Table 3

Example potential indicators of MSHT—skin, dental and sensory systems (non-exhaustive)45 65 70–72

Presenting concernPossible MSHT-related cause
Skin rash, skin damage, itching, weeping, discomfort.Unsanitary conditions increase the risk of skin infection, infestation and exacerbation of pre-existing eczema or skin conditions. Stress may also aggravate skin.
Contact dermatitis may occur with use of cleaning chemicals or pesticides without protective equipment.
Hair loss, hair texture change.Secondary to stress, micronutrient deficiency or infection (including fungal).
Dental pain, tooth damage and loss.Tooth and gum disease due to lack of dental hygiene and ability to provide dental self-care, dental infection, injury and/or dental decay secondary to illegal substance use (notably methamphetamine ‘meth mouth’, cocaine and heroin).
Vision and eye problemsMay be caused by chronic and/or uncorrected eye conditions, secondary to environmental exposure to irritants or infection (ie, exposure to farm pesticides and animal stool without hygiene measures or protective equipment).
Hearing problemsMay be chronic and uncorrected or secondary to unprotected noise exposure, infection or injury.
  • MSHT, modern slavery and human trafficking.