Investigation of Dermal Contact with Soil in Controlled Trials

A systematic characterization of soil/dust ingestion for typical subpopulations in China

An accurate assessment of human exposure to pollutants through the ingestion of dust and/or soil particles depends on a thorough understanding their rate of human ingestion. To this end, we investigated the load and size distribution patterns of dust/soil particles on the hands of three typical subpopulations, including preschoolers, college students, and security guards (outdoor workers). The geometric mean diameter of dust/soil particles on hands was observed to be 38.7 ± 11.2, 40.0 ± 12.1, and 36.8 ± 10.4 μm for preschoolers, college students, and security guards, respectively. The particle size distribution differed between subpopulations: Preschoolers were more exposed to fine particles, whereas security guards were exposed to more coarse particles. The geometric means of dust/soil particle loading on the hands were 0.126, 0.0163, and 0.0377 mg/cm2 for preschoolers, college students, and security guards, respectively. Males had statistically higher dust/soil particle loadings on hands than females, notably for preschoolers and college students; preschoolers with frequent hand contact with the bare ground had higher dust/soil particle loadings compared to those of peers in contact with commercial and residential grounds. The mean total dust/soil particle ingestion rate was estimated to be 245, 19.7, and 33.1 mg/day for preschoolers, college students, and security guards, respectively. Our estimates for college students and security guards are close to the consensus central-tendency values recommended by the U.S. EPA's Exposure Factor Handbook for American adults, whereas the estimates for children are much higher than the upper percentile values recommended for American children.

Is hand-to-mouth contact the main pathway of children's soil and dust intake?

Children (n = 240) between the ages of 2 and 17 years were randomly selected from three cities in China. The total amount of soil and dust (SD) on their hands was measured and ranged from 3.50-187.39 mg (median = 19.49 mg). We screened for seven elements (Ce, V, Y, Al, Ba, Sc, and Mn), and Ce levels were used to calculate hand SD by variability and soil elements. The main factors affecting SD amount were location and age group, as identified using a conditional inference tree. Hand SD and the hand SD intake rate were highest in Gansu Province, followed by Guangdong and Hubei provinces, respectively. Hand SD and the hand SD intake rate were highest among children in primary school, followed by kindergarten and secondary school, respectively. The hand SD intake rate of the three typical areas was 11.9 mg/d, which was about 26.6% of the children's soil intake rate (44.8 mg/d), indicating that hand-to-mouth contact is not the main route for children's soil intake in the three areas of China.

Particle transfer and adherence to human skin compared with cotton glove and pre-moistened polyvinyl alcohol exposure sampling substrates

Measurement of skin exposure to particles using interception (e.g., cotton gloves) and removal (e.g., wiping) sampling techniques could be inaccurate because these substrates do not have the same topography and adhesion characteristics as skin. The objective of this study was to compare particle transfer and adherence to cotton gloves, cotton gloves with artificial sebum, and a pre-moistened polyvinyl alcohol (PVA) material with bare human skin (fingertip, palm). Experiments were performed with aluminum oxide powder under standardized conditions for three types of surfaces touched, applied loads, contact times, and powder mass levels. In the final mixed model, the fixed effects of substrate, surface type, applied load, and powder mass and their significant two-way interaction terms explained 71% (transfer) and 74% (adherence) of the observed total variance in measurements. For particle mass transfer, compared with bare skin, bias was -77% (cotton glove with sebum) to +197% (PVA material) and for adherence bias ranged from -40% (cotton glove) to +428% (PVA material), which indicated under- and over-sampling by these substrates, respectively. Dermal exposure assessment would benefit from sampling substrates that better reflect human skin characteristics and more accurately estimate exposures. Mischaracterization of dermal exposure has important implications for exposure and risk assessment.

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.

