preventing skin complaints for start-up ......when you build a house, you don’t just need bricks,...

TRANSNATIONAL ESF PROJECT

PREVENTING SKIN COMPLAINTS FOR START-UP HAIRDRESSERS

‘A Close Shave’ Promoter: UBK/UCB vzw-asblAuthor: Miet Verhamme

Colophon: PREVENTING SKIN COMPLAINTS FOR START-UP HAIRDRESSERS

Miet Verhamme

Coiffure.org by UBK/UCB vzw-asbl, 2015

Vijfwindgatenstraat 21 F, 9000 Ghent, Belgium

Design and translation: Mangrove Productions

Contents1 SKIN ..................................................................................................................................................................................... 6

1.1 SKIN ........................................................................................................................................................................................................... 61.1.1 The average skin of a human being measures 2m2 ................................................................................................................ 61.1.2 Why do we need our skin? ......................................................................................................................................................... 61.1.3 Layer after layer ............................................................................................................................................................................. 6

1.2 RISK FACTORS FOR THE SKIN ............................................................................................................................................................. 91.2.1 Water dries skin out ..................................................................................................................................................................... 91.2.2 Chemical substances ................................................................................................................................................................... 101.2.3 Other aspects that put a strain on the skin .......................................................................................................................... 11

1.3 OCCUPATIONAL SKIN COMPLAINTS ............................................................................................................................................ 121.3.1 Occupational skin complaints – enough to make you jump out of your skin ............................................................... 121.3.2 What are the occupational skin complaints? ........................................................................................................................ 131.3.3 Other possible skin complaints ................................................................................................................................................ 141.3.4 Eczema test ................................................................................................................................................................................... 15

2 THE APPLICATION ..................................................................................................................................................................................................16

2.1 SKIN PROTECTION ............................................................................................................................................................................... 162.1.1 The principle of skin-care products ........................................................................................................................................ 162.1.2 Protective skin cream ................................................................................................................................................................. 172.1.3 Protective gloves .......................................................................................................................................................................... 182.1.4 Wear protective clothing ......................................................................................................................................................... 212.1.5 Use nickel-free equipment ........................................................................................................................................................ 212.1.6 Remove jewellery from your hands and fingers when working ....................................................................................... 222.1.7 Cut hair before dyeing it ............................................................................................................................................................ 222.1.8 Personal protection .................................................................................................................................................................... 222.1.9 Extra tips ....................................................................................................................................................................................... 22

2.2 CLEANING HANDS ............................................................................................................................................................................... 222.2.1 Principle: as little as possible, as much as necessary ............................................................................................................ 222.2.2 Hand soap ..................................................................................................................................................................................... 232.2.3 Use lukewarm water .................................................................................................................................................................. 232.2.4 Which towels to use? ................................................................................................................................................................. 232.2.5 How to dry hands? ...................................................................................................................................................................... 232.2.6 Always wash your hands in a separate room ........................................................................................................................ 23

2.3. SKIN CARE ................................................................................................................................................................................................ 242.3.1 Use protective cream after your work as well as after household chores .................................................................... 242.3.2 Apply a hand mask before going to bed (at night) ............................................................................................................... 24

3. ADDENDUM: HOW TO DEAL WITH CRITICAL CUSTOMERS ................................................................................. 25

3.1 CRITICAL CUSTOMERS ........................................................................................................................................................................ 253.3.1 How can you react in these instances? .................................................................................................................................. 253.3.2 Is the customer still not convinced? ....................................................................................................................................... 25

3.2 IT’S NOTHING ......................................................................................................................................................................................... 263.2.1 How can you convince Maria? .................................................................................................................................................. 263.2.2 Is Maria still not convinced? ...................................................................................................................................................... 26

3.3 CONVINCING YOUR BOSS ................................................................................................................................................................ 273.3.1 How can you convince your boss? .......................................................................................................................................... 273.3.2 Is your boss still not convinced? .............................................................................................................................................. 27

4. ADDENDUM 1: ECZEMA CAUSED BY REPETITIVE CONTACT WITH IRRITANTS ............................................. 284.1 PHASE 1: THE FILM OF WATER/OIL DISAPPEARS ......................................................................................................................... 28

4.2 PHASE 2: OILS FROM THE TOP LAYER OF SKIN DISAPPEAR ................................................................................................... 284.3 PHASE 3: SUBSTANCES PENETRATE THE SKIN ............................................................................................................................ 28

5. ADDENDUM 2: HOW ALLERGIES EMERGE ................................................................................................................. 30

5.1 PHASE 1: THE SKIN BECOMES SENSITIVE ...................................................................................................................................... 30

5.2 PHASE 2: IMMUNE REACTION AND ALLERGY-RELATED INFLAMMATION OF THE SKIN ............................................ 30

4 PREVENTING SKIN COMPLAINTS FOR START-UP HAIRDRESSERS

5PREVENTING SKIN COMPLAINTS FOR START-UP HAIRDRESSERS

1 Germany: website Safehair, www.safehair.eu

Module skin protectionDid you know that…1

• Regular contact with water, shampoo and hair dye can cause problems for unprotected skin and can even lead to occupational skin complaints?

• Dry, flaky skin is your first alarm signal?

• A lot of hairdressers often develop occupational skin conditions during their training?

• Some hairdressers have to abandon their career because of these skin conditions?

• You can avoid occupational skin complaints effectively by taking a few simple measures to protect your skin?


1. SKIN2

1.1. SKIN

1.1.1. The skin of an average person measures 2m².

1.1.2. Why do we need our skin?

Our skin is a tactile organ (e.g. temperature, pain). It also plays some very important protective functions. It protects us against:

• Hot and cold

• Pressure and impacts

• Water

• Dehydration

• Chemical substances (e.g. lye, acids3, water)

• Infections: pathogens (e.g. bacteria, fungi, viruses)

• UV-rays, when skin turns brown it is protect-ing your skin against UV rays

1.1.3. Layer after layer

Illustration 14

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Laag na laag3

Afbeelding 14

3 Duitsland: website Safehair; www.safehair.eu

Bijvoorbeeld bij amazone.com kan men een didactisch voorbeeld van de huid kopen in de vorm van een huisje

4 Afbeelding 1:

https://www.google.be/search?q=hoornlaag+van+de+huid&client=safari&hl=nl-BE&biw=1024&bih=648&source=lnms&tbm=isch&sa=X&ei=bdPkVOT_CMe6UcPDg7AC&ved=0CAYQ_AUoAQ#imgrc=TXRjXVMin5bjnM%253A%3BXXZWzBDLkwuJeM%3Bhttp%253A%252F%252Fwww.saluberproducten.nl%252Fwebshop%252Fimg%252Fcms%252FStructuur%252520van%252520de%252520huid.png%3Bhttp%253A%252F%252Fwww.saluberproducten.nl%252Fwebshop%252Fnl%252Fcontent%252F7-de-huid%3B491%3B348

Illustration 25

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Laag na laag3

Afbeelding 14


Bijvoorbeeld bij amazone.com kan men een didactisch voorbeeld van de huid kopen in de vorm van een huisje

4 Afbeelding 1:

https://www.google.be/search?q=hoornlaag+van+de+huid&client=safari&hl=nl-BE&biw=1024&bih=648&source=lnms&tbm=isch&sa=X&ei=bdPkVOT_CMe6UcPDg7AC&ved=0CAYQ_AUoAQ#imgrc=TXRjXVMin5bjnM%253A%3BXXZWzBDLkwuJeM%3Bhttp%253A%252F%252Fwww.saluberproducten.nl%252Fwebshop%252Fimg%252Fcms%252FStructuur%252520van%252520de%252520huid.png%3Bhttp%253A%252F%252Fwww.saluberproducten.nl%252Fwebshop%252Fnl%252Fcontent%252F7-de-huid%3B491%3B348

Illustration 36

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Afbeelding 25

Afbeelding 36

1.De Onderhuid (subcutis) De onderhuid bestaat uit een reservoir voor voedingsstoffen (het vetcelweefsel) en biedt bescherming tegen koude en druk.

2.De lederhuid (dermis)

De lederhuid bevat verschillende celstructuren (bijv. bloedvaten, haarwortels, zweetklieren) en vele elastische vezels.

