Modern Industrial Hygiene, Volume 2: Biological Aspects. Perkins JL ed., Cincinnati, OH: American Conference of Governmental Industrial Hygienists, Inc., 2003 Apr; 2:47-133
This chapter will focus on the cutaneous route, with reference to ingestion only when hand to mouth transfer may occur. Chemicals that contact the skin can interact with it in two ways. First, and most obvious, is, when the skin itself is affected and there are pathological changes. The most likely effects include allergic and irritant contact dermatitis. Another way skin contact can affect the worker, but is often much more obscure, is when potentially toxic chemicals are absorbed through the skin, adding to the systemic body burden and toxicity in internal organs. The preponderance of occupational hygiene measurements have historically been conducted to evaluate inhalation exposures. There are relatively few published studies characterizing skin exposure, and in practice it is rare for occupational hygienists to actually measure skin exposures. This should not be inferred to mean that occupational skin exposures are of little importance as a potential hazard. To the contrary, it has been estimated that 42 percent of the U.S. workforce is at risk of dermal exposure to hazardous chemicals (NIOSH, 1993). Rather, the lack of attention most likely stems from the sometimes crude and non-validated measurement techniques, a lack of guidance criteria, and lack of government compliance emphasis on skin exposures relative to inhalable exposures. What may have become commonplace is a dangerous philosophy that, if one doesn't look for problems, they won't be found and one will not have to try to figure out how to deal with these exposures as potential problems. The result of this course of inaction is that both employees and employers may suffer the consequences of this ignorance. Fortunately, there seems to be a growing number of professionals in a wide cross-section from government, industry, and labor that believe that more attention to documenting and reducing skin exposures is necessary if we truly intend to protect workers. It is the purpose of this chapter to convince the reader that skin exposures that potentially result in illness are important.