Asthma caused by chromium salts


Occupations
  • Bricklayer
  • Building industry
  • Ceramic industry
  • Chrome plater
  • Metallurgist
  • Painter
  • Photographic processing
  • Tanner
  • Textile industry
  • Welder
Agents
Chromic acid, Chromium oxide, Hexavalent chromium, Potassium dichromate, Zinc chromate.
 
Incidence
Incidence: asthma is much less common than dermatitis and nasal complaints caused by chromates, amongst these workers.
 
Sensitization can take from several days to several years to develop.
Atopic predisposition has yet to be established.
 
IgE-dependent mechanism, however skin tests with unstable conjugates are often negative.
 
Chromium salts are very caustic. Subjects suffering from alveolitis caused by chromium's toxicity have been noted as well as RADS (Reactive airways dysfunction syndrome or asthma caused by irritants – Brooks syndrome).
 
Conditions
Chrome plating, polishing, chrome yellow paint, aluminium production, stainless steel welding and production of chromium metal. The cement used by bricklayers can cause asthma.
 
Symptoms
Asthma attacks at and/or after work with cough and
tight chest, sometimes severe and developing into permanent dyspenoea. Hemorrhagic rhinitis and nasal pain. Eruption of facial oedema and urticaria, contact eczema. ENT cancers have also been reported.
 
Diagnostic methods
Skin prick test: 0.1, 1, 5, 10 mg/ml Cr2(SO4)3.
 
Immunological dosage: RAST with Cr2(SO4)3 coupled to HSA.
 
Bronchial provocation tests (in hospital) are sometimes performed with potassium bichromate. The bichromate is used at 0.3% over 60 seconds. In addition to the recognized risks associated with BPT, problems with arterial tension may also occur.
 

References

  1. INRS 2000 DMT 82 TR 25 page 153 Rosenberg N.
  2. Thorax 1997,52:28 - Bright P. et al.
  3. Am. J. Ind. Med 1998,34:169 - De Raeve H. et al.
  4. Fiche All. Resp. Prof. n°14 INRS
  5. Fol. All. Imm. and Clin. 1985,32:21
  6. Clin. All. 1980,10:151
  7. Jap. J. Allergy 1972,21:665
  8. Arch. Mal. Prof. 1989 ;1957,18:284
  9. J. Allergy Clin. Immunol. 1986,77:451
  10. J. Allergy Clin. Immunol. 1983,72:407

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.