Determination of hand soil loading, soil transfer, and particle size variations after hand-pressing and hand-mouthing activities

Hand-pressing trials and hand-to-mouth soil transfer experiments were conducted to better understand soil loadings, soil transfer ratios for three mouthing activities, and variations in particle size distributions under various conditions. Results indicated that sand caused higher soil loadings on the hand than clay. When the moisture level of clay soil exceeded its liquid limit, soil loadings also increased. Greater pressing pressures also led to larger clay loadings. Clay with a moisture content close to its plastic limit caused the smallest soil loadings due to strong soil cohesion. Particle sizes of the transferred clay were larger than that of the original clay, indicating that hand-pressing and the pressure exerted may have enhanced clay particles of larger sizes adhering onto the hand. Nevertheless, the sizes of most particles that adhered to the hand were still smaller than 150 μm. Higher pressing pressures and greater moisture contents resulted in larger soil loadings on the hand, and transfer ratios became smaller. Transfer ratios from palm-licking with clay particles were smaller than those from finger-mouthing, which may have been due to finer particles that more readily adhered to the skin of the palm and that were transferred from the hand to the mouth with greater difficulty.

Estimation of the daily soil/dust (SD) ingestion rate of children from Gansu Province, China via hand-to-mouth contact using tracer elements

A total of 60 children (31 males and 29 females) between the ages of 3 and 12 years were randomly selected from Lanzhou City in Gansu Province, northwest China. Hand (soil/dust) SD samples from these children were collected using hand wipes. We determined the approximate amounts of hand SD and the concentrations of three tracer soil elements (Ce, Y, and V) in these samples. The approximate amounts of hand SD ranged from 42.28 to 173.76 mg, with a median value of 85.42 mg. In addition, the mean amounts of hand SD estimated using the concentrations of Ce, Y, and V in the samples were 4.63, 3.43, and 3.42 mg, respectively. The amount of hand SD varied greatly among the age groups: primary school children had more hand SD than kindergarten children, males had more hand SD than females, and children from rural areas had more hand SD than those from urban areas. The rates of daily ingestion of hand SD for kindergarten and primary school children were estimated to be 7.73 and 6.61 mg/day, respectively.

Microplastic pollution in deposited urban dust, Tehran metropolis, Iran

Environmental pollutants such as microplastics have become a major concern over the last few decades. We investigated the presence, characteristics, and potential health risks of microplastic dust ingestion. The plastic load of 88 to 605 microplastics per 30 g dry dust with a dominance of black and yellow granule microplastics ranging in size from 250 to 500 μm was determined in 10 street dust samples using a binocular microscope. Fluorescence microscopy was found to be ineffective for detecting and counting plastic debris. Scanning electron microscopy, however, was useful for accurate detection of microplastic particles of different sizes, colors, and shapes (e.g., fiber, spherule, hexagonal, irregular polyhedron). Trace amounts of Al, Na, Ca, Mg, and Si, detected using energy dispersive X-ray spectroscopy, revealed additives of plastic polymers or adsorbed debris on microplastic surfaces. As a first step to estimate the adverse health effects of microplastics in street dust, the frequency of microplastic ingestion per day/year via ingestion of street dust was calculated. Considering exposure during outdoor activities and workspaces with high abundant microplastics as acute exposure, a mean of 3223 and 1063 microplastic particles per year is ingested by children and adults, respectively. Consequently, street dust is a potentially important source of microplastic contamination in the urban environment and control measures are required.

Assessment of health risks due to arsenic from iron ore lumps in a beach setting

In 2011, an artificial hook-shaped peninsula of 128ha beach area was created along the Dutch coast, containing thousands of iron ore lumps, which include arsenic from natural origin. Elemental arsenic and inorganic arsenic induce a range of toxicological effects and has been classified as proven human carcinogens. The combination of easy access to the beach and the presence of arsenic raised concern about possible human health effects by the local authorities. The objective of this study is therefore to investigate human health risks from the presence of arsenic-containing iron ore lumps in a beach setting. The exposure scenarios underlying the human health-based risk limits for contaminated land in The Netherlands, based on soil material ingestion and a residential setting, are not appropriate. Two specific exposure scenarios related to the playing with iron ore lumps on the beach ('sandcastle building') are developed on the basis of expert judgement, relating to children in the age of 2 to 12years, i.e., a worst case exposure scenario and a precautionary scenario. Subsequently, exposure is calculated by the quantification of the following factors: hand loading, soil-mouth transfer effectivity, hand-mouth contact frequency, contact surface, body weight and the relative oral bioavailability factor. By lack of consensus on a universal reference dose for arsenic for use in the stage of risk characterization, three different types of assessments have been evaluated: on the basis of the current Provisional Tolerable Daily Intake (PTWI), on the basis of the Benchmark Dose Lower limit (BMDL), and by a comparison of exposure from the iron ore lumps with background exposure. It is concluded, certainly from the perspective of the conservative exposure assessment, that unacceptable human health risks due to exposure to arsenic from the iron ore lumps are unlikely and there is no need for risk management actions.

