Moisturizers

The term 'moisturizer' was generated by Madison Avenue marketers 15 . The definition of 'moisturizers are substances used to reduce the signs and Table 1. The US Food and Drug Administration identified 13 skin protectants and their concentrations Table 1. The US Food and Drug Administration identified 13 skin protectants and their concentrations symptoms of dry, scaly skin, making the rough surface soft and smooth' may lack specificity. Also, the term 'dry skin' is not generally accepted 15, 16...

Abstract

In the metal industry, workplaces with a high skin risk used to be frequent. This has changed in recent years in big plants, where technological progress and automatization have eliminated many hazards. However, in many small and middle-sized companies without supervision by an occupational physician, high-risk workplaces may still prevail. Therefore skin protection plays an important role in this industry, with its focus on irritant exposures. From our own studies and campaigns, the following...

Barrier Creams

A BC, in theory, is designed to prevent or reduce the penetration of harmful agents 6-13, 19-21 . BCs are also called 'skin-protective creams' or 'protective creams' as well as 'protective ointments', 'invisible glove', 'barrier', 'protective'or 'pre-work' creams and or gels (lotions), 'antisolvent' gels and so on 19, 21-25 . Frosch et al. 19 consider 'skin-protective creams' a more appropriate terminology since most creams do not provide a real barrier, at least not comparable to the stratum...

Biogenic Amines

Regarding the irritative and barrier-disrupting properties of the biogenic amines 8 ammonium hydroxide, dimethylamine and trimethylamine in single and combined application with SLS, all 3 tested biogenic amines induced a barrier disruption and a pH increase paralleled with a 1-day-delayed onset of inflammatory signs. These effects were further enhanced and accelerated by a sequential application of SLS together with the biogenic amines, and inflammation occurred earlier than with the single...

Evidence Based Medicine and Skin Protection

Although barrier creams are one of the most commonly recommended measures to prevent occupational dermatoses such as irritant contact dermatitis and allergic contact dermatitis, their actual benefit at the workplace is still lively debated 13 . Nevertheless, there is a lack of placebo-controlled, randomized clinical studies, evaluating the benefit of skin protection products in the prevention of occupational diseases under real workplace conditions. Moreover, the literature data are...

Materials and Methods

The ingredients of the formulations are listed according to the declaration of the International Nomenclature of Cosmetic Ingredients. Water-in-oil emulsion aqua, paraffinum liquidum, panthenol, cera microcristallina, ceresin, glycerin, polyglyceryl-3-diisostearate, isopropyl palmitate, tocopheryl acetate, lanolin alcohol, magnesium sulfate, phenoxyethanol, diammonium citrate, aluminum stearates, citric acid, sodium citrate, potassium sorbate, magnesium stearate, perfume. Multiple (water oil...

Proof of Efficacy Test and Evaluation Methods

The number of workplace substances is uncountable and technical progress enforces the adaptation of substances such as cutting fluids to the new demands. For that reason every new substance can hardly be tested in in vivo studies. Thus, testing of the efficacy of skin protection products, by both in vitro and in vivo models, is limited to a certain number of model irritants such as SLS as a hydrophilic model irritant. However, for some substance classes like lipophilic irritants, model...

Protection against Infectious Agents

In the healthcare setting, disinfection and hand hygiene are indispensable with regard to prevention of cross-infections. Easy access to hand hygiene and skin protection appears necessary for a satisfactory hand hygiene behaviour. Alcohol-based hand rubs may be superior to traditional hand washing as they require less time, act faster, irritate the hands less often and have recently been shown to significantly contribute to a sustained improvement in compliance associated with decreased...

References

1 de Boer EM, van Ketel WG, Bruynzeel DP Dermatoses in metal workers. I. Irritant contact dermatitis. Contact Dermatitis 1989 20 212-218. 2 Goh CL, Yuen R A study of occupational skin disease in the metal industry (1986-1990). Ann Acad Med Singapore 1994 23 639-644. 3 Berndt U, et al Hand eczema in metalworker trainees - An analysis of risk factors. Contact Dermatitis 2000 43 327-332. 4 Drexler H Skin protection and percutaneous absorption of chemical hazards. Int Arch Occup Environ Health 2003...

