NIOSH: Be aware of dermal hazards

Skin notations offer summary of risk

The skin is a very effective barrier to hazards such as blood or body fluids. But because some chemicals can penetrate the skin, health care workers need to be aware of the risks and necessary protections, says Scott Dotson, PhD, CIH, an industrial hygienist with the Education and Information Division of the National Institute for Occupational Safety and Health in Cincinnati.

NIOSH is issuing a series of "skin notation profiles" to provide detailed information on serious hazards, including formaldehyde and glutaraldehyde.

"A lot of pesticides can actually get through the skin and contribute to neurotoxicity. There are compounds that can get through the skin and they're so toxic that they can contribute to a life-threatening event," notes Dotson.

Yet the standards and guidelines from the U.S. Occupational Safety and Health Administration focus on the inhalation hazards related to chemicals by setting airborne permissible exposure levels, he says. "Out of about 30 chemicals they've developed standards for, only one is specifically designated as a dermal hazard," says Dotson.

That chemical is 4,4' Methylenedianiline (MDA), which is used in the manufacture of epoxy resin and other industrial substances. Although OSHA still set a PEL for the chemical, the standard calls for medical surveillance related to dermal exposure.

NIOSH's skin notation profiles use a standardized system to denote the potential effects of dermal exposure — systemic, localized or immune-mediated responses. They include a review of the medical literature.

"We hope the manufacturers will start taking these new skin notations into consideration and including them in their dossiers," says Dotson. "To help facilitate that, we've tried to align some of our notations with the Globally Harmonized System."

For example, glutaraldehyde is designated as SK: DIR (COR)-SEN. That means its skin notation (SK) indicates that there can be direct effects from skin exposure, including the potential for the chemical to be corrosive. It also is a sensitizer that can lead to immune-mediated reactions.

So far, NIOSH has published 20 skin notation profiles. Another 150 chemicals are being evaluated. "We're trying to [promote] better risk assessment and better risk communication," Dotson says.

When workers don't understand the hazards of chemicals they're handling, they may not take the proper precautions. That concern was underscored when Dotson recently taught a class in Cincinnati. "The employees were putting gloves on to protect themselves from solvents, and they made the comment that the gloves were dissolving after five minutes," he says. "They were wearing the wrong kind of gloves."

In fact, wearing the wrong gloves could increase the hazard by allowing the chemical to penetrate and then trapping it against the skin, he says. For example, latex gloves are not recommended for exposure to glutaraldehyde, but Butyl, Viton or neoprene gloves are acceptable, he says.

"It's important to know the hazards of your chemical and couple it with the right recommendations," he says.