Techniques for Estimating the Percutaneous Absorption of Chemicals Due to Occupational and Environmental Exposure

Estimating retrospective exposure of household humidifier disinfectants

We conducted a comprehensive humidifier disinfectant exposure characterization for 374 subjects with lung disease who presumed their disease was related to humidifier disinfectant use (patient group) and for 303 of their family members (family group) for an ongoing epidemiological study. We visited the homes of the registered patients to investigate disinfectant use characteristics. Probability of exposure to disinfectants was determined from the questionnaire and supporting evidence from photographs demonstrating the use of humidifier disinfectant, disinfectant purchase receipts, any residual disinfectant, and the consistency of their statements. Exposure duration was estimated as cumulative disinfectant use hours from the questionnaire. Airborne disinfectant exposure intensity (μg/m(3)) was estimated based on the disinfectant volume (ml) and frequency added to the humidifier per day, disinfectant bulk level (μg/ml), the volume of the room (m(3)) with humidifier disinfectant, and the degree of ventilation. Overall, the distribution patterns of the intensity, duration, and cumulative exposure to humidifier disinfectants for the patient group were higher than those of the family group, especially for pregnant women and patients ≤6 years old. Further study is underway to evaluate the association between the disinfectant exposures estimated here with clinically diagnosed lung disease.

PRACTICAL IMPLICATIONS

Retrospective exposure to household humidifier disinfectant as estimated here can be used to evaluate associations with clinically diagnosed lung disease due to the use of humidifier disinfectant in Korea. The framework, with modifications to account for dispersion and use patterns, can also be potentially adapted to assessment of other household chemical exposures.

Chlorine and hydrogen cyanide gas interactions with human skin: in vitro studies to inform skin permeation and decontamination in HAZMAT incidents

Accidental or intentional toxic gas releases may result in significant public health and psychological consequences. Management of exposed individuals during HAZMAT incidents should be risk-based and supported by a suitable scientific evidence base. There appear to be large evidence gaps in relation to dermal absorption of gases, as well as management advice for potentially exposed individuals. Chlorine and hydrogen cyanide are two common HAZMAT gases and this paper addresses the need for experimental data tailored to HAZMAT scenarios and first responders. In addition to time variations of gas concentration, the modifying effects of clothing, temperature, and oil-based sunscreen on epidermal absorption and penetration are assessed. Results for chlorine show little penetration up to 500 ppm but with small enhancing effects due to heavy cotton and oil-based sunscreen. Hydrogen cyanide up to 800 ppm shows minor penetration consistent with previous studies, with little variability in the presence of sunscreen and clothing. Practical guidelines to support the decision-making of emergency responders with regard to personal decontamination have been derived.

Application of skin contamination studies of ammonia gas for management of hazardous material incidents

In an atmospheric HAZMAT release unprotected public dermal exposure is often of short duration, but with potential secondary exposure if not decontaminated promptly. Mass decontamination is resource intensive and needs to be justified. For many HAZMAT agents there is no evidence-base on which to provide guidance on decontamination, particularly for non-symptomatic worried well. It is important to understand the influence of street clothing and environmental and other factors. Ammonia is a common HAZMAT agent and was selected for in vitro human skin studies of absorption, penetration and off-gassing at test concentrations up to 2000 ppm, incorporating primary and secondary exposure combinations up to 60 min. Intact skin provided a good barrier to ammonia penetration. Heavy street clothing such as denim was found to act as an initial barrier to skin absorption but subsequently as a reservoir for secondary exposure, under variable temperature and humidity conditions. Rapid off-gassing was observed for lighter fabrics including polyester and cotton. The findings here have been summarized as a set of practical guidelines for emergency responders who are required to make decisions about ammonia decontamination including for non-symptomatic individuals. This evidence-based diagrammatic approach allows for specific actions based on different atmospheric ammonia concentrations and other parameters.