Results and Discussion

In the ROIT, all 3 test formulations significantly reduced skin irritation (visual score data not shown) and the transepidermal water loss increase caused by 0.5 SDS. The best protection was offered by the multiple emulsion (water oil water), followed by petrolatum and the water-in-oil formulation (fig. 1). In theory the protective effect of an emulsion or ointment can be based on a purely physical effect. That means the compounds of the formulations are building up a protecting film on the...

Specific Effects of Topical Formulations

Dermatological creams and PCs exert a number of effects, in and on the skin, including skin hydration, skin cooling and barrier effect 10 . The relative cooling effect of a PC can be attributed to the amount of water and or alcohol in the emulsion system(s) and to water 'activity', more precisely the amount of freely evaporating water that is liberated in the early phase after topical application. Moreover, the emulsion structure (e.g. liquid crystals) and the presence of hydrotopes determine...

Sulfur Mustard Toxicity

In order to improve its efficacy, iodine replaced PI and was formulated with tetraglycol (TG). Topical treatment with this preparation significantly protected the skin at an interval of 30min between SM exposure and iodine treatment (fig. 2, 3) 4 . The histopathological findings 4 are quantified in figure 4. At the interval of 15 min between exposure and treatment, a significant reduction was observed in dermal parameters indicative of acute tissue damage such as acute inflammation, hemorrhage...

Theoretical Basis

Skin protection training courses are by their nature primarily intervention measures at the level of health-related behavioural prevention. In the sphere of primary prevention this would involve the training required under the legislation discussed above for employees whose skin was at risk, to be provided either at work or as lessons at vocational training colleges. The spheres of secondary and tertiary prevention primarily involve patient training in the sense of a 'high-risk strategy' aimed...

Mechanical Irritation

In this study, we found the following rank of irritancy 9 occlusion with SLS and mechanical irritation > occlusion with SLS > occlusion with water and mechanical irritation > mechanical irritation and occlusion with water > occlusion with a glove and mechanical irritation > mechanical irritation > occlusion with water. Barrier disruption caused by occlusion or mechanical irritation was enhanced by the tandem application. The choice of irritant under occlusion, time of occlusion and...

Spectrum of Occupational Skin Diseases

Skin diseases are among the most frequent occupational diseases in many countries. In Germany, 40 of all notified and acknowledged occupational Others 1,747 Vertebral column disorders 308 Chronic Bronchitis Emphysema 336 Others 1,747 Vertebral column disorders 308 Chronic Bronchitis Emphysema 336 Occupational hearing impairments 5,478 Fig. 1. Notified and acknowledged occupational diseases in Germany 2005 1 . Occupational hearing impairments 5,478 Fig. 1. Notified and acknowledged occupational...

Fields of Combined Application

Application of skin protection cannot be regarded as equivalent to usage of protective gloves 6 . While gloves are indispensable in exposure settings with toxic or mutagenic materials, dangerous microbes, as well as when dealing with strong irritants, skin-protective products are primarily intended to diminish the barrier-impairing effects of repeated exposure to mild irritants and a high wet-work load in order to prevent irritant contact dermatitis of the cumulative type. In contrast to skin...

Practical Determinants of the Use of Barrier Creams

Even if a proper logistics of barrier creams is assured and workers are provided with adequate medical advice on dermal exposures at the workplace and skin protection (plan), one must not automatically expect that they will use barrier creams properly Figure 2 shows that subjects with a very high risk of hand eczema on the one hand ( group 1 in instructions for special periodical medical examinations for the prevention of occupational skin diseases 8 but only non-relevant dermal exposures at...

