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CAR WASH WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on October 9, 2020 by Edward Singer

Car Wash Workers have many unique issues with respect to workers’ compensation. Car Wash Workers perform varied tasks which place them at risk for injury. Car Wash Workers are exposed to chemicals and liquids which may place them at risk for injury.

This article will discuss Car Wash Workers and the job tasks that place them at risk for industrial injury.

What Makes Car Wash Workers at Risk for Injury?

“The car wash industry, however, has salient features that predispose to important occupational health risks, namely, the use of hazardous chemicals (ie, hydrofluoric acid), the requirement of repetitive use of extremities, [and] close contact with moving machinery,” Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, DrPH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What are the Common Job Tasks Do Workers Perform at Car Washes?

In the study, most participants rotated among the few major tasks at the car wash, including drying cars (63%), brushing and soaping cars (56%), and vacuuming and cleaning cars (50%).
Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, DrPH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What Type of Complaints Can Car Wash Workers Have?

In the study, “Car wash workers reported a high prevalence of health symptoms during the 12 months prior to the survey, including at least one site of musculoskeletal pain (80%); upper airway, eye, or skin irritation (71%); and at least one lower respiratory symptom (47%) (Table 2). Approximately one-half of all workers reported eye and throat irritation, back pain, neck or shoulder pain, hand pain, headaches, or nausea/stomach discomfort. The majority of workers reported multiple symptoms across the different symptoms groups. Thirty-eight (54%) participants reported two or more musculoskeletal symptoms in the past 12 months, and 37 (53%) reported two or more types of irritation (nose bleeds, throat irritation, eye irritation/burning, skin rash, or skin burn). Two workers had suffered fractures at work in the past 12 months, and one-quarter of the work force reported a laceration or abrasion of the skin. Three workers reported an episode of asthma or an asthma attack in the past 12 months.” Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, Dr PH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What Type of Hand Movements Can Be a Source of Injury?

There are numerous tasks at Car Washes that can be a source of injury. These tasks involve Manual Handling, Awkward Hand Positions, Applying Pressure, and the use of Vibrating Tools.

Manual Handling includes “lifting, pulling, pushing, carrying and holding. Tasks that require these actions can include moving and transporting heavy equipment; everyday machines, such as vacuums; and loads, such as laundry.”

Awkward Hand Position includes “contorting hand posture to abnormal positions to clean hard-to-reach areas or slanted surfaces, such as windows. This would also include risks associated with using older or cheap spray bottles or equipment handles.”

Applying Pressure includes “pressing down or applying extra pressure to remove dirt or soil. Consider more powerful cleaning products or equipment if workers are using too much elbow grease to get the job done.”

The Use of Vibrating Equipment which includes “losing control and constant shaking. Machines that vibrate too much can cause hand fatigue, increasing the chances of workers losing control of the equipment.” . The importance of hand care in the car care industry Rich DiPaolo (2016)

Are There Chemical Exposures That Are Injurious to Car Wash Workers?

Yes. Chemicals used at Car Washes have been implicated in causing occupational illness.

“Exposure to hydrofluoric acid (HF) causes corrosive chemical burns and potentially fatal systemic toxicity. Car and truck wash cleaning products, rust removers, and aluminum brighteners often contain HF because it is efficient in breaking down roadway matter.” Reeb-Whitaker CK, Eckert CM, Anderson NJ, Bonauto DK. Occupational Hydrofluoric Acid Injury from Car and Truck Washing–Washington State, 2001-2013. MMWR Morb Mortal Wkly Rep. 2015;64(32):874-877. doi:10.15585/mmwr.mm6432a4

“Occupational exposure to HF-based wash solutions can result in chemical burns, disability, and death. HF’s potential to cause severe injury.” Supra.

Are Car Wash Employees At Risk for Skin Disorders?

