Skin conditions associated with dermal exposure to oil spill chemicals among Deepwater Horizon disaster response and cleanup workers

Background
Previous studies have associated oil spill response and cleanup (OSRC) work with skin symptoms, but evidence is lacking on the specific exposure agents that contributed to these skin effects.

Objectives
We investigated OSRC-related exposures, including dermal exposure to specific chemical agents, in relation to acute and longer-term skin conditions among the 2010 Deepwater Horizon (DWH) OSRC workers.

Methods
At GuLF Study enrollment, workers reported duration of work, jobs performed, and skin contact with crude oil/tar, dispersants, and decontamination chemicals. Cumulative dermal exposure to polycyclic aromatic hydrocarbons (PAHs) from oil/tar was estimated based on the “GuLF DREAM model”. We used Poisson regression with robust standard errors to evaluate associations of exposures with prevalent skin conditions during spill cleanup and at enrollment (1–3 years later) and incident eczema diagnoses after the start of OSRC work. We examined modification of associations between exposures and prevalent conditions by use of rubber/synthetic gloves.

Results
Duration of OSRC work was positively associated with skin conditions and eczema diagnoses (p-trend<0.01). Workers in operations, response, and decontamination jobs had higher skin condition prevalence (during cleanup: PR range=3.13–4.51; at enrollment: PR range=2.20–2.94) and eczema risk (RR range=1.44–1.89) compared to support workers. After adjusting for co-exposures, we saw associations of skin conditions during cleanup with dermal exposure to oil/tar (PR=3.41, 95 %CI: 3.14, 3.69), decontamination chemicals (PR=1.55, 95 %CI: 1.46, 1.64), dispersants (PR=1.44, 95 %CI: 1.33, 1.57), and PAHs (p-trend<0.01). These associations remained apparent at enrollment. Eczema diagnosis was associated with exposure to oil/tar (RR=1.56, 95 %CI: 1.20, 2.04) and PAHs (Tertile 3 vs. 1: PR=1.33, 95 %CI: 0.86, 2.07). Effect estimates were on average 21 % lower among workers who used rubber/synthetic gloves.

Conclusions
Duration of work, working in non-support jobs, and dermal exposure to oil/tar, dispersants, decontamination chemicals, and PAHs were associated with acute and longer-term skin effects among the DWH OSRC workers.