Tandem Repeated Irritation Test

As the model seemed to have potential for testing protective creams (PCs), the sequential application of 2 irritants in the TRIT was investigated in a study to evaluate the benefit of a commercially available PC compared to non-pretreated control sites 12 . Twenty healthy non-preselected Caucasian volunteers without any skin diseases were included. Informed consent was obtained from all participants, and the study passed the local ethical committee. Subjects were allowed to bathe as usual but...

Allergens in the Workplace

So-called universal precautions resulted in the marked increase in use of latex gloves as personal protective equipment. Since then, the rate of NRL allergy, especially type I allergy, has increased. While approximately 1 of the general population is sensitized to latex, it is now believed that 10-17 of healthcare workers have a type I allergy to NRL allergenic proteins 6, 7 . However, these numbers may be inflated by self-reported allergy assessments. In a study by Allmers 8 , it was found...

Combination of Iodine and Anti Inflammatory Agents

The evolution of a chemical burn involves a variety of inflammatory processes including production of inflammatory mediators 4, 13-19 and dermal infiltration of polymorphonuclear cells 4 . This was supported by the beneficial effect of anti-inflammatory agents such as olvanil and indomethacin against SM in the mouse ear edema model 14 . A combination of iodine with steroidal (clobetasol) and nonsteroidal (piroxicam) anti-inflammatory agents led to improved therapeutic activity in the guinea pig...

Risk Factors for Occupational Skin Diseases Examples

Skin protection products are designed to protect the skin against exogenous risk factors occurring at the workplace. Among the most frequent non-toxic, non-cancerogenous and non-sensitizing low-grade hazards in the occupational field, water, wet work, detergents, solvents and cutting fluids seem to play an important role 3 . Regular skin cleansing with washing substances is one of the probable potential ways by which skin irritation might be induced 4 . The surfactants in modern cleansing...

Pathological Aspects of Skin Irritation

Exposure to skin irritants such as heat and ultraviolet light causes an inflammatory response initiated by erythema (local vasodilation) followed by blister formation and or dermal and epidermal ulceration and necrosis. In general, this is a feature common to the pathology of skin irritants however, they differ from each other by the kinetics of the evolution of the tissue response. For instance, heat burns develop rapidly there is an immediate burning sensation, and the appearance of erythema...

Avoidance of Photosensitizing Drugs

Intake of phototoxic drugs (whose action spectrum almost always involves the UVA range) and exposure to UV radiation cause erythema and edema or even vesiculobullous lesions on sun-exposed skin within hours in susceptible patients. In contrast, a photoallergic reaction is a delayed-type hypersensitivity response in which patients do not have clinical manifestations upon the first exposure to the photoallergic drugs. Sensitized individuals may develop pruritic eczematous eruptions. Photoinduced...

Fruit Acids

Twice daily application of either citric or malic acid alone did not induce a significant irritant reaction. Combined exposure to one of the fruit acids 6, 7 and SLS caused marked barrier disturbance, but the latter irritant effect was smaller than that obtained by a combined exposure to SLS and water. Thus, the combined exposure to the above-mentioned fruit acids and SLS did not enhance cumulative skin irritation. In a second study, we assessed the irritant effects and barrier disruption...

Methods

The study started in September 2000 and was terminated in February 2001. Ninety-four healthy apprentices of the occupational school for food-processing trades, Gera, Germany, were included in this controlled intervention study after providing their and their parents' written informed consent. The study was approved by the ethical committee of the Friedrich Schiller University of Jena. Fifty-eight apprentices were assigned to the UV hardening group (UV), and the remaining 49 apprentices were...

Risk Factors of Occupational Contact Dermatitis

The development of occupational contact dermatitis depends on a combination of endogenous (individual susceptibility) and exogenous factors (exposure). Except for an exposure to strong sensitizing substances, occupational contact dermatitis usually develops in steps, frequently starting with atopic hand dermatitis, followed by irritant dermatitis leading to sensitization and eventually allergic contact dermatitis (multistep eczema). Therefore, susceptibility to irritant dermatitis is of high...

