SKIN EXPOSURES & EFFECTS

Recommendations and Resources

Employers should follow the hierarchy of controls in order to prevent occupational skin disease in workers. Employers should take the following step to protect workers from OSD:

• Elimination: In most cases, preventing skin contact with chemicals or other skin damaging agents will prevent disease. Eliminating exposure to the compound or product that causes the skin condition is the most effective method of control.
• Substitution: If possible, employers should attempt to substitute the hazardous agent a less hazardous compound.
• Engineering controls: If elimination or substitution is not possible, engineering controls such as local exhaust ventilation systems and isolation booths can prevent hazardous agents from contacting workers’ skin.
• Administrative controls: Employers should provide training programs that educate workers about hazards that they may be exposed to and ways to protect themselves from the hazards.
• Personal protective equipment: Personal protective equipment such as gloves, safety glasses or goggles, shop coats or coveralls, and boots should be provided by employers and worn by workers involved in the following activities (not an exhaustive list):
  • Wet or dry cleaning of work tools, equipment and work areas
  • Disinfection of work tools, equipment, and work areas
  • Contact with solvents
  • Contact with monomers of epoxy resins and tacky surfaces or hardening agents (such as glue or epoxy resins)
  • Use of preparations containing soaps, detergents, and disinfectants

Occupational dermal risks can also be assessed using control banding, an approach in which a single control technology (such as general ventilation) is applied to a range or band of chemical exposures (such as 1−10 mg/m³) that falls within a given hazard group. Additional information on the application of control banding to prevent or control dermal exposures to hazardous substances can be found on the NIOSH Control Banding Topic Page.

Dermal Resources

Current Intelligence Bulletin 61: A Strategy for Assigning New NIOSH Skin Notations
DHHS (NIOSH) Publication No. 2009-147 (July 2009)
The publication presents a strategic framework and the scientific rationale for the assignment of multiple hazard-specific skin notation (SK). The new strategy is a form of hazard identification that has been designed to do the following:

• Ensure that the assigned skin notations reflect the contemporary state of scientific knowledge.
• Provide transparency behind the assignment process.
• Communicate the hazards of chemical exposures of the skin.
• Meet the needs of health professionals, employers, and other interested parties in protecting workers from chemical contact with the skin.

NIOSH Resources

NORA
The National Occupational Research Agenda was founded in 1996, in order to create an occupational health research agenda for the nation.

NIOSH Pocket Guide to Chemical Hazards
The Pocket Guide is a source of general industrial hygiene information on several hundred chemicals/classes found in the work environment. The guide includes exposure limits, respirator recommendations, first aid, and more. Provides key data for each chemical/substance includes name (including synonyms/trade names), structure/formula, CAS/RTECS Numbers, DOT ID, conversion factors, exposure limits, IDLH, chemical and physical properties, measurement methods, and respirator recommendations. Entries contain information related to skin exposures and effects in the form of skin notations and in sections on personal protection and sanitation recommendations and information on health hazards including route, symptoms, first aid and target organs.

NIOSH Program Portfolio: Immune, Dermal & Infectious Diseases
The NIOSH Immune, Dermal and Infectious Diseases Program supports laboratory and field investigations and the development of scientifically based recommendations to promote safe and healthful working conditions.

NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.
NIOSHTIC-2 search results on Skin Exposures and Effects

Skin Permeation Calculator
This Java-based calculator estimates the value of kp from an aqueous vehicle using three different models: Frasch, Potts & Guy and Modified Robinson.

Skin Notation (SK) Profiles
The Skin Notation Profile for a chemical will provide information supplemental to the skin notation, including a summary of all relevant data used to aid in determining the hazards associated with skin exposures.

Related NIOSH Publications

Chemical Protective Clothing (CPC) Database
February 1998 NTIS No. PB98-137730
NIOSH recommendations for Chemical Protective Clothing (CPC) for workers and employers.

Criteria for a Recommended Standard: Occupational Exposure to Metalworking Fluids
DHHS (NIOSH) Publication No. 98-102 (January 1998)
Reviews available information about the adverse health effects associated with occupational exposure to metalworking fluids and aerosols.

NIOSH Alert: Preventing Asthma in Animal Handlers
DHHS (NIOSH) Publication No. 97-116 (January 1998)
Describes three case reports of workers affected by exposures to animals. Includes recommendations to help reduce exposures and prevent animal-induced asthma and allergies.

NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace 
DHHS (NIOSH) Publication No. 97-135 (June 1997)
Presents existing data and describes six case reports of workers who developed latex allergy.