Dermal absorption of benzene in occupational settings: estimating flux and applications for risk assessment

There is growing emphasis in the United States and Europe regarding the quantification of dermal exposures to chemical mixtures and other substances. In this paper, we determine the dermal flux of benzene in neat form, in organic solvents, and in aqueous solutions based on a critical review and analysis of the published literature, and discuss appropriate applications for using benzene dermal absorption data in occupational risk assessment. As part of this effort, we synthesize and analyze data for 77 experimental results taken from 16 studies of benzene skin absorption. We also assess the chemical activity of benzene in simple hydrocarbon solvent mixtures using a thermodynamic modeling software tool. Based on the collective human in vivo, human in vitro, and animal in vitro data sets, we find that the steady-state dermal flux for neat benzene (and benzene-saturated aqueous solutions) ranges from 0.2 to 0.4 mg/(cm²·h). Observed outlier values for some of the animal in vivo data sets are possibly due to the use of test species that have more permeable skin than humans or study conditions that resulted in damage to the skin barrier. Because relatively few dermal absorption studies have been conducted on benzene-containing organic solvents, and available test results may be influenced by study design or vehicle effects, it is not possible to use these data to quantify the dermal flux of benzene for other types of solvent mixtures. However, depending on the application, we describe several potential approaches that can be used to derive a rough approximation of the steady-state benzene dermal flux for these mixtures. Important limitations with respect to quantifying and evaluating the significance of dermal exposures to benzene in occupational settings include a lack of data on (1) factors that affect the dermal uptake of benzene, (2) the dermal flux of benzene for different organic solvent mixtures, (3) meaningful metrics for evaluating the dermal uptake of benzene, (4) steady-state versus non-steady-state dermal flux values for benzene, (5) the effect of skin damage on the dermal flux of benzene, (6) standardized test methods for estimating the dermal flux of benzene, and (7) robust estimates of the evaporation rate of benzene from different liquid vehicles.

Percutaneous absorption of aromatic amines - a contribution for human health risk assessment

Several aromatic amines (AA) are human carcinogens. AA are widely-used, e.g., in the rubber industry. The uptake of AA at the workplace occurs by inhalation and percutaneous absorption. At present there are no risk assessment studies for percutaneous AA absorption using occupationally relevant concentrations. We conducted diffusion cell experiments for aniline (ANI), o-toluidine (OT), 4,4'-methylenedianiline (MDA) and N-phenyl-2-naphthylamine (PBNA). Excised human skin was exposed to different AA concentrations in vehicles containing water and solvents. Recovery for ANI in receptor fluid was about 20-38% and for MDA 15% over 24h. PBNA could not be detected in the receptor fluid. Further data for OT and beta-naphthylamine (BNA) were considered from our recent study. A semi-quantitative percutaneous absorption ranking for AA was derived: BNA>OT>ANI>MDA>PBNA. For aqueous ANI solutions up to saturation a linear relationship of exposed dose and penetrated amount was observed. However, a linear extrapolation of the flux of neat compounds, as often recommended for risk assessment policies, underestimates considerably the percutaneous uptake. The in vitro data support our recent findings in rubber industry workers that the percutaneous absorption may significantly contribute to overall exposure of AA.

Historical estimation of exposure to 1,3-butadiene, styrene, and dimethyldithiocarbamate among synthetic rubber workers

Quantitative estimates of exposure to 1,3-butadiene (BD), styrene (STY), and dimethyldithiocarbamate (DMDTC) were developed for a follow-up study of workers at six North American synthetic rubber plants. Procedures entailed identifying tasks and jobs involving exposure, identifying factors influencing historical changes in exposure potential, and using mathematical models to calculate job- and time-period-specific exposures. Exposure metrics included 8-hour time-weighted average (TWA) intensity, the annual number of peak exposures (BD: >100 ppm, STY: >50 ppm) and TWA intensity below and above the peak threshold. The 5th and 95th percentiles of the approximate probability distribution of each exposure estimate served as its 90% uncertainty interval. Job- and year-specific estimates were linked with subjects' work histories to obtain cumulative exposure indices. Exposure estimates varied among tasks, jobs, plants, and time periods. BD TWAs were approximately 10 ppm during the 1940s-1960s and declined during the 1970s and 1980s. STY TWAs were always <2 ppm. DMDTC exposure began in the 1950s, was high through the 1960s, and later declined. BD peak exposure accounted for a large proportion of cumulative BD exposure, whereas almost none of the STY exposure was experienced at levels >50 ppm. Exposure indices were correlated. Exposures were higher than previously estimated. Multiple correlations among DMDTC, BD, and STY exposure estimates make it difficult to estimate agent-specific effects. Limitations of the methodology include the potential inaccuracy of the estimates, the lack of adequate industrial hygiene data to validate the estimates, the additional inaccuracy of linkage with poorly specified job groups, and the potential for differential exposure misclassification because the jobs and work areas where excess leukemia mortality occurred were well-known at the time of this study. Nevertheless, the new exposure estimates were highly correlated with the old, yielding equivalent exposure ranking of workers and were comparable to limited industrial hygiene data published by NIOSH.

