Dermal and respiratory sensitization to chromate in a cement floorer

Abstract

Background To report a well‐documented case of both allergic contact dermatitis and occupational asthma due to chromate exposure in a 48‐year‐old floorer Methods and Results A 48‐year‐old floorer, occupationally exposed to cement and with a documented chromate contact dermatitis, reported dyspnea and wheezing after work. These conditions were demonstrated by self‐measured sequential peak expiratory flows. A first bronchial provocation test (BPT) with potassium dichromate (K2Cr2O7) (0.3% nebulized for a total of 60 minutes) led to pronounced and sustained decreases in forced expiratory volume in 1 second (FEV1) and forced vital capacity, accompanied by pruritus, a decrease in arterial PO2, a slight rise in temperature, and peripheral blood leukocytosis. (This concentration of K2Cr2O7 is not recommended for BPT). Bronchoalveolar lavage performed 2 days later showed 18% eosinophils. Two years later, a BPT with a lower dose of K2Cr2O7 (0.01% for a total of 31 min) led to an “early late” reaction (FEV1 dropped by 29% compared with the initial FEV1 value), accompanied by pruritus. A BPT with dry cement, containing 12 ppm hexavalent chromium, was borderline (FEV1 dropped by 13%), and a similar result (FEV1 dropped by 14%) was obtained after smoking five cigarettes, laced with 10 mg of cement per cigarette. Conclusions This report illustrates that a subject, with allergic contact dermatitis to chromates, may develop a respiratory allergic reaction to an airborne source of this metal. The main novelty of our report is that the smoking of cigarettes contaminated with cement may have been a significant factor in the causation or elicitation of these reactions. Am. J. Ind. Med. 34:169–176, 1998. © 1998 Wiley‐Liss, Inc.

Occupational Allergic Contact Dermatitis and Asthma due to a Single Low Molecular Weight Agent

“…De Raeve et al, in 1998, reported that a subject, with allergic contact dermatitis to chromates, may develop a respiratory allergic reaction to an airborne source of this metal 13) . However, the relationship between the pathophysiological mechanisms of ACD and asthma caused by a single metal is not well-known [12][13][14] . In our 3 case reports, the observation of delayed bronchial responses with positive patch tests to LMW agents such as DGEBA or HEMA suggest that expiratory troubles could be linked to a cell-mediated mechanism 16) .…”

“…In observations of ACD and OA caused by a single metal, Eslander et al 12) , and more recently, Spinelli et al 14) reported cases with allergic contact dermatitis, allergic contact urticaria, rhinitis and asthma from nickel. De Raeve et al, in 1998, reported that a subject, with allergic contact dermatitis to chromates, may develop a respiratory allergic reaction to an airborne source of this metal 13) . However, the relationship between the pathophysiological mechanisms of ACD and asthma caused by a single metal is not well-known [12][13][14] .…”

“…This IgE-mediated allergy has also been identified for some LMW agents responsible for OA, such as anhydric acids 4) , reactive dyes 5,6) , platinum salts 7,8) , and other metals [9][10][11] . Metals have been reported to cause both allergic contact dermatitis (ACD) and OA in the same factory [12][13][14] . However, the relationship between the pathophysiological mechanisms of these two manifestations from a single causative agent is not well-known.…”

“…Metals have been reported to cause both allergic contact dermatitis (ACD) and OA in the same factory [12][13][14] . However, the relationship between the pathophysiological mechanisms of these two manifestations from a single causative agent is not well-known.…”

Occupational Exposure and Co-Occurrence of Work-Related Skin and Respiratory Disorder in Cleaner: A Case Report

“…There are many studies of respiratory symptoms in working populations, comparatively not so much studies of dermal symptoms in working populations, but only few publishing studies that reported on co-existing skin and respiratory symptoms in certain occupations [2][3][4][5].…”