INDUSTRIAL INDUSTRIAL HYGIENEHYGIENE

SkinSkin

ENTRY INTO BODYENTRY INTO BODY The approximate order of descending The approximate order of descending

effectiveness for effectiveness for Intravenous administrationIntravenous administration Inhalation route Inhalation route IntraperitonealIntraperitoneal SubcutaneousSubcutaneous IntramuscularIntramuscular IntradermalIntradermal OralOral TopicalTopical

ENTRY INTO BODYENTRY INTO BODY Industrial exposure to toxic agents is most Industrial exposure to toxic agents is most

frequently a result offrequently a result of Inhalation Inhalation Topical Topical

SKINSKIN

Organ of the body Surface area is 2 m² and about 2 mm thick

SKINSKIN Skin Functions

Body Covering Keep tissue fluids in Keep chemicals out Keep bacteria, fungi, and viruses out

Permit movement of underlying muscles & joint Sensors for touch, pain, and temperature Adornment Vitamin D production Temperature regulation

sweating, blood flow Sun protection

Detoxification/activation of drugs and chemicals

Immunoserveillance Langerhaus cells, t-lymphocytes

ANATOMY OF SKINANATOMY OF SKIN Epidermis

Outer layer contains the stratum corneum The rate limiting step in dermal or percutaneous absorption is

diffusion through the epidermis

Dermis Much thicker than epidermis True skin & is the main natural protection against trauma Contains

Sweat glands Sebaceous glands Blood vessels Hair Nails

Subcutaneous Layer Contains the fatty tissues which cushion & insulate

CAUSES OF OCCUPATIONAL CAUSES OF OCCUPATIONAL SKIN DISORDERSSKIN DISORDERS  Skin disorders account for 23-25% of all

occupational diseases Lacerations & punctures accounts for 82% of all

occupational skin injuries Skin disorders account for 13% (1997) down from

50-70% in 1950s Dermatitis is 2nd most common cause of reported

occupational disease in US.

Underreporting of occupational disease may increase this by 10-50 times

CAUSES OF SKIN DISORDERSCAUSES OF SKIN DISORDERS 

  CONTACTDERMATITIS

FOLLICULITISAND ACNE

PIGMENTARYDISTURBANCE

NEOPLASMS,ULCERATIONGRANULOMA

 

CHEMICAL X X X X

MECHANICAL X      

PHYSICAL     X X

BIOLOGICAL       X 

CAUSES OF OCCUPATIONAL CAUSES OF OCCUPATIONAL SKIN DISEASESKIN DISEASE

Chemical Predominant cause of

dermatoses Primary irritants React on contact

Damage skin because they have innate chemical capacity to do so

Most inorganic and organic acids act as primary irritants

Organic solvents and metallic salts

Keratin solvents Injure the keratin layer-alkalis, organic &

inorganic chemicals

CAUSES OF OCCUPATIONAL CAUSES OF OCCUPATIONAL SKIN DISEASESKIN DISEASE

Chemical Keratin stimulants

Skin undergoes growth patterns that can lead to tumor or cancer formation

petroleum products & PAH

Fats & Oil solvents Remove skin surface lipids

Protein precipitants Heavy metals precipitate protein and denature it

Reducers Keratin layer reduced by acids and urea

Sensitizers Chemicals, plants, biological agents

CAUSES OF OCCUPATIONAL CAUSES OF OCCUPATIONAL SKIN DISEASESKIN DISEASE

Mechanical Friction, punctures, irritation

Physical Heat, cold, radiation

Ionizing radiation sources Alpha radiation stopped by skin

Ingestion Beta radiation can injure skin by contact

Localized at skin surface or outer layers of skin

Gamma radiation and x-rays are skin and systemic hazards

Skin cancer my develop

CAUSES OF OCCUPATIONAL CAUSES OF OCCUPATIONAL SKIN DISEASESKIN DISEASE

Biological Bacteria, fungi, viruses, & parasites.

