Concrete & Cement Burns: How to Treat Cement Burns on Skin

Most people are familiar with concrete-related hazards like crush injuries, silicosis, and even asbestos-containing concrete, but many people underestimate one of the most insidious cement-related injuries: concrete chemical burns, also known as cement burns or concrete poisoning.

Nearly every construction project includes concrete and cement products, and it's easy to become too comfortable with such familiar material. It's important for workers to understand the risks of concrete-related skin injuries.

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Can Concrete Burn You?

Yes, and the consequences can be severe. Concrete or cement products can cause third-degree chemical burns. Burns take so long to develop that by the time you notice even the mild symptoms, it may be too late to prevent more serious injuries.

According to A Safety & Health Practitioner's Guide to Skin Protection, there are four types of skin problems caused by cement-containing products. In order of seriousness, they are:

  • Dry Skin or Irritation. Basically, this is mild ICD, or "concrete rash."
  • Acute or Chronic Irritant Contact Dermatitis (ICD). ICD is caused directly by the chemical composition of cement or concrete reacting with your skin to cause redness, scaling, and blistering. ICD is curable, but multiple bouts of can lead to ACD.
  • Allergic Contact Dermatitis (ACD). While ICD is caused by the chemicals in cement, ACD is caused by an immune response to cement or concrete ingredients. ICD and ACD look similar and require diagnostics tests to tell apart. There's no way to tell who will develop ACD, it can develop without any warning, and it's difficult to cure. ACD drives many cement workers out of the business.
  • Caustic Burns (or Cement Burns). Cement products can cause second or third-degree burns after a fairly short exposure. Symptoms include blisters, dead or hardened skin, and black or green discoloration. In severe cases, cement burns will go all the way down to the bone. They can cause scarring, disability, skin grafts, or even amputation.

How & Why Does Concrete Burn You?

There are three factors in concrete poisoning: the abrasiveness of concrete mixtures, the alkaline (high pH) nature of cement, and the chemical and metal content.

Cement, which you find in products like concrete, mortar, and grout, is extremely caustic or corrosive. Once you mix dry cement with water, it has a pH of 12 to 13 (on a scale of 14) until it cures and dries. That, by itself, is enough to cause chemical burns on unbroken skin with extended contact.

Normally, your skin has a pH of 5.5 – being a little acidic helps keep moisture and bacteria out of your body. Contact with cement makes your skin more alkaline and permeable.

Portland cement, specifically, often contains the metal hexavalent chromium as well. It's a toxic form of chromium that sensitizes your skin and causes contact dermatitis. Certain apoxies, accelerators, water reducers, superplasticizers, retardants, and other admixtures in concrete can also have a sensitizing effect.

Finally, concrete and Portland cement is abrasive, creating microscopic cuts and scrapes on your skin. This allows the alkaline, toxic substance to contact with deeper tissues and worsens the problem.

Who Is At Risk for Cement Burns?

Anyone who works with or around fresh cement-containing products, including wet concrete, mortar, plaster, grout, stucco, or terrazzo, is at risk for concrete burns on their skin. At least a quarter-million people in the U.S. work directly with these fresh cement products, which puts them at risk for concrete skin irritation, contact dermatitis, and concrete burns on skin.

A 1997 survey of apprentice concrete masons revealed that 35% of them experienced concrete burns (and they only had an average of 3 years experience on the job).

Tasks that put you at risk for concrete burns include:

  • tending concrete pour,
  • mixing and spreading grout,
  • preparing cement underlayer for terrazzo,
  • hosing out ready mixed con, mixer, and chute,
  • using mortar to set brick, cinder block, and other masonry,
  • dismantling formwork contaminated by Portland cement,
  • pouring, leveling, smoothing, and finishing concrete,
  • attaching tiles to walls, floors, and ceilings,
  • mixing mortar and providing it to other craftworkers,
  • mixing and applying plaster, stucco, and EIFS,
  • spraying Portland cement products such as fireproofing, gunite, or shotcrete, and
  • grinding finished concrete, which releases cement dust.

How to Treat Concrete Burns

The most important things to know about cement burn treatment are that:

  • Acting early is critical.  If you work around concrete and find any kind of burn on your skin, tell a medical professional immediately. Even if you only see pinkness, you can't assume the burn will stop there. Washing away the chemicals is good, but the burns could still get worse without treatment.
  • Disclosing concrete exposure can save your life. Concrete burns are treated very differently than other burns, but they can look identical. Normal burn treatment can make cement burns worse. Even if you're not sure what caused your burn, you should tell medical professionals when and how you were exposed to fresh concrete. Concrete burns can appear hours or even days after exposure.

With those two things in mind, what do you put on a concrete burn and what's the best concrete burn treatment protocol to follow when you're exposed?

Remove Concrete Dust and Wet Protective Gear Immediately

If you suspect you're experiencing a concrete burn, or you get splashed with wet concrete while wearing permeable clothes, immediately (and carefully) remove any clothing, jewelry, or protective gear. These items can trap wet concrete against your skin, prolonging your exposure to burns.

Since water actually activates the dangerous properties of dry cement, be sure to brush any concrete powder off your skin before washing the area. Otherwise, you're actually creating more exposure to wet cement.

Flush the Area With Water & Concrete Burn Neutralizer for Twenty Minutes

Continually rinse the potentially exposed skin with cold running water for 20 minutes. Adding vinegar or another mildly acidic substance to the water can neutralize the alkalinity and stop the chemical damage from worsening.

Even if you're already on the way to the hospital, flushing the skin continuously can save tissue and prevent more serious damage.

If wet concrete splatter may have contacted your face or eyes, you should flush your eyes with clean, cool water continuously for 15 minutes.

Know What to Put on a Concrete Burn (and What Not To)

While clean water and neutralizing agents are a "yes" for cement burns, most other substances are a "no."

We're used to thinking about creams or lotions to relieve the sting of a burn, but petroleum jelly, lanolin lotion, and many creams can actually trap contaminants against the skin, causing concrete burns to worsen.

Know When to Call 911

If a concrete burn is larger than three inches across, is very deep, or covers the hands, feet, face, groin, or a major joint, call 911 immediately and follow the steps above while you wait for an ambulance.

Remember to repeat to every medical professional that treats you that you've handled wet cement.

How to Prevent Cement Burns

OSHA has specific standards and recommendations to help you prevent cement burns on the job.

Well-maintained and impermeable personal protective equipment (PPE) is crucial for protecting hands, arms, legs, feet, and eyes from direct contact with fresh concrete or cement.

Proper hygiene and relevant worksite supplies are also crucial. Keep concrete burn first aid kits on-site, including pH indicating strips to check exposure. Anyone working with fresh cement products needs access to fresh clean water and concrete burn neutralizers. The average person needs several gallons of water available in a concrete exposure emergency, as well as pH-neutral soap and clean towels. Eye-wash stations capable of a 15-minute flush are necessary, as well.

Encourage workers to store dedicated concrete PPE separately from other tools and supplies. They should change before entering their personal vehicle and leave these items at work; if that's not possible, they should take steps to avoid contaminating their upholstery and other clothing.

Finally, it's essential to provide training in the hazards of cement work and the safety measures to prevent injury. This can be handled through yearly formal training, like online OSHA courses in the appropriate language. Regular reminders, given during a toolbox talk or other informal gatherings, can also make a big difference in safety compliance.

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