JMIR Publications

ABSTRACT

Background:

Environmental vinyl chloride (VC) exposure may result in serious acute and chronic dermatological conditions. Because existing literature largely focuses on exposures in occupational settings, a gap persists in our understanding of medical consequences from large-scale chemical spills.

Objective:

To examine the potential dermatological manifestations of VC exposure in the context of industrial spills and other environmental disasters and to highlight the public health and justice implications of such releases.

Methods:

Relevant evidence-based, peer-reviewed scientific sources, grey literature, and media reports were identified via searches of search PubMed and Google utilizing pre-determined keyword search terms related to vinyl chloride, VC spills and releases, train derailment, cutaneous disease, public health, and vulnerable and marginalized populations.

Results:

Contact dermatitis and frostbite may arise acutely, highlighting the importance of swift decontamination. Long-term manifestations from chronic VC exposure due to persistence in environmental reservoirs include Raynaud’s disease, sclerodermatous skin changes, acro-osteolysis, and cutaneous malignancies. The clinical severity of cutaneous manifestations is influenced by individual susceptibility as well as duration, intensity, and route of exposure. Additionally, chemical releases of VC more frequently impact communities of color and those of lower socioeconomic status resulting in greater rates of exposure-related disease.

Conclusions:

Dermatologists and public health officials should also aim to better understand the ways in which the disproportionate impacts of hazardous chemical exposures on lower-income and minority populations may exacerbate health disparities. With environmental release events of hazardous chemicals becoming increasingly common and because skin has increased contact with environmental toxins relative to other organs, an urgent need exists for greater understanding of the overall short- and long-term health impacts of large-scale, toxic exposures, underscoring the need for ongoing clinical vigilance. Herein, we describe the health implications of toxic releases with particular consideration paid to marginalized and vulnerable populations. In addition to legal and regulatory frameworks, we advocate for improved public health measures, to not only mitigate the risk of environmental catastrophes in the future, but also ensure timely and effective responses to them.