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Dermal and respiratory sensitization to chromate in a cement floorer
Author(s) -
De Raeve Hilde,
Vandecasteele Carlo,
Demedts Maurits,
Nemery Benoit
Publication year - 1998
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/(sici)1097-0274(199808)34:2<169::aid-ajim10>3.0.co;2-t
Subject(s) - medicine , bronchoalveolar lavage , potassium dichromate , provocation test , respiratory system , allergic contact dermatitis , occupational asthma , asthma , anesthesia , allergy , dermatology , lung , immunology , pathology , inorganic chemistry , chemistry , alternative medicine
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 (K 2 Cr 2 O 7 ) (0.3% nebulized for a total of 60 minutes) led to pronounced and sustained decreases in forced expiratory volume in 1 second (FEV 1 ) and forced vital capacity, accompanied by pruritus, a decrease in arterial PO 2 , a slight rise in temperature, and peripheral blood leukocytosis. (This concentration of K 2 Cr 2 O 7 is not recommended for BPT). Bronchoalveolar lavage performed 2 days later showed 18% eosinophils. Two years later, a BPT with a lower dose of K 2 Cr 2 O 7 (0.01% for a total of 31 min) led to an “early late” reaction (FEV 1 dropped by 29% compared with the initial FEV 1 value), accompanied by pruritus. A BPT with dry cement, containing 12 ppm hexavalent chromium, was borderline (FEV 1 dropped by 13%), and a similar result (FEV 1 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.