Wanneer je je snijdt en je bloedt, ben je door de opperhuid en lederhuid gegaan. Zonder bloed is er ook geen nieuwe huid 5 Afbeelding 2: https://www.google.be/search?q=hoornlaag+van+de+huid&client=safari&hl=nl-BE&biw=1024&bih=648&source=lnms&tbm=isch&sa=X&ei=bdPkVOT_CMe6UcPDg7AC&ved=0CAYQ_AUoAQ#imgdii=TXRjXVMin5bjnM%3A%3BTXRjXVMin5bjnM%3A%3BZ8A2qbgi0Fk4EM%3A&imgrc=TXRjXVMin5bjnM%253A%3BXXZWzBDLkwuJeM%3Bhttp%253A%252F%252Fwww.saluberproducten.nl%252Fwebshop%252Fimg%252Fcms%252FStructuur%252520van%252520de%252520huid.png%3Bhttp%253A%252F%252Fwww.saluberproducten.nl%252Fwebshop%252Fnl%252Fcontent%252F7-de-huid%3B491%3B348 6 Oostenrijk: AUVA: Schöne Hände sind deine Visitenkarte (ppt)

1. Subcutaneous layer

The subcutaneous layer of skin acts as a reservoir for nutrients (fat cells) and protects against cold and pressure.

2. The dermis

The dermis is made up of different cell structures (e.g. veins, hair routes, sweat glands) and a lot of elastic tissue.

2 Germany: website Safehair, www.safehair.eu. Example on amazone.com – educational skin example can be purchased in the form of a house. 3 Acids: see effect of peeling an orange the whole day4 Illustration 1: www.saluberproducten.nl5 Illustration 2: www.saluberproducten.nl6 Illustration 6: Austria: AUVA: Schöne Hände sind deine Visitenkarte (ppt)


When you cut yourself and you bleed, you have gone through the epidermis and the dermis.

If there is no blood, there will be no new skin.

3. The epidermis

The epidermis protects the body against environmental influences and does not contain any veins.

4. The dermis – the body’s wall7

The epidermis is the outer layer of our skin covering our body.

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3.De opperhuid (epidermis) De opperhuid beschermt het lichaam tegen milieu-invloeden, en bevat geen bloedvaten. 4.De hoornlaag – de muur van het lichaam7

De hoornlaag is de buitenste laag van ons lichaam.

Functie:

- Ze beschermt ons tegen chemische stoffen, water en ziektekiemen (virussen, bacteriën, schimmels… en andere micro-organismen)

- Tegelijkertijd beschermt ze ons tegen vochtverlies

Hoe komt de hoornlaag tot stand:

Zonder dat we het merken, wordt de ‘opperhuid’ constant vernieuwd! Dit proces is uniek, want geen enkel ander orgaan is daartoe in deze omvang in staat! 7 Duitsland: https://www.bgw-online.de/DE/Arbeitssicherheit-Gesundheitsschutz/Gesunde-Haut/Hintergrundinfos-Haut/Hintergrundinfos-Haut_node.html

Function:

• It protects us against chemical substances, water and pathogens (viruses, bacteria, fungi and other micro-organisms).

• It also protects us against dehydration.

How is the epidermis formed:

The epidermis is constantly renewing itself without anyone noticing. This process is unique, because no other organ is able to do this on this scope. New cells are formed through cell division in the epidermis – above the subcutaneous and the bottom layer of the skin. During their journey to the surface of the skin, they change appearance and transform into basal cells. Every day we lose millions of basal cells without noticing it. This complete renewal of the skin takes around 28 days, so 4 weeks. For wounded hands this repair process takes longer. This top layer of the skin is the epidermis and is 0.02 mm thick.

Appearance:

When you build a house, you don’t just need bricks, you need mortar. If your skin was 2 m thick, it would be like armour. Skin needs to be elastic. You could compare the epidermis with a brick wall with cement. The bricks are the dead corneocytes and the cement is the oil that holds the bricks together.

Our epidermis has also been rendered. On top of the epidermis is a film of water and oil. The water comes from the sweat glands and the fat from the sebaceous glands.

7 Germany: https://www.bgw-online.de/DE/Arbeitssicherheit-Gesundheitsschutz/Gesunde-Haut/Hintergrundinfos-Haut/Hintergrundinfos-Haut_node.html


TEST 1: HAND PRINT ON A MIRROR

In order to demonstrate this, put your hand on a mirror. You can see your hand print on the mirror. If you then wash your hands and dry them and put your hand back on the mirror you will no longer see anything. You have removed the film of water and oil.

Soap washes oil away! Soap does not know the difference between oil on hands and oil that has been applied to the hands. It takes about 1.5 - 3 hours for the skin to restore this film. Think about how many times you wash your hands before you go to work.

Function of the film of water and oil:

a) It protects us against unwanted bacteria, viruses and fungi, water and chemical substances.

The film of water and oil reacts at a pH value of around 5.5 which is slightly acidic. This is when the metabolism is the most active.

The pH value indicates whether a water-based solution is acid, neutral or alkaline/basic. The pH value can be between 0 and 14. pH 7 is neutral and one example of this is water. Values between 0 and 7 are acid (e.g. gastric acid, lemon and Coca-Cola) and values between 7 and 14 are alkaline (e.g. soap and washing agents). Skin has a pH value of approximately 5.5.

pH-neutral = 7 eg. water

The surface of our skin has a pH value of 5.5 which is slightly acidic and is our most important protective shield against unwanted bacteria, viruses and fungi. The film of water and oil on our skin is also called our acid mantle.

pH-neutral skin = 5.5

Cleaning hands:

In order to protect the slightly acidic pH value of our skin, we need to use pH-balanced skin products to clean our hands. They also have a pH value of around 5.5 and clean the skin effectively.

When buying these products you have to be sure you buy pH-balanced products and not pH–neutral products which are less skin-friendly.

Washing hands:

Because of the 7 pH value of water, long-term contact with water can damage the skin. The pH value of the water can lead to a slight increase in the pH value of 5.5 of our skin. This results in the skin losing its acidic characteris-tics, which in turn means it has less protection against pathogens (bacteria, viruses, fungi).

See the model of the little house: mortar gone, oil gone. Substances can penetrate the skin more easily. Or: too long in the bath, your skin goes wrinkly, the cells shrink, natural oils are lost.


TEST 28 : DEFINING THE PH VALUE

• Guessing the pH value

• Testing with bar codes (see urine test)

• Baby soap pH 10 (misleading marketing)

Tests are carried out to define the pH value of soap, baby soap, shower cream, hand soap, washing up liquid, Dove, etc.

Some products have a pH value of 10, like baby soap. These are real ‘soaps’. Some products put a strain on the skin because it has to work hard to bring the pH value back to 5.5. Other products have a pH value of 5. These products are pH-balanced or skin-neutral. These are not soaps, but ‘washing lotions’. Using these means that you put less strain on your skin. It is advisable to use a washing lotion that contains no colouring agents or perfume because these substances can cause allergies. Colouring agents and perfumes are harmful for the skin because they remove the film of water and oil.

Be aware of misleading advertising on products. Cosmetic products do not fall under the same regulations as medicines. Manufacturers can write what they want even if it’s not true.

b) The epidermis protects the body against moisture loss.

If skin had no epidermis, our bodies would lose approximately 20-30 litres of water via the surface of our skin. It is impossible to drink this volume of water.

But even with a healthy barrier our skin is not completely sealed. Each day we lose about 300 ml of water via our skin. Water creates a constant hydration of the skin, that is able to

retain the water via special moisture-retention factors.

The epidermis of the soles of the feet and the palms of the hand is thick.

The epidermis is thin between the fingers: a risk for hairdressers!

Skin itself is not oily. The epidermis contains keratin and this absorbs water.

1.2. RISK FACTORS FOR THE SKIN

Our wall-resembling epidermis with its film of water and oil that acts as a render protects us against foreign substances. When our skin barrier breaks down, foreign substances can penetrate the skin more easily. Important factors that damage the skin barrier are frequent contact with water and chemical substances.

1.2.1. Water dries out the skin

‘Water dries out the skin’ may sound like a contradiction in terms, but it is true!

The basal cells swell up when in contact with water and retain a lot of water. Cells can expand to three times their size.

When your hands return to a dry environment, the surplus water evaporates and the cells shrink back to their former size.

