Dermatitis and the Jeweler
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 includes
Acetic 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).