ABSTRACT
I. Introduction 53
II. External Factors 53
A. Irritant Exposure 53
1. Physicochemical Characteristics of the Chemical 53 2. Exposure Time 54
3. Simultaneous Exposure Factors 54
B. Allergen Exposure 54
C. Climate 55
III. Internal Factors 55
A. Location 55
B. Constitutional Factors 55
1. Sweating 55
2. Age, Race, and Sex 55
3. “Sensitive” Skin 56
4. Atopy 56
5. Other Skin Diseases 56
6. Previous Contact Sensitivities 57
IV. Conclusions 57
References 57
I. INTRODUCTION
Wet work is a major external risk factor for hand dermatitis. This fact has been verified in several studies.1-4 Water, as such, decreases the protective capacity of the skin and occlusion further increases the irritant effect.5-8 In many wet work occupations, lipid-soluble chemicals are added to water to achieve the cleaning effect. In the skin this effect is unfavorable because intercellular lipids are washed away. Those lipids are an important factor in the cutaneous protective capacity.9-11 There moval of lipids induces structural and physiochemical alterations in the skin.12-16 which apparently facilitates the process of cutaneous irritation. The cascade of cutaneous alterations leading to skin irritation is, however, dependent on many external and internal factors.