NIOSH Hazard Controls: Control of Spotting Chemical Hazards in Commercial Dry cleaning
DHHS (NIOSH) Publication No. 97-158
Describes controls such as ventilation, isolation, and personal protective equipment to prevent dermatitis from chronic or acute exposure. Also see the set of Hazard Control documents for perchloroethylene in dry cleaning:

• HC16 DHHS (NIOSH) Publication No. 97-154
• HC17 DHHS (NIOSH) Publication No. 97-155
• HC18 DHHS (NIOSH) Publication No. 97-156
• HC19 DHHS (NIOSH) Publication No. 97-157

NIOSH Hazard Review: Carbonless Copy Paper
DHHS (NIOSH) Publication No. 2001-107 (December, 2000)
Includes recommendations for preventing or reducing exposure to carbonless copy paper to prevent symptoms of skin irritation and irritation of the mucosal membranes of the eyes and upper respiratory tract.

NIOSH Hazard Controls: Controlling Chemical Hazards During the Application of Artificial Fingernails
DHHS (NIOSH) Publication No. 99-112 (January 1999)
Describes ventilated tables and other controls to prevent contact dermatitis from MMA and EMA.

Occupational Dermatoses: A Program for Physicians
A NIOSH presentation (updated in 2001) endorsed by The American Academy of Dermatology and The American Academy of Occupational Medicine that includes 114 slides and narrative on occupational dermatoses with an additional 26 slides on dermal case studies.

What You Need to Know About Occupational Exposure to Metalworking Fluids
DHHS (NIOSH) Publication No. 98-116 (March 1998)
Contains a critical review of the scientific and technical information available on the extent and type of health hazards associated with metalworking fluids and the adequacy of control methods.

Worker Health Chartbook
DHHS (NIOSH) Publication No. 2004-146
Provides data on the magnitude and trends by industry and occupation as well as numbers and rates among states for dermatitis and other skin disorders.

Other Workplace Resources

American Contact Dermatitis Society (ACDS)
The ACDS was founded in 1989 “to promote, support, develop and stimulate information about contact dermatitis and occupational skin disease for improved patient care.” The society is made up of dermatologists, allergists, physicians, researchers, nurses and health care professionals and provides dermal information and education tools to physicians in order to improve patient care.

BAuA - German Federal Institute for Occupational Safety and Health
(Bundesanstalt für Arbeitsschutz und Arbeitsmedizin).
Contains a number of guidance documents for preventing skin hazards to workers.

TRGS (German Technical Standards for Hazardous Substances)
Guidance documents relating to preventing skin hazards to workers are available. The translations jointly prepared by NIOSH and BAuA are available from this site.

Contact Dermatitis
Wiley-Blackwell publishes papers describing original research on all aspects of cutaneous biology and skin disease.

Dermatology Information System (DermIS)
Searchable database for dermatological diagnoses.

EPA Dermal Exposure Assessment: Principles and Applications 
Information applicable to water, air and soil exposures.

EPA Exposure Factors Handbook
Provides data on skin surface area and soil adherence to skin.

EPA Health Effects Test Guidelines: Skin Sensitization
Local Lymph Node Assay (LLNA) is a preferred alternative to the Guinea Pig Maximization Test and Buehler Test, where applicable.

EPA Proposed Rule for In Vitro Dermal Absorption Testing
Proposed test procedures for eighty chemicals of interest to OSHA.

EPA Summary Report for the Workshop on Issues Associated with Dermal Exposure and Uptake
Workshop summary addresses generic technical issues related to dermal exposure and risk assessment that were raised during the February 1998 peer review of the Superfund Dermal Guidance (SDG).

European Agency for Safety and Health at Work: Occupational Skin Diseases and Dermal Exposure in the European Union (EU-25)-Policy and Practice Overview
Report summarizing the state of dermal exposures and skin diseases, policies and recommendations within the EU.

HSE-British Health and Safety Executive 
Contains numerous technical and non-technical documents related to dermal contact with hazardous substances and potential control methods

• Skin at Work
• Looking after your hands in the kitchen [PDF - 52 KB]
• Medical aspects of occupational skin disease [PDF - 47 KB]

Human Exposure Research Organizations Exchange (HEROX)
A forum for people interested in research on human exposure to hazardous substances.

Interactive log Kow (KowWin) Demo
This online interactive demo will calculate log P (octanol-water partition coefficient) and retrieve experimental log P data from an experimental database of 13,000 compounds.

International Chemical Safety Cards (ICSCs)
Summarizes essential health and safety information on chemicals for their use at the "shop floor" level by workers and employers. Includes information related to skin as an exposure route and resulting effects. NIOSH makes a version available as U.S. National Cards.

Journal of Investigative Dermatology (JID)
JID publishes papers describing original research on all aspects of cutaneous biology and skin disease.

OSHA Dermal Exposure Site
OSHA Dermal Exposure Site provides links to the following dermal information: application of OSHA standards, recognition, evaluation, prevention and control of dermal hazards, and more.

Skin Cancer Foundation
The foundation was founded in 1979 to educate the public and the medical profession about skin cancer and the need for its prevention, early detection and treatment.