Evidence of increased skin irritation after wet work: impact of water exposure and occlusion

Background. Exposure to humid environments/water and prolonged glove occlusion are both believed to cause irritant contact dermatitis. Objectives. To study the effects of different forms of wet work, especially the differences between water exposure and occlusion, by using an experimental model simulating occupational wet work. Methods. The responses to water exposure and occlusion over multiple daily exposure periods for 7 days were compared in 73 volunteers. After the 1 week exposure, the sites were irritated with sodium lauryl sulfate (SLS). Comparison was performed via visual inspection and bioengineering methods. Results. Whereas occlusion did not induce measurable alterations in skin physiology, water exposure for more than 3 hr daily caused a significant increase in transepidermal water loss (TEWL) as compared with the control areas. SLS irritation of the previously occluded and the water-exposed sites induced higher TEWL and clinical scores in a time-dependent fashion as compared with the control areas, with more pronounced reactions in the water-exposed sites than in the occluded sites. Conclusion. Both previous occlusion and water exposure were capable of inducing higher susceptibility to SLS irritation. Skin hydration by occlusion had a different biological effect than water exposure. Short occlusions seem to harm the skin less than water exposure for the same duration.