Background: Measurements of transepidermal water loss (TEWL) and stratum corneum (SC) pH can help indicate work-related skin barrier damage, but sensitivity to confounding personal and ambient factors limits their potential as biomonitoring tools.
Objectives: To evaluate the difference between hand and forearm skin barrier conditions as a tool for early recognition of workers with occupational contact dermatitis.
Participants and methods: The participants were nursing apprentices (N = 238, median age 19 years) from Zagreb, Croatia. They filled out a questionnaire based on the Nordic Occupational Skin Questionnaire, underwent a clinical examination of skin on the hands, and were evaluated for their TEWL and SC pH on the dorsum of the hand and volar part of the forearm.
Results: We found that the difference between hand and forearm TEWL values (ΔTEWL) greater than 7 g/m2/h, or >50%, or the difference in SC ΔpH >0.50, predicted visible skin changes found on clinical examination. However, only the association with ΔpH >0.50 retained statistical significance when controlled for sex, age, ambient temperature, and relative humidity in a multiple regression model.
Conclusions: The difference between hand and forearm SC pH values is suggested as a reliable biomonitoring tool in recognition of damaged skin barrier conditions in occupational settings.
Keywords: TEWL; age; forearm; gender; hand; nursing apprentices; pH.
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