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Dermal Exposure

Skin exposure to chemicals in the workplace is a significant problem in the US. Both the number of cases and the rate of skin disease in the US exceeds recordable respiratory illnesses. In 2010, 34,400 recordable skin diseases were reported by the Bureau of Labor Statistics (BLS) at a rate of 3.4 injuries per 10,000 employees, compared to 19,300 respiratory illnesses with a rate of 1.9 illnesses per 10,000 employees. [See Table 6a and Table 6b in Workplace Injuries and Illnesses - 2010 [268 KB PDF*, 29 pages].

Most chemicals are readily absorbed through the skin and can cause other health effects and/or contribute to the dose absorbed by inhalation of the chemical from the air. Many studies indicate that absorption of chemicals through the skin can occur without being noticed by the worker. In many cases, skin is a more significant route of exposure than the lung. This is particularly true for non-volatile chemicals which are relatively toxic and which remain on work surfaces for long periods of time. The number of occupational illnesses caused by skin absorption of chemicals is not known. However, it is argued that an estimated 60,000 deaths and 860,000 occupational illnesses per year in the US attributed to occupational exposure, a relatively small percentage caused by skin exposure would represent a significant health risk.(1)

Dermal exposures are addressed in specific standards for the general industry, shipyard employment, marine terminals, the construction industry, and identification, classification, and regulation of carcinogens.

OSHA Standards

This section highlights OSHA standards, preambles to final rules (background to final rules), and directives (instructions for compliance officers) related to dermal exposure. The following information is only a partial list of references to skin exposure in OSHA standards, guidelines, and chemical sampling methods.

Note: Twenty-five states, Puerto Rico and the Virgin Islands have OSHA-approved State Plans and have adopted their own standards and enforcement policies. For the most part, these States adopt standards that are identical to Federal OSHA. However, some States have adopted different standards applicable to this topic or may have different enforcement policies.

General Industry (29 CFR 1910)

Shipyard Employment (29 CFR 1915)

  • 1915 Subpart D, Welding, cutting and heating
    • 1915.51, Ventilation and protection in welding, cutting and heating

  • 1915 Subpart I, Personal protective equipment
    • Appendix A, Non-mandatory guidelines for hazard assessment, personal protective equipment (PPE) selection, and PPE training program

  • 1915 Subpart Z, Toxic and hazardous substances

Marine Terminals (29 CFR 1917)

Construction (29 CFR 1926)

Identification, Classification, and Regulation of Carcinogens (29 CFR 1990)

Preambles to Final Rules

Directives

Hazard Recognition

The US Bureau of Labor Statistics (BLS) states occupational skin diseases are the second most common type of occupational disease. The following references will aid in creating a greater awareness of possible hazards.

Health Effects

  • Occupational Dermatoses. National Institute for Occupational Safety and Health (NIOSH) Slide Presentation, (1981), 139 slides. Provides a slide presentation with notes of skin disorders due to occupational exposures to chemicals, UV radiation, etc.

  • Data From the Bureau of Labor Statistics—Worker Health by Industry and Occupation [597 KB PDF, 109 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No.2001-120, (2001, January). Contains data on dermatitis in 1996.

Exposure Evaluation

A variety of methods exist for estimating dermal exposure. Hand rinses, dermal/surface wipes, and skin patches are some of the tools which can be used to determine the effectiveness of gloves or the extent of the contamination in "clean" work areas, such as break rooms and lunch rooms. Biological monitoring results are also a very valuable means of determining if dermal exposure is a major route of exposure. Presently, there are a limited number of guidance values for chemicals measured in the body, that is the biological exposure indices (BEIs) which are published by the American Conference of Governmental Industrial Hygienists (ACGIH). In addition, there are many studies published in peer-reviewed literature which report chemical exposure levels for workers in a variety of different occupations and different industries.

  • While "Skin" notation is an alert, the means to evaluate the magnitude of dermal exposure, its importance relative to airborne exposure, and the effectiveness of preventive controls, are limited.

  • Limits for biological response, called Biological Exposure Indices (BEIs) by the ACGIH, have been set for 36 chemicals or chemical groups(2); however, only 15 of these chemicals have a "Skin" notation, suggesting that less than half of these BEIs are for chemicals that are significantly absorbed through the skin. Biomonitoring methods are discussed at greater length elsewhere.(27-28)

Monitoring and Evaluation Methods

Dermal exposure evaluation methods have been broadly categorized into direct and indirect methods.