Percutaneous absorption of arsenic from environmental media

Current knowledge of percutaneous absorption of arsenic is based on studies of rhesus monkeys using soluble arsenic in aqueous solution, and soluble arsenic mixed with soil (Wester et al., 1993). These studies produced mean dermal absorption rates in the range of 2.0-6.4% of the applied dose. Subsequently, questions arose as to whether these results represent arsenic absorption from environmental media. Factors such as chemical interactions, the presence of other metals, and the effects of weathering on environmental media all can affect the nature of arsenic and its potential for percutaneous absorption. Therefore, research specific to more relevant matrices is important. The focus of this effort is to outline study design considerations, including particle size, application rates, means of ensuring skin contact and appropriate statistical evaluation of the data. Appropriate reference groups are also important. The potential for background exposure to arsenic in the diet possibly obscuring a signal from a dermally applied dose of arsenic will also be addressed. We conclude that there are likely to be many site-or sample-specific factors that will control the absorption of arsenic, and matrix-specific analyses may be required to understand the degree of percutaneous absorption.

Quantification of soil/dust (SD) on the hands of children from Hubei Province, China using hand wipes

A total of 120 children (58 males and 62 females) between the ages of 2 and 17 years were randomly selected from Wuhan City and Wufeng County in Hubei Province, China. We gathered hand SD samples from these children using hand wipes. We determined approximate amounts of hand SD and concentrations of three tracer soil elements (Ce, Y, V) in these samples. The approximate amounts of hand SD ranged from 6.35 to 85.42mg with a median value of 20.62mg. In addition, mean amounts of hand SD estimated using concentrations of Ce, Y, and V in samples were 1.07, 1.00, and 0.92mg, respectively. The amounts of hand SD varied greatly among age groups: primary school children had more hand SD than kindergarten and middle school children, males had more hand SD than females, and children from rural areas had more hand SD than those from urban areas. The rates of daily ingestion of hand SD for kindergarten, primary school, and middle school children were estimated as 1.79, 2.12, and 0.49mg/d, respectively.

Human health risk assessment related to contaminated land: state of the art

Exposure of humans to contaminants from contaminated land may result in many types of health damage ranging from relatively innocent symptoms such as skin eruption or nausea, on up to cancer or even death. Human health protection is generally considered as a major protection target. State-of-the-art possibilities and limitations of human health risk assessment tools are described in this paper. Human health risk assessment includes two different activities, i.e. the exposure assessment and the hazard assessment. The combination of these is called the risk characterization, which results in an appraisal of the contaminated land. Exposure assessment covers a smart combination of calculations, using exposure models, and measurements in contact media and body liquids and tissue (biomonitoring). Regarding the time frame represented by exposure estimates, biomonitoring generally relates to exposure history, measurements in contact media to actual exposures, while exposure calculations enable a focus on exposure in future situations. The hazard assessment, which is different for contaminants with or without a threshold for effects, results in a critical exposure value. Good human health risk assessment practice accounts for tiered approaches and multiple lines of evidence. Specific attention is given here to phenomena such as the time factor in human health risk assessment, suitability for the local situation, background exposure, combined exposure and harmonization of human health risk assessment tools.

