Alterations in health examination items and skin symptoms from exposure to ultra-low humidity.

OBJECTIVES: Several lines of evidence have shown that insufficient humidity could result in health problems but no studies have been performed in ultra-low humidity (ULH) environments. The aims of this study are to investigate the health examination items alterations and skin symptoms of workers exposed to ULH environment based on a longitudinal study design. METHODS: Twelve male ULH (RH = 1.5%) workers and 12 age-sex-matched reference workers were selected. The examination items in blood and urine as well as the skin problems were compared between ULH workers and controls, and between ULH workers in 2000 and 2003. Biochemistry analysis of blood and urine were implemented from annual health examinations. Information on skin symptoms and diseases were obtained from a structured questionnaire in 2000 and 2003. RESULTS: The alterations in mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and total cholesterol in blood analysis and only sediment-WBC in urine analysis were found significantly different in 2000. These changes were almost fully recovered in 2003 although a consistently significant elevation in the urine specific gravity was found during the 3-year follow-up period. Skin disorders, however, showed an earlier elevated itching symptom in lower limb and pretibial that developed to physician-diagnosed contact dermatitis. CONCLUSIONS: Long-term ULH exposure could cause progressive pathological changes in the skin and urine concentration elevation. Because low humidity condition occurs frequently in air-conditioned buildings, the findings of this study suggest the population long-term exposed to low humidity should be cautious about health manifestations living in a low humidity environment. While the indoor environment is equipped with an air-conditioner, continuous monitoring on the humidity is recommended.

Using urine specific gravity to evaluate the hydration status of workers working in an ultra-low humidity environment.

In environments with ultra-low humidity, workers may have excessive body water loss due to evaporation through the skin, which can lead to dehydration. Before the development of clinical symptoms and signs, concentrated urine may be applied as an early indicator of dehydration. We used urine specific gravity (USG) as a biomarker to evaluate the hydration status of workers working in such an environment. We collected the urine samples from workers at a lithium battery plant during their annual health examination, and the relative humidity of some working areas called "dry rooms" in the plant was 1.5 +/- 1%. We recruited workers in those dry rooms as the exposure group (N=50) and defined the remaining workers, including administration office workers, as the comparison group (N=122). The prevalence of abnormally concentrated urine (USG>1.030) and related factors were compared between these two groups. While the exposure group were younger and had shorter employment durations compared to the comparison group (p<0.05), they had a higher prevalence of abnormally concentrated urine (p<0.01). After adjusting for age, gender, employment duration, and body surface area, we found that working in the dry rooms was associated with an odds ratio of 11.9 (95% confidence interval: 2.5 to 56.9) of having abnormally concentrated urine. Therefore, USG is a good biomarker for evaluating the hydration status of workers working in ultra-low humidity environments, who need proper protection and adequate fluid supply to prevent excess water loss and its adverse health effects.

Transepidermal water loss and skin capacitance alterations among workers in an ultra-low humidity environment.

No studies have been performed evaluating skin barrier alterations in humans exposed to ultra-low humidity (ULH) in spite of several lines of evidence from animal experiments suggesting that the skin barrier is altered on exposure to ULH. The objectives of this study were to assess barrier function changes in workers occupationally exposed to ULH (relative humidity 1.5%), and to evaluate whether the exposure duration shows a dose-response relationship with transepidermal water loss (TEWL) and skin capacitance. A total of 49 male workers exposed to ULH for 12 h per working day were classified into five subgroups based on their ULH exposure duration (<0.5 months, 0.5-1.0 month, 1.1-10.0 months, 10.1-20.0 months, and >20.0 months). A group of 12 age-matched male laboratory workers from a normal humidity environment were recruited as a control group. TEWL and skin capacitance were measured to evaluate their skin barrier function. TEWL measurements showed a significant decline (8.3+/-0.4 vs 10.0+/-0.4 g m(-2) h(-1), P < 0.05) but no differences were found in skin capacitance (39.7+/-1.3 a.u. vs 45.0+/-2.4 a.u., P = 0.68) between the whole ULH exposure group and the control group. Maximum decreases in TEWL and skin capacitance were seen in the subgroups exposed for <0.5 months and 0.5-1.0 month, respectively. Almost completely natural recovery occurred in skin capacitance after 20 months ULH exposure, in contrast to less than 90% recovery in TEWL. Three stages were defined according to the pattern of alterations in TEWL and skin capacitance in relation to ULH exposure duration. A positive association between TEWL and skin capacitance occurred in the control group and stage I but a negative correlation in stage II. No correlation was found in stage III. Our study demonstrated that workers exposed to a ULH environment could exhibit skin barrier alterations. Both TEWL and skin capacitance decreased within 2 weeks of ULH exposure. The maximum alterations in TEWL and skin capacitance occurred during 0.5-1.0 months and 2 weeks, respectively. TEWL recovered partially and more slowly than skin capacitance which recovered earlier and almost completely.