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INDUSTRIAL HYGIENE. Skin. ENTRY INTO BODY. The approximate order of descending effectiveness for Intravenous administration Inhalation route Intraperitoneal Subcutaneous Intramuscular Intradermal Oral Topical. ENTRY INTO BODY.
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INDUSTRIAL HYGIENE Skin
ENTRY INTO BODY • The approximate order of descending effectiveness for • Intravenous administration • Inhalation route • Intraperitoneal • Subcutaneous • Intramuscular • Intradermal • Oral • Topical
ENTRY INTO BODY • Industrial exposure to toxic agents is most frequently a result of • Inhalation • Topical
SKIN • Organ of the body • Surface area is 2 m² and about 2 mm thick
SKIN • 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 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 SKIN 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
CONTACT DERMATITIS FOLLICULITIS AND ACNE PIGMENTARY DISTURBANCE NEOPLASMS, ULCERATION GRANULOMA CHEMICAL X X X X MECHANICAL X PHYSICAL X X BIOLOGICAL X CAUSES OF SKIN DISORDERS
CAUSES OF OCCUPATIONAL SKIN 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 SKIN 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 SKIN 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 SKIN DISEASE • Biological • Bacteria, fungi, viruses, & parasites. • Animal breeders, vets, horticulturists, bakers, tanners, bricklayers, etc. are all possible victims of biological
CAUSES OF OCCUPATIONAL SKIN DISEASE • Predisposing Factors • Age & experience • Skin type • Sweating • Gender • Seasons and humidity • Hereditary allergy • Personal hygiene • Preexisting skin disease
CLASSIFICATION OF OCCUPATIONAL 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 OCCUPATIONAL 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 OCCUPATIONAL 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 OCCUPATIONAL 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 OCCUPATIONAL 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 OCCUPATIONAL 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 OCCUPATIONAL SKIN DISEASE • Diagnosis • Following criteria are used • Appearance of lesion • Sites of involvement • History & course of disease • Ancillary diagnostic tests • Treatment
WORKERS COMPENSATION • Evaluation of occupational dermatoses • Diagnosis • Causation • Impairment evaluation • Conclusions & recommendations • Physical examinations
PREVENTION & CONTROL • Environment • Planning • Process Control • Selection of Materials • Monitoring & Control Technology • Sampling procedures • Good housekeeping • Personal Cleanliness • Prevention of contact • Barrier creams
PREVENTION & CONTROL • Personal Protective Equipment • Protective clothing • Fabrics • Gloves • Safety • Responsibility for Control