Fluhr J W, Akengin A, Bornkessel A, Fuchs S, Praessler J, Norgauer J, Grieshaber R, Kleesz P, Elsner P
Skin Physiology Laboratory, Department of Dermatology and Allergology, Friedrich-Schiller-University, Erfurter Str. 35, 07740 Jena, Germany.
Br J Dermatol. 2005 Jul;153(1):125-31. doi: 10.1111/j.1365-2133.2005.06430.x.
The interaction between potential irritants in the workplace might be important because workers are not usually exposed to a single irritant, but to multiple potentially harmful substances. Physical irritant contact dermatitis caused by friction or mechanical abrasion is a common occupational dermatosis. Prolonged water exposure by occlusion is also common in the workplace. Several studies have revealed the negative effect of the common anionic detergent sodium lauryl sulphate (SLS) on permeability barrier function.
To study the additive impairment of permeability barrier function by mechanical irritation combined with 0.5% SLS or prolonged water exposure by occlusion, as models of mild irritation.
The volar forearms of 20 healthy volunteers were exposed to mechanical irritation and occlusion with water or 0.5% SLS for four consecutive days in a combined tandem repeated irritation test (TRIT). Permeability barrier function was measured with a Tewameter TM 210. Irritation was assessed with a Chromameter CR 300 and a visual score.
Barrier disruption in our model was rated as follows: occlusion with SLS and mechanical irritation > occlusion with SLS > occlusion with water and mechanical irritation > mechanical irritation and occlusion with water > occlusion with a glove and mechanical irritation > mechanical irritation > occlusion with water. Barrier disruption caused by occlusion or mechanical irritation was enhanced by the tandem application. The choice of irritant under occlusion, time of occlusion and order of tandem application all affected the degree of barrier disruption. Evaporimetry was able to detect early stages in the development of an irritant reaction before it became visible. Chromametry was not able to detect this early response.
Physical irritants (friction, abrasive grains, occlusion) and detergents such as SLS represent a significant irritation risk and should be minimized, especially when acting together, as shown in our TRIT model.
工作场所中潜在刺激物之间的相互作用可能很重要，因为工人通常并非暴露于单一刺激物，而是多种潜在有害物质。由摩擦或机械磨损引起的物理性刺激性接触性皮炎是一种常见的职业性皮肤病。工作场所中因封闭导致的长时间接触水也很常见。多项研究已揭示常见阴离子洗涤剂月桂醇硫酸酯钠（SLS）对皮肤屏障功能的负面影响。
通过机械刺激联合0.5% SLS或封闭导致的长时间接触水，作为轻度刺激模型，研究对皮肤屏障功能的累加损害。
在联合串联重复刺激试验（TRIT）中，20名健康志愿者的掌侧前臂连续四天接受机械刺激并接触水或0.5% SLS。使用Tewameter TM 210测量皮肤屏障功能。使用色差仪CR 300和视觉评分评估刺激情况。
我们模型中的屏障破坏程度分级如下：SLS封闭与机械刺激＞SLS封闭＞水封闭与机械刺激＞机械刺激与水封闭＞手套封闭与机械刺激＞机械刺激＞水封闭。串联应用会增强由封闭或机械刺激引起的屏障破坏。封闭下刺激物的选择、封闭时间和串联应用顺序均会影响屏障破坏程度。蒸发测定法能够在刺激性反应变得可见之前检测到其早期发展阶段。色差测定法无法检测到这种早期反应。
物理性刺激物（摩擦、磨粒、封闭）和洗涤剂（如SLS）构成显著的刺激风险，应尽量减少，特别是如我们的TRIT模型所示，当它们共同作用时。