Yes. Cash Wash Employees suffer skin-related due to working with liquids. This type of work is called “wet work.” Zani MLC, Lazzarini R, Silva-Junior JS. W arm-water immersion foot among car wash workers. Rev Bras Med Trab. 2017;15(3):217-221. Published 2017 Sep 1. doi:10.5327/Z1679443520170021

“Wet work is characterized by activities involving frequent immersion of the hands in water, frequent or intensive hand washing or frequent use of impermeable gloves. Workers exposed to wet work might develop hand eczema and contact dermatitis”

Car Washes provide for the risk of both hand skin disorders as well as foot skin disorders. Supra.

“Prolonged contact with water causes different forms of dermatitis, including hand eczema among workers exposed to wet work3. In turn, superficial mycoses are the conditions that most commonly affect the lower limbs. However, continuous and excessive contact with water might also cause a disorder known as immersion foot or trench foot. The latter is a dermatosis that results from prolonged exposure to physical agents such as dampness and cold, and was first described among soldiers in World War I (1914-1918). ”
Supra.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

CALIFORNIA FIREFIGHTERS AND WORKERS’ COMPENSATION: FIRE FIGHTERS, WORK INJURIES AND THE MOST RECENT RAND STUDY: WHAT YOU NEED TO KNOW

Posted on October 5, 2020 by Edward Singer

California Firefighters are tasked with some of the most difficult jobs. California is perhaps the Forest Fire Capitol of the United States or even the World! Firefighters provide a vital services in ensuring that we live in safety.

In performing their duties, Firefighters get hurt and have industrial claims. California Firefighters’ work injuries have been studied by the Rand Corporation and they have prepared a recent report. The study is entitled The Frequency and Economic Impact of Musculoskeletal Disorders for California Firefighters: Trends and Outcomes of the Past Decade, Dworsky, Seabury, and Broten.

This article will address the most recent Rand Corporation Study and what it means to Firefighter and their careers with respect to their work injuries.

What Is the Rand Corporation? What Did It Study?

Rand Corporation is commonly known as a “think tank.” According to Rand, it “was established over 70 years ago to strengthen public policy through research and analysis. Over seven decades, our research teams have answered the difficult questions and generated actionable insights by combining the very best analytical tools and methods with a distinct, interdisciplinary approach.” They are frequently used by government, such as the State of California to do research. The term “public policy” implies that their results can impact laws and proposed legislation. For our purposes, their conclusions may become the impetus for new changes in workers’ compensation law.

The Rand Corporation Study, with respect to California Firefighters was done with “[t]he purpose of this report was to provide new information to policymakers about the frequency, nature, and consequences of firefighter injuries in California, with a particular focus on MSDs.” In other words, the State of California may use the data to change workers’ compensation law with respect to Firefighters, or Fire Departments may change their risk management approaches to attempt to reduce claims.

What Did the Rand Study Find?

Highest Rate of Injuries

The Rand Study found that “firefighters are significantly more likely to be injured than workers in other occupations.”

Highest Rate of Musculoskeletal Disorders (MSDs)

The Rand Study found that “ a larger share of those injuries are MSDs.”

Specifically, we found that nearly half (47 percent) of firefighter injuries are MSDs, compared to 38 percent for police officers, 42 percent for other public-sector workers, 37 percent in our private-sector comparison group with similar job requirements to firefighters, and 42 percent for other private-sector workers.

Spine and Knee Injures Are More Common Than Upper Extremity Injuries

The Study found that there were “differences in the nature and cause of firefighter injuries. Compared to other occupations, injuries to firefighters are less likely to involve the upper extremities and significantly more likely to involve lower extremities or the trunk. Strains are the modal cause of injury for firefighters.”

Burn Injuries Are More Significant Than Other Occupations

The Rand Study found that “burns are significantly more common among firefighters than other workers but still represent a small share of injuries (6 percent) in comparison to MSDs.”

Cumulative Trauma vs. Specific Dates of Injury

The Rand Study found that “a lower share of firefighter injuries were reported as being due to cumulative trauma than workers in other occupations.”

Psychiatric Injuries for Firefighters

The Rand Study shows that the dated indicated that “firefighters and police have similar rates of psychiatric comorbidities. However, perhaps surprisingly, incidence rates of psychological injuries—including PTSD—for public safety workers are substantially lower than rates observed among other public-sector workers or comparable private-sector workers.”

