Review of methods to determine hand surface area of children less than six years old: a case study.

Various methods exist to determine the surface area of hands. The consistency of these methods is essential given that risk assessments utilize hand surface area (HSA) to quantify exposure to environmental contaminants. HSA is also utilized in the clinical setting to estimate size of burns, and to determine specific treatments and medication dosages. A reliable method of surface area measurement is important to guide these decisions, especially in children who are vulnerable to environmental contaminants and medication side effects. Despite this, fewer HSA-determining studies have been performed for children compared to adults. In this study, 122 children completed hand tracings, and the tracings were digitized using an ImageJ program to determine HSA. Six previously published methods of determining HSA were utilized based on the child's height, weight, and length and width of hand. Children were analyzed by age group including 0-2, 3-4, and 5-6 years. The HSA measurements determined by five of the six methods were statistically different from HSA determined using direct hand tracings/Image J methodology (p < 0.001). The single remaining study that did not differ significantly from the hand tracing method provided a uniform hand to total body surface area (TBSA) ratio for children of all ages. Based on these results, we propose a novel age-group-specific ratio utilizing the HSA results from hand tracings and TBSA calculations. The percentages of TBSA that reflect HSA for children aged 0-2, 3-4 and 5-6 years were 0.91%, 0.90% and 0.87%, respectively. These percentages should be considered for use in risk assessments and the clinical setting to guide treatment and prognosis.

Correction: Ferguson et al. Soil, Hand, and Body Adherence Measures across Four Beach Areas: Potential Influence on Exposure to Oil Spill Chemicals. Int. J. Environ. Res. Public Health 2020, 17, 4196.

In the original publication [...].

Soil-skin adherence measures from hand press trials in a Gulf study of exposures.

Marine oil spills and the resulting environmental contamination is common along coastal areas; however, information is lacking about the safety of impacted beaches for public use, especially for the most vulnerable population: children. One route of exposure for children at oil impacted beaches is through contact with sands. The purpose of this study was to evaluate beach sand skin adherence for children under the age of seven. Each of 122 children participated in a hand press trial conducted at one of four different U.S. beaches (two in Miami, FL, and two in Galveston, TX USA). During the hand press trials, hand conditions of the children were randomized (dry, wet, or with sunscreen), and soil adherence (mass of sand per palmar surface area of the hand) and the maximum pressure applied (force applied per area of hand) was measured and calculated. Each child was instructed to press their hands on a soil laden tray for 5 s and pressure of contact was measured using a scale. Results (n = 98) showed that the average soil adherence for both palmar hands across the four beaches ranged from 0.200 to 234 mg/cm2 with an average of 35.7 mg/cm2, with boys (40.4 mg/cm2) showing slightly higher means than girls (31.7 mg/cm2), but these differences were not significant even after adjusting for age. Among the three conditions evaluated, the highest loading was measured for children with wet hands (mean 65.3 mg/cm2), followed by dry hands (mean 24.5 mg/cm2). Sunscreen hands (mean 23.2 mg/cm2) had the lowest loadings. The pressure of contact ranged from 0.180 to 1.69 psi and varied by age groups and by height and weight, where pressure of contact did not have a significant influence on soil adherence. The average adhered sand grain size and average ambient sand grain size both had a statistically significant impact on hand soil adherence. Overall results from this study can be utilized in exposure and risk assessment models to evaluate the possible health impacts from contaminants found in beach sands.

Soil, Hand, and Body Adherence Measures across Four Beach Areas: Potential Influence on Exposure to Oil Spill Chemicals.

Skin adherence (SA) of soil affects exposure from soil contaminants through dermal routes via loading on the skin and through ingestion routes through hand to mouth activities. The objectives of this study were to evaluate the relationships between adherence versus child-specific and environmental factors. Two sets of soil-to-skin adherence were evaluated. The first was based on loading on hands following hand presses (Hand SA). The second was based on body rinses following one hour of play activities on the beach (Body SA). Results for 98-119 children conducted at four beach sites show that mean Hand SA was 35.7 mg/cm2 (std. dev. 41.8 mg/cm2), while Body SA based on full coverage was 352.3 mg/cm2 (std. dev. 250.4 mg/cm2). Statistically significant differences in Body SA were observed between male (419.2 mg/cm2) and female (300.4 mg/cm2) children (p < 0.05). No significant difference by sex was found for Hand SA. Other statistically different observations were that Hand SA (p < 0.05), but not Body SA, differed across the four beaches (p < 0.05). For Hand SA, this difference was associated soil size variability across the beaches. Hand and Body SA values measured during this study are recommended for use in risk assessments that evaluate beach exposures to oil spill chemicals for young children.