This means that the distance between the cells expands and skin becomes porous to external substances.

It is now particularly easy for irritants and allergens to penetrate the skin. At the same time a lot of extra water is able to escape. Skin dries out and feels dry and rough.

8 Germany: Report study visit Osnabruck – prof. Swen Malte John – Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück (26 – 29 August 2014)


TEST 3: SUGAR CUBE IN WATER

A sugar cube is put into a glass of water.

Goal: to demonstrate that water is a solvent.

Hairdressers’ hands come under particular strain because they:

• Come into contact with water or damp objects very frequently,

• Are damp for more than two hours each day,

• Are frequently washed,

• Frequently become very dirty and need to be cleaned.

1.2.2. Chemical substances9

TEST 4: CHEMICAL SUBSTANCES ON THE SKIN

Perm fluid is applied to a piece of pigskin. Neutralising liquid is also applied to the pigskin. The pH value of both fluids is ascertained.

Goal: to visualise the effect of chemical substances on the skin

TEST 5: CHEMICAL SUBSTANCE ON A CUBE OF POLYSTYRENE

A chemical substance is applied to a cube of polystyrene.

Goal: to show that the chemical substance penetrates rapidly through the polystyrene which dissolves due to the aggressive chemical substance.

Washing substances (e.g. in soaps or shampoos) wash away the oils of the skin. This can damage the skin barrier and consequently damage the protective role it plays. Dry, rough skin is the first sign of a damaged skin barrier. Allergens, eg. in hair dye, shampoo or perm solution can penetrate the skin more easily and cause an allergic reaction.

There are so many different occasions when your hands come in contact with water and chemical products:

• Washing/rinsing/dyeing/perms with bare hands

• Equipment smeared with chemical sub-stances

• Touching contaminated clothing, equipment, etc.

• Splattering when mixing or handling chemical products

• Aerosols and substances on your skin and on objects you touch

9 See Belgium: Brochure Risk Trainer, p. 23


How to identify the dangers for your skin

a) Abrasive/corrosive substances

You can identify corrosive substances by the following labels (pictogram). These must be printed on products or the packaging:

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Dan kunnen ook allergieverwekkende stoffen (allergenen), bijv. uit haarverf, shampoo of permanentvloeistof gemakkelijker in de huid dringen en een allergische huidreactie veroorzaken.

Er zijn verschillende mogelijkheden waardoor je handen in contact komen met water en chemische producten:

– wassen /spoelen/ kleuren haren/permanenten met blote handen – gereedschap besmeurd door chemische stoffen – door het aanraken van verontreinigde kleding, gereedschappen… – spatten, bij het mengen of het behandelen, van chemische producten op je

huid – spuitbussen (aerosolen) en stof op je huid en op voorwerpen waarmee je

in contact komt

Zo herkent u de gevaren voor de huid

a)Bijtende/corrosieve stoffen

Corrosieve stoffen herkent u aan de volgende etikettering (pictogram), die op het product of op zijn verpakking gedrukt moet zijn:

Corrosief? Irriterend? Allergieverwekkend? Zo herkent u de gevaren voor de hui

Nieuw en oud gevarenpictogram voor de etikettering van „corrosieve” stoffen (links: nieuwe etikettering vanaf 2009; rechts: oude etikettering tot 2009)

Producten met een dergelijk pictogram hebben een bijtend effect op de huid en kunnen leiden tot een plotseling optredende, acute ontsteking van de huid

New and old pictograms depicting danger on labels containing corrosive substances (on the left new labels introduced in 2009, on the right old labels in force until 2009)

Products bearing these types of pictograms have an abrasive effect on the skin and may lead to a sudden inflammation of the skin.

b) Irritants

You can identify irritants by the following pictogram:

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b)Irriterende stoffen

Irriterende stoffen herkent u aan het volgende pictogram:

Nieuw en oud gevarenpictogram voor de etikettering van „huidirriterende” stoffen (links: nieuwe etikettering vanaf 2009; rechts: oude etikettering tot 2009)

Stoffen met een dergelijke etikettering kunnen bij herhaaldelijk contact de huidbarrière overbelasten en eveneens ontstekingen van de huid veroorzaken.

Er zijn echter uitzonderingen! Water, shampoo en huidreinigende producten hebben bij herhaald gebruik eveneens een irriterend effect, zonder dat de desbetreffende etiketteringsplicht hierop van toepassing is. Of hebt u al ooit een „X” op een waterkraan gezien?

c)Allergieverwekkende stoffen

Allergieverwekkende stoffen zijn moeilijk te herkennen en worden niet geëtiketteerd met een pictogram. In principe kan nagenoeg iedere stof een allergie veroorzaken.

Allergieverwekkende haarverf mag daarom sinds november 2011 niet meer bij personen onder 16 jaar worden gebruikt of aan hen worden verkocht en er bestaat voor fabrikanten een etiketteringsplicht voor producten, waarin bepaalde stoffen zitten waarvan bekend is dat ze sterk allergieverwekkend zijn.

3.Andere belastingen voor de huid10

10 Oostenrijk: Auva ppt Schöne Hände sind deine Visitenkarte

New and old pictograms representing danger on the labels of irritants for the skin (on the left new labels introduced in 2009, on the right old labels in force until 2009)

Substances with these labels can put a strain on the skin barrier if used repeatedly and also cause inflammation of the skin.

There are exceptions however! Water, shampoo and skin cleansing products can also have an irritating effect with repetitive use, yet they do not have to carry the corresponding label. Have you ever seen an ‘X’ sign on a tap?

c) Allergens

Allergens are difficult to identify and do not bear labels with a pictogram. In principle almost any substance can cause an allergy.

Hair dye with allergens has been banned since November 2011 for use on people under 16 nor can it be sold to them and manufacturers are obliged to label products in such a way as to make it clear that they contain allergens.

1.2.3. Other sources of strain for the skin10

Hairdressers’ hands are not only put under strain by water and chemical substances but also by:

• wounds

• infections

• heat (hairdryers, curling tongs, etc.)

• wearing water-resistant gloves for more than 2 hours

• cold and wind

10 Austria: Auva ppt Schöne Hände sind deine Visitenkarte


1.3. OCCUPATIONAL SKIN COMPLAINTS

1.3.1. Occupational skin complaints – enough to make you jump out of your skin

Occupational skin complaints are complaints caused by carrying out your work.

The hairdressing profession belongs to the group of professions that present a risk for the skin. This means that hairdressers often suffer from skin complaints.11

Risks:

• Washing hair frequently without gloves

• Contact with chemical products (shampoo, hair dyes, hair treatments, etc.)

• Scissors and razors

• Etc.

The most important symptoms are12:

• dry skin

• red patches

• itching

• flaking skin

• split skin/blisters

• pain

• cracked skin

Dermatitis image gallery13

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3. BEROEPSGERELATEERDE HUIDAANDOENINGEN

Beroepsgerelateerde huidaandoeningen – om uit je vel te springen

Beroepsgerelateerde huidaandoeningen zijn huidaandoeningen die veroorzaakt worden door het uitvoeren van je werk.

Het beroep van kapper behoort tot de zogenaamde ‘risicoberoepen voor de huid’. Dat betekent dat kappers relatief vaak te maken hebben met huidaandoeningen 11.

Risico’s:

- frequent haren wassen zonder handschoenen - contact met chemische producten (shampoo, haarkleuren,

haarverzorging…) - scharen en scheermessen

De belangrijkste symptomen zijn12:

– droogte – roodheid – jeuk – schilfers – scheuren/ blaarvorming – pijn – gekrakeleerde huid

Dermatitis image gallery13

• 11 Nederland, website Kapperspoli http://www.huidenarbeid.nl/kapperspoli/ 12 GB : Kapperswebsite van HSE http://www.hse.gov.uk/hairdressing 13 GB : Kapperswebsite van HSE http://www.hse.gov.uk/hairdressing/gallery.htm

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5.jpg%3Bhttp%253A%252F%252Fwww.huidziekten.nl%252Ffolders%252Fnederlands%252Fatopischeczeem.htm%3B1024%3B768 15 Oostenrijk Auva ppt Schöne Hände sind deine Visitenkarte 16 Nederland: ppt Harma Stenveld – presentatie 4 mei 2015 Gent (slotevenement)

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5.jpg%3Bhttp%253A%252F%252Fwww.huidziekten.nl%252Ffolders%252Fnederlands%252Fatopischeczeem.htm%3B1024%3B768 15 Oostenrijk Auva ppt Schöne Hände sind deine Visitenkarte 16 Nederland: ppt Harma Stenveld – presentatie 4 mei 2015 Gent (slotevenement)

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Note17

Some people’s skin (and mucous membranes) are genetically inclined to be ultra-sensi-tive to environmental substances. This may manifest itself in complaints such as hay fever, itchy skin that is perpetuated by scratching or rubbing (neurodermatitis), allergic asthma, etc.