Particle size distributions, size concentration relationships, and adherence to hands of selected geologic media derived from mining, smelting, and quarrying activities

Hand-to-mouth activity, especially in children, is a potentially significant pathway of exposure to soil contaminants. Hand-mouthing behavior is of particular concern in areas impacted by mining, smelting, and quarrying activities as these activities may lead to elevated levels of heavy metals in soil. In order to estimate potential exposures to contaminated geologic media attributable to hand-to-mouth contact, it is useful to characterize adherence of those media to skin, as contaminant concentrations in adhered media may differ greatly from unfractionated, whole media concentrations. Such an investigation has been undertaken to aid estimation of exposures to arsenic, cadmium, lead, and zinc in nine different geologic media collected in the Pacific Northwest region of the United States. After establishing the particle size distribution of each medium (fractions <63 μm, 63-150 μm, 150-250 μm, and 250 μm-2mm were determined) and target elemental concentrations within each particle size fraction, an active handling protocol involving six volunteers was conducted. Wet media always adhered to a greater extent than dry media and adhered media generally had higher elemental concentrations than bulk media. Regression analyses suggest smaller particle fractions may have higher elemental concentrations. Results of application of a maximum likelihood estimation technique generally indicate that handling of dry media leads to preferential adherence of smaller particle sizes, while handling of wet media does not. Because adhered material can differ greatly in particle size distribution from that found in bulk material, use of bulk concentrations in exposure calculations may lead to poor estimation of actual exposures. Since lead has historically been a metal of particular concern, EPA's Integrated Exposure Uptake Biokinetic (IEUBK) Model was used to examine the potential consequences of evaluating ingestion of the selected media assuming concentrations in adhering versus bulk media.

Water adherence factors for human skin

On incidental dermal exposure to chemicals in water, a key exposure factor is the amount of water adhering to skin. Although soil adherence factors have been developed for risk assessment, measurements of water adherence on human skin have not been described. In the Environmental Protection Agency's (EPA's) dermal risk assessment guidance, dermal dose from environmental exposures is based upon the flux rate across the skin, which assumes that an unlimited amount of chemical is available for absorption. This assumption is applicable to certain exposure scenarios such as swimming and bathing. However, exposures to contaminated water frequently involve scenarios where the available chemical is limited by the amount of water adhering to the skin, for example, during accidental splashes.

Modeled estimates of soil and dust ingestion rates for children

Daily soil/dust ingestion rates typically used in exposure and risk assessments are based on tracer element studies, which have a number of limitations and do not separate contributions from soil and dust. This article presents an alternate approach of modeling soil and dust ingestion via hand and object mouthing of children, using EPA's SHEDS model. Results for children 3 to <6 years old show that mean and 95th percentile total ingestion of soil and dust values are 68 and 224 mg/day, respectively; mean from soil ingestion, hand-to-mouth dust ingestion, and object-to-mouth dust ingestion are 41 mg/day, 20 mg/day, and 7 mg/day, respectively. In general, hand-to-mouth soil ingestion was the most important pathway, followed by hand-to-mouth dust ingestion, then object-to-mouth dust ingestion. The variability results are most sensitive to inputs on surface loadings, soil-skin adherence, hand mouthing frequency, and hand washing frequency. The predicted total soil and dust ingestion fits a lognormal distribution with geometric mean = 35.7 and geometric standard deviation = 3.3. There are two uncertainty distributions, one below the 20th percentile and the other above. Modeled uncertainties ranged within a factor of 3-30. Mean modeled estimates for soil and dust ingestion are consistent with past information but lower than the central values recommended in the 2008 EPA Child-Specific Exposure Factors Handbook. This new modeling approach, which predicts soil and dust ingestion by pathway, source type, population group, geographic location, and other factors, offers a better characterization of exposures relevant to health risk assessments as compared to using a single value.

