or visit the NIOSH Web site at www.cdc.gov/niosh.For a monthly update on news at NIOSH, subscribe to NIOSH eNews by visiting www.cdc.gov/niosh/eNews.
DHHS (NIOSH) Publication No. 2009-147
August 2017Appendix E, section E.2, was revised to clarify the data evaluation process. This revision did not change the data evaluation process.iii
ForewordThe National Institute for Occupational Safety and Health (NIOSH) has estimated that workplace skin diseases account for 15%-20% of all reported occupational diseases in the United States, with estimated total annual costs (including lost workdays and lost productivity) up to $1 billion. Skin exposures to chemicals can cause a wide array of injuries and illness including contact dermatitis, immunemediated responses, and irreversible damage to the skin. Despite the relatively high incidence of contact dermatitis and other workplace skin diseases, the impact and risk of skin contact with chemicals and other hazardous agents are not well known, hampering the recognition and prevention of these disorders. Additionally, skin contact represents a significant route of exposure for chemicals that have the potential to be percutaneously absorbed and subsequently cause systemic effects including, but not limited to, acute toxicity, cancers, neurotoxicity, and effects on the reproductive system. NIOSH has long recognized the hazards of skin contact with chemicals in the workplace and the importance of quality research and policies to prevent such exposures. In 1999, NIOSH launched an Interdisciplinary Cross-Sectional Research Program as part of the National Occupational Research Agenda (NORA). This Dermal Exposure Research Program (DERP) was established to promote the identification and control of skin exposures to hazardous agents and conditions in the workplace. The focus of DERP was to expand the current knowledge base through laboratory and field research and to apply scientific decision-making processes for policy development. NIOSH has entered the second decade of NORA and, through its Immunological and Dermal Cross-Sector Program, continues to investigate methods for protecting workers from hazardous skin exposures and for reducing the prevalence of occupational skin diseases.NIOSH skin notations are hazard warnings used worldwide to alert workers and employers to the health risks of skin exposures to chemicals in the workplace. This Current Intelligence Bulletin (CIB) provides the rationale for assigning new NIOSH skin notations. The new system reflects the current state of scientific knowledge and involves critical evaluation of scientific data so that scientists can assign multiple skin notations that distinguish between the systemic, direct, and sensitizing effects of skin exposures to chemicals. This new strategy is a form of hazard identification that advances our understanding of the hazards posed by skin exposures to chemicals. Such improved understanding will enable us to implement better risk management practices and controls for the prevention of workplace skin disea...