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Dermatitis is a
group of skin conditions that may often be contracted by exposure to chemicals
and metals. These may include scaling, splitting, eczema and so on. Dermatitis
is a real hazard for jewelers. Metal workers suffer high rates of skin disorders
(Tver and Anderson 66). About 65% of all occupational diseases are skin
diseases (Stellman and Daum 54). A toxic reaction to chemicals, a reaction
that results from contact with them, and not from slow sensitization or
allergic reactions, is the most common cause of occupational skin disease
(Goldner 37). Up to 75% of occupational dermatitis is caused like this (haz-map
page 1). However, sensitization is of tremendous importance to those jewelers
who do get dermatitis as a result of repeated contact with chemicals in
the workshop. Occupational dermatitis happens most often to the hands (Goldner
54). Dermatitis is often linked with hereditary allergic tendencies. It
can be made worse by fatigue or stress. Rarely, dermatitis is caused by
a deficiency of B-complex vitamins or protein deficiency (Tver and Anderson
76).
In general, jewelers come in contact with dermatitis-causing chemicals
in "cleansers, acids, alkalis, solvents, abrasives, adhesives and
soldering fluxes" (Goldner 41). Not to mention metals, metal decomposition
products (patinas for instance), plating solutions, polishing compounds
such as rouge, waxes and lots more (Carson and Mumford 228-229). The top
materials for increased risk include chromium and nickel (and their salts),
aniline and other dyes, epoxy resins, acrylate resins, formaldehyde and
its resins, rubber chemicals, certain pharmaceuticals and glutaraldehyde
(the latter are found in molding materials). Chemical agents that cause
occupational eczema and contact dermatitis are: '(1) oxidizers, such as
peroxides and hypochlorites; (2) dehydrating agents, including many acids
and alkalis; (3) protein precipitates, such as heavy metal salts and tannic
acid; (4) keratolytics, including resorcinol and pyrogallo; (5) degreasing
agents, such as alcohol and trichloroethylene, and (6) other organic compounds'
(Tver and Anderson 66). Solvents that can contribute greatly to dermatitis
include all the alcohols, most solvents with chlorine as part of the name,
coal tar products like benzol, naptha, toluene, xylene, ketones like acetone,
benzene, ether, gasoline, stoddard varsol, white spiritis, kerosene and
turpentine (Tver and Anderson 76). Heat, cold and certain electromagnetic
energies can cause skin cell damage (Tver and Anderson 66).
I knew someone once whose dermatitis got so bad that her hands would
begin to crack and bleed whenever she walked into a jewelry studio, and
she had to give her career up, in her fourth year of school. Dermatitis
reactions may often be enough to cause one to change professions. I have
had several bouts with it, luckily controllable and rare so far.
Certain types of people tend to get dermatitis more easily than others
and should therefore take careful precautions to avoid it when working.
Predisposing factors include dry skin, fair skin, aging skin, hairiness
and sweating (Goldner 38).
The most common solvent of all is water, and all by itself it can cause
some people's skin to crack if they dip their hands into it often. Jewelers
tend to dip their hands in water a fair bit and to scrub them with degreasing
mixtures such as soap and ammonia, dish washing liquid and proprietary
products (not to mention those really unacceptable solvents that jewelers
historically have dipped into right and left). Solvents in general are
rather more drastic than water. They can enter your body by inhalation
and skin contact. Cuts make entry easier. And they can enter as well through
hair follicles and sweat gland openings (Spandorfer et al 7). Solvents
tend to damage the body in other ways, as well as by dermatitis.
Many ordinary skin cleansers like soaps and waterless hand cleaners can
raise the pH of skin and dissolve protective surface fats. Some have added
abrasives which can cause additional skin damage. Industrial cleaning
products also tend to contain chemicals other than soaps. Detergents,
surfactants, wetting agents and emulsifiers are all used. These can "denature"
your skin's protein and damage cells as well as just dissolving protective
fats (Goldner 38). Many skin cleansers can cause or foster dermatitis.
Repeated immersion of the hands in hot water containing detergents can
also cause diseases and later infections of the nails (Hogan and Tanglertsampan
389). The most likely detergents to cause skin reactions are the cationics,
the anionics less so and the nonionic detergents being the least likely
to cause dermatitis (Waldron 131).