The skin of these people can be damaged much more easily and occupational skin complaints may appear more quickly than among other people.

If these people become hairdressers they need to take particular care of their skin and make sure it is thoroughly protected and well cared for.

11 The Netherlands: website Kapperspoli http://www.huidenarbeid.nl/kapperspoli/12 UK: HSE hairdressing website http://www.hse.gov.uk/hairdressing13 UK: HSE hairdressing website http://www.hse.gov.uk/hairdressing/gallery.htm14 www.huidziekten.nl15 Austria: Auva ppt Schöne Hände sind deine Visitenkarte16 The Netherlands: ppt Harma Stenveld – presentation 4 May 2015 Ghent (closing event)17 Germany: website Safehair, www.safehair.eu


1.3.2. What are the occupational skin complaints?

Occupational skin complaints are almost always associated with eczema.

Eczema is an inflammatory reaction of the skin (epidermis and upper subcutaneous layer) that is caused by several different things.

Eczema is not contagious (and is not caused by bacteria, fungi or viruses) and cannot be passed on from one person to another. Damaged skin is a perfect place however for germs to settle in.

There are two kinds of contact eczema (dermatitis): irritant and allergic.

Inflammation on hands is usually the result of irritated skin = irritant dermatitis18 caused by:

• Short-term contact with strong chemical products such as bleach (acute toxic contact dermatitis),

• (mainly) repeated contact with irritants: through frequent work with wet products or mild chemical products such as shampoo, soap (degenerative dermatitis) = ‘hairdress-ers’ eczema’.

Repeated contact with water is one of the most important causes of eczema19. You run a greater risk of skin complaints if your hands come into contact with water for more than 2 hours a day. Or if your hands are wet several times a day or if you apply shampoo to customers more than 10 times a day. Staff who wash hair a lot run a greater risk therefore.

Hairdresser’s eczema can become so serious that they can no longer continue their career.

But eczema is also sometimes caused by an allergy

= allergic contact dermatitis.

a) Eczema through repeated contact with irritants (degenerative dermatitis)20.

Degenerative dermatitis develops in 3 phases due to long-term or repetitive absorption of one or more irritants.

Phase 1: Removal of the film of water and oil

Washing hands -> water and oily layer disappear -> dry skin

Phase 2: Disappearance of oil in the epidermis

Washing hands frequently -> the layer of oil between the basal cells disappears -> result: seriously dry skin

Phase 3: Absorption of professional substances

Skin is damaged -> harmful substances can penetrate the skin -> result: red patches, itching, blisters

18 The Netherlands: website FNV Mooi, http://www.fnvmooigeregeld.nl/gezond-werken/eczema-en-luchtwegen/ UK: HSE Hairdressers’ website, http://www.hse.gov.uk/hairdressing19 UK: HSE Hairdressers’ website, http://www.hse.gov.uk/hairdressing20 Germany: Report study visit Osnabruck – prof. Swen Malte John – Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at

the University of Osnabrück (26 – 29 August 2014)


b) Allergic contact dermatitis21

Allergens are substances that cause an allergic inflammation when in contact with the skin22.

Nobody knows exactly why some people suddenly develop an allergy for certain substances.

A lot of people become allergic to nickel (in white metal objects), to certain hair dyes, to latex gloves or preserving agents in hair products. When this is the case one-off contact is enough to cause allergic contact dermatitis. But it can also take months or even years before the allergy develops.

Allergens are absorbed into the skin. They warn our immune system that there is a threat to the body and need to be rejected. They are transported via Langerhans cells to the lymph glands. The next time you come into contact with the allergen, the immune system reacts strongly and this manifests itself in an inflammation. The reaction will only appear after 3 days. The allergy to that particular substance never goes away. Each time this person comes in contact with this substance the eczema will flare up again.

Recommendations from hairdressers23:

• Regular cleaning of the working environ-ment prevents invisible contamination with hairdressing products. Good hygiene helps prevent hairdresser’s eczema.

• Stress has a negative impact on skin com-plaints and can cause allergies to flare up. Train yourself to relax.

1.3.3. Other possible skin complaints24

Nail fungus

Changes in the colour of nails (grey, brown, yellow or white bits) or the structure (rough or thick zones or splits) indicate a problem.

It is indeed a kind of fungus that attacks the nail. If the complaint is not actually a fungal infection, it could also be a symptom of an illness.

You are strongly advised to have a doctor look at your nail and not to try to diagnose it yourself.

Calluses

Calluses are areas of thick skin that harden due to constant friction. A hard, yellowish mass appears on the skin. Calluses often appear on the fingers of hairdressers due to working with scissors.

Barber’s disease

Barber’s disease is caused by hairs that penetrate the skin, mainly between the fingers. The hairs can cause an inflammation. Small purple-red spots then appear between the fingers, usually with an opening in the middle where pus can form and escape intermittently.

21 Germany: website Safehair, www.safehair.eu Belgium: Idewe: Niets aan de hand? Toch wel (Nothing wrong? Oh yes there is) 22 There are substances that lead more frequently to allergies than others. These include a lot of typical hairdressing chemicals. A widespread allergen for

instance is p-phenylendiamine (PPD), that is found in oxidising hair dye and hairdressers as well as customers can often develop an allergy to it.23 The Netherlands: website Healthy hairdresser, http://www.healthyhairdresser.nl/24 Belgium: Brochure Risk Trainer p.33- 34


1.3.4. Eczema test25

Look at your hands, wrists and lower arms and do the Skin and Work Test. This test will help you answer the question: “Do I have (hand) eczema?” The Skin and Work Test will also help you ascertain whether your eczema could be caused by your work.

The Hand Eczema Test is actually made up of two tests:

1) the Quick Scan: this is a test to check whether you have sensitive skin. And if you need to take extra care.

2) the Hand Eczema Test: this will reveal if you have hand eczema and if so how bad it is.

You also get advice about what to do about it. The test includes photos of eczema, from early onset to extremely advanced. You have to indicate whether the skin on the photos resembles your own skin.

TEST 6: ECZEMA TEST

Carrying out the eczema test

25 The Netherlands: Kapperspoli: http://www.healthyhairdresser.nl/dwnlds/handexceemtestkln.pdf


2. THE APPLICATION26

Skin protection – ending up with healthy skin

For hairdressers to end up with health skin is no easy feat.

By following a few basic rules, you can succeed in avoiding all the risk factors. We show you how!

All good things come in threes!

Systematic skin protection is based on three important elements:

1. Skin protection

2. Skin cleansing

3. Skin care

28

Deel II: DE TOEPASSING.

Huidbescherming – er met gezonde huid vanaf komen.

Er als kapper/kapster met een gezonde huid vanaf komen, is helemaal niet zo simpel.

Door een paar basisregels op te volgen, kan je erin slagen om al de risicofactoren van je lijf te houden. Wij tonen je hoe!

Huidbescherming – Er met een gezonde huid vanaf ko Alle goede dingen bestaan uit drie!

Een systematische huidbescherming is gebaseerd op 3 pijlers:

1. Huidbescherming 2. Huidreiniging 3. Huidverzorging

Systematische huidbescherming

Systematic skin protection

2.1. SKIN PROTECTION

The aim: dry, pure skin.

2.1.1. Principle of skin-care products

This comes down to protecting your skin better in order to avoid putting too much strain on it.

29

1.HUIDBESCHERMING (blauw)26

Bedoeling : een droge, zuivere huid.

Werkingsprincipe van huidbeschermende producten.

Het komt erop aan om de huid beter te beschermen en om de huidbelasting te verminderen.

Werkingsprincipe van huidbeschermende producten

De huid kan men beter beschermen door een zo doeltreffend mogelijke beschermlaag te vormen = huidbeschermende crèmes.

