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Cement/Concrete Burns : Causes, Symptoms, Treatment, Prevention

What is Cement/Concrete Burns?

Cement burns, also known as concrete burns or even concrete poisoning, are a type of chemical burns caused by cement. The reason concrete and cement are often used interchangeably since there is a very subtle difference between the two. Concrete is a mixture of cement along with gravel, sand, and pieces of rock. Nearly 10 to 15 percent of concrete is made up of cement. The cement hardens over time after reacting with air molecules.(1, 2)

When your skin comes in contact with wet cement, the chemicals present in cement react with the water molecules present in the skin. This chemical reaction produces alkaline molecules that can cause a breakdown of the skin tissue. And the longer cement remains in contact with your skin, the worse this burn becomes.

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Cement/Concrete Burns : Causes, Symptoms, Treatment, Prevention

What Causes Cement/Concrete Burns?

When water is added to cement powder, it transforms a molecule known as calcium oxide into calcium hydroxide. During this reaction, the pH of the cement increases. The pH scale is a measurement of how basic or acidic a substance is on the basis of a scale of 1 to 14. A pH of 1 means the substance is strongly acidic, and a pH of 14 indicates it is a strong base. A pH of 7 is neutral. On average, the natural pH of human skin is around 4.7. Substances that are on the lower or higher end of the pH scale can cause chemical burns when they come in contact with your skin, damaging the skin.

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Chemicals present in wet cement react with water and sweat molecules in the skin, producing ions that are made up of hydrogen and oxygen molecules. These molecules dissolve proteins and collagen fibers on the skin while also breaking down fats and dehydrating the cells in the skin. The dangerous part is that the longer the wet cement remains in touch with your skin, the longer it has the time to react with the water and sweat molecules in the skin, and the worse your burn gets. An older study from 2007 looked at the cases of cement burn injuries at the St. James Hospital in Dublin, Ireland, from the years 1996 to 2005. The researchers discovered that it took an average of 60 minutes of exposure for people to be admitted to the burn unit with cement burns.(3, 4, 5, 6)

However, brief exposure to cement is not likely to cause any concrete chemical burns if you wash your hands immediately with slightly acidic or pH-neutral soap.

Nevertheless, to be on the safe side, it is best to avoid touching wet concrete when not necessary. If you do end up touching wet cement, you should wash off your hands at the earliest before you start to develop any noticeable symptoms. According to Poison Control, though, once burnt, the burns continue to get worse even after you have washed off the cement.(7, 8)

When Is There A High Risk of Getting Cement/Concrete Burns?

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Cement or concrete burns tend to happen when the cement gets trapped in places like your boots or gloves. These are places where the substance is most likely to go unnoticed and thus delay treatment. Rings, watches, and other jewelry can also easily trap cement, and you may not notice it at that time, increasing the risk of getting a chemical burn.

A case study from 2015 described the case of a 28-year-old man who got severe burns after kneeling down on cement to resurface his basement floor for almost three hours. The researchers of the study found that most of the cement burns happened in the lower limbs, especially around the foot, ankle, and knee.(9) In developed countries, most cases of cement/concrete burns are observed in construction workers or people who are working with cement at home on some DIY construction projects.

According to Poison Control, two other case studies of people who needed emergency medical assistance after getting exposed to cement must be highlighted when educating others about cement burns. The first case was of a two-year-old girl who poured a bag of dry cement on herself, and it was only after three hours after reaching the emergency room that her symptoms subsided. She was suffering from symptoms like chokingcoughing and vomiting.  

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The second case involved a 57-year-old man who got deep burns on his skin and both knees after kneeling in the concrete while he poured it on the floor.(7, 10)

A case study from 2013 looked at the case of a 28-year-old man who jumped into a truck full of cement and was stuck there for at least three to four hours until he was found by emergency services. The man passed away after 13 days of being admitted to the hospital because of multiple organ failure linked to ingestion of concrete, burn injuries, and other related complications.(11)

What are the Symptoms of a Cement/Concrete Burn?

Cement chemical burns don’t tend to appear right after the initial exposure to concrete/cement. Neither is it always visible that you have gotten burnt from concrete, as the contact could have taken place several hours ago. Such burns are also slow to show up and tend to get worse over time. Depending on the severity of your cement burns, the symptoms may include the following:(12)

Treating Cement/Concrete Burns

Here are some steps on how concrete burns are treated.

