4.1.3. Exposure routes
Chemical substances may enter the human body in different ways, depending on their properties (e.g.
liquid, gas, etc.) and the way they are used. They may penetrate into the body through the respiratory
system when inhaled, direct contact with eyes or skin, or by accidental ingestion.Dermal exposure:
Hands are the major body part where skin contact with cleaning agents can occur. In addition of
possible irritant or toxic properties, cleaning agents contain substances that can degrease and break
down the natural barriers of the skin. Also, frequent exposure to water (wet work) alters the defense
mechanisms of the skin barrier with the consequence that the skin becomes more “permeable” and
more sensitive to other chemical substances. A damaged natural defense of the skin can lead to the
development of (irritant) contact dermatitis. The systemic intake of substances may also increase where
the skin is damaged. Although gloves protect the skin from wet work and contact with chemical agents,
they may paradoxically lead to skin problems if they do not permit the skin to “breathe”. The use of
disposable natural rubber latex gloves can be a risk factor for latex allergy of the skin [21]. In addition, in
practice, inappropriate gloves are sometimes used, or correct gloves are used but over too long a
period of time without taking in account how long the glove actually offers protection, which becomes a
risk in itself15. According to Directive 89/656/EEC16, protective gloves – as well as any personal
protective equipment (PPE) – should be assessed before its selection and use. Appropriate barrier
creams, together with regular training and awareness rising of workers at risk, have been positively
evaluated as protection measure against dermal risk. Last but not least, proper skin care programmes,
which includes skin protection, skin cleaning and skin care, are also important [35].