De huidbelasting (tegen gevaarlijke stoffen) kan men verminderen door

= beschermende handschoenen

= het dragen van beschermkledij (schort)

= gebruik van nikkelvrij materieel 26 Duitsland: website Safehair; www.safehair.eu Duitsland: website https://www.bgw-online.de/DE/Arbeitssicherheit-Gesundheitsschutz/Gesunde-Haut/Hintergrundinfos-Haut/Hintergrundinfos-Haut_node.html

Principle of skin-care products

You can protect your skin better by ensuring the most effective protective layer = skin protection creams.

You can reduce the strain (against dangerous substances) by:

• protective gloves

• wearing protective clothing (apron)

• using nickel-free equipment

• removing jewellery from your hands and fingers when working

• cutting hair before dyeing it

26 Germany: website Safehair, www.safehair.eu Germany: website https://www.bgw-online.de/DE/Arbeitssicherheit-Gesundheitsschutz/Gesunde-Haut/Hintergrundinfos-Haut/Hintergrundinfos-Haut_

node.html


Also:

• Wear warm gloves when going out in the winter.

• Use protective gloves when carrying out wet work at home.

• Treat wounds immediately and hygienically.

• Alternate wet and dry work.

2.1.2. Protective skin cream27

TEST 7: HAND CREAM ON A BLOCK OF POLYSTYRENE + CHEMICAL SUBSTANCE

The polystyrene block is first smothered with hand cream. A chemical substance is then added.

Goal: to demonstrate that chemical substances are absorbed and dissolve more slowly due to the protective hand cream.

TEST 8: HAND CREAM ON A SUGAR CUBE AND IN WATER

A sugar cube is first smothered in hand cream before being put in a glass of water.

Goal: to demonstrate that the sugar cube dissolves less rapidly with the hand cream than without. The hand cream acts as a protective barrier therefore (see Test 4).

Hairdressing work involves a lot of water, moisture and wearing gloves for long periods of time. Moisture also gathers in gloves and creates a moist environment.

You must use protective skin cream therefore to protect against the water and to prevent the skin barrier weakening. By using creams the skin repairs itself immediately.

Recommended skin creams28

The recommended skin creams are neutral, hydrating/moisturising creams. The creams must contain no colouring agents or perfumes as these can cause allergies.

All employees must have their own cream, or the cream must be in a dispenser so that cross-contamination is not possible between the different employees.

It is good to have cream at different spots in the hairdressing salon: on the trolleys, at the washbasins, at the reception, etc.

You can buy these creams at the pharmacy or in the supermarket.

How to apply the cream?

• Rub it into your hands thoroughly and ev-erywhere.

• Rub it in well between the fingers and cuticles.

• Use sufficient cream to ensure effective pro-tection.

27 Germany: website Safehair, www.safehair.eu28 UK: HSE Hairdressers’ website http://www.hse.gov.uk/hairdressing/ Belgium. OiRA Tool: Risk Statement 4.2.4. Hands must be looked after regularly with a neutral, hydrating hand cream


When should you use the cream?

• Rub in thoroughly after washing your hands.

• Rub in shortly after wearing gloves.

• Rub in regularly, namely after coffee, after eating, after taking payments, before a long break, after work and in the evening. The ef-fectiveness of the cream reduces quickly.

Beware: protective creams cannot protect you against hairdressing chemicals such as hair dye, perm solution, etc. Only protective gloves can help against this.

Hand cream can never be considered as a replacement for gloves therefore!

2.1.3. Protective gloves29

TEST 9: GLOVES ON POLYSTYRENE BLOCK + CHEMICAL SUBSTANCE

A block of polystyrene is placed inside a glove. A chemical substance is put onto the gloves.

Goal: To demonstrate that the glove completely protects the polystyrene against the chemical substance. The block is not damaged thanks to the glove.

TEST 10: GLOVE OVER A SUGAR CUBE AND IN WATER

A sugar cube is placed inside a glove, which is put into water.

Goal: To demonstrate that the glove completely protects the sugar cube against water. The sugar cube does not dissolve.

TEST 11: TESTING GLOVES + TAKING THEM OFF CORRECTLY

The course participants test different types of gloves and put them on several times and take them off correctly.

Goal:

• To learn:

- The different materials gloves are made of (vinyl, nitrile etc.).

- The different sizes (S, M, L, etc.).

• Learning to take off the gloves correctly..

Types of protective gloves:

Only the right kind of gloves offers protection. All gloves are different and are made in different materials including:

• Disposable gloves that are very thin and that feel good on your hands,

• Re-usable gloves that are thicker.

29 Germany: website Safehair, www.safehair.eu UK: Video GB http://www.hse.gov.uk/hairdressing, Maxime’s story Belgium. OiRA Tool: 1.1 submodule: Gloves: Owners of hairdressing salons are legally obliged to make personal protective equipment such as gloves

available to employees.


a) Disposable gloves30

Definitely when dyeing, bleaching, defrizzing and perms.

Because protective gloves are the most important measure to take against skin complaints, they must most definitely be worn when:

• Mixing, applying and rinsing out hair dye and colour rinses.

• Mixing, applying and rinsing out bleaching agents.

• Preparing, applying, neutralising and rinsing out perm solutions.

Strongly recommended when using shampoos31

Because it is much easier to get hairdresser’s eczema when working a lot with wet hands, it is advisable to wear disposable gloves when using shampoos.

Beware:

• Wrists and a part of the forearm must be covered so that liquids cannot end up in the gloves.

• Working with your hands in water for more than 30 minutes per hour is not good. If more than half your working day is spent washing and rinsing, your skin is very likely

to dry out. If disposable gloves are worn when using shampoos, it is possible to work more than 30 minutes per hour.

• Alternating activities (tasks that put a lot of strain on the skin and those that don’t) strongly reduces the chance of complaints.

Which disposable gloves should I wear when working with water and chemical products?32

Show different types of gloves: nitrile, vinyl, latex etc. (vinyl is cheaper, a bit sturdier; nitrile is a bit more supple, thinner than latex).

Use gloves:

• Made out of nitrile or vinyl. Nitrile is partic-ularly suitable due to the good fit and the protection it offers33.

• With long cuffs.

• Ideally around 30 cm in length (from top to the end) – so that no liquids can run into them (eg. when washing hair).

• That are powder-free.

• That are smooth all over.

• That bear the label with the pictogram of a glass beaker (DIN EN 374), the EC sign34.

Thin cotton gloves that absorb perspiration can be worn under the waterproof gloves.

30 Belgium. OiRA Tool Risk Statement 4.1.1: Disposable gloves (nitrile or vinyl, with long cuffs) must be worn when dyeing, bleaching, de-frizzing and perms.

31 Belgium. OiRA Tool Risk Statement 4.1.1: Disposable gloves (nitrile or vinyl, with long cuffs) must be worn when using shampoo.32 Belgium. OiRA Tool Risk Statement 4.1.1 and 4.1.2 UK: HSE Hairdressers’ website, http://www.hse.gov.uk/hairdressing33 Croatia: Study visit – Dr. Marija BuBas - Croatian Institute for Health Protection and Safety at Work (21 – 24 April 2014) Nitrile is also recommended if you are allergic to the proteins in natural latex. 34 Germany: website Safehair, www.safehair.eu, checklist for the choice of protective gloves. Aremadeaccordingtoacertainpatternthatmeetsspecificqualitynormsgoverningpersonalprotection.


Do NOT use:

• Normal rubber gloves,

• Latex gloves35, because these can cause allergic skin reactions.

b) Re-usable gloves36

In order to prevent hairdresser’s eczema you should also use gloves for cleaning and disinfecting equipment, washbasins, floors, etc.37

Which gloves should you use when cleaning and disinfecting?

• Use thicker, re-usable gloves (with long cuffs). They are resistant. The thicker they are though the less practical they are for working.

• Make sure you have gloves in different sizes, so that you always have gloves that will fit all employees.

Watch out for the following:

• Gloves are personal and must never be lent out.

• Rinse re-usable gloves with water before taking them off.

• Let the inside of re-usable gloves dry before using them again.

When wearing gloves, you should take care that:

• You choose the right shape and size!

