Occupational asthma caused by chromium

Abstract

We report four cases of occupational asthma caused by chromium salts, three of whom showed dual and one isolated early asthmatic responses on specific chromium bronchoprovocation test (BPT). All of them were ex-smokers. Two showed positive skin-prick tests to 10 mg/ml of Cr2(SO4)3, but negative results on patch testing. The remaining two showed positive results on patch testing with Cr2(SO4)3. Three had airway hyperresponsiveness to methacholine on initial examination. Although initial methacholine airway challenge testing showed a negative result in the remaining patient, airway hyperresponsiveness developed transiently 24 h after an isolated immediate asthmatic reaction induced by chromium. Three patients were reassessed after complete avoidance of chromium. Two subjects showed marked improvement of their symptoms with significant increases of PC20 methacholine. We conclude that chromium induces occupational asthma in exposed workers. Further investigations are needed to clarify the pathogenetic mechanism.

Occupational Asthma due to Chromium

“…A history of contact dermatitis preceding the occurrence of respiratory symptoms, if present, may facilitate the recognition of occupational disease. However, the association of both manifestations is not the rule [4,8,9]. The recognition of occupational asthma may thus be difficult, especially when, as in the present case, the job description is misleading: as a roofer is expected to be mostly exposed to wood dusts, a careful description of a usual day at work was necessary.…”

“…The mechanism responsible for asthma is not known. Our patient had a negative patch test to chromium, but positivity had been previously reported [4]. Anyway, contact dermatitis is not an IGE-mediated type of allergy, but rather a 'cellular' allergy [1].…”

“…To date, only few cases of occupational asthma due to chromium have been documented [2][3][4]. Workers involved in several activities, including welding and building, are at risk of exposure to chromium salts [5].…”

Occupational asthma due to chromium and nickel salts

“…Although there are several occupations in which there is exposure to chromium and nickel salts, few cases of documented work-related asthma caused by these metallic salts have been described. Occupational asthma due to chromium has been reported among workers in the electroplating industry (Bright et al 1997;Olaguibel and Basomba 1989;Park et al 1994;Sastre et al 2001), stainless steel welders (Keskinen et al 1980), tanners (De Raeve et al 1998), and concrete or construction workers (Cockcroft et al 1977;Novey et al 1983). There have also been some reports of occupational asthma due to nickel in metal plating (De Raeve et al 1998, Olaguibel andBasomba 1989).…”

“…Since then, there have been several reports (e.g., Bright et al 1997;Olaguibel and Basomba 1989;Park et al 1994;Sastre et al 2001) demonstrating that bronchoconstriction can be experimentally induced by aerosol inhalation of chromium and nickel salts. Although there are several occupations in which there is exposure to chromium and nickel salts, few cases of documented work-related asthma caused by these metallic salts have been described.…”