Note: as noted in the study, Firefighters may carry with them a stigma concerning mental health issues. Firefighters with mental health concerns may seek treatment privately rather than file a work injury claim.

Is There Any Good News for Firefighters with respect to the Study?

There was some good news in the Rand Study for Firefighters. The economic consequences of musculoskeletal disorders was less serve than for other similar occupations. It was noted the Fire Departments appear to do better than other employers, including other public sector employers, at retaining Injured Workers. Also, SB 863, a recent law change, provided for higher ratings for MSD injuries for Firefighters. Finally, there was no evidence found that treatment caps for chiropractic, occupational therapy, or physical medicine treatments did not substantially impact most Firefighters.

What is there to Make of the Rand Study?

In light of the findings, it would appear that there would be no effort to try to increase additional indemnity to Firefighters. Further, it would appear that there would be no effort to change treatment protocol as well. Perhaps, injury rate reduction would be explored. In sum, risk management for the departments may try to take steps to reduce injuries. Any reduction may be difficult to achieve due to the job’s physical demands.

What if I Need Advice?

HOTEL WORKERS AND WORKERS’ COMPENSATION: HOTEL WORKERS SUSTAINING INDUSTRIAL INJURIES AND WORKERS COMPENSATION: WHAT YOU NEED TO KNOW

Posted on September 2, 2020 by Edward Singer

Hotel Workers are at risk for injury. They have demanding jobs that are time sensitive. There are many tasks that they perform that can cause musculoskeletal disorders. In addition, some workers use tools and materials which can place them at risk for skin and respiratory injuries.

There was a study awhile ago which analyzed work injuries in the Hotel Industry. Moving forward from the study, you can see how the industry has dealt with the problem of their high rate of workers’ compensation claims. At the time, the study found that the Hotel Industry was at high risk when compared to others. Disparities in the US Hotel Industry Susan Buchanan, MD, MPH, * Pamela Vossenas, MPH, Niklas Krause, MD, PhD, Joan Moriarty, MS, Eric Frumin, MA, Jo Anna M. Shimek, MS, Franklin Mirer, PhD, CIH, Peter Orris, MD, MPH, and Laura Punnett, AMERICAN JOURNAL OF INDUSTRIAL MEDICINE 53:116–125 (2010)

This article will discuss Hotel Workers, their tasks, their rates of work injuries and the tactics that Risk Management has used to address the high rate of work injuries.

Why Should Hotel Employees Be Concerned?

Any time an Industry is subject to significant amounts of work injuries, Risk Management will take measures to reduce work injuries. These measures may impact Hotel Employees and how they perform their work assignments. Additionally, it may impact how Injured Workers will be treated after claims have been reported.

Why Are Work Injuries in the Hotel Industry Important?

When the study was done, it was noted that “[w]ithin the US hospitality industry, hotels, and motels employ 1.8 million workers [USBLS, 2007b].” Supra.

At the time, the study reported the significant number of work injuries that occur at Hotels. “In the United States, hotel workers are nearly 40% more likely to be injured on the job than all other service sector workers. Hotel workers also sustain more severe injuries resulting in more days off work, more job transfers, and more medically restricted work compared to other employees in the hospitality industry [USBLS, 2005]. Supra.

What is the Service Industry?

The Service Industry is part of the employment/business sector that provides customer services and occasionally provides goods. The Service Industry does not manufacture products.

Examples of the Service Industry include food services: i.e., McDonalds, Starbucks, and Taco Bell, retail, i.e. Target, Walmart and Food-4-Less, transport, i.e. Greyhound and Southwest Airlines, and distribution, i.e. Fed-Ex, UPS and DHL.

Manufacturing and Raw Materials are the other employment/industrial sectors.

What is the Hotel Industry?

The Hotel Industry is considered as part of the “Hospitality Industry”. The term “Hospitality Industry” includes additional employers such as food service, drink service, event planning, theme parks and transportation.