Gloves that are too big reduce your sensitivity. Gloves that are too small tire the hands quickly and your hands will perspire more quickly. So, first test different gloves by different manufacturers.

In the same way as when you buy a pair of shoes, you should also try different models and different sizes of gloves. Because let’s face it, we don’t all go around wearing the same shoes do we?

SMLXLXXL

The right size gloves

• Make sure your hands are clean and dry before putting on your gloves!38

• Don’t wear waterproof gloves non-stop (max. 4 hours).39

If the work you are doing does not involve contact with irritants, when making appointments, talking on the phone, drying hair etc. you are best taking your gloves off.

35 Latex: latex often contains animal protein powder. People may be allergic to the powder and sometimes to the latex itself. It is not always clear what causes the allergy.

36 Belgium. OiRA Tool Risk Statement 4.1.3 Gloves must be worn when cleaning and disinfecting. France: Brochure ‘Hairdressing and your health’ (2006)37 Belgium. OiRA Tool Risk statement 7.2. 38 France: Brochure ‘Hairdressing and your health’ (2006)39 The Netherlands: website FNV Mooi http://www.fnvmooigeregeld.nl/gezond-werken/eczema-en-luchtwegen/


Your hands sweat inside gloves, which means that your basal cells also swell up. When your hands are back in a dry environment, the surplus water evaporates and the basal cells shrink again. This means that the distance between the cells is bigger and your skin becomes porous to external substances.

This means that immediately after wearing gloves, your skin does not have an effective protective layer and that you need to be particularly careful about substances you come into contact with.

You should put a protective cream on straight away.

• You should only wear disposable gloves once!

As the name ‘disposable’ indicates, you must throw your disposable gloves away after you have used them one time.

When you first put on a pair of gloves, little tears and holes appear that are invisible to the naked eye. The more you wear them these tears and holes get bigger until the gloves are no longer able to protect you.

Never use dirty gloves. You must be wary of your skin being contaminated (by remains of dye etc.), which could lead to an allergic reaction. Cutting off the fingertips of your gloves means that your hands are no longer protected.

• When carrying out wet work turn over the cuff of your gloves!

A clever tip! If the edge of the cuff of your gloves is turned over, the water when you are washing or rinsing out hair, or when you are carrying out work above your head, cannot run back into the gloves.

• Disposable gloves must be available at different spots in the hairdressing salon.

Everywhere in the hairdressing salon: at the washbasins, on trolleys, at mixing stations, etc.

2.1.4. Wear protective clothing (apron)40

When carrying out different procedures you should also wear an apron. Gloves and aprons must be made available by your employer.

2.1.5. Use nickel-free equipment41

Nickel is a metal that is used in different stainless steel utensils such as scissors, hairpins, jewellery, etc. Some people have an allergic reaction when objects or equipment containing nickel come in contact with their skin. A lot of people already have an allergy to nickel before they become hairdressers. This often comes from wearing stainless steel jewellery at a young age. If you have one allergy, you are all the more likely to get another.

Scissors and razors are often not nickel-free, which increases the danger of irritation or an allergy to nickel.

Avoid objects that contain nickel as much as possible, or test metal instruments first.

40 Belgium. OiRA Tool Risk statement 7.7. Employers are responsible for cleaning and maintenance of work clothes and protective clothing. France:‘SynergieCoiffure.Aninnovativeeducationalapproach:makingsecurityanintegralpartoftheprofessionalqualification’(2009)41 Belgium. OiRA Tool Risk statement 7.1. Employees must work with ergonomic nickel-free and well-maintained equipment (e.g. scissors). France:Fmpcisme.org:website:‘LesitedesFiches-Médico-Professionnelleshttp://www.fmpcisme.org/Ficherésumé-fichesdepost(Coiffeur)’


2.1.6. Remove jewellery from your hands and fingers when working42

It is strongly recommended that you remove jewellery on your hands and fingers for the whole working day.

When carrying out wet work or using hair cosmetics, you must not wear jewellery on your hands or wrists. If you wear jewellery you are unable to wash and dry your hands correctly.

Moisture and chemicals can collect under the jewellery and cause skin complaints. Moreover rings can create tears and holes in gloves which are then no longer protective of course.

And by the way, who actually sees those lovely rings under your protective gloves?

2.1.7. Cut hair before dyeing it43

Limit contact with chemical products by cutting hair before dyeing it.

It will cost you less as well because you need less product for shorter hair.

2.1.8. Personal protection44

The following can lead to an increased risk of allergies:

• tattoos with black henna (PPD)

• piercings

• dyeing eyebrows and eyelashes

• artificial nails

2.1.9. Extra tips

• Wear warm gloves when going out in the winter.

• Use protective gloves when working at home with your hands in fluids.

• Treat wounds immediately and hygienically (and use waterproof plasters).

• Alternate wet and dry work.

2.2. CLEANING SKIN45

2.2.1. Principle: ‘As little as possible, as much as necessary’

This means that you should not clean hands with skin cleansing products unless they are dirty or have dye on them. Cleaning hands after wearing gloves for example is not necessary in principle.

42 Germany: website Safehair, www.safehair.eu Belgium. OiRA Tool Risk Statement 4.1.4 Employees must remove jewellery when working. France: Brochure ‘Hairdressing and your health’ (2006) France:‘SynergieCoiffure.Aninnovativeeducationalapproach:makingsecurityanintegralpartoftheprofessionalqualification’’(2009)43 Denmark: Report study visit prof. Jeanne Duus - National Allergy Research Centre (Videncenter for Allergi) Copenhagen (11 – 13 June 2014). Report peer review 2 - 1 December 2014 (Willem Kruithof)44 Denmark, presentation Dr. Jeanne Duus - National Allergy Research Centre (Videncenter for Allergi) Copenhagen (11 – 13 June 2014).45 Germany: website Safehair, www.safehair.eu


2.2.2. Hand soap46

• Soap must have a pH-balanced value (around 5.5) so that it doesn’t put too much strain on the acid mantle of the skin.

• It should not contain any colouring or pre-serving agents or perfume, as they can cause allergies (the same applies to foreign substances such as glitters).

• The product should not contain any solvents or abrasive substances.

• Don’t use shampoo to wash your hands!

Look out for misleading information on products such as ‘dermatologically tested,’ ‘tested for allergies’, ‘pH-neutral’. The fact that these aspects are mentioned does not mean that they actually apply. Cosmetics manufacturers (unlike drug manufacturers) are allowed to write what they want.

2.2.3. Use lukewarm water47

Avoid fluctuations in water temperature. If possible, use thermostatic taps with a pre-pro-grammed temperature and lukewarm water.

Hot water always accelerates the elimination of the natural oils in your hands.

2.2.4. What type of towel should you use?48

• Your hand towels should be as soft as possible.

• Use hand towels for one-time use only.

• Use disposable paper towels.

• Never use hand towels that have been used for customers; they have remains of products on them such as hair dye or shampoo that can irritate the skin and even cause allergies.

2.2.5. How to dry your hands

• Gently pat your hands dry.

• Rubbing hard will lead to ‘tears’ in the upper protective layer of your skin and can damage the skin barriers.

• Make sure you dry between your fingers thoroughly.

2.2.6. Always wash your hands in a separate room (not in the washbasin of the hairdressing salon)49

If your hands are very dirty, you should disinfect them first (with a good product) before washing them. When you wash your hands your remove the protective layer.

Disinfecting kills 10 times more bacteria than washing. The oily layer is not removed when you disinfect your hands which means that it puts less strain on your skin than washing.

46 Belgium. OiRA Tool Risk Statement 4.2.2 Hands should be washed with a pH-balanced soap for hands.47 France: Brochure ‘Hairdressing and your health’ (2006)48 Belgium. OiRA Tool Risk Statement 4.2.3 After washing them, hands should be dried with a towel for one-time use only. 49 Belgium. OiRA Tool Risk Statement 4.2.1 A separate room should be provided for washing and treating hands.


2.3. SKIN CARE50

2.3.1. Use skin-care cream after your work as well as after doing household chores

This will help your skin repair better.

When it’s cold be sure to use a soothing hand cream after your work.51

2.3.2. Apply a hand mask before going to bed (at night)!52

All you need is a suitable skin-care cream and a pair of cotton gloves. Night cream is thicker than day cream. Smother your hands with the cream and put on your gloves. That’s all.

