Skin Barrier Impairment due to the Occlusive Effect of Firefighter Clothing.

At fire scenes, firefighters are exposed to potentially harmful substances. Besides inhalation of these products, also skin contamination and the risk of dermal absorption is getting more attention. In this perspective, skin barrier impairment due to the occlusive effect of firefighter clothes could enhance the risk of penetration of hazardous substances. The effect of a firefighter jacket and cellophane on the skin was studied in a paired comparison involving 16 volunteers. Biophysical parameters were measured before, immediately after and 30 min after ending the occlusion. Reflectance confocal microscopy was used to study the skin morphology. Immediately after wearing a firefighter jacket, Transepidermal Water Loss values were significantly increased. This is an indication of an occlusive effect of the firefighter jacket. The skin barrier was fully restored after 30 min after occlusion with cellophane or wearing a firefighter jacket.

Exploring the biomechanical load of a sliding on the skin: understanding the acute skin injury mechanism of player-surface interaction.

BACKGROUND: Currently, there is a shortage of biomechanical data regarding acute skin injury mechanisms that are involved in player-surface contact in soccer on artificial turf. It is hypothesized that peak loads on the skin during the landing phase are an important factor in causing an acute skin injury. METHODS: Simultaneously, video analysis and load measurements using an in-ground force plate of the landing phase of a sliding tackle were recorded and correlated with observed clinical skin lesions. RESULTS: Video analysis revealed two sliding techniques: a horizontal jump and a sliding-in technique. The first technique resulted in both significantly higher vertical and horizontal peak forces during impact on the knee (2.3±0.4 kN and 1.4±0.5 kN) and thigh (4.9±0.9 kN and 1.8±0.5 kN). In combination with the observed skin lesion areas, a combined normal-shear stress of at least 24 and 14 N.cm-2 induce abrasion injuries on dry artificial turf. CONCLUSIONS: The findings of this study confirm that high peak stresses during the landing phase of a sliding is critical for inducing skin injuries on the knee and thigh. Reducing these peak shear stresses could be an important first step towards preventive measures.

Psychosensorial assessment of skin damage caused by a sliding on artificial turf: the development and validation of a skin damage area and severity index.

OBJECTIVES: Injury prevention is an important reason for the development of performance standards in football. Currently, there is no objective method available to classify sliding induced skin injuries, which includes the perceived sliding friendliness of football pitches. The purpose of this study was to develop a non-invasive method for quantification of the observed sliding induced skin damage and evaluate whether there is a correlation between the subjective perceived skin irritation and sliding friendliness. STUDY DESIGN: Randomized controlled trial. METHODS: Previously obtained clinical images of sliding induced skin lesions where rated by a dermatologist on the degree of abrasion, erythema and type of exudation. To test the practical feasibility of a proposed Skin Damage and Severity Index (SDASI) to characterize sliding induced skin lesions, a randomized user trial with nine amateur football players was performed. The sliding friendliness of three different grades of infill materials was tested. RESULTS: The Skin Damage and Severity Index correlates both with the perceived skin irritation (r=-0.53, P=0.02) and sliding friendliness (r=-0.58, P=0.01). Statistical analysis of the individual clinical scores showed that perception of skin irritation and sliding friendliness correlate very well with the degree of erythema and abrasion. However, these scores are independent of the size of the lesion and type of exudation. There was no statistical significant difference found between the three evaluated types of infill and their sliding performance. CONCLUSIONS: This study demonstrated that the Skin Damage and Severity Index, which is a tool for quantification of a sliding induced skin lesion, correlates very well with the perceived skin irritation and the sliding friendliness.

Understanding the Acute Skin Injury Mechanism Caused by Player-Surface Contact During Soccer: A Survey and Systematic Review.

BACKGROUND: Superficial skin injuries are considered minor, and their incidence is probably underestimated. Insight into the incidence and mechanism of acute skin injury can be helpful in developing suitable preventive measures and safer playing surfaces for soccer and other field sports. PURPOSE: To gain insight into the incidence and severity of skin injuries related to soccer and to describe the skin injury mechanism due to player-surface contact. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: The prevention model by van Mechelen et al (1992) combined with the injury causation model of Bahr and Krosshaug (2005) were used as a framework for the survey to describe the skin injury incidence and mechanism caused by player-surface contact. RESULTS: The reviewed literature showed that common injury reporting methods are mainly based on time lost from participation or the need for medical attention. Because skin abrasions seldom lead to absence or medical attention, they are often not reported. When reported, the incidence of abrasion/laceration injuries varies from 0.8 to 6.1 injuries per 1000 player-hours. Wound assessment techniques such as the Skin Damage Area and Severity Index can be a valuable tool to obtain a more accurate estimation of the incidence and severity of acute skin injuries. CONCLUSION: The use of protective equipment, a skin lubricant, or wet surface conditions has a positive effect on preventing abrasion-type injuries from artificial turf surfaces. The literature also shows that essential biomechanical information of the sliding event is lacking, such as how energy is transferred to the area of contact. From a clinical and histological perspective, there are strong indications that a sliding-induced skin lesion is caused by mechanical rather than thermal injury to the skin.