title: Protection afforded by controlled application of a barrier cream: a study in a workplace setting.
abstract: BACKGROUND
  Skin protective creams (PCs) are used widely in industrial work environments to prevent irritant contact dermatitis. However, workplace studies remain equivocal in terms of their effectiveness, which may be partly owing to whether the PC remains on the skin.
  
  
  OBJECTIVE
  To assess the practicability of using skin occlusion testing in a workplace as a method to determine whether PCs applied under controlled conditions can reduce skin damage against known irritants. This study also compares two methods of skin evaluation: clinical dermatological assessment and bioengineering techniques.
  
  
  METHODS
  Daily occlusion testing for 1 h (over two consecutive weeks) was conducted in an engineering company on the volar forearm of 21 healthy volunteer engineers with sodium lauryl sulfate (SLS) and a PC that was used on site. The engineers conducted their normal work activities during the occlusion testing period. The skin areas tested were assessed using transepidermal water loss (TEWL), Chroma Meter and by visual dermatological scoring.
  
  
  RESULTS
  Testing with PC and SLS together showed that PC does not prevent irritant contact dermatitis but significantly reduced skin damage compared with SLS alone (P < 0.01). The changes in skin were evident earlier with the biophysical measurements when compared with the dermatological assessment.
  
  
  CONCLUSIONS
  Occlusion testing is a useful method for assessing the potential effectiveness of protective creams and can be used in a workplace without affecting work practices. TEWL and the Chroma Meter provide useful objective information and should be used in combination with dermatological examinations.
authors.affiliation: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham, U.K.
authors.forename: S S
authors.initials: SS
authors.lastname: Sadhra
authors.forename: O P
authors.initials: OP
authors.lastname: Kurmi
authors.forename: N I
authors.initials: NI
authors.lastname: Mohammed
authors.forename: I S
authors.initials: IS
authors.lastname: Foulds
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D017453:Dermatitis, Irritant / Q000517:prevention & control*; D009783:Dermatitis, Occupational / Q000517:prevention & control*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004338:Drug Combinations; D004347:Drug Interactions; D004890:Erythema / Q000517:prevention & control; D006801:Humans; D006813:Humidity; D007616:Kaolin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009821:Oils / Q000008:administration & dosage; D010328:Patch Tests; D063465:Skin Cream / Q000008:administration & dosage*; D012967:Sodium Dodecyl Sulfate / Q000008:administration & dosage; D013501:Surface-Active Agents / Q000008:administration & dosage; D013696:Temperature; D014870:Water Loss, Insensible; D014885:Waxes; D017132:Workplace
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D004338:Drug Combinations; D009821:Oils; D013501:Surface-Active Agents; D014885:Waxes; D007616:Kaolin; D012967:Sodium Dodecyl Sulfate