Reference Guide - wsib

Screening
The purpose of the screening and initial assessment, completed at the worker’s first contact with the
physician, is to determine the appropriateness of the worker for the Program of Care, to determine
whether any specialist referrals are required, and to begin treatment.
The diagnosis of contact dermatitis should be suspected in workers in high-risk occupations and/or industry
sectors with known workplace agents (e.g. agriculture, health care, manufacturing). Physicians should determine
whether there is a suspected workplace agent (allergen or irritant) that can be identified. Screening should
include determination of the following:
A. Did the skin condition start after the worker started the job?*
OR
Did the skin condition become worse after the worker started the job?*
AND
B. Are symptoms better on weekends or holidays off work?
*NOTE: “started the job” includes changing job duties or locations within the same workplace.
Those patients who answer “yes” to BOTH A and B should be enrolled in the Program of Care.
Referral to a specialist with experience diagnosing and treating occupational contact dermatitis should be
considered when any of the following are suspected:
• all cases of possible ACD
• ICD with allergic features
• chronic ICD
• complicated OCD (e.g., not improving, deteriorating, confounded by another skin disease
such as psoriasis).
Following referral, the specialist will:
• confirm a relationship between contact dermatitis and workplace exposure
• conduct diagnostic tests (e.g. industrial patch testing) to identify a specific allergen.
NOTE: Only a small number of physicians in Ontario are able to conduct patch testing for industrial allergens. Please
call the WSIB Health Professional Access Line to obtain a list of locations where this specialized
testing is performed.
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