Biological Effects and Side Effects of Suncare Products

In the past years, the safety and usefulness of sunscreens had been controversially and critically discussed on the basis of the following objections the use of a sunscreen may convey a misleading impression of security to the consumer, which may result in longer sun exposure and, therefore, greater skin damage 12 and, therefore, UV erythema should serve as a warning signal to discontinue sun exposure instead of being suppressed by sunscreen use 13 . Ingredients of sunscreen products may also...

Climatic Conditions

Environmental humidity has been shown to contribute to the appearance of the outermost surface of the skin. Employing a mouse model, the effects of the humidity on the skin's pathology have been studied 7 a dry environment leads to a drastic decrease in amino acids, i.e. filaggrin generation, and consecutively to stratum corneum imbalance and skin surface dryness. A decreased amino acid content has been found in dry skin 5 . In dry compared to normal skin, the expression of the...

Personal Protective Equipment

Barrier creams are used as both primary and secondary prevention from exposure to allergens in the workplace. Their functional intent is to provide a nonpermeable barrier, separating the skin from potential irritating, noxious and or allergenic substances to which a worker may be exposed. There are three types of nonspecific barrier creams, water repellant, oil repellant and silicone based. Water-repellant barrier creams contain hydrophobic substances. They are used in wet work professions and...

Electromagnetic Radiation

Electromagnetic radiation may irritate the skin. The effects of short-wave ultraviolet irradiation present a good example of this type of irritation. Details on UV protection are presented in the chapter by Kutting and Drexler (pp. 87-97). Changes in small cutaneous vessels, particularly capillaries, represent the earliest damage induced in the skin by ionizing radiation in those individuals administering X-rays. Later the caliber of the vessels increases, accompanied by a reduced blood flow....

Physical Irritant Contact Dermatitis

Physical irritant contact dermatitis (PICD) is a common occupational dermatosis with multiple types and many mechanisms involved in its development 1 . The diagnosis is primarily based on a history of exposure to a known irritant and negative patch test results to exclude contact allergy. The basic concept of PICD is physical skin damage without preceding or concomitant chemical irritation and sensitization, respectively. Initial PICD is characterized by a local inflammatory reaction, i.e....

Conclusion

The use of skin protection products such as BCs and moisturizers may help people to avoid or reduce the intensity of skin irritations caused by irritants at home and at the workplace. We should clearly educate people that BCs should be not used as a primary protection against high-risk substances as well as corrosive agents. It is recommended to provide the protection against low-grade irritants. However, wet workers utilizing water, soaps and detergents daily may benefit by applying BCs...

Protection against Irritants

Wet work and irritant exposure (table 2) in the healthcare setting are frequent due to hand hygiene which is indispensable with regard to prevention of cross-infections. Alcohol-based hand rubs may be superior to traditional hand washing and irritate the hands less often 2, 3 . Besides easy access to hand hygiene, skin protection has been introduced as a necessary prerequisite for a satisfactory hand hygiene behaviour 2 . In the healthcare setting, frequently protection gloves are used...

Suncare Products

The biological activity and efficacy of a suncare product, as represented by the SPF, is evaluated by its ability to protect human skin from erythema and edema. It is measured by determination of the dose which is required to induce a just perceptible redness (MED minimal erythema dose) on untreated and on sunscreen-treated skin. The SPF is defined as the ratio of the dose of UV radiation required to produce a minimal erythematic response 24 h after exposure on protected skin after application...

Mechanical Influences

Mechanical traumas to the skin can affect all levels from the stratum corneum to subcutaneous tissue. Excessive friction can result in the formation of various dermatoses. Hyperkeratosis, lichenification and calluses may be induced. However, sudden friction may induce blisters. Under experimental settings, tape strippings have been employed to induce PICD and to collect the intercellular composition of ceramides, sterols and fatty acids, i.e. stratum corneum lipids that maintain the water...