title: Accuracy of a semiquantitative method for Dermal Exposure Assessment (DREAM).
abstract: BACKGROUND
  The authors recently developed a Dermal Exposure Assessment Method (DREAM), an observational semiquantitative method to assess dermal exposures by systematically evaluating exposure determinants using pre-assigned default values.
  
  
  OBJECTIVE
  To explore the accuracy of the DREAM method by comparing its estimates with quantitative dermal exposure measurements in several occupational settings.
  
  
  METHODS
  Occupational hygienists observed workers performing a certain task, whose exposure to chemical agents on skin or clothing was measured quantitatively simultaneously, and filled in the DREAM questionnaire. DREAM estimates were compared with measurement data by estimating Spearman correlation coefficients for each task and for individual observations. In addition, mixed linear regression models were used to study the effect of DREAM estimates on the variability in measured exposures between tasks, between workers, and from day to day.
  
  
  RESULTS
  For skin exposures, spearman correlation coefficients for individual observations ranged from 0.19 to 0.82. DREAM estimates for exposure levels on hands and forearms showed a fixed effect between and within surveys, explaining mainly between-task variance. In general, exposure levels on clothing layer were only predicted in a meaningful way by detailed DREAM estimates, which comprised detailed information on the concentration of the agent in the formulation to which exposure occurred.
  
  
  CONCLUSIONS
  The authors expect that the DREAM method can be successfully applied for semiquantitative dermal exposure assessment in epidemiological and occupational hygiene surveys of groups of workers with considerable contrast in dermal exposure levels (variability between groups >1.0). For surveys with less contrasting exposure levels, quantitative dermal exposure measurements are preferable.
authors.affiliation: Risk Assessment in the Work Environment, TNO Quality of Life and IRAS, Utrecht, Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: van Wendel de Joode
authors.forename: R
authors.initials: R
authors.lastname: Vermeulen
authors.forename: J J
authors.initials: JJ
authors.lastname: van Hemmen
authors.forename: W
authors.initials: W
authors.lastname: Fransman
authors.forename: H
authors.initials: H
authors.lastname: Kromhout
mesh_terms: D003020:Clothing; D004784:Environmental Monitoring / Q000379:methods / Q000592:standards*; D005542:Forearm; D015386:Hazardous Substances / Q000032:analysis*; D006801:Humans; D007866:Leg; D019370:Observation; D015588:Observer Variation; D016273:Occupational Exposure / Q000032:analysis*; D012680:Sensitivity and Specificity; D012867:Skin / Q000737:chemistry*; D011795:Surveys and Questionnaires / Q000592:standards*; D013909:Thorax
chemical_list: D015386:Hazardous Substances