Cross sectional study of skin complaints and respiratory symptoms in workers in the furniture upholstery industry. Final report on HSE contract 1/HPD/126/275/91

A cross sectional study of skin complaints and respiratory symptoms in workers in the furniture upholstery industry included thirty-seven companies, providing a representative cross section of upholstery manufacturing activity and scale of production.A self-administered questionnaire was developed to gather information from all company employees.This information included details of skin problems and respiratory symptoms experienced in the previous twelve months, background healthinformation, smoking history and occupational history. Definitions of clinical syndromes were developed, based on questionnaire responses, to allow the calculation of the numbers of workers who experienced work-related dermatitis and other skin problems affecting the upper limbs, work-related conjunctivitis and rhinitis, wheezing, asthma or daytime cough in the previous 12 months and also current prevalence of chronic bronchitis in the study population.The questionnaire response rate was low in spite of efforts to improve it and the possible effect of non-response on the study results was investigated. Trends observed in differences in the prevalence of health problems between occupational groups were found to be more pronounced in companies where the response rate was over 60%, compared with companies with response rates less than this. Non-response was considered not to have substantially affected the reliability of the main study findings.Each company was visited by an occupational hygienist to gather exposureinformation which was recorded on a structured proforma. Background information about each company and details of the fabrics used in the previous twelve months, including type of fire retardant treatment on each fabric, was obtained by interviewing a company manager. Occupational groups were identified and observation made of the tasks performed by each group, with particular emphasis on the time spent in contact with upholstery fabric, the degree of fabric handling and manipulation, the speed of work, the areas of skin touching fabric, the degree of manual pressure applied when handling fabric and whether exposure to other hazardous substances occurred.The prevalence of the following health problems in the previous 12 months were found to be higher in fabric contact occupational groups than in non-fabric contact occupational groups: work-related dermatitis”” of the upper limbs (16% vs. 5%);work-related other skin problems of the upper limbs (19% vs. 8%); work-related episodes of conjunctivitis (11% vs. 3%); work-related episodes of rhinitis (18% vs. 9%); and asthma (8% vs. 4%). All of these differences were found to be statistically significant by applying approximate Chi-square tests. There was good correlation between the prevalence of dermatitis and rhinitis in individual fabric contact occupational groups and the ranking of these four groups for degree of exposure to upholstery fabrics: sewers and cushion fillers were found to have the highest exposure, followed by upholsterers, with the lowest exposure found in cutters.A provisional analysis was carried out of the relationship between the prevalence of health problems and the degree of company usage of fire retardant treated fabrics. There was no clear evidence of usage-response relationships. The study has confirmed that work-related dermatitis, conjunctivitis, rhinitis and probably asthma are problems in the furniture upholstery industry.A follow-up case-referent study is proposed, to investigate the relationship between dermatitis and fabric exposure and specific fire retardant agent exposure in fabric contact occupational groups, by utilising exposure estimates based on the detailed hygiene assessment data gathered during this study to model fabric exposure, and by gathering information about the specific type of fire retardant agent applied to individual fabrics from fabric suppliers, manufacturers or finishers. “”