Determinants and Correlates of Occupational Skin Diseases and Workplace Risk Stratification in a Metal Casting Factory: A Cross-Sectional Study From a Rural Coastal Region of Southern India

Introduction Workers in metal casting industries are routinely exposed to high temperatures, hazardous chemicals, metal fumes, and dust, placing them at significant risk of occupational skin diseases (OSD). Despite the considerable morbidity and productivity loss associated with OSD, systematic assessment in the Indian metal casting industry remains limited. This cross-sectional study aimed to assess the prevalence, pattern, and determinants of OSD among workers at a private metal casting factory in Goa, India, and to explore the association between personal protective equipment (PPE) use and OSD occurrence. Materials and methods A cross-sectional observational study was conducted at a private limited metal casting factory in Kundaim Industrial Estate, Kundaim, Goa, as part of the mandatory annual free health check-up under the Factories Act, 1948. Of the 414 registered employees, 345 (83.3%) were examined on the day of the check-up. A pretested, pre-validated, and structured questionnaire captured sociodemographic details, work experience, and self-reported and observed PPE use. A dermatologist (MBBS, MD - Dermatology) independently examined all participants and, based on a detailed history and clinical examination, classified skin disorders as occupational or non-occupational. Data were analysed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States). Chi-square test, Fisher's exact test, and binary logistic regression were applied, with p<0.05 considered as statistically significant. Results The study population was predominantly made up of male subjects (87.5%). The most common age group was 31-45 years (36.5%), and the majority belonged to Class II socioeconomic status (SES) (69.3%). Overall, 121 workers (35.1%) were diagnosed with at least one OSD. Contact dermatitis was the most prevalent condition (15.1%), followed by prickly heat (14.5%), tinea (4.6%), burn scars (3.5%), and urticaria (2.6%). OSD prevalence was significantly associated with age (p=0.027), workplace type (p<0.01), years of work experience (p=0.001), and self-reported PPE use (p<0.01). Among workplace categories, core-making workers had the highest OSD burden (65%). On binary logistic regression, workers who reported to use PPE were 50.8 times more likely to be free of OSD compared to non-users (AOR 50.8; 95% CI: 18.2-141.7; p<0.01). Conclusion More than one in three metal casting workers had a clinically diagnosed OSD, with contact dermatitis being the most prevalent condition. Among workplace categories, core-making workers bore the highest burden of OSD. Reported PPE use was the single most significant modifiable protective factor, with users several times more likely to be free of OSD. Targeted interventions including consistent PPE promotion, periodic dermatological screening, and workplace hazard reduction are essential to reduce the burden of OSD in the metal casting industry sector.