. Contact urticaria can also develop to natural rubber latex gloves.

Latex allergy

Latex allergy has a significant public health impact and can affect both food handlers and consumers. Life threatening reactions to latex have been reported in latex sensitive customers who have eaten food prepared by someone wearing latex gloves3. Latex proteins from latex gloves (especially the powdered variety) can be transferred to food during preparation. The use of this type of glove also increases the risk of latex allergy in the food handlers as well.

If gloves are required to be used during food preparation, the recommended glove types are plastic or vinyl.

Skin care advice for food handlers

When people from the food handling industry visit a dermatologist for patch testing, it is important to educate them about looking after their skin at work. The following are helpful ways to do that:

Moisturise

  • Regularly apply an appropriate greasy moisturising cream, at the end of the working day and before bed. A lotion is thinner and more watery than a cream, but soaks in quickly and may be easier to use during the working day.
  • If possible, use a moisturiser during the day. There are brands available which are suitable for the food industry.

Gloves

  • Wear suitable gloves for the job such as vinyl or plastic. Do NOT wear latex gloves, either powdered or non-powdered.
  • Change gloves regularly
  • For wet work, such as dishwashing, use PVC (polyvinyl chloride) or rubber gloves with cotton gloves underneath to reduce sweating. Ensure they are an appropriate length, so water does not get inside the glove.
  • Remember people can develop latex allergy from using reusable rubber dishwashing gloves4

Important tips

  • Take your rings off at work, as soaps, detergents and water get trapped under rings, causing dermatitis to start.
  • When suitable, use tongs or deli tissues when handling foods, to limit the number of times you need to wash your hands and reduce direct contact with food

Patch testing and food handlers

When patch testing someone from the industry it is important to consider testing the following series and allergens:

SeriesAllergensAdditional notes
  • Australian Baseline Series
  • Rubber series, if using rubber gloves
  • Consider bakery series if patient works in this industry.
  • Garlic (diallydisulfide) (Plant Series)
  • Compositae mix (lettuce) (ABS)
  • Prick test to own foods
  • Blood serum test for latex if wearing latex gloves (formerly known as a RAST test)
  • Total IgE
  • Other blood serum tests for foods if applicable. E.g. seafood, egg, wheat, rye etc.
  • If a baker, consider the possibility of bakers’ asthma.
  • Look at hand wash products used

Videos to watch:

Talk 31 Food Handlers

https://www.occderm.asn.au/resources-about-skin-health/rash-presentations/food-handlers/

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