Which of the following is a proper guideline for the nursing assistant to follow when there is a fire?

Skin injuries and diseases account for a large proportion of all occupational injuries and diseases. Skin injuries in the healthcare environment include cuts, lacerations, punctures, abrasions, and burns. Skin diseases and conditions of healthcare workers include dermatitis, allergic sensitization, infections such as herpes, and skin cancer. Chemicals can directly irritate the skin or cause allergic sensitization. Physical agents can also damage the skin, and skin that has been chemically or physically damaged is vulnerable to infection.11

The most common and often the most easily preventable of all job-related health problems are skin reactions (dermatitis).11 The skin is the natural defense system of the body: it has a rough, waxy coating, a layer of protein, keratin, and an outer layer of dead cells to help prevent chemicals from penetrating the tissues and being absorbed into the blood.11

Many chemicals cause irritation on contact with the skin, irritant contact dermatitis, by dissolving the protective fats or keratin protein layer, dehydrating the skin, or killing skin cells. Symptoms of this kind of irritation are red, itchy, peeling, dry, or cracking skin. Some chemicals are not irritants under normal conditions, but they will irritate skin that has already been damaged by sunburn, scratching, prolonged soaking, or other means. Tars, oils, and solvents can plug the skin pores and hair follicles, causing blackheads, pimples, and folliculitis (inflammation of hair follicles).11

Some persons become sensitized to chemicals days, months, or even years after their first exposure. This allergic reaction does not occur in every worker who contacts the chemical. Symptoms are red, itchy, and blistering skin, like poison oak or ivy reaction, and maybe much more severe than the direct irritation described in the previous subsection.11

The association between basal and squamous cell carcinomas and ultraviolet radiation has been well established. The association between skin cancer and exposure to other agents is less well documented. Still, ionizing radiation and antineoplastic drugs have been implicated. Other evidence indicates that malignant transformation of cells damaged by chronic allergic contact dermatitis may occur.11

The skin can be damaged by a variety of microorganisms, including bacteria, fungi, viruses, and parasites. Herpes simplex is the most common dermatologic infection among healthcare workers.11

Relatively simple precautions can greatly reduce skin hazards. Effective measures include work practices and engineering controls (procedure steps that prevent exposure) that limit solvent exposure, the use of PPE, the substitution of less irritating chemicals, use of non-powdered gloves, and the institution of good hygiene program.11