Why report to EPIDERM?
Personal view: Professor David J Gawkrodger
You are one of the dedicated band of reporters to EPIDERM, and you may be wondering, why do I bother reporting? After all, reporting is not easy. It requires effort to keep a note of patients seen and to fill in a return, monthly for core contributors. You get a newsletter that includes case of the quarter and the Beck Report, but where does it all get us?
The public has high expectations for its health - at work as well as personal. It is vital that the occupational well being of the nations of the UK is improved along with the high profile areas of cancer, heart disease and diabetes. The diagnosis of occupational disease is often difficult and the data cannot readily be obtained from general practice records. It frequently needs specialist input from occupational physicians and organ-specific specialists. Hence to monitor rates and trends of occupational skin disease, a national set up was needed that involved those who can diagnose the conditions.
We have already obtained a lot from EPIDERM. It has allowed an insight into the skin health of the working nation and as such is unique. The project had yielded papers on the national prevalences of occupational skin disease as well as studies on more specific areas such as nickel. Not withstanding the efforts of all those involved, it is still apparent that the reported rates of occupational skin disease are an underestimate. There are many reasons for this not least the reticence of patients to come forward, the reluctance of GPs to refer on, and under-recognition of the contribution of occupational factors by secondary care professionals. One area of gross under-reporting is occupational skin cancer, where the contribution of a lifetimes’ sun-exposure from outdoor work is often not even enquired about, perhaps as many of those affected are retired.
So, is it worth it? Well, yes of course it is! How else are we going to monitor what is happening nationally, and how else are we going to inform politicians of the requirements for better workplace skin health? Besides, where else can you read the pearls of wisdom of Mike Beck every three months!
Professor David J Gawkrodger
Consultant Dermatologist and Honorary Professor of Dermatology
Royal Hallamshire Hospital
University of Sheffield
Sheffield S10 2JF
Personal view: Dr J English
Unfortunately our recall for details of patients is not always as it may seem so the main reason for me reporting to EPIDERM is that THOR and I have an accurate record of the occupational skin disease patients I see. Another reason is that it is a nationwide (multinational with Ireland, Scotland and Wales) reporting scheme that was until recently unique in Europe and probably in the world. Admittedly it is not a perfect reporting scheme but Dr Mike Beck and Professors Cherry and Agius have refined it over the years so that it can give a reasonable indication of trends in occupational dermatology.
Dr Richard Rycroft and the British Contact Dermatitis Group originally started EPIDERM in the early 1990’s with continued financial support from the Health and Safety Executive. It is simple to collect the information on a card and online computerisation is probably going to make it even easier to record patient details. I am attracted to the simplicity of the scheme and this is why I have continued to support it from its inception.
I hope the HSE will support it for many more years to come and also that dermatologists, occupational physicians and GPs will continue to send in their reporting cards.
Dr J English
Queen’s Medical Centre
Nottingham NG7 2UH