Cement dermatitis in underground workers during construction of the Channel Tunnel

The construction of the Channel Tunnel is one of the largestcivil engineering projects ever undertaken. The British driveemployed 5900 underground workers, and a number developed dermatitisduring 1990/1991. As a result, the Translink Joint Venture (TLJV)Medical Centre set up a surveillance programme aiming to monitorand investigate the men working closely with cement as wellas other groups of workers with skin problems. Men attendedthe Medical Centre voluntarily and were assessed, includinghistory, examination and patch tests to a series of 15 testsubstances (from the European standard series) where indicated.A programme of education about the hazards of working with cementwas instituted, including leaflets, videos, local newspaperarticles and personal explanation by the Medical Centre staff.Between January 1990 and January 1992, 1138 men were seen atthe Medical Centre regarding their skin and 332 were diagnosedas having occupational dermatitis, past or present. Patch testswere performed on 180 men from all trades. Of the 800 grouters,466 (58 per cent) were assessed and 111 had a history of occupationaldermatitis at some time. Many gave a history of a single episodeof dermatitis during a particularly hot and wet phase of tunnelling.Patch tests performed on 86 grouters showed allergy to chromatein 56 (65 per cent). Of the 466 grouters assessed, 17 per centhad positive patch tests to chromate but men with no skin problemspast or present were not patch tested. Cobalt allergy was oftenfound with chromate allergy (50 out of 56). Allergy to epoxyresin was also found in 30 per cent of grouters who were patchtested. Only three men had to change their occupation becauseof their skin disease. Most cases of occupational dermatitisimproved with regular medical supervision, education and personalprotective measures, with relocation to less exposed work wherenecessary. Many cases cleared as the tunnel entered better terrain.The addition of ferrous sulfate has been shown to decrease thelevel of the allergenic hexavalent chromate in cement and itscompulsory use in Scandinavia has reduced the incidence of cementdermatitis in construction workers. The rest of Europe shouldnow follow the Scandinavian lead and consider legislation tomake cement less hazardous to workers' health.