Concepts of skin protection: considerations for the evaluation and terminology of the performance of skin protective equipment.

This article proposes a common language for better understanding processes involved in dermal exposure and skin protection. A conceptual model has been developed that systematically describes the transport of agent mass from sources, eventually resulting in "loading" of the skin surface or the skin contaminant layer. In view of a harmonized glossary of exposure terminology this is considered the exposure surface. Loading is defined as agent mass present in this layer divided by the exposure surface area. Skin protective equipment (SPE) is meant to reduce uptake, that is, an agent crosses the absorption barrier of the skin, by intervening in the processes of loading the exposure surface; however, the design of the equipment may fail to cover skin surface entirely. In addition, part of the mass intercepted by the SPE may reach the skin surface either by permeation, penetration, or by transfer when touching the contaminated exterior of the SPE. Evaluation of SPE performance has earlier focused on chemical resistance performance testing for permeation, penetration, or degradation of SPE-materials. In use-scenario practice, however, all processes will occur concurrently. Thus, SPE field performance evaluation including user-SPE interaction complementary to material testing is warranted. Results of laboratory testing for SPE-materials are reported as substance-specific breakthrough times and permeation rates. SPE field performance should be evaluated for reduction of either uptake or parameters that reflect the outcome of dermal exposure. Ideally, this should be based on the results of intervention-type workplace studies, for (e.g., assessment of exposure loading). The level of reduction can be expressed as a protection factor (ratio without/with SPE) for different parameters of dermal exposure or uptake. It is concluded that for evaluation of SPE-type performance, generic protection factors can be derived for substance-independent processes (e.g., reduction of exposure loading) but not for substance-specific reduction of uptake.