Background: There is an emerging perspective that it is not sufficient to just assess skin exposure to physical and chemical stressors in workplaces, but that it is also important to assess the condition, i.e. skin barrier function of the exposed skin at the time of exposure. The workplace environment, representing a non-clinical environment, can be highly variable and difficult to control, thereby presenting unique measurement challenges not typically encountered in clinical settings. Methods: An expert working group convened a workshop as part of the 5th International Conference on Occupational and Environmental Exposure of Skin to Chemicals (OEESC) to develop basic guidelines and best practices (based on existing clinical guidelines, published data, and own experiences) for the in vivo measurement of transepidermal water loss (TEWL) and skin hydration in non-clinical settings with specific reference to the workplace as a worst-case scenario.
Background
The skin provides a permeable barrier which may be impaired in occupational settings. Transepidermal water loss (TEWL), stratum corneum hydration (SCH) and skin surface pH (SSpH) have been used in occupational settings to predict early onset of occupational skin diseases, to measure the effectiveness of prevention strategies for occupational skin diseases, and to assess skin condition during exposure. The aim was to compare the findings, identify shortcomings in the methodology and data reporting and furthermore, to make recommendations for future studies.
Materials and Methods
A literature study was conducted on studies published before December 2018 to provide a review on the measurement of TEWL, SCH and SSpH in occupational settings.
Results
TEWL, SCH and SSpH were previously measured in a wide variety of industries. Results between studies were highly variable, due to different study designs and different anatomical positions measured. Not all of the measurement conditions were reported and variations in study objectives led to data being reported and interpreted differently for most studies.
Conclusion
Incomplete reporting of methodology hinders comparison of bioengineering measurements. No bioengineering method has been proven useful as a predictive tool for occupational skin diseases, however, it is useful in the acute assessment of skin condition. It is recommended that future studies on TEWL, SCH and SSpH adhere to guidelines for occupational settings as far as possible to enable comparison between studies.
During the last few decades, the interest in skin permeation of, specifically, metals has increased with the in vitro method utilizing diffusion cells as the prominent method of investigating permeability. This review provides a systematic synopsis focused on an in vitro diffusion cell method utilizing human skin and examines the differences in experimental design as this could influence the results obtained. The permeation of metals such as chromium, cobalt, copper, gold, lead, mercury, nickel, palladium, platinum, rhodium, silver, titanium, and zinc are discussed. The metals included in this review, except for titanium and zinc, can permeate through intact human skin under physiological conditions. On the basis of flux values, the order of permeability could be summarized as Cu > Pb > Cr > Ni > Co > Pt > Hg > Rh (excluding nanoparticles). Permeability of metals through human skin is highly variable with the different methodologies as a contributing factor. Furthermore, metals are retained in the skin which could lead to reservoir (depot) formation and extended exposure even after the removal thereof from the outer surface of the skin. Finally, recommendations are provided on the standardization of experimental design and format of data reporting to enable the comparison of results from future in vitro metal permeation studies.
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