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      Methods to assess dermal exposures in occupational settings: a scoping review

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          Abstract

          Objectives

          The dermal exposure route is expected to become increasingly significant relative to total worker exposure as inhalational exposure limits continue to decrease. However, standardization of occupational exposure assessment methods and scientific consensus are needed. This is the first scoping review mapping the literature across all dermal exposure assessment methods and their targeted substances/chemicals in occupational settings.

          Methods

          Eligibility criteria broadly included studies reporting any noninvasive dermal exposure assessment method in an occupational setting. The literature search (Web of Science and MEDLINE) was restricted to peer-reviewed, primary literature published in the last 20 years (2002–2022). Titles/abstracts were dual independently screened. Data charting was performed by a single reviewer using standard template. All stages were pilot tested. The JBI (formerly, the Joanna Briggs Institute) scoping review methods and PRISMA-ScR checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) were used.

          Results

          In total, 493 articles were data charted and categorized by 4 study types: methods development (22%), exposure assessment (51%), health outcomes (21%), and controls assessment (6%). Fourteen types of dermal exposure assessment methods were charted with biomarkers (51%), dosimeters (21%), and qualitative assessments such as questionnaires or surveys (17%) most common. Seventeen different chemicals/substances were charted; pesticides (28%) and polycyclic aromatic hydrocarbons (PAHs) (22%) associated with crude oil products and combustion were most common. Mapping between substances and exposure assessment method categories, pesticide dosimeters (11%), and PAH biomarker studies (14%) were most reported. Literature gaps were identified for cleaning agents, hair dyes, glycol ether, N, N-dimethylformamide/ N-methyl-2-pyrrolidone, dioxins, and bisphenol A.

          Conclusions

          To foster scientific consensus, standardization across study reporting is needed for describing: (i) exposure assessment methods used, (ii) worker tasking/conditions, (iii) targeted substances and substance state, and (iv) targeted exposure routes. Overall, this review categorizes, maps, and defines the scope of literature for occupational dermal exposure assessment methods.

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          Most cited references70

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          PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

          Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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            Updated methodological guidance for the conduct of scoping reviews

            The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR).
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              Potential Health Effects Associated with Dermal Exposure to Occupational Chemicals

              There are a large number of workers in the United States, spanning a variety of occupational industries and sectors, who are potentially exposed to chemicals that can be absorbed through the skin. Occupational skin exposures can result in numerous diseases that can adversely affect an individual’s health and capacity to perform at work. In general, there are three types of chemical–skin interactions of concern: direct skin effects, immune-mediated skin effects, and systemic effects. While hundreds of chemicals (metals, epoxy and acrylic resins, rubber additives, and chemical intermediates) present in virtually every industry have been identified to cause direct and immune-mediated effects such as contact dermatitis or urticaria, less is known about the number and types of chemicals contributing to systemic effects. In an attempt to raise awareness, skin notation assignments communicate the potential for dermal absorption; however, there is a need for standardization among agencies to communicate an accurate description of occupational hazards. Studies have suggested that exposure to complex mixtures, excessive hand washing, use of hand sanitizers, high frequency of wet work, and environmental or other factors may enhance penetration and stimulate other biological responses altering the outcomes of dermal chemical exposure. Understanding the hazards of dermal exposure is essential for the proper implementation of protective measures to ensure worker safety and health.
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                Author and article information

                Contributors
                Journal
                Ann Work Expo Health
                Ann Work Expo Health
                annhyg
                Annals of Work Exposures and Health
                Oxford University Press (UK )
                2398-7308
                2398-7316
                May 2024
                15 March 2024
                15 March 2024
                : 68
                : 4
                : 351-365
                Affiliations
                ExxonMobil Biomedical Sciences, Inc. , 1545 U.S. Highway 22 East, Annandale, NJ, United States
                ExxonMobil Biomedical Sciences, Inc. , 1545 U.S. Highway 22 East, Annandale, NJ, United States
                ExxonMobil Technology & Engineering , 22777 Springwoods Village Parkway, Spring, TX, United States
                ExxonMobil Biomedical Sciences, Inc. , 1545 U.S. Highway 22 East, Annandale, NJ, United States
                ExxonMobil Biomedical Sciences, Inc. , 1545 U.S. Highway 22 East, Annandale, NJ, United States
                ExxonMobil Biomedical Sciences, Inc. , 1545 U.S. Highway 22 East, Annandale, NJ, United States
                ExxonMobil Biomedical Sciences, Inc. , 1545 U.S. Highway 22 East, Annandale, NJ, United States
                Author notes
                Corresponding author: ExxonMobil Biomedical Sciences, Inc., 1545 U.S. Highway 22 East, Annandale, NJ 08801-3059, United States. Email: Jennifer.H.Therkorn@ 123456exxonmobil.com
                Author information
                https://orcid.org/0000-0001-7742-9938
                Article
                wxae015
                10.1093/annweh/wxae015
                11033572
                38466914
                4dd90f56-a621-4970-9ba6-99ad9fd1c526
                © The Author(s) 2024. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 20 October 2023
                : 27 February 2024
                Page count
                Pages: 15
                Funding
                Funded by: ExxonMobil Biomedical Sciences Inc;
                Categories
                Reviews
                AcademicSubjects/MED00640

                exposure,industrial health,methodological study,occupational health,occupational safety,risk assessment,skin,standardization,workers,workplace

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