Asthma caused by nickel


Occupations
  • Ceramic industry
  • Metallurgist
  • Petrochemical industry
  • Welder
Agents
Nickel, Nickel salts.
 
Incidence
Incidence: low, however all subjects who are exposed to nickel and develop asthma symptoms must be investigated because the disease is severe and can develop into chronic bronchopathy.
 
IgE-dependent mechanism.
 
Atopy does not appear to play an important role. A positive nickel patch test has no predictive value to judge the likelihood of developing asthma. Skin tests producing an immediate result are not always reliable and may be dangerous.
 
Conditions
Manufacture of stainless steel, enamelling of steel, production of fats, edible oils and batteries.
 
Symptoms
Cough and breathing difficulties at first followed by asthma during and after work. Initially, symptoms are associated with work but become permanent. Urticaria and angioneurotic oedema are observed in addition to classic eczema lesions.
 
Diagnostic methods
Skin prick test: 0.1, 1, 10 and 100mg/ml NiSO4 or 0.1mg/ml NiSO4.6H2O.
 
Immunological assay: RAST (special coupling) with NiSO4-HSA.
 
A bronchial provocation test (in hospital) is the most reliable diagnostic tool.

References

  1. Eur. Resp. J. 1990,3:202
  2. Fiche All. Resp. Prof. n°13 INRS
  3. IARC. Sci. Publ.1984,403
  4. Br. Ind. Med. 1984,41:51
  5. J. Allergy. Clin. Immunol. 1983,72:407
  6. J. Allergy. Clin. Immunol. 1982,69:55
  7. Int. Arch. Occup. Environ. Health 1975,36:137
  8. Int. Arch. Occup. Environ. Health 1985 56:11

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