Jim Zimmerman tells a typical tale, working unsafely, dipping fingers
into solvents, into cutting oils for lapidary, mixing investments with
bare hands and so on. Many of these actions "de-fat" the skin,
which then loses its protection against other chemicals and metals. After
14 years of this, his hands started breaking out in water blisters and
became very painful. His dermatologist pointed out that the hand creams
he prescribed and the working precautions he recommended were "a
way of life and not just a one-time fix-it." Even shampoos, dishwashing
liquid, soaps, glass cleaner, changing oil in the car, paints etc. were
hazards and triggers at this point. Moving to mechanical cleaning methods
(Scotch-Brite?, scrubbing) to reduce chemical (soap-even the mild ones)
exposure helps as well. He writes, "So take a warning new jewelers/metalsmiths
and limit what you do to your hands right now" (Jim Zimmerman, Orchid
list, 4/12/97, "Re: Hand damage").
My own story is that one day I coated my mother's driveway with driveway
sealer. I got some on my right hand (the sealer was a coal tar derivative,
as it turned out very carcinogenic and a sensitizer) and three days later
most of the skin on my hand turned white and fell off in flaky bits. Very
scary. The dermatologist I saw prescribed hand creams, cotton gloves and
minimal contact with metals and chemicals that might aggravate the problem.
He explained that the damage in my case was only to the top layer of skin;
the lower level of cells was not altered permanently (or not much anyway)
although I now have the very occasional small white skin bit that peels.
It is a rare thing, but boy, am I more careful. When the skin cells are
sensitized you can become reactive to other chemicals and metals (including
silver and gold) and so, if your skin is in a reactive state, you must
be extremely careful not to sensitize the cells to other chemicals and
materials you are working with. I recently fought off a dermatitis scaling
on my right index finger-treatments with a petrolatum-based barrier cream
cured it. Who needs to worry about their skin falling off? And cracking
and bleeding when you use your materials of choice? My suggestion: take
good care of skin that might be in contact with chemicals and especially
degreasers, such as are often used in removing polishing compound residues.
Your first choice should be to use tongs as much as possible; next should
be using latex, vinyl or nitrile gloves when immersing your fingers into
a degreasing solution, using the mildest degreasing solution possible,
or using an appropriate barrier cream, refreshed regularly, when bringing
your skin in contact with degreasers. Avoiding a problem is always the
best way of not having to deal with it.
The major cause of dermatitis amongst machinists is that they often use
solvents to degrease their hands. It takes the grease off all right but
leads more quickly to dermatitis (Waldron 132-33). I've seen people use
gasoline as a solvent to take oils off their hands. That should, today,
be a shocking thing to do. Use a barrier cream before working instead,
and use mild soaps (not with pumice for instance). Take especially good
care of small cuts and nicks as they can increase susceptibility to dermatitis
(Challis and Roberts 69).
So these days, I am careful. I find that one of the most difficult things
in life is that one often cannot understand something until one has experienced
it-actually, I hate that part of it. So, do your best to learn from others;
don't reinvent the wheel with your own health and body. It is far easier
than dying or living in illness because you didn't try to protect yourself.
An old saying runs, "the truly smart person learns from their mistakes,
the truly wise one from the mistakes of others." Sometimes I think
I am not among the wise.
I have some sensitivity to copper oxides because when I began we were
not told anything about safety in patination applications, not even glove
use, and I exposed the skin of my neck and forehead to copper patinating
fumes, and developed a rash. I have to be careful now when working with
copper oxides (particularly when mixed with sweat). I use a barrier cream
on my skin before beginning to work and come in contact with copper oxides,
as happens when I am demonstrating fold-forming in copper sheet.
Treat the next paragraph as a reference one, skip it if you like-it is
a bit thick.