Who are Hotel Workers? What Do They Do? What Types of Labor Makes Them at Risk for Injury?

Hotel Workers have many titles and perform various tasks. Hotel Workers have many job titles such as bartender, banquet server, cashier, chef, cook, dishwasher, door person, host, hostess, housekeeper, lobby attendant, pot washer, room attendant, and stewards.

Hotel tasks can be broken down into five distinct categories. These are Housekeepers, Banquet Servers, Stewards/Dishwasher, Cooks/Kitchen Workers and Other.

What Tasks Do Housekeepers Perform?

”Housekeepers perform guest room cleaning including making beds, vacuuming floors, cleaning shower walls and bathroom fixtures, dusting furniture, and pushing carts.” Occupational Injury Disparities in the US Hotel Industry Susan Buchanan, MD, MPH, * Pamela Vossenas, MPH, Niklas Krause, MD, PhD, Joan Moriarty, MS, Eric Frumin, MA, Jo Anna M. Shimek, MS, Franklin Mirer, PhD, CIH, Peter Orris, MD, MPH, and Laura Punnett, AMERICAN JOURNAL OF INDUSTRIAL MEDICINE 53:116–125 (2010)

NOTE: Housekeepers perform physically arduous work.

What Tasks Do Banquet Servers Perform?

“Banquet servers provide food service such as carrying plated food from the kitchens to the customers, dispensing drinks, and supplying food to cafeteria and buffet services.” Supra.

NOTE: Banquet Servers perform physical activities which are time sensitive.

What Tasks Do Stewards/Dishwashers Perform?

“Stewards retrieve, sort, load/lift, unload, and return dishes, glasses, pots, utensils and silverware, and provide these items by pushing carts to cafeteria and buffet lines. In addition, stewards maintain cleanliness in food preparation areas.” Supra.

NOTE: Stewards/Dishwashers, like the Banquet Servers, perform physical activities which are time sensitive.

What Tasks Do Cooks/Kitchen Workers Perform?

Cooks lift, weigh, measure, mix, cut and grind food ingredients; they cook these ingredients and compose salads and other food for serving Supra.

NOTE: Cooks/Kitchen, like the Banquet Servers, perform physical activities which are time sensitive. Likewise, they may also be involved in shift work.

What Tasks Do Others Perform?

All remaining jobs were categorized as “other.” Jobs classified as “other” were those that did not share similar job tasks or exposures with the other four key job categories. These included lobby attendant, cashier, door person, host/hostess, among others. Supra.

NOTE: Other work may involve various physical activities as well as perform shift work.

What Are the General Types of Injuries that Hotel Workers Can Sustain?

Most commonly, Hotel Workers are subject to musculoskeletal injuries.

The study cited that “[a]mong Las Vegas hotel room cleaners, the prevalence of self-reported pain associated with work was 75% during the previous year [Scherzer et al., 2005]; 63% had had severe or very severe low back pain just in the prior month [Krause et al., 2005].” Supra.

Additionally, Hotel Workers who work with water or other liquids or who use gloves as subject to “wet-work” injuries. These injuries are to the skin, i.e. contact dermatitis. For an article discussing “wet work,” click here. Further Hotel workers may work with products that contain fragrances. These products may cause respiratory injuries such as “occupational asthma.” For an article discussing “fragrance-related injuries,” click here.

What Did the Study Tell Us About Hotel Workers? As an Injured Worker, Should It Matter?

The study found that with respect to certain Hotel Employees that women had a greater rate of work injuries than men. It found that there were some racial differences in that certain ethnic groups had greater injury rates than whites.

NOTE: With respect to these rates, it is this writer’s opinion that more data should be explored. Non-English-Speaking workers may stay with a work position that is physically harming them longer than English Speaking workers. One reason for them remaining on such as a job is that that their lack of English Fluency may limit their ability to obtain less physical employment. As a result of this, they may at a greater risk of injury. Thus, the ethnic group itself may not really be the issue. It may be more the ability of worker to seek other employment that is less injurious in nature.