Direct

    Direct means assessing what is deposited onto the skin.
    • The most common direct method is the use of dermal dosimeters in the form of either patches(3-17) or whole body suits.(3,12) Other direct evaluation methods include skin washes and wipes,(3,10,11,13) and the video detection of fluorescent tracers.(3,8,11,13,15)

Indirect

    Indirect means estimating dermal dose either as attributable to some biologic indicator that is actually measured or that which could potentially result from a contaminant measured on an accessible surface.(3)
    • Indirect methods refer primarily to measuring a biologic response such as cholinesterase activity in blood(5,6,14) or urinary excretion(5-7,9,12,14,15), but also include measuring surface contamination.(3,5,6,11,18-20)

Monitoring surfaces for contamination is an old method frequently used in the radiation health field where control is based on keeping exposure as low as reasonably achievable. In comparison, chemical hazards allow exposures to define limits or thresholds of exposure. The problem is defining a relationship between surface contamination and dose that would be used to set a surface contamination threshold. Most reviewers have found poor correlations between the two.(11,18,19) For instance, Caplan concluded there is no correlation between surface contamination levels as determined by wipe sampling and air concentration levels; however, wipe sample levels can be useful in estimating dermal exposure if skin absorption data is available.(18) In the area of pesticide foliar residues, this relationship has been called a "transfer coefficient."(3) There are currently no OSHA standards that specify surface contamination criteria. However, several standards do require appropriate provision of personnel protective equipment (PPE), housekeeping, decontamination, and related procedures to control surface contamination hazards.

Other Resources

Control and Prevention

Dermal exposure can be controlled and prevented. Many times it is as simple as changing the chemicals being used. When that is not an option, there are many types of personal protective equipment (PPE) that are available. Being familiar with the material on this page will help in the effort to lessen hazardous dermal exposure.

  • Substitution to a less toxic chemical is almost always a good option, unless the alternative chemical is much more volatile.

  • Consideration should be given to re-designing the work process to avoid splashes or immersion. Where that is not feasible, personal protection in the form of chemical protective gloves, an apron, or clothing should be selected. Good housekeeping can avoid the accumulation of stable, low volatility, dermally toxic contaminants on horizontal surfaces. Enclosure and isolation may be feasible for both liquid and solid large aerosols.

  • Published breakthrough information from glove manufacturers and lab test data should be used with caution. Glove breakthrough can occur in considerably less time than expected based upon many factors.

Personal Protective Equipment (PPE)

  • Hand contact is a significant route of exposure. Therefore, proper glove selection is a major means of controlling dermal exposure. Factors that affect glove selection include:
    • type of chemical(s) to be handled (or used)
    • frequency and duration of chemical contact (often to rarely)
    • nature of contact (total immersion, splash, mist, contaminated surfaces)
    • concentration of the chemical
    • temperature of the chemical
    • abrasion, puncture, tear resistance requirements of the job or task
    • length to be protected (hand only, forearm, arm)
    • dexterity requirements of the job or task
    • grip requirements (dry grip, wet grip, oily)
    • glove features (e.g. cuff edge, lining, color (to show contamination))
    • thermal protection
    • size and comfort requirements
    • price

  • Personal Protective Equipment (PPE). OSHA Safety and Health Topics Page. Addresses the importance of using PPE and implementing a PPE program in the workplace.

  • Personal protection is a last option or a supplemental option to help control all of the above exposure mechanisms. OSHA guidance in selecting appropriate personal protective clothing may be found in 29 CFR 1915 Subpart I, Appendix A.

  • Emergency Response Resources - Personal Protective Equipment. National Institute for Occupational Safety and Health (NIOSH) Workplace Safety and Health Topic. Covers respirators, protective clothing, latex allergy and eye safety.

  • Chemical Glove Selection. Electronic Library of Construction Occupational Safety and Health (eLCOSH) and the University of Delaware Cooperative Extension (Ronald C. Jester), (1991, March). Oriented toward agricultural pesticides, but is well organized and informative to any reader. Covers qualitative description of selection criteria, glove material and feature options, and use/care guidelines.

  • Many examples of generic glove selection charts are available.(31) More quantitative charts (involving "breakthrough time" and "permeation rate" data) are available from manufacturers. A similar, although less quantitative, procedure is appropriate for chemical protective clothing. As the importance of dermal exposures to occupational chemical hazards grows, so too will the tools to evaluate and control these hazards improve.

Additional Information

Related Safety and Health Topics Pages

Other Resources

  • Dermal Assessment Guide [5 MB PDF*, 13 pages]. OSHA and the Independent Lubricant Manufacturers Association (ILMA) Alliance. Helps small businesses understand the possible connection between instances of employee dermatitis and facility operations that use metal removal fluids.

  • Manufacturers of protective apparel provide information on permeation rates applicable to their specific products. Contact these companies directly or online for this information.

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