  • Immediate Administration of First Aid: First aid is necessary at the earliest in cases of concrete burns. As soon as you notice that you have cement on any part of the body, immediately remove any protective gear you are wearing, jewelry, and clothes that have concrete stuck on them. If there is any dry concrete on the skin, brush it off and immediately flush that burn with lukewarm water for at least 20 minutes to half an hour. After rinsing the area, seek medical attention at the earliest. You should not think about ignoring the burn, hoping it gets better with time. It is always necessary to seek proper medical attention.
  • Using a Concrete Burn Neutralizer: According to recommendations by the US Occupational Safety and Health Administration, you should apply diluted vinegar or citrus juice, or any other type of acidic substance to the burn to help neutralize the area and prevent the burn from getting worse. You should not apply any lotions or creams to the skin unless recommended by your doctor.(13)
  • Medical Treatment: After reaching the hospital or any doctor, inform them that you have a concrete burn upon arriving. The medical professional will again rinse the burn and dress up the wound with bandages. They may also prescribe antibiotics to lower the risk of infection. In case of severe burns, and if the burn is spread over a large area or it completely circles an extremity, you may need to be hospitalized. In case of a severe burn, doctors may need to perform a procedure known as debridement, where the dead skin tissue and any debris are removed and cleaned from the wound and follow it up with a skin graft.(14)

You need to immediately seek medical attention if you notice that the cement burn is bigger than three inches across the skin. A burn that covers your hands, genitals, face, or feet or a burn that is causing a lot of pain needs emergency medical attention.

Is it Possible to Prevent Cement/Concrete Burns?

Yes, it is possible to prevent concrete/cement burns by being vigilant towards your safety. Here are some steps to take to prevent concrete burns.

  • Wear proper safety equipment and clothing when working with concrete/cement. This includes gloves, safety goggles, long pants, long sleeves, and knee pads.
  • Wear waterproof boots that are high enough to ensure that concrete does not leak inside from the top of the shoes. You should ideally tuck in your pants in inside the boots or even use duct tape to tape the boots together to your pants to prevent concrete from leaking inside.
  • Wear well-fitting gloves.
  • Avoid unnecessary exposure to wet concrete.
  • Remove any concrete that gets splattered on the skin as soon as you see it.
  • Try to avoid getting concrete directly on your skin when removing your clothes or protective gear.
  • Avoid wearing watches and jewelry when working with or around the cement.

Conclusion

Concrete/cement burns are caused when the chemicals in wet cement come in contact with your skin. If you get wet concrete on your skin, you should immediately rinse it off with water and a slightly acidic of pH neutral soap at the earliest. Concrete burns develop slowly and may go unnoticed at the moment when you actually get burnt. This is why it is essential to seek immediate medical assistance as soon as you notice them because the longer you wait to treat these types of burns, the more severe they may become. And keep in mind that the symptoms may continue to worsen even after you have washed off the concrete. Staying safe when working with concrete is the only way of preventing such types of burns.

References:

  1. Concrete basics: Essential ingredients for a concrete mixture: CSC (2019) Concrete Supply Co. Available at: https://concretesupplyco.com/concrete-basics/#:~:text=Concrete%20is%20a%20mixture%20of,sand%2C%20and%2040%25%20gravel. (Accessed: October 5, 2022).
  2. Howden (no date) Concrete vs Cement: What’s The Difference? Available at: https://www.howden.com/en-us/articles/cement/how-is-cement-made (Accessed: October 5, 2022).
  3. Alam, M., Moynagh, M. and Lawlor, C., 2007. Cement burns: the dublin national burns unit experience. Journal of burns and wounds, 7.
  4. Spoo, J. and Elsner, P., 2001. Cement burns: a review 1960–2000. Contact Dermatitis, 45(2), pp.68-71.
  5. Sherman, S.C. and Larkin, K., 2005. Cement burns. Journal of Emergency Medicine, 29(1), pp.97-99.
  6. Poupon, M., Caye, N., Duteille, F. and Pannier, M., 2005. Cement burns: retrospective study of 18 cases and review of the literature. Burns, 31(7), pp.910-914.
  7. Don’t get burned by cement (no date) Poison Control. Available at: https://www.poison.org/articles/cement (Accessed: October 5, 2022).
  8. The hidden danger of concrete burns – Barry, Corrado & Grassi: Cape may: Cumberland (no date) Barry, Corrado & Grassi | Cape May | Cumberland. Available at: https://capelegal.com/the-hidden-danger-of-concrete-burns/ (Accessed: October 5, 2022).
  9. Ng, N.Y.B., Abdullah, A. and Milner, S.M., 2015. Cement burn. Eplasty, 15.
  10. (no date) UpToDate. Available at: https://www.uptodate.com/contents/topical-chemical-burns-initial-assessment-and-management (Accessed: October 5, 2022).
  11. Catalano, F., Mariano, F., Maina, G., Bianco, C., Nuzzo, J. and Stella, M., 2013. An unusual case of extensive self-inflicted cement burn. Annals of burns and fire disasters, 26(1), p.40.
  12. Concrete irritation, Burns, and dermatitis (no date) HexArmor. Available at: https://www.hexarmor.com/posts/concrete-irritation-burns-and-dermatitis (Accessed: October 5, 2022).
  13. Preventingskinproblems fromworkingwith portlandcement (no date). Available at: https://www.osha.gov/sites/default/files/publications/OSHA-3351-portland-cement.pdf (Accessed: October 5, 2022).
  14. Feldberg, L., Regan, P.J. and Roberts, A.H.N.R., 1992. Cement burns and their treatment. Burns, 18(1), pp.51-53.
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