Relevance of multiparametric skin bioengineering in a prospectively‐followed cohort of junior hairdressers

Abstract

There is conflicting evidence concerning predictors of individual susceptibility to develop irritant contact dermatitis in wet work. A cohort of initially 92 hairdresser apprentices was prospectively followed for 3 years. The association between anamnestic and clinical findings, and multiparametric skin bioengineering data (transepidermal water loss [TEWL], microcirculation, capacitance, pH, sebum, temperature) was investigated. The observation intervals were 3 months in the 1st year of training and 12 months thereafter. Of the 92 apprentices, 6 had already developed hand dermatitis on 1st examination, 20 dropped out or had occupational exposure longer than 7 weeks prior to investigation. Of the remaining 66 participants considered here, 19 (29%) developed moderate or severe dermatitis ("cases"), 32 minimal skin changes, 15 none within the observation period. Average incidence rate of hand dermatitis was 21.1 cases per 100 person years. Atopy score was not associated with the development of dermatitis, nor were the investigated basal bioengineering parameters, including TEWL, in a multivariable model. However, there was a significant increase in TEWL within the 1st year of training in presumptive "cases". The aim to develop an objective and predictive instrumentary for pre-employment counselling in wet work, by a combination of (a) clinical and (b) relevant non-invasive bioengineering parameters, has not yet been accomplished. Skin-provocation tests employing bioengineering seem to be required. Notwithstanding, work-related monitoring of basal biophysical skin-functions may become useful in the secondary prevention of occupational dermatitis.

Duration of wet work in hairdressers

“…Common opinion is that wet work-correlated hand dermatitis and hand eczema is more frequent in trainee hairdressers than in master hairdressers because trainees have to wash (customers) hair more often: in one prospective German study (John et al 2000), contact dermatitis in trainee hairdressers was observed during a 2-year period. The observation intervals were 3 months in the 1st year of training and 12 months thereafter.…”

Individual Susceptibility to Occupational Contact Dermatitis

“…To assess skin barrier function, usually the measuring of transepidermal water loss (TEWL) has been used. Several prospective field studies have investigated whether increased TEWL and hence reduced skin barrier modify the risk for OCD (mainly ICD) 14,[43][44][45] . The majority of these studies didn't find any association between pre-exposure TEWL value and the incidence of CD, not even when different barrier function parameters were combined.…”

“…Several tests based on the response to experimentally induced irritation have been proposed for the identification of susceptible individuals in the work place 43,45,63,89,90) . Traditionally, the response to skin irritants has been assessed by measuring TEWL and erythema, and only recently also the levels of pro-and antiinflammatory cytokines in the skin 47,91) .…”

Impact of wet work on epidermal barrier (TEWL and stratum corneum hydration) and skin viscoelasticity in nurses

“…Jego oceny dokonywano m.in. u uczniów zawodu fryzjera (15,16), piekarza i cukiernika (17), pracowników przemysłu metalowego (18)(19)(20), przetwórstwa rybnego (21), małych zakładów gastronomicznych (22), u zatrudnionych w warunkach niskiej wilgotności powietrza (23), pracowników rafinerii metali nieszlachetnych (24) i działu wysyłkowego drukarni gazet (12). Stosunkowo często badane grupy rekrutowały się ze służby zdrowia, a w ich skład wchodziły uczennice lub studentki szkół pielęgniarskich (15,25), pielęgniarki zatrudnione na sali operacyjnej (26), pielęgniarki geriatyczne (27) czy pracownicy ośrodka neonatologicznego (28).…”

“…Takie badania dotyczyły np. zatrudnionych w warunkach niskiej wilgotności powietrza (20), pracowników przetwórstwa rybnego (21), działu wysyłkowego drukarni gazet (12), rafinerii metali nieszlachetnych (24), małych zakładów gastronomicznych (22), personelu sprzątającego (31) i uczniów zawodu fryzjera (16). W niektórych eksperymentach odnotowano znaczący wpływ warunków pracy na badany parametr.…”