Estimation of the health risks associated with polychlorinated biphenyl (PCB) concentrations found onboard older U.S. Navy vessels

PCBs have been identified on surfaces and in component materials and equipment from inactive U.S. Navy nuclear submarines commissioned prior to 1970. Health risks associated with PCBs present onboard submarines were estimated for hypothetical crew members and shipyard workers. Median non-cancer hazard quotients for shipyard workers and submarine crew ranged between 0.4-54.6, with the highest quotients estimated for unprotected shipyard workers. Median cancer risk estimates ranged from 7.3 x 10(-6) to 1.1 x 10(-3) with the highest estimated risk calculated for unprotected shipyard workers. Our findings suggest that PCB surface concentrations found onboard inactive nuclear submarines commissioned prior to 1970 may be high enough to constitute a possible risk to the health of persons involved in dismantling of Navy submarines if PCB exposure is not minimized. Potential sources of uncertainty in our risk assessment include the correlation between PCB contamination levels on inactive versus active nuclear submarine vessels, the relationship between wipe sample concentrations and human exposure, dermal contact frequency with PCB-contaminated surfaces, carcinogenicity of PCBs in humans, and uncertainties inherent with the PCB cancer slope factor and oral RfD. Our findings support Navy policy that shipyard workers should wear personal protective equipment when PCB contamination is suspected or has been identified and that IH surveys should continue to identify sources of PCB contamination onboard vessels and reduce PCB contamination to concentrations that are reasonably achievable.

Assessment of dermal absorption and penetration of components of a fuel mixture (JP-8)

Occupational and environmental multi-chemical exposures are extremely common. Methods for assessment of the risks from dermal exposures to complex mixtures vary depending on the information available. The composition of a volatile mixture (such as JP-8 jet fuel) can change radically, depending on the phase of the mixture - vapor, liquid or aerosol. Assessing the absorption (into the skin) and penetration (through the skin) of components of the mixture can reduce uncertainty in the risk assessment process. Permeability coefficients of the 12 individual components that could be detected to penetrate the skin could be used to assess the toxicity of each individual component in the JP-8. The penetration of each of these components is related to and can be predicted from molecular weight and octanol water partition coefficients of that component. The composition of the components that penetrate the skin would be different from the composition of JP-8 because the permeability of the components differs by two orders of magnitude. Concentrations of the aliphatic chemicals found in the skin correlated well with carbon number. The JP-8 jet fuel is used as an example of how component data on absorption and penetration can be integrated into an assessment (McDougal et al., Toxicol Sci 2000; 55: 247-255). The component approach shows promise for estimating systemic toxicity of mixtures. Local toxicity (irritation, sensitization, etc.) may be better understood in the future when quantitative information becomes available about the duration and magnitude of chemical exposures required to cause local effects.

Proposal for the assessment of quantitative dermal exposure limits in occupational environments: Part 1. Development of a concept to derive a quantitative dermal occupational exposure limit

Dermal uptake of chemicals at the workplace may contribute considerably to the total internal exposure and so needs to be regulated. At present only qualitative warning signs--the "skin notations"--are available as instruments. An attempt was made to develop a quantitative dermal occupational exposure limit (DOEL) complementary to respiratory occupational exposure limits (OELs). The DOEL refers to the total dose deposited on the skin during a working shift. Based on available data and experience a theoretical procedure for the assessment of a DOEL was developed. A DOEL was derived for cyclophosphamide and 4,4-methylene dianiline (MDA) according to this procedure. The DOEL for MDA was tested for applicability in an actual occupational exposure scenario. An integrated approach is recommended for situations in which both dermal and respiratory exposures contribute considerably to the internal exposure of the worker. The starting point should be an internal health based occupational exposure limit--that is, the maximum dose to be absorbed without leading to adverse systemic effects. The proposed assessment of an external DOEL is then either based on absorption rate or absorption percentage. The estimation of skin penetration seems to be of crucial importance in this concept. If for a specific substance a maximal absorption rate can be estimated a maximal skin surface area to be exposed can be assessed which may then serve the purpose of a DOEL. As long as the actual skin surface exposed is smaller than this maximal skin surface area the internal OEL will not be exceeded, and therefore, no systemic health problems would be expected, independent of the dermal dose/unit area. If not, the DOEL may be interpreted as the product of dermal dose/unit area (mg/cm2) and exposed skin surface area (cm2). The proposed concept for a DOEL is relevant and can be made applicable for health surveillance in the occupational situation where dermal exposure contributes notably to the systemic exposure. Further research should show whether this concept is more generally applicable.

