Handbook of Occupational Safety and Health, 3rd Edition

CHAPTER 7OCCUPATIONAL DERMATOSES

DAVID E. COHEN

Dermatology Department, NYU Medical Center, 560 First Ave., New York, NY, 10016

7.1 INTRODUCTION

The skin represents the largest organ in the body, encompassing 1.5–2 m² of surface area. In its role as a primary defender against external insult, the skin is particularly vulnerable to damage by physical and chemical assaults in the workplace. Barrier function represents only a fraction of the duties performed by the entire integumentary system, which participates directly in thermal, electrolyte, hormone, and immune regulation without which life is not possible. The metabolic potential of the skin is impressive, and rather than merely repelling chemical or physical assaults, the skin may compensate by metabolizing and biotransforming agents to less harmful ones. Hence, the skin is far from a passive coat of armor but rather an interactive organ that is in constant flux with its environment.

The skin's precarious location has rendered it the most commonly injured organ from chemical agents and physical conditions of the workplace. Pathologic responses of the skin can vary from excessive dryness and mild redness to more generalized exfoliative dermatitides that are life threatening. Neoplasms of the skin may occur as the result of primary skin exposures or through systemic absorption via the skin or other route of entry. Benign or malignant, such events can have catastrophic consequences to the host. Historically, occupational skin ...