NIOSH Skin Notation Profiles Focus Attention on Dermal Exposures
A growing collection of NIOSH-authored technical documents about the health effects of chemicals that contact the skin is drawing attention to dermal exposures, which agency scientists describe as an “overlooked” aspect of industrial hygiene. The documents summarize the data NIOSH uses to determine skin notations—terms that offer warnings about the direct, systemic, and sensitizing effects of chemical exposures to the skin. Forty-five of these documents, known as “Skin Notation Profiles,” are currently available as PDFs on the NIOSH website. The agency plans to release dozens more in the next few years. The documents result from a change in strategy for assigning skin notations that NIOSH adopted in 2009. “The former strategy, which just used the word ‘skin’ to represent dermal absorption, really did not capture all the complexity associated with dermal exposures. It did not tell you what the health endpoint was,” explained Scott Dotson, PhD, CIH, a lead health scientist with the agency’s Education and Information Division in Cincinnati. Under the new strategy, Dotson said, “we’re looking at the health effects, and we’ve expanded beyond dermal absorption to include irritation, sensitization, and systemic toxicity.”
“You need to think more along the lines of, ‘Do we need engineering controls? Do we need substitution? Do we need isolation?’ But that is not how industrial hygienists are trained or historically think about dermal exposures.”
“To prioritize chemicals for review under the new strategy, NIOSH first assessed the 160 chemicals that had previously been assigned the dermal absorption notation,” said Naomi Hudson, DrPH, a NIOSH epidemiologist who serves as the project officer for the Skin Notation Profiles. Other chemicals in line for Skin Notation Profiles include those that are important to emergency responders. “Some of the things we take into consideration when we are selecting or prioritizing chemicals include their potential health hazards, the potential for occupational exposure, annual production volume, and if there were any OELs [developed] by other governmental and nongovernmental organizations,” said Hudson, whose responsibilities include drafting the profiles and responding to comments submitted by stakeholders and the public during the agency’s review process. That process also subjects the documents to a peer review conducted by subject matter experts. According to Dotson, one benefit of the Skin Notation Profiles is simply to remind industrial hygienists of the importance of dermal exposures.
“Historically, industrial hygienists have always focused on inhalation exposure,” Dotson said. “If you see a chemical that is a known inhalation toxicant, the automatic response of a good industrial hygienist should be, ‘How do we manage it from a risk management standpoint, how do we apply the hierarchy of controls?’ “Well, because of the way dermal exposures have been treated to date, when you see a chemical that may even be corrosive when it gets on the skin, people’s automatic response is to go to the bottom of the hierarchy of controls and say, ‘What PPE do we need?’ And that’s the wrong way to think about it. You need to think more along the lines of, ‘Do we need engineering controls? Do we need substitution? Do we need isolation?’ But that is not how industrial hygienists are trained or historically think about dermal exposures.” NIOSH Skin Notation Profiles are available on the agency’s website. To learn more about the NIOSH strategy for assigning skin notations, see Current Intelligence Bulletin 61.