Evaluating the coherence between environmental quality objectives and the acceptable or tolerable daily intake

Environmental quality objectives (EQOs) for surface water, soil, air, drinking water, and food products are often derived independently. This may result in incoherent EQOs. A set of EQOs is called incoherent if simultaneous exposure to all media which are polluted up to their EQO results in the acceptable or tolerable daily intake (ADI or TDI) being exceeded. This paper outlines an integrated human exposure and uptake model (NORMTOX) which was developed to test the coherence of EQOs. NORMTOX predicts lifetime-averaged daily uptake levels of contaminants and compares these with acceptable or tolerable daily uptake levels. The model deals with variability and uncertainty in put data by using the Monte Carlo simulation technique. The model was applied to test the coherence of Dutch EQOs for benzene, lead, and lindane. The EQOs of these substances turned out to be coherent with probabilities of 100, 23, and 0%, respectively. The variance in the coherence indicators results from interpersonal variability in exposure, consumption, and uptake patterns and from uncertainty in input data due to a lack of knowledge. To prevent incoherent EQOs in the future, induction of a procedure for coherence testing and EQO adjustment is suggested.

Estimating skin permeation. The validation of five mathematical skin permeation models

This study provides an analysis of the reliability of five mathematical models, simulating permeation of substances through the skin from aqueous solutions. An extensive database was generated, containing data on 123 measured permeation coefficients of 99 different chemicals and their physicochemical properties. In addition, in this database all relevant experimental conditions are included. The coefficients of the different skin permeation models were estimated by non-linear multiple regression, using the octanol-water partition coefficient and the molecular weight as independent parameters. The reliability of the models was evaluated by testing variation of regression coefficients and of residual variance for subsets of data, randomly selected from the complete database. Three models were considered to provide reliable estimations of the skin permeation coefficient. These are based on the McKone and Howd model, the Guy and Potts model and the Robinson model. The last-mentioned two models were adaptations, because MW0.5 as independent parameter provided a better fit than MW (MW = molecular weight) in the original models. The McKone and Howd model and the Robinson model have the advantage, that they predict more precisely the skin permeation of highly hydrophilic and highly lipophilic chemicals compared to the Guy and Potts model. The revised Robinson model resulted always in the smallest residual variance.

A study of chromium induced allergic contact dermatitis with 54 volunteers: implications for environmental risk assessment

Over the past 60 years, dose-response patch test studies by various methods have been conducted in an attempt to identify the minimum elicitation threshold (MET) concentration of hexavalent chromium (Cr(VI)) that produces an allergic response in Cr(VI) sensitive subjects. These data are not adequate, however, to provide an accurate estimate of the MET because of the variability in the patch testing techniques and the variability in diagnostic criteria used. Furthermore, the data were not reported in terms of mass of allergen per surface area of skin (mg Cr/cm2-skin), which is necessary for conducting occupational or environmental health risk assessments. Thus the purpose of this study was to determine the MET (mg allergen/cm2) for Cr(VI) and trivalent chromium (Cr(III)) by patch testing techniques. A patch test method that delivers a controlled amount of allergen per surface area of skin was used. A group of 54 Cr(VI) sensitised volunteers were patch tested with serial dilutions of Cr(VI) and Cr(III) to determine the cumulative response rate at several concentrations. The results indicate that the 10% MET for Cr(VI) based on the cumulative response was 0.089 micrograms Cr(VI)/cm2-skin. Only one of the 54 volunteers may have responded to 33 micrograms Cr(III)/cm2-skin, otherwise Cr(III) was unable to produce allergic contact dermatitis in these highly sensitive volunteers. Two supplemental studies were also conducted to assess whether the surface area of the patch and the concentration of Cr(VI) in the patch (related to patch thickness) were likely to influence the results. The data from these studies were used to assess the risk of developing allergic contact dermatitis due to contact with Cr(VI) and Cr(III) in soil. The findings indicated that soil concentrations at least as high as 450 ppm Cr(VI) and 165,000 ppm Cr(III) should not pose an allergic contact dermatitis hazard for at least 99.99% of the people in the community who might be exposed.