Skin protection measures as prevention in occupational dermatitis
J. Kurpiewska*, J. Liwkowicz, K.M. Benczek
Central Institute for Labour Protection - National Research Institute, Warsaw, Poland
Barrier creams and gloves are generally used to protect the workers’ skin against exposure to substances hazardous to health. Sometimes the application of gloves is forbidden, for example at workplaces where milling machines, metal-working machines and other machines with rotating parts which can hit the glove and injure the hand. During performing such works as: mechanists, maintenance technicians, hairdressers, etc. gloves make it very difficult and cannot be used as protective equipment. At the same time about 6,4% of population suffer from an allergy to natural rubber, so it is sometimes impossible to use the rubber gloves. That is why barrier creams or ointments are the only possible way to protect the workers’ hands against hazardous substances at the workplaces where gloves cannot be used.
Occupational skin diseases are the most popular ones and cause enormous financial losses, which reach tenths of thousands euro per person annually.
It is estimated that contact dermatitis determine about 90% of all occupational skin diseases and are the main cause of dermatologists' claims.
Skin protection measures and skin care products (moisturing or oiling the skin of hands) are very often misused. It ought to be pointed out that care creams (usually oil-in-water or water-in-oil emulsions) used as skin protection may be harmful for the user. For example: an oiling cream used as the protection against such harmful substances as petrol, greases, lubricants, pesticides and other fat - soluble substances may cause the situation that the above mentioned substances will dissolve in the oil contained in this cream, penetrate into the epidermis more easily, irritate it and cause cutaneous damage.
A similar situation occurs in the case when a moisturing cream is used before “wet-work” occupations and water-soluble hazardous substances can easily penetrate into softened and moistured skin.
These are the main causes of the sometimes expressed opinion that barrier creams are not effective and dermal lesions cannot be avoided by the use of barrier creams.
None of barrier creams protects against all hazardous substances.
Council Directive of 30 November 1989 on the minimum safety and health requirements for the Personal Protective Equipment used by the employees at the workplace (89/656/EEC) in Annex II – “Non-exhaustive guide list of items of personal protective equipment” barrier creams/ointments classifies as skin protection. That is why they should be marked – CE.
The evaluation of barrier creams and ointments were conducted by in vitro and in vivo tests on animals and humans (volunteers). Dermatological tests, in vivo, are based on the visual assessment of skin irritation (repeated insult patch, cumulative irritation and chamber scarification) after a single or repeated application of a substance to the skin of animals or humans. There are also various biophysical methods (measurement of transepidermal water loss by evapometry, skin blood flow volume by laser Doppler velocimetry and skin color by colorimetry path test, etc.) used for evaluating the effectiveness of barrier creams.
Generally, there is no standardised testing method to determine the properties and effectiveness of barrier creams.
Technical methods for assessing the effectiveness of skin protection were investigated in the Central Institute for Labour Protection – National Research Institute in Warsaw, Poland. The following methods for testing the resistance of skin protecting thin layer were developed:
- permeation of organic solvents through hydrophilic skin protection (flame ionisation detection method);
- penetration of oils and greases through hydrophilic skin protection (planimetry method);
- removing paint/liqueur’s coat from the surface covered by skin protection (cross – cut test according ISO 2409:1999);
- resistance of hydrophobic skin protection against water and water solutions of detergents (gravimetric method);
- acid and basis resistance of hydrophobic skin protection (change of the colour of an indicator).
Various preparations available on the Polish market, offered as skin protection barrier creams were tested with the above mentioned technical methods. It was found that only two of them protected against water, acids and basis water solutions.
A test with the controlled application of one of hydrophobic cream was conducted in Dermatological Ambulatory of Occupational Medicine. Nurses, physicians, electro cardiology technicians, cleaning ladies, car cleaners, hairdressers and farmers were subjected to test. They suffered from redness, erythema, scalling with or without vesicles that led to bullae and crusting, etc, Protecting properties were investigated during exposure to water, surfactants, aldehydes, alcohols, acetic acid, formaline, phosphoric acid, photographic reagents, epoxy-resins, artificial fertilizers, disinfectants and latex gloves. The results showed that in all cases just after ten days of application the condition of the skin was much more better.
Hydrophilic gel was tested in three Dermatological Clinics in Poland. The results proved good barrier properties of this SPM.
Content last modified: 10 July 2005