Your cream will penetrate intensively throughout the night.

The cream opens up the spaces between the basal cells and boosts the repair work. Because this cream opens the pores, you should only use it before going to sleep.

This cream facilitates the absorption of foreign substances so you should definitely not use it at work.

50 Germany: website Safehair, www.safehair.eu51 Austria: Auva ppt Schöne Hände sind deine Visitenkarte.52 Belgium. OiRA Tool Risk Statement 4.2.4 You should regularly apply a neutral, hydrating hand cream. Germany: Report study visit Osnabruck – prof. Swen Malte John – Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at

the University of Osnabrück (26 – 29 August 2014).


3. ADDENDUM: HOW TO DEAL WITH CRITICAL CLIENTS53

Arguments and counter-arguments – Safehair

In this training programme you can also include the skin protection theme. An argumentation training course in which you can role play with your course participants to help them to promote skin protection in the workplace among their customers, colleagues and bosses. This material can serve as the basis for an argumentation training course.

3.1. CRITICAL CUSTOMERS

43

Argumenten en tegenargumenten – Safehair.

In de opleiding kan je het thema „Huidbescherming” opnemen. Een argumentatietraining met je cursisten, bijv. door middel van een rollenspel, kan je cursisten helpen om het thema huidbescherming op de werkplek te kunnen motiveren tegenover klanten, collega’s en de baas. Hier volgt materiaal als basis voor een argumentatietraining:

Kritische klant.

"Kritische klant!"

Sara volgt nog maar pas een kappersopleiding en mag nu haar eerste klant shampooën. Ze begeleidt de klant naar de wastafel en trekt haar beschermende handschoenen aan.

Plots zegt de klant: ”Waarom draagt u handschoenen? Wilt u mij niet aanraken? Zo vuil zijn mijn haren niet en bovendien trekken handschoenen aan mijn haren!”

Hoe kun je in dit geval reageren?

”Het spijt mij dat u die indruk hebt. Dat ik handschoenen draag heeft niets met u, maar met mij te maken, want ik moet mijn huid beschermen tegen het vele contact met vocht. Kappers krijgen namelijk vaak af te rekenen met contacteczeem aan de huid.

Bovendien gebruiken wij wegwerphandschoenen, die niet aan de haren trekken. Laten we het gewoon proberen en u zegt het meteen als het voor u onaangenaam is."

Is de klant nog niet overtuigd?

Critical customer!

Sara is still carrying out her training to become a hairdresser and is allowed to shampoo her first customer. She accompanies the customer to the washbasin and puts on her protective gloves.

Suddenly the customer says: “Why are you wearing gloves? Don’t you want to touch me? My hair’s not that dirty and what’s more gloves pull at my hair!”

3.1.1. How should you react in these circumstances?

“I’m sorry that you get that impression. The fact that I am wearing gloves is nothing to do with you, but with me because I have to protect my skin against contact with fluids. Hairdressers have to be careful about not getting contact dermatitis.

Moreover we always use disposable gloves that don’t pull the hair. Let’s just try it and you can tell me if it is unpleasant for you.”

3.1.2. Is the client still not convinced?

“If I only had to shampoo one customer per day it wouldn’t be a major problem but having frequent contact with water and shampoo all day long means natural oils are constantly being washed off my skin. After a while my skin becomes dry and rough and my skin barrier is damaged.

Did you know that a lot of hairdressers even have to give up their career because they suffer from an occupational skin complaint? Please give me the chance to show you how it feels with gloves. Professional hairdressers today wear gloves, like dentists in fact. Would you want someone to put bare fingers into your mouth?”



3.2. IT’S NOTHING

44

”Wanneer ik slechts één keer per dag bij klanten het haar zou moeten wassen, dan zou het niet zo erg zijn. Maar het frequente contact met water en shampoos zorgt ervoor dat de vetten constant uit mijn huid worden gewassen. Daardoor voelt mijn huid na verloop van tijd droog en ruw aan en mijn huidbarrière wordt beschadigd.

Wist u dat vele kappers zelfs hun beroep moeten opgeven, omdat ze aan een beroepsgerelateerde huidaandoening lijden? Geeft u mij alstublieft de kans om mijn kunnen ook met handschoenen te bewijzen! Een professionele kapper draagt vandaag de dag handschoenen, net zoals bijvoorbeeld een tandarts. Of zou u zich met blote vingers in de mond laten aanraken?”

Dat is toch niets.

„Dat is toch niets!”

•

•

Je nieuwe collega Maria voert zorgvuldig alle taken uit die haar worden toevertrouwd zoals wassen, föhnen, verven en permanenten. De klanten zijn enthousiast over de creativiteit en vakcompetentie van Maria. Sinds enkele dagen merk je bij je collega huidveranderingen op aan de handen. Vooral de ruimten tussen de vingers zien er al duidelijk rood uit.

44

”Wanneer ik slechts één keer per dag bij klanten het haar zou moeten wassen, dan zou het niet zo erg zijn. Maar het frequente contact met water en shampoos zorgt ervoor dat de vetten constant uit mijn huid worden gewassen. Daardoor voelt mijn huid na verloop van tijd droog en ruw aan en mijn huidbarrière wordt beschadigd.

Wist u dat vele kappers zelfs hun beroep moeten opgeven, omdat ze aan een beroepsgerelateerde huidaandoening lijden? Geeft u mij alstublieft de kans om mijn kunnen ook met handschoenen te bewijzen! Een professionele kapper draagt vandaag de dag handschoenen, net zoals bijvoorbeeld een tandarts. Of zou u zich met blote vingers in de mond laten aanraken?”

Dat is toch niets.

„Dat is toch niets!”

•

•

Je nieuwe collega Maria voert zorgvuldig alle taken uit die haar worden toevertrouwd zoals wassen, föhnen, verven en permanenten. De klanten zijn enthousiast over de creativiteit en vakcompetentie van Maria. Sinds enkele dagen merk je bij je collega huidveranderingen op aan de handen. Vooral de ruimten tussen de vingers zien er al duidelijk rood uit.

It’s nothing!

Your new colleague carries out all her jobs meticulously: washing, drying, dyeing and perms. The customers are enthusiastic about her creativity and professional skills. A few days ago you noticed changes to your colleague’s hands. Especially between the fingers where her skin is clearly red.

Maria talks it down: “It’s nothing. My hands are OK. I don’t wear gloves because I can’t feel anything in them.”

3.2.1. How can you convince Maria?

“Maria, you must go to the dermatologist because even the smallest changes to your skin such as dry and red patches have to be taken seriously. Don’t wait until you have painful skin problems and cracks that can cause problems for your work. The earlier you identify and treat skin complaints, the easier it is to cure them. You can still get your skin back to its normal condition without too much hassle.

You must start wearing gloves. Trust me, you’ll be able to feel things again after a while. Doctors sometimes carry out operations wearing two pairs of gloves and they need a lot of sensitivity!”

3.2.2. Is Maria still not convinced?

“Surveys also show that you can learn to work with gloves and that your sensitivity comes back after a little while. So, it’s important that you keep on trying and you need to be patient, especially in the beginning. And finally all hairdressers have to learn and practice cutting techniques until they are adept at it, so why not this?

One important condition is to have gloves that fit well, because nobody can carry out sensitive treatments with gloves that are too big or too small.”


3.3. CONVINCING YOUR BOSS

Convincing your boss

You only recently started carrying out typical procedures such as washing, cutting and drying, but your hands already burn at the slightest contact with shampoo and hair and they are red and itchy.Your boss, Peter, is not in the slightest bit interested. When you ask for protective gloves and protective hand cream, he brushes it off and says: “Protective gloves and protective creams are not needed in the hairdressing sector. A bit of water and shampoo are not harmful for the skin. In my salon we only use the very best, skin-friendly products. What’s more buying gloves and creams for all the staff is far too expensive! Don’t make such a fuss and look after your hands better at home. You’re responsible for yourself after all!”

3.3.1. How can you convince your boss?

“Frequent contact with water and shampoo at work means that the natural oils in my skin are washed away. This is why my hands feel dry and rough after a while and my skin barrier is damaged. This happens no matter how mild and skin-friendly the products are that we work with or if they are superior quality. Plain pure water can dry skin out. My hands are already inflamed and they hurt. I have also learned that hairdressers are particularly susceptible to getting contact dermatitis.

