Effect of mineral oil and linoleic-acid-containing emulsions on the skin vapour loss of sodium-lauryl-sulphate-induced irritant skin reactions

This study evaluates the influence of mineral oil and linoleic-acid-containing emulsions on the skin vapour loss (SVL) of detergent-induced irritant skin reactions. During a period of 2 weeks, 2 x 45 min applications of a sodium lauryl sulphate solution of low molarity were performed on the forearm of 9 volunteers. In the same period, a standard amount of each emulsion was applied on the induced irritant skin reactions, 3 times each day. The effect of the emulsions on the barrier function of the skin was evaluated by means of SVL measurements. The emulsion based on mineral greases significantly reduced SVL values during both weeks, possibly because of an occlusive effect. The emulsion with 15% of linoleic acid significantly reduced SVL values during the 1st week but not during the 2nd week. The emulsion with 38% of linoleic acid did not reduce SVL values at all.     

Skin protection in nursing work: promoting the use of gloves and hand alcohol

Nursing has been identified as a wet-work occupation, with a high prevalence of occupational irritant contact dermatitis. Reduction of exposure to skin irritants contributes to the prevention of occupational skin disease in nurses. The role of the use of soap and water, hand alcohol and gloves in prevention programmes is discussed. 2 additional measures for reducing exposure to skin irritants are postulated: use of hand alcohol instead of soap and water in disinfection procedures when the hands are not visibly dirty; use of gloves in wet activities such as patient washing to prevent the hands from becoming wet and visibly dirty. We investigated the effectiveness of these recommendations in a model. Mean daily wet-work exposure during nursing work was modelled: regular model. We also modelled exposure to skin irritants in combination with the implementation of these recommendations: prevention model. The hands of healthy volunteers were exposed to the regular or the prevention model over 3 weeks for 5 days a week. The change in transepidermal water loss (TEWL) on the back of the hands was measured after 3 weeks of exposure to these wet-work simulations. An increase in TEWL occurred with the regular model, while mean TEWL decreased in the prevention model. Skin irritation from occlusion by gloves appeared to be more pronounced in the regular model compared to the prevention model. The results of this study justify the conclusion that in nursing work, hand alcohol is the preferred disinfectant. Although the prevention model implies increased occlusive exposure, this has no additional irritant effect, probably because of the absence of soap exposure.