Contribution of dermal ethanol absorption during laboratory-controlled high-frequency use of alcohol-based hand rubs followed by glove use
Archives of Toxicology, vol. 100, pp. 3947–3960
Abstract
Abstract The safety of using ethanol-based products for hygienic hand disinfection in healthcare workers is controlled by restricting air levels. This raises the question of whether these workers are sufficiently protected against potential dermal absorption. The study aim was to determine the contribution of the dermal route to the total uptake of ethanol. A laboratory-controlled study of 25 sequential alcohol-based-hand-rubs (ABHRs) with subsequent intermediate glove use was conducted in seven healthcare workers. Two exposure conditions were compared: hands and forearms placed inside a laboratory fume hood preventing inhalation (skin-only condition) and the same procedure but outside the fume hood to allow inhalation (native condition). The hand hygiene product contained 84% ethanol and 1% ethanol-d6 added to verify exogenous origin. Inhalation exposure was measured by personal air sampling. Blood was collected at baseline, during exposure and a post-exposure wash-out period and analysed for ethanol and ethanol-d6 by HS-GC-MS. The contribution of dermal uptake was assessed by comparing the area-under-curve (AUC) of blood ethanol concentrations in the skin-only condition with that in the native condition within each study participant. Inhalation exposure in the breathing zone was (mean ± sd): 5.3 ± 3.6 mg/m 3 in the skin-only condition and 120 ± 7 mg/m 3 in the native condition. The corresponding AUCs for blood ethanol concentrations were 1400 ± 1100 and 3300 ± 2300 (mg/L)*min ( p = 0.014), respectively, indicating a contribution from dermal absorption of 43 ± 28% ( N = 7). For ethanol-d6 these values were 17 ± 4 and 48 ± 17 (mg/L)*min ( p = 0.064), respectively, with a contribution of dermal uptake of 40 ± 16% ( N = 3). In conclusion, high-frequency ABHRs lead to significant dermal absorption of ethanol.
Authors 17
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Paul T.J. Scheepers corresponding
Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands. paul.scheepers@ru.nl
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Radboud University Nijmegen · Radboud University Medical Center
Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
Radboudumc Community for Infectious Diseases, Department of Medical Microbiology, Research Institute for Medical Innovation, Radboud University Medical Center, PO Box 1, 6500 HB, Nijmegen, The Netherlands
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Dermatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZG, Leiden, The Netherlands
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Amsterdam University Medical Center, Amsterdam, The Netherlands
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Affiliation as printed
Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, Laboratoire national de santé, Dudelange, 3555, Luxembourg
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Affiliation as printed
Department Health Protection, Health Directorate, 1445, Strassen, Luxembourg
Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, Laboratoire national de santé, Dudelange, 3555, Luxembourg
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Affiliation as printed
Radboud Institute for Biological and Environmental Sciences, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center
Affiliation as printed
Department of Pharmacy, Pharmacology and Toxicology, Research Institute for Medical Innovation, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
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Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Amsterdam University Medical Center, Amsterdam, The Netherlands
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