How Does the High Rate of Work Injuries Impact Hotels?

Industries with high rates of workers’ compensation claims will seek to reduce their injury rates. Since the study, Hotel Risk Management has already taken steps to reduce injuries. For those who visit hotels, it is apparent that what has been done. Reducing staff hours and tasks translates into lower rates of injuries. Many Hotels, under the auspices of being “green” encourage patrons to reuse towels and decline daily “room service.” In doing so, labor time of laundry service and housekeeping is reduced. Long term, if staff hours are reduced, staffing may in turn be reduced. In sum, less employees.

With respect to food service workers, many catered events feature buffets and no longer offer table service. Further, beverage stations are offered so that attendees can get their own coffee, juice, etc.. Again, less labor hours translates to less risk of injury. In sum, less labor hours, less employees.

Additionally, Risk Management may engage in more surveillance of their employees via cameras to prove or disprove work injuries. NOTE: This may be most effective with respect to specific injuries and not so much with respect to cumulative trauma injury claims.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information.

SUN EXPOSURE AND WORKERS’ COMPENSATION: WORK INJURIES FROM OCCUPATIONAL SUN EXPOSURE: WHAT YOU NEED TO KNOW

Posted on August 20, 2020 by Edward Singer

Many Workers spend significant periods of time working outdoors. This outdoor exposure during working hours can be a cause of Occupational Skin Disease. If a cause of one’s Skin Disease is partially caused by work-related exposure, the Injured Worker is then able to make a claim for workers’ compensation claim and may be entitled to monetary compensation, temporary disability and permanent disability benefits, medical care, vocational rehabilitation benefits and death benefits.

“Currently, it is estimated that one in five Americans will develop skin cancer during their lifetime, the majority diagnosed with nonmelanoma skin cancer (NMSC), which includes basal cell (BCC) and squamous cell (SCC) carcinomas.” Skin cancer as an occupational disease: the effect of ultraviolet and other forms of radiation Claudia C. Ramirez, MD, Daniel G. Federman, MD, and Robert S. Kirsner, MD

This article will discuss the nature of Sun Exposure Skin Diseases, What Occupations Are at Risk for Occupational Skin Disease, Statutes that Relate to Skin Disorders, and Case law discussing Skin Conditions.

What are Sun-Related Skin Diseases?

Sun Exposure can lead to various skin conditions. These include cancerous, pre-cancerous, and non-cancerous conditions. These can include photoaging -solar lentigo, wrinkles and loose or irregular skin. Pre-Cancerous Skin conditions include Actinic Keratosis. Cancerous Conditions include Basal Cell Carcinoma, Squamous Cell Carcinoma and Malignant Melanoma.

What Occupations are at Risk for Occupational Skin Disease?

Occupations at risk for Occupational Skin Disease include the following jobs: cabin attendants, construction workers, farmers, landscapers, physical education teachers, pilots, police officers, postal workers, roofers, telephone line workers, waterman, and welders.

What is Exposure? Are There Different Exposures?

“The damaging effects of ultraviolet radiation accumulate over the years. In general, the risk of developing skin cancer increases with the amount of time spent under the sun and the intensity of radiation. The intensity of radiation varies according to the season of the year, time of day, geographic location (latitude), elevation above sea level, reflection from surfaces (e.g., white sand or concrete, water, snow), stratospheric ozone, clouds, and air pollution.

Recent studies have focused on the effects of intermittent (short-term, occasional) sun exposure in comparison to chronic (long-term) exposure. It appears that the type of exposure may influence the type of cancer that develops. For example, intermittent solar exposure may be an important factor leading to the onset of basal cell carcinoma of the skin. …

In contrast, the relationship between squamous cell carcinoma and solar UVR appears to be quite different. For squamous cell tumours, high levels of chronic occupational sunlight exposure, especially in the 10 years prior to diagnosis, results in an elevated risk for this cancer in the highest exposure group.” https://www.ccohs.ca/oshanswers/diseases/skin_cancer.html

Besides Typical Sun Exposure, Are There Other Suspected Causes of Occupational Skin Disease?

