Ann. occup. Hyg., Vol. 48, No. 3, pp. 183-185, 2004
© 2004 British Occupational Hygiene Society
Published by Oxford University Press
Editorial |
Dermal Exposure to Chemicals
TNO Chemistry, Department of Chemical Exposure Assessment, PO Box 360, 3700 AJ Zeist, The Netherlands
Received 1 September 2003; in final form 4 November 2003
If you drove in France on the so-called ‘Route du Soleil’ to the south last summer you might have noticed a sign indicating that there was no reason to drive fast, since the (Mediterranean) sea would not evaporate. This was indeed most unlikely to happen, even with the heatwave in Europe. Occupational dermal exposure to chemicals on the other hand is very likely to occur in many different situations and for all sorts of chemicals. Few people immerse themselves in chemicals as they do in the sea, but, as Mark Boeniger said in his editorial in our December issue, there are many cases of ill health from the sort of skin exposures that occur every day in the workplace (Boeniger, 2003). Boeniger pointed out that there has been slow movement towards standards which take account of skin exposure. What we have not had until recent years is a framework for risk assessment in the workplace, and this has been very difficult to formulate without detailed information on the actual dermal exposure levels in practice. In the December issue we presented progress towards a toolkit for risk assessment (Goede et al., 2003; Marquart et al., 2003; Oppl et al., 2003; Schumacher-Wolz et al., 2003; Warren et al., 2003). In this issue we present information on exposure levels drawn from many industries and some other workplaces in different parts of Europe. The data were obtained and the toolkit was developed under the RISKOFDERM project funded by the European Commission (Van Hemmen et al., 2003).
Exposure to chemicals is an integral aspect of life, through consumption, lifestyle and virtually any other human activity. In the past, even in occupational settings, we were almost only aware of inhalation and oral exposure. This changed dramatically with the introduction of pesticides, since some of them proved toxic by uptake through the skin, leading to several cases of serious morbidity and even mortality in the USA, mainly during harvesting activities of pesticide-treated commodities. Mark Boeniger’s (2003) editorial referred to cases of other chemicals where ill health has been demonstrated, especially for people with skin disorders. In daily life we have become used to medication that acts systemically by application to the skin and this has convinced us that the skin is not just a barrier but also a portal of entrance.
Nevertheless, it took quite a while for many occupational hygienists to take proper account of skin exposure, and this has been discussed in earlier editorials (Fenske and Van Hemmen, 1994; Fenske, 2000). Possible approaches for dermal occupational exposure limits to cope with this have been published (Bos et al., 1998; Brouwer et al., 1998). These limits have not (yet) been accepted for use in workplaces, although the UK has a few biological limit values for potent skin penetrators such as 4,4' methylenedianiline (MDA), to cover dermal exposure and uptake.
In 2002, the US National Institute of Occupational Safety and Health organized a 3 day international conference in Washington, DC on ‘Occupational and Environmental Exposures of Skin to Chemicals: Science and Policy’. The results of this conference are available via a website (www.cdc.gov/niosh/topics/skin). On the basis of this success, the second conference is now being prepared for June 2005 in Stockholm, Sweden, and details of this are available at www.cdc.gov/niosh/topics/skin/OEESC2/index.html. In The Netherlands and the UK, the Dermex course has now been held three times, focusing on the various issues related to occupational skin exposure (www.dermex.org). Information can also be obtained on the HEROX website (www.herox.org).
In Europe, an important part of this developing work has been the Dermal Exposure Network. This was sponsored by the European Commission and brought together many scientists with a clear interest in the interaction between skin and chemicals (Dost, 1995; Van Hemmen, 1997). Benford et al. (1999) described some of the approaches taken by the Network in the Millennium Issue of the Scandinavian Journal of Work Environment and Health. One important outcome was an excellent paper on a conceptual model for dermal exposure (Schneider et al., 1999). A dedicated issue of the Annals of Occupational Hygiene (Vol. 44, No. 7, October 2000) brought together a series of important papers produced by one of the subgroups of the Network with the Fenske (2000) editorial already mentioned. The papers were by Brouwer et al. (2000a,b), Byrne (2000), Cherrie et al. (2000), Fogh and Andersson (2000), Kromhout et al. (2000), Schneider et al. (2000), Soutar et al. (2000) and Vermeulen et al. (2000). The Network gave also impetus to a Ph.D. study still going on in The Netherlands on approaches to estimate and prioritize dermal exposures (Van Wendel de Joode et al., 2003).
The Dermal Exposure Network initiated a large EU funded project (‘RISKOFDERM: Risk Assessment of Occupational Dermal Exposure to Chemicals’, contract no. QLKA4-CT-1999-01107) in which 15 European institutes/organizations from 10 European member states work together with the following major aims:
- to develop a validated/benchmarked predictive model for estimating dermal exposure for use in generic risk assessment for single chemicals;
- to develop a practical dermal exposure risk assessment and management toolkit for use by small and medium sized enterprises (SMEs) and others, in actual workplace situations.
- to develop a practical dermal exposure risk assessment and management toolkit for use by small and medium sized enterprises (SMEs) and others, in actual workplace situations.
To achieve the above-mentioned aims, a research programme comprising four interrelated work parts was formulated.
- 1. Qualitative surveys in European workplaces to obtain an overview of tasks, processes and determinants relevant for dermal exposure.
- 2. Quantitative surveys to obtain detailed data on dermal exposure and determinants in the most relevant tasks and processes.
- 3. Development of a predictive dermal exposure model (set) using all relevant variables.
- 4. Development of a risk assessment and management toolkit from data on hazard, dermal absorption, dermal exposure and effectiveness of control measures for use in workplaces.
- 2. Quantitative surveys to obtain detailed data on dermal exposure and determinants in the most relevant tasks and processes.
The project is in its final year and will indeed produce the anticipated predictive models for dermal exposure assessment and a toolkit for dermal exposure risk assessment and risk management. The final phase of the project will be the implementation of the results in European regulations on notification of chemicals in current frameworks, but possibly also under the proposed REACH framework (European Union, 2001), as well as for workplace risk assessments of chemical compounds. As already mentioned, the preliminary results on part 4, the toolkit, were published in a series of papers in Annals of Occupational Hygiene, Vol. 47, No. 8, with an outline of the project (Van Hemmen et al., 2003). In this current issue, we present a large series of quantitative dermal exposure measurements carried out in work part 2, with an overview paper (Rajan-Sithamparanadarajah et al., this issue) and a statistical analysis of the exposure data (Kromhout et al., this issue).
Fenske (2000) wrote of the 1990s as a decade of real progress in this field. We hope that the results of the RISKOFDERM project will be seen as a further major step in the quantification of dermal exposure and its integration into systematic risk assessment and management.
FOOTNOTES
* Dr Van Hemmen is project coordinator of the RISKOFDERM project. E-mail: vanhemmen{at}chemie.tno.nl 
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