Field Measurements of Inadvertent Ingestion Exposure to Metals.

The determinants of inadvertent occupational ingestion exposure are poorly understood, largely due to a lack of available exposure measurement data. In this study, perioral exposure wipes were used as a surrogate for inadvertent ingestion exposure to measure exposure to eight metals (chromium, nickel, aluminium, cobalt, lead, arsenic, manganese, and tin) among 38 workers at 5 work sites in the UK. This work was done alongside a previously reported observational study of hand/object-to-mouth contact frequency. Systematic wipes of the perioral area, and of both hands were taken with proprietary cellulose wipes pre-moistened with deionized water. Measurements were taken at the beginning, middle and end of the shift. Mixed-effect models of exposure measurements were built with area of skin sampled, time during shift, and job group entered as fixed effects and worker identification as a random effect. Linear regression modelling was used to study the effect of hand/object-to-mouth contact frequency on perioral exposure, adjusting for the measured exposure on the hand and observed respirator use. Hand and perioral exposure measurements were correlated with one another (r = 0.79) but mass per unit area exposure was significantly higher on the perioral area than on the hands for seven of the metals (at P < 0.05). There were no significant differences between measurements taken at the middle or the end of the shift for five of the metals suggesting that dermal loading may remain relatively constant for much of the workday. This applies to both hand and perioral measurements. In linear regression modelling there was no relationship between hand/object-to-mouth contact frequency and perioral exposure, but hand exposure was significantly positively related to perioral exposure and workers who used respirators had significantly higher perioral exposure than those who did not. The results suggest the levels of exposure on the hand and respirator use are important determinants of potential inadvertent ingestion exposure. The results did not demonstrate a relationship between perioral exposure and hand-to-mouth contact frequency. Perioral wipe sampling may be a useful surrogate measure for exposure by the inadvertent ingestion route, but further research is required to confirm the link between perioral levels and actual exposure, measured using biological monitoring.