A partial list of jewelry studio chemicals
that can cause dermatitis includesAcetic acid, acetone, aluminum salts, ammonia, beryllium compounds, boron
compounds (including borax), carbon tetrachloride, cellosolve, chlorine,
chromic acid, coal tar compounds (like petroleum tar-based pitches), copper
compounds, fluorine compounds (like glass-etching pastes), formaldehyde
(in urethane molding compounds), furfural (in some sand casting mixtures),
gasoline, hydrochloric acid and gas, hydrogen peroxide, selenium compounds
(gun bluing), hydrogen sulfide (liver of sulfur), kerosene, ketones (acetone
etc.), methylene chloride (acrylic glue), naphtha, nickel compounds, nitric
acid, oxalic acid, platinum salts, silver compounds, sodium and potassium
hydroxides, sulfuric acid, thallium compounds (Clerici solution for gemology),
toluene, trichloroethylene, tri-sodium phosphate, turpentine, xylene,
zinc compounds (Stellman and Daum 57-58). The most common types of chemicals
that cause contact dermatitis include chromium salts (plating and stripping
solutions), epoxy resins and catalysts, germicidal agents in hand soaps
(hexachlorophene, bithional, halogenated salicylanilides), aniline dyes,
nickel compounds, and mercury compounds (Stellman and Daum 59).
To rephrase that block of text, here are some main categories of dermatitis-causing
chemicals which are used by jewelers.
Alkalis: soaps, ammonia, lye (sodium hydroxide), potassium hydroxide,
potassium carbonate, ammonium carbonate, cement, sodium silicate, trisodium
phosphate, amines (epoxies). Remember that if your skin feels slippery
and slimy when in contact with an alkali (like ammonia), what you are
really feeling is dissolving skin cells. Abrasive soaps are definitely
not recommended (Goldner 55).
Acids: all acids in the shop can cause dermatitis (and worse, of course).
These might include sulfuric, hydrochloric, phosphoric, nitric, acetic,
and oxalic acids. Salts such as ferric chloride, which releases HCl, and
sodium bisulfate pickle, which releases sulfuric acid, are also potential
causes of dermatitis (Waldron 125).
Oils: cutting and lubricating oils, particularly ones used on machinery,
can cause dermatitis, and in some cases acne. All forms of mineral oil
can. As well, petroleum oils, petroleum pitch, tar, "white spirit"
and paraffin (Kinnersly 135). I have heard jewelers who have done a lot
of polishing talk about getting rashes when exposed to the greases and
abrasives in polishing compounds.
Solvents and degreasers: Almost all solvents can cause dermatitis. Assume
they all can and take suitable precautions. Examples include petroleum
solvents, coal-tar solvents, chlorinated hydrocarbons, esters, ketones,
turpentine, terpenes, carbon bisulfide, alcohols (Waldron 125).
Oxidizing agents: hydrogen peroxide, bleach, potassium chlorate and certain
other salts.
Plants and animals: for jewelers, "plants" means primarily
certain woods and fibers one might come across. An example is African
boxwood (Gonomia kamassi) which as well as causing dermatitis can cause
nasal cancer (Kinnersly 132). Walnuts and many other commonly used woods
can cause skin and other problems. Lists of plant materials that can cause
dermatitis also include such innocuous sounding materials as citrus peel
(note that it is a source for D-limonene and other citrus-based solvent
substitutes), garlic, mustard, barley, corn and buttercup. Sometimes jewelers
work with shells, bones, cuttlebones, leathers and even insects, some
of which can cause skin irritations. Take precautions as necessary (Goldner
39-40). Sometimes organic materials carry bacteria or fungi which can
foster dermatitis or cause other diseases and infections, an example being
anthrax, potentially fatal and carried by wool, hair, bristles, leather
and bones (Kinnersly 171). Pine pitch used for chasing contains colophony,
or pine resin. Colophony and related compounds are considered important
skin sensitizers (Keira et al 1). Pine pitch is, however, in my opinion,
not as dangerous as petroleum-based pitches.
And metals: nickel and its salts are particularly bad. Other metals and
metal salts that cause dermatitis include arsenic (and salts), antimony
(and salts), chromium (and chromate salts), copper sulfates, copper cyanide,
mercury salts, zinc chloride, and rarely, platinum (and salts) (Waldron
125).
Other causes include adhesives, epoxies and other synthetic resins, some
plastics, soot and friction, especially when dust or grit gets between
the skin and clothing (or a ring shank) (Kinnersly 135).
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