Yes. Irradiation, Nonionizing Microwave Frequencies, Cosmic Radiation, and Ionized Radiation are also suspected causes of Occupational Skin Disease.

“Although sun exposure is thought to be a common etiologic factor, some studies have suggested alternative explanations, such as irradiation from the welding arc in welders, nonionizing microwave frequency radiation from radar use in police officers, and cosmic radiation in pilots and cabin attendants. Disturbances in circadian rhythm have also been suggested as having a role in the increased risk of skin cancer in pilots and cabin attendants and should be elucidated in future studies. Occupations in which there is an increased exposure to ionizing radiation, such as radiation technicians and radiologists, showed an increased risk for melanoma and NMSC. Surprisingly, there is a paucity of publications regarding skin cancer incidence amongst lifeguards, ski instructors, professional cyclists, and other professionals who spend time outside as part of their jobs. Ample evidence exists, however, that amongst selected occupations skin cancer is an important occupational disease.” Skin cancer as an occupational disease: the effect of ultraviolet and other forms of radiation Claudia C. Ramirez, MD, Daniel G. Federman, MD, and Robert S. Kirsner, MD

Are There Any Labor Code Sections which Support Claims of Occupational Skin Disease?

Yes. With respect to the present issue of Sun-Related Occupational Skin Disease, there is the Cancer presumption which applies to both certain Law Enforcement and Safety Officers. This is Labor Code Section 3212.1. For an article discussing the Cancer Presumption, click here.

Is There Case Law Concerning Sun Exposure?

Yes. A sample of sun-related cases include issues such as: Defendant claiming non-industrial sun exposure as the source of nasal cancer. See County Sanitation District No. 2 vs. WCAB (2004) 69 C.C.C. 1463; Defendant disputing CT injury date in which there was a claim of multiple CT injury dates. Injury was claimed as skin cancer caused by sun exposure. City of Vista vs WCAB (2017) 83 C.C.C. 95; also see City of Corona vs. WCAB (1997) 62 C.C.C. 1693. In the matter, “Applicant was treated by Shira Young, M.D., and was evaluated by James Lineback, M.D. Dr. Young felt that there was a probability that sunlight played a role in the development of Applicant’s skin cancer. Dr. Lineback opined that it was reasonably probable that the skin lesions were directly related to sunlight exposure.”

Are There Anything a Worker Should Do?

In my years of representing Injured Workers, one of the most tragic cases I ever had was a melanoma case. While the melanoma initially appeared in a location on the body which was not exposed to the sun, the cancer turned out to be fatal. Despite seeking advanced medical treatment, the worker died shortly after he opened his claim.

Early detection of the disease is of import. If you do so, there is a chance for a successful recovery.

For all those who work in the sun or with skin issues, you should check your skin on a regular basis and seek medical attention. Per the Centers for Disease Control, “[a] change in your skin is the most common sign of skin cancer. This could be a new growth, a sore that doesn’t heal, or a change in a mole. Not all skin cancers look the same.

For melanoma specifically, a simple way to remember the warning signs is to remember the A-B-C-D-Es of melanoma—“A” stands for asymmetrical. Does the mole or spot have an irregular shape with two parts that look very different? “B” stands for border. Is the border irregular or jagged? “C” is for color. Is the color uneven? “D” is for diameter. Is the mole or spot larger than the size of a pea? “E” is for evolving. Has the mole or spot changed during the past few weeks or months?”

What If I Need Legal Advice?

Skin Conditions, Skin Diseases & Workers’ Compensation: What You Need to Know

Posted on January 15, 2018 by Edward Singer

California Workers’ Compensation Law covers injuries and illnesses to one’s entire body. There are a number of Skin-Related Conditions and/or Injuries that can be work-related. Per the Centers for Disease Control, it is estimated that more than 13 million workers in the United States are potentially exposed to chemicals that can be absorbed through the skin. Dermal exposure to hazardous agents can result in a variety of occupational diseases and disorders, including Occupational Skin Diseases (OSD) and systemic toxicity.

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