Dermal absorption of environmental contaminants from soil and sediment: a critical review

Risk assessment of hazardous wastes sites may require characterization of the dermal availability of chemical contaminants in soil and/or sediment. Current U.S. Environmental Protection Agency guidance for assessment of dermal exposures to contaminants in water and soil was finalized in 2004 as a supplement (Part E) to the Risk Assessment Guidance for Superfund (RAGS). The soil protocol presented in RAGS Part E is less sophisticated than the water protocol and is supported by less empirical data. Investigations of dermal absorption of soil and sediment-borne contaminants that have been conducted to date include in vitro and in vivo experiments using both human and surrogate skin. A review of that literature was conducted with attention to relevant criteria including consideration of layering effects, degree of chemical saturation of soil, appropriateness of particle size distribution employed, soil-chemical contact time, and continuity of soil-skin contact (in in vivo studies). Most studies published to date are deficient by virtue of execution or reporting on one or more of the selected criteria. In addition the lack of methodological standardization evident in the literature hinders systematic evaluation of results. Since additional experimental work is needed, general agreement on acceptable approaches would be useful. Recommendations for good practice are presented.

Bioaccessibility of metals in urban playground soils

Children ingest soil. The amount ingested varies with the child's behaviour, and daily ingestion rates have been calculated to be between 39 and 270 mg day(-1). During play, children ingest soil both involuntarily and deliberately, and it can be assumed that the latter may result in ingestion of a larger soil particle size fraction and a larger soil mass than the former. Measurements of soil metal contents commonly display the total metal content, where soil sieved to <2 mm has been digested with strong acids. This procedure does not consider differences in metal contents between size fractions or ingested soil masses. Moreover, it does not consider the difference between bioaccessible and total metal content, possibly resulting in an incorrect evaluation of the potential health risks from soil intake. Intervention and guideline values are commonly calculated via tolerable daily intake values, in turn derived from toxicological studies where the contaminant is administered to a test animal in feed or water. It is then assumed that the bioavailability of a contaminant in soil equals the bioavailability in the matrix used in the toxicology study. However, the complexity and heterogeneity of soil often results in a lower bioavailability than from food or water. The current study investigated the bioaccessibility of soil As, Cd, Cr, Ni and Pb from two different particle size fractions representing deliberate (<4 mm) and involuntary (<50 microm) ingestion, as well as from two different soil masses representing deliberate soil intake; 2 g for a child with pica behaviour and 0.6 g for a non-pica child. The bioaccessibility was investigated using an in vitro digestion model and urban playground soils collected away from any point pollution sources. The bioaccessibility (%) of the different metals increased in the order Ni=Cr=Pb<<As<Cd for the involuntary ingestion (<50 microm, 0.6 g) and pica behaviour (<4 mm, 2 g) scenarios, while the deliberate non-pica scenario (<4 mm, 0.6 g) displayed increasing bioaccessibility in the order Ni=Cr<Pb<As=Cd. The difference in bioaccessibility between elements was concluded to be due to differences in origin, sorption behaviour and pH dependence. The study also found that the bioaccessible amount of metal in ingested soil is not always related to particle size or to soil mass in soils with low contaminant levels. Factors such as pH dependence of the metal and the soil's clay content are also significant in determining bioaccessibility.

The SHEDS-Wood model: incorporation of observational data to estimate exposure to arsenic for children playing on CCA-treated wood structures

BACKGROUND

Lumber treated with chromated copper arsenate (CCA) compounds has been used in residential outdoor wood structures and public playgrounds. The U.S. Environmental Protection Agency (EPA) has conducted a probabilistic assessment of children's exposure to arsenic using the Stochastic Human Exposure and Dose Simulation model for the wood preservative scenario (SHEDS-Wood). The assessment relied on data derived from an experimental study conducted using adult volunteers and designed to result in maximum hand and wipe loadings to estimate the residue-skin transfer efficiency. Recent analyses of arsenic hand-loading data generated by studies of children actively involved in playing on CCA-treated structures indicate that the transfer efficiency coefficient and hand-loading estimates derived from the experimental study significantly overestimate the amount that occurs during actual play.

OBJECTIVES

Our goal was to assess the feasibility of using child hand-loading data in the SHEDS-Wood model and their impact on exposure estimates.