Animal breeders, vets, horticulturists, bakers, tanners, bricklayers, etc. are all possible victims of biological

CAUSES OF OCCUPATIONAL CAUSES OF OCCUPATIONAL SKIN DISEASESKIN DISEASEPredisposing Factors

Age & experience Skin type Sweating Gender Seasons and humidity Hereditary allergy Personal hygiene Preexisting skin disease

CLASSIFICATION OF CLASSIFICATION OF OCCUPATIONAL SKIN DISEASEOCCUPATIONAL SKIN DISEASE

Contact Dermatitis Most frequent cause

Irritant contact dermatitis Causes damage at site of contact.

Important factors are nature of substance pH, solubility, physical state, concentration, duration of

contact, host & environmental factors Allergic contact dermatitis

A form of cell-mediated, antigen-antibody immune reaction. Irritants affect many whereas sensitizers affect few Rhus, nickel, rubber, chromates, plastics, cobalt,

formaldehyde, epoxy resins, etc. May cause both types of dermatitis

CLASSIFICATION OF CLASSIFICATION OF OCCUPATIONAL SKIN DISEASEOCCUPATIONAL SKIN DISEASE

Contact urticaria/Latex allergy Caused by latex rubber products

It is an immunoglobulin (Ig) E-mediated hypersensitivity to proteins.

Photosensitivity Certain chemicals or organisms are stimulated to

activity by light

Occupational acne Contact with petroleum and its derivatives (cutting oils)

or certain halogenated hydrocarbons (chloracne) Coal tars, creosote, & pitch produce extensive acne

CLASSIFICATION OF CLASSIFICATION OF OCCUPATIONAL SKIN DISEASEOCCUPATIONAL SKIN DISEASE

Pigmentary abnormalities Exposure to chemicals, physical & biological agents

Hyperpigmentation Skin darkening Coal tar, pitch, plant &

drug photosensitizers; ultraviolet light, radiation; certain chemicals such as arsenic

Hypopigmentation Pigment or color loss Physical or chemical

damage to skin from thermal, ultraviolet, radiation or chemical burns

CLASSIFICATION OF CLASSIFICATION OF OCCUPATIONAL SKIN DISEASEOCCUPATIONAL SKIN DISEASE

Sweat-induced reactions Miliaria and intertrigo

Prickly heat or heat rash. Cutaneous tumors

Neoplastic growths can be benign lesions, precancers, or cancers

Ulcerations Caused by trauma, thermal or chemical burns, cutaneous

infections Granulomas

Cause by bacteria (anthrax), viral (herpes simplex), parasitic (protothecosis), botanical (thorns)

CLASSIFICATION OF CLASSIFICATION OF OCCUPATIONAL SKIN DISEASEOCCUPATIONAL SKIN DISEASE

Alopecia Absence of hair

Caused by trauma, cutaneous and systemic disease, drugs, chemicals, ionizing radiation

Nail disease Paronychia

Inflammation of fingernail tissue Nail discoloration from exposure to chemicals; nail dystrophy from

exposure to chemicals Solvents

Systemic intoxication Many materials absorbed through skin can lead to

systemic effects

CLASSIFICATION OF CLASSIFICATION OF OCCUPATIONAL SKIN DISEASEOCCUPATIONAL SKIN DISEASE

Burns Types of burns include explosion, steam, hot-

water, molten metal, hot-solid, flame, and electricity and radiant energy

Classified as: First-degree Second-degree Third-degree

CLASSIFICATION OF CLASSIFICATION OF OCCUPATIONAL SKIN DISEASEOCCUPATIONAL SKIN DISEASE

Diagnosis Following criteria are used

Appearance of lesion Sites of involvement History & course of disease Ancillary diagnostic tests Treatment

WORKERS COMPENSATIONWORKERS COMPENSATIONEvaluation of occupational dermatoses

Diagnosis Causation Impairment evaluation Conclusions & recommendations Physical examinations

PREVENTION & CONTROLPREVENTION & CONTROL

Environment Planning Process Control Selection of Materials

Monitoring & Control Technology Sampling procedures Good housekeeping

Personal Cleanliness Prevention of contact Barrier creams

PREVENTION & CONTROLPREVENTION & CONTROLPersonal Protective Equipment

Protective clothing Fabrics Gloves Safety

Responsibility for Control