BOHS EXPOSURE ALERT JANUARY 2017

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1 OEESC2016 John Cherrie Chair, BOHS Skin Working Group The Occupational and Environmental Exposure of Skin Conference has now been held seven times since the first meeting in Washington DC in The conference is of great interest to researchers, regulators and practitioners across a wide range of disciplines involved in dermal exposure, skin uptake and health effects. Conference discussions are always very relevant to occupational hygiene, and BOHS has hosted the conference on two occasions; this year in Manchester ( This meeting has been the culmination of the work of the conference organising committee (Kate Jones, Helen Taylor and Terry McDonald) and the background work done by the ad hoc Skin Working Group set up by the Society. The conference took place over three days, and was attended by 110 people from sixteen different countries. In all there were 58 presentations, including two workshops, a discussion panel and six eminent keynote speakers. Most of the presentations are available to download from There were sessions on measurement of skin exposure, the use of models to assess dermal exposures, risk assessment for dermal hazards, cleaning and workwear, training issues - P a g e 1

2 including what occupational hygienists know about dermal exposure - and several occupational hygiene research studies. The keynote talks covered issues from new developments in our understanding of exposure-related skin disease through to UV exposure and practical aspects of control. In most of the sessions we were treated to the appalling sights of the skin of workers affected by exposure to a range of substances. This alone must have motivated the delegates to assess and control risks to the skin more carefully in the future. Professor Swen Malte John, from Osnabrück University, spoke about the personal and financial burden from contact dermatitis and related skin diseases. He highlighted the plight of hairdressers and healthcare workers who have high incidence of both irritant and allergic contact dermatitis. A study of Danish hairdressers had shown that over a year, about half of those working in this job reported at least one period with dermatitis. The main causes are wet-work and the chemicals they use. The solutions proposed included the use of nitrile gloves to protect against hair dyes containing aromatic diamines, pre- and post-work emollient creams, and the use of alcohol disinfectants in hospitals rather than hand washing. A number of recent studies have demonstrated that early and systematic dermatological intervention as well as interdisciplinary rehabilitation schemes for severe cases of occupational contact dermatitis can save patients health and jobs, and thus avoid individual suffering as well as substantially reduce costs for society. This is certainly a lesson that needs to be transferred to countries other than Germany. New developments in prevention of skin disease also featured in the presentation given by Diane Llewellyn from HSE. She noted that from the scientific evidence it is difficult to distinguish the relative effect of one control measure over another, and it is likely that employers will need to deploy a package of measures. Diane used two industrial activities P a g e 2

3 to illustrate the approaches that can be used: 3D printing and cobots. In particular, she emphasised the need for good information, instruction and training of the workforce to enable reliable control. Chris Packham followed later in the conference outlining some practical aspects of controlling skin exposure, drawn from his extensive professional experience. There were a number of other presentations during the conference that dealt with the practical aspects of dermal exposure control and training of workers to take preventative steps. Professor Thomas Diepgen, from the University Hospital in Heidelberg, spoke about UV exposure and the skin. This is a new topic for the OEESC conference but very relevant to the prevention of occupational skin disease. Occupational and recreational sun exposure is the cause of almost all malignant melanoma and non-melanoma skin cancers, and the incidence rates of these cancers are increasing over time. In Germany, there are around 2.5 to 3million outdoor workers at risk, and since 2015 the Ministry of Work and Social Affairs has recognised Squamous cell carcinoma or multiple actinic keratoses induced by natural UV irradiation as an occupational disease; there were almost 8,000 cases notified in Occupational solar UV exposure was found to be particularly prevalent amongst construction workers and a few other key occupations, and despite there being a clear risk most employers were doing little to protect their workers. Dr Linn Holness from St Michael s Hospital in Toronto also spoke about UV exposure and the role of risk assessment and safety management systems in protecting outdoor workers from sun exposure. Dr Majella Lane from University College London spoke about percutaneous penetration and skin exposure. Her research involves mechanisms of drug absorption, transdermal drug delivery and percutaneous absorption. She gave an interesting insight into the scientific issues involved and how these might relate to occupational and consumer exposure. The P a g e 3

4 final keynote speaker was Dr Fred Frasch from NIOSH. He presented a critique of the current methods used by regulators to estimate dermal uptake of pesticides. He was particularly concerned by moves to use default uptake values proposed by the European Food Standards Agency (EFSA) of 6% of the exposure (mg/day) for liquid concentrates and 30% for spray dilutions. He argued that at the level of exposure commonly encountered in agricultural settings these values were not sufficiently conservative and that the main problem was the unrealistically high loadings used in the in vitro tests of uptake. There were some really interesting presentations dealing with specific occupational exposure issues, for example relating to solvent exposure during cleaning, on dermal exposure to PAHs in Swedish firefighters and various talks about metal exposure including transfer of nanomaterials from surfaces to the hands and then from hands to mouth. The main concern of the researchers was to better understand the possibility of workers inadvertently ingesting nanoparticles. Dr Schinkel from TNO spoke about a study to validate the ECETOC Targeted Risk Assessment (TRA) tool for occupational dermal exposure. He showed that the TRA seems to overestimate low exposures and underestimate high exposures, with exposure being underestimated by the tool in 20% of cases. This is something that those using this tool for regulatory purposes or in their daily practice need to take into account. Overall the conference provided an excellent update of knowledge about dermal exposure, uptake and the consequent effects on the skin. The one disappointment was the relatively small number of professional occupational hygienists from the UK who attended the sessions. This was a great opportunity to learn about the main issues in a practical conference from the key international experts. We know from a survey of BOHS members and others that most hygienists come up against skin exposure issues in their day-to-day practice and most feel that they lack knowledge. The survey showed that the majority of respondents were interested to find out more about the topic. I hope that some of the issues we talked about at the OEESC conference will reappear at the Annual BOHS meetings and at regional meetings. We do need to take the opportunity to learn from the information presented at this event. P a g e 4

5 The next OEESC will be held in San Francisco in If you are interested to find out more about the conference then you should join the LinkedIn group: P a g e 5