METHODS

We used data generated by the larger of the studies of children in SHEDS-Wood, instead of the distributions used by U.S. EPA. We compared our estimates of the lifetime average daily dose (LADD) and average daily dose (ADD) with those derived by the U.S. EPA.

RESULTS

Our analysis indicates that data from observational studies of children can be used in SHEDS-Wood. Our estimates of the mean (and 95th percentile) LADD and ADD were 27% (10%) and 29% (15%) of the estimates derived by U.S. EPA.

CONCLUSION

We recommend that the SHEDS-Woods model use data from studies of children actively playing on playsets to more accurately estimate children's actual exposures to CCA.

Size distributions of soil particles adhered to children's hands

The size distributions of the soil particles adhered to children's hands were preliminarily investigated and compared with a cutoff soil particle size recently specified in the official analytical method in Japan. To facilitate fieldworks involving child participants, we tested a methodology using a laser scattering particle size distribution analyzer and validated it for field applications. The laboratory experiments using this method showed finer soil particles tended to be adhered more efficiently to human hands. Meanwhile, our preliminary field survey revealed large variations in mass (mean 26.2 mg/hand, median 15.2 mg/hand, max 162.5 mg/hand) and size distributions (particle mode diameter of 39 +/- 26 microm) of the particles adhered to children's hands after various playing activities. Even though the ways the particles adhered were noticeably varied under actual playing situations, the adhered particles were consistently and considerably smaller than the 2-mm cutoff diameter defined by the Ministry of the Environment, Japan. Since soil contaminant concentrations are generally higher for finer soil particles, measurement of contaminant concentrations for the soil fraction including the non-adherent millimeter particles may underestimate the risk of direct soil contaminant intakes.

Child dermal sediment loads following play in a tide flat

Dermal contact with sediment is sometimes identified as a pathway of concern in risk assessments. Dermal exposure to sediment is poorly characterized and exposure assessors may rely on default soil adherence values. The purpose of this study was to obtain sediment adherence data for a genuine exposure scenario, child play in a tide flat. This study reports direct measurements of sediment loadings on five body parts (face, forearms, hands, lower legs and feet) after play in a tide flat. Each of nine subjects participated in two timed sessions and pre- and post-activity sediment loading data were collected. Geometric mean (geometric standard deviation) dermal loadings (mg/cm(2)) on the face, forearm, hands, lower legs and feet for the combined sessions were 0.04 (2.9), 0.17 (3.1), 0.49 (8.2), 0.70 (3.6) and 21 (1.9), respectively. Participants' parents completed questionnaires regarding their child's typical activity patterns during tide flat play, exposure frequency and duration, clothing choices, bathing practices and clothes laundering. Data presented in this paper supplement very limited prior adherence data for sediment contact scenarios. Results will be useful to risk assessors considering exposure scenarios involving child activities at a coastal shoreline or tide flat.

Field measurement of dermal soil loadings in occupational and recreational activities

Risks associated with dermal exposure to contaminated soil are not well-characterized, but nevertheless must be estimated to define endpoints for remedial strategies. Among the parameters contributing to the uncertainty of these estimates is soil adherence to skin. Pre- and postactivity soil loadings have been obtained from hands, forearms, lower legs, faces, and/or feet of volunteers engaged in various occupational and recreational activities. These data are distinguished from other sources of estimates of soil adherence by the manner of their collection. Soil loads were obtained directly from multiple body parts before and after uncontrived exposure scenarios. Data presented for the first time here supplement prior results and roughly double the available data base. This expanded data base provides a useful perspective on types of behavior likely to lead to soil contact falling within general classes of activity (e.g., background, low, moderate, or high contact). Prior conclusions supported by the additional data include the following: (1) post-activity loadings are typically higher than preactivity levels, demonstrating that exposure is episodic; (2) hand loadings are dependent upon class of activity; (3) hand loadings generally provide conservative estimates of loadings on nonhand body parts within activity classes; and (4) hand loadings do not provide conservative estimates of nonhand loadings across activity classes. Finally quantitative estimates of relative loads on unclothed nonhand body parts are presented.