As far as the cost of gloves and creams is concerned you are fortunately mistaken. It is just the opposite in fact: wearing gloves will save you money. Because being unable to work because of a skin complaint costs a lot more. And actually as you are my employer, you are responsible for my protection at work.”

3.3.2. Is your boss still not convinced?

“It may sound contradictory, but by spending money on gloves you save money!

If I or one of my colleagues is off sick just one day because of a skin complaint and we are unable to work the money you lose would pay for gloves for a whole year. And absenteeism due to skin complaints usually lasts longer than one day!

What’s more: gloves are not nearly as expensive as you may think. As with all products, there are different manufacturers and it’s worth doing a price comparison. If you order in volume, you can usually save money. And studies show that an employer only needs to invest about 1% of his/her total turnover in order to protect his/her employees.”


ADDENDUM 154: ECZEMA FROM REPEATED CONTACT WITH IRRITANTS (DEGENERATIVE DERMATITIS)55

47

Bijlage 154 : Eczeem door herhaald contact met huidirriterende stoffen (degeneratief eczeem)55.

Intacte huidbarrière

Fase 1: Verwijdering van de water-/vetfilm

54 Duitsland: website Safehair; www.safehair.eu België: Idewe: Niets aan de hand? Toch wel, 55 Duitsland: Verslag study visit Osnabruck – prof. Swen Malte John, – Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück (26 – 29 augustus 2014)

Intact skin barrier

3.4. PHASE 1: ELIMINATION OF THE FILM OF WATER AND OIL

47

Bijlage 154 : Eczeem door herhaald contact met huidirriterende stoffen (degeneratief eczeem)55.

Intacte huidbarrière

Fase 1: Verwijdering van de water-/vetfilm

54 Duitsland: website Safehair; www.safehair.eu België: Idewe: Niets aan de hand? Toch wel, 55 Duitsland: Verslag study visit Osnabruck – prof. Swen Malte John, – Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück (26 – 29 augustus 2014)

The acid mantle is removed.

Shampoos, for example dissolve oils. Frequent contact with shampoo removes the oils that protect our skin and make it water-repel-lent. The so-called skin barrier is lost and the subcutaneous layer is exposed. Skin then reacts like a sponge and absorbs water and dissolved irritants more easily. Skin goes taught and feels rough. It takes hours before the natural acid mantle is restored.

3.5. PHASE 2: LOSS OF OIL FROM THE SUBCUTANEOUS LAYER

48

Fase 1:

De water-/vetfilm (zuurbeschermingsmantel) wordt verwijderd.

Shampoos, bijvoorbeeld, hebben een vetoplossende werking. Door veelvuldig contact met de huid verwijderen shampoos de vetten die onze huid beschermen en ‘waterafstotend’ maken. De zogenaamde huidbarrière gaat dan verloren en de hoornlaag wordt blootgelegd.

De huid gaat zich gedragen als een spons waarin water, en de daarin opgeloste irriterende stoffen, makkelijk worden geabsorbeerd. De huid spant en voelt ‘dof’ aan. De heropbouw van de natuurlijke zuurbeschermingsmantel duurt uren..

Fase 2: Ontvetting van de hoornlaag

Fase 2:

Bij steeds nieuwe irritaties lopen de beschadigingen op. Deze stoffen irriteren dan de celletjes die instaan voor de aanmaak van een nieuwe huidlaag. De natuurlijke hoornlaagvetten verdwijnen. De hoornlaag wordt daardoor doorlatend voor verschillende beroepsstoffen.

Door de verstoorde aanmaak van een nieuwe huidlaag wordt de huid broos, droog en schilferig, en ontstaan er kloofjes.

Each time the skin is irritated the damage worsens. The substances irritate the cells that are responsible for creating the new layer of skin. The natural oils in the epidermis disappear. The epidermis becomes porous and absorbs different hairdressing substances. If there are problems restoring the new layer of skin, the skin becomes dry and flaky and cracks appear.

3.6. PHASE 3: PENETRATION OF HAIRDRESSING SUBSTANCES

49

Fase 3: Binnendringen van beroepsstoffen

Fase 3:

Wanneer er daadwerkelijk beroepsstoffen binnendringen in de huid, stoten ze daar op de bewakers van de opperhuid. Dat zijn speciale afweercellen van het immuunsysteem, de zogenaamde Langerhanscellen. De cellen van ‘Langerhans’ weren de beroepsstoffen af.

Tenslotte volgt er een ontstekingsreactie van de huid. Er ontstaat een degeneratief eczeem. De huid reageert met een ontsteking om zich te beschermen tegen het binnendringen van lichaamsvreemde en misschien schadelijke stoffen en om je te waarschuwen!

De chemische stoffen, de afwisseling van nat en uitdrogend werk (bv. haardrogen), de afwisseling van warmte en koude, en de wrijving op de huid oefenen nu voortdurend een beschadigend effect uit. Hierdoor worden er ontstekingsletsels veroorzaakt en onderhouden: roodheid, pijn, jeuk, zwelling, kloofvorming…

When occupational substances penetrate the skin, they clash with the guardians of the epidermis. These are Langerhans cells that are produced by the immune system. Langerhans cells reject occupational substances. And finally the skin reacts by becoming inflamed.

54 Germany: website Safehair, www.safehair.eu Belgium: Idewe: Nothing wrong? Oh yes there is. (Niets aan de hand? Toch wel)55 Germany: Report study visit Osnabruck – prof. Swen Malte John – Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at

the University of Osnabrück (26 – 29 August 2014)


Degenerative dermatitis sets in. Skin reacts with an inflammation to protect itself from absorbing foreign and often harmful substances and to send you a warning!

Chemical substances, alternating between wet work and work that dries out the skin (e.g. drying hair), alternating from hot to cold and friction now have a long-term damaging effect. Lesions appear and stay: red patches, itching, swellings, cracks, etc.


4. ADDENDUM 2: THIS IS HOW ALLERGIES APPEAR56

4.1. PHASE 1: SENSITISATION PHASE

Sensitisation (arming and recruiting): an allergen, e.g. PPD (paraphenylenediamine) found in hair dye, penetrates the skin. The Langerhans cells assume that PPD is a very dangerous substance for the body. The occupational substances are then considered to be what we call antigens, that have to be fought with weapons and against which an immunological memory is created.

The Langerhans cells take one or more penetrators to a guarding and recruiting station of the immune system – lymph glands. A special unit is then formed called antibodies. The phase in which your body arms itself against allergens is called the sensitisation phase.

50

Bijlage 2

Zo ontstaat een allergie56.

Fase 1:

Sensibilisatie (bewapening en rekrutering): een allergeen, bijv. PPD (p-fenyleendiamine) uit haarverf, dringt binnen in de huid. De cellen van ‘Langerhans’ gaan ervan uit dat PPD een zeer gevaarlijke stof is voor het lichaam. De beroepsstoffen worden vervolgens beschouwd als zogenaamde ‘antigenen’, waartegen met harde wapens moet worden gestreden en waartegen een immunologisch geheugen wordt gevormd.

De cellen van ‘Langerhans’ brengen één of meerdere indringers naar een bewakings- en rekruteringsstation van het immuunsysteem (=lymfeklieren).Vervolgens wordt er een speciale eenheid gevormd, de zogenaamde ‘antilichamen’. De fase, waarin uw lichaam zich bewapent tegen een allergeen, wordt de sensibilisatiefase genoemd.

Binnendringen van allergenen door de beschadigde huidbarrière


Allergens penetrate the damaged skin barrier

51

De afweercel start het immunologische antwoord.

Fase 2:

Zodra er een leger aan afweercellen en een immunologisch geheugen werden gevormd, volstaan reeds eenmalig kleine hoeveelheden van het allergeen, om een immuunreactie, en dus een allergiegerelateerde ontsteking van de huid, uit te lokken.

The antibodies start the immunological reaction

4.2. PHASE 2: IMMUNE REACTION AND ALLERGY-RELATED INFLAMMATION OF THE SKIN

As soon as an army of antibodies and an immunological memory have been formed all that’s needed is a small quantity of the allergen to trigger an immune reaction which means an allergy-related inflammation of the skin.

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Allergische ontstekingsreactie

Allergic inflammation


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