Posted By Colin Reeves
There have been a number of threads lately where the use of barrier creams has been strongly discouraged ("they are sold as cosmetics" and other similar comments).

I am a little puzzled as the HSE recommmend the use of barrier creams in several documents, e.g. RR300, RR079, MDHS61, INDG359 and INDG365 to mention but a few.

There seems to be a disparity in views .....

Colin

Posted By MT
You are right to be confused. Recent training events which I have attended regarding occupational dermatitis in the hairdressing industry have reiterated the fact that barrier creams are not effective.

The HSE does indeed contradict itself, as you can see they advise against reliance on barrier creams in their own advice: http://www.hse.gov.uk/pubns/guidance/sr11.pdf

Posted By Chris Packham
One or two statements about so-called barrier or protective creams:

“It is now generally accepted by the medical and legal professions that barrier creams have no protective function on the skin, and recent evidence would suggest that they may indeed facilitate penetration of the skin by irritants. Occasionally, dermatitis has even developed to the barrier cream itself.”
Burrows, D: Industrial Dermatitis Today and its Prevention, in Essentials of Industrial Dermatology, edited by Griffiths, W.A.D. and Wilkinson, D.S., 1985

“Pre-work creams cannot be relied upon for primary protection of the skin as there is no information on the rate of penetration of chemicals through creams. Also, people habitually miss areas of their exposed skin when applying creams and so complete skin cover cannot be guaranteed. It is not always obvious if the barrier has been removed, damaged or thinned. Because of this, pre-work creams should not be regarded as PPE. They cannot give the same level of protection as gloves and should not be used as an alternative to properly selected PPE.”
“Assessing and managing risks at work from skin exposure to chemical agents”, U.K.Health and Safety Executive, 2001, ISBN 0-7176-1826-9

Note that most of the HSE documents mentioned in this thread are older publications. The more modern publications, e.g. the latest one on metalworking fluids discourage the concept that these creams can be used as protection.

At the 2nd World Congress on Work-Related Allergy in Weimar last May two papers were presented on studies showing greater absorption of the test chemical into the skin on barrier cream "protected" skin compared with untreated skin.

Another problem is that there are no validated tests for performance of these creams, so what data you have must be suspect. How do you know whether the cream is protecting adequately. What would your situation be if your employee were to use the cream and then develop dermatitis? How would you claim to have adequately controlled exposure in the absence of any scientifically validated performance data?

Particularly relevant is application. If your worker dons a pair of gloves you know that the skin is properly covered. In one study recently it was found that certain parts of the hands were left uncovered in 84% of all cases. What protection, if any, would the employee be getting.

I have one of our Technical Bulletins reviewing the evidence on these products. We normally charge for these but if anyone contacts me by e-mail I will e-mail them back a copy.

One final point. These creams should never be used underneath gloves. If they are there is a significant potential for allergic contact dermatitis.

Chris

Posted By Chris Packham
Ian

I would never add PPE on top of barrier cream. All these creams contain some form of preservative. For "preservative" read "biocide", i.e. a skin irritant and sensitiser. In the small concentration present they can still occasionally cause problems on unoccluded skin. However, in the hyperhydrated skin that will exist underneath a glove, for example, there is a significantly increased risk of development of irritant and/or allergic contact dermatitis.

Chris