Abstract
BACKGROUND: Exposure to chromium during electroplating is a recognised though poorly characterised cause of occupational asthma. The first series of such patients referred to a specialist occupational lung disease clinic is reported. METHODS: The diagnosis of occupational asthma was made from a history of asthma with rest day improvement and confirmed by specific bronchial provocation testing with potassium dichromate and nickel chloride. RESULTS: Seven workers had been exposed to chrome and nickel fumes from electroplating for eight months to six years before asthma developed. One subject, although exposed for 11 years without symptoms, developed asthma after a single severe exposure during a ventilation failure. This was the only subject who had never smoked. The diagnosis was confirmed by specific bronchial challenges. Two workers had isolated immediate reactions, one a late asthmatic reaction, and four a dual response following exposure to nebulised potassium dichromate at 1-10 mg/ml. Two of the four subjects were also challenged with nebulised nickel chloride at 0.1-10 mg/ml. Two showed isolated late asthmatic reactions, in one at 0.1 mg/ml, where nickel was probably the primary sensitising agent. Four workers carried out two hourly measurements of peak expiratory flow over days at and away from work. All were scored as having occupational asthma using OASYS-2. Breathing zone air monitoring was carried out in 60 workers from four decorative and two hard chrome plating shops from workers with similar jobs to those sensitised. No measurement exceeded the current occupational exposure standard for chromate or nickel, the mean levels of chromate exposure for jobs similar to those of the affected workers were 9-15 micrograms/m3. CONCLUSION: Chrome used in electroplating is a potential cause of occupational asthma. Sensitivity to chrome in electroplaters may occur in situations where exposure levels are likely to be within the current exposure standards. There may be cross reactivity with nickel. Inhalation challenge with nebulised potassium dichromate solution is helpful in making the specific diagnosis where doubt exists.
Full Text
The Full Text of this article is available as a PDF (112.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson S. D., Schoeffel R. E., Finney M. Evaluation of ultrasonically nebulised solutions for provocation testing in patients with asthma. Thorax. 1983 Apr;38(4):284–291. doi: 10.1136/thx.38.4.284. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Block G. T., Yeung M. Asthma induced by nickel. JAMA. 1982 Mar 19;247(11):1600–1602. [PubMed] [Google Scholar]
- Dahl R., Mikkelsen H. B. Asthma bronchiale og kromallergi udløst af svejsning af rustfrit stäl. Ugeskr Laeger. 1982 Mar 15;144(11):801–802. [PubMed] [Google Scholar]
- Dolovich J., Evans S. L., Nieboer E. Occupational asthma from nickel sensitivity: I. Human serum albumin in the antigenic determinant. Br J Ind Med. 1984 Feb;41(1):51–55. doi: 10.1136/oem.41.1.51. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gannon P. F., Newton D. T., Belcher J., Pantin C. F., Burge P. S. Development of OASYS-2: a system for the analysis of serial measurement of peak expiratory flow in workers with suspected occupational asthma. Thorax. 1996 May;51(5):484–489. doi: 10.1136/thx.51.5.484. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Keskinen H., Kalliomäki P. L., Alanko K. Occupational asthma due to stainless steel welding fumes. Clin Allergy. 1980 Mar;10(2):151–159. doi: 10.1111/j.1365-2222.1980.tb02092.x. [DOI] [PubMed] [Google Scholar]
- Magyar P., Dervaderics M., Tóth A. Bronchial challenge with hypertonic KCl solution in the diagnosis of bronchial asthma. A comparison with the challenge performed by inhalation of distilled water. Schweiz Med Wochenschr. 1984 Jun 23;114(25):910–913. [PubMed] [Google Scholar]
- McConnell L. H., Fink J. N., Schlueter D. P., Schmidt M. G., Jr Asthma caused by nickel sensitivity. Ann Intern Med. 1973 Jun;78(6):888–890. doi: 10.7326/0003-4819-78-6-888. [DOI] [PubMed] [Google Scholar]
- Peltonen L., Fräki J. Prevalence of dichromate sensitivity. Contact Dermatitis. 1983 May;9(3):190–194. doi: 10.1111/j.1600-0536.1983.tb04356.x. [DOI] [PubMed] [Google Scholar]
- Shirakawa T., Kusaka Y., Fujimura N., Kato M., Heki S., Morimoto K. Hard metal asthma: cross immunological and respiratory reactivity between cobalt and nickel? Thorax. 1990 Apr;45(4):267–271. doi: 10.1136/thx.45.4.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Venables K. M., Dally M. B., Nunn A. J., Stevens J. F., Stephens R., Farrer N., Hunter J. V., Stewart M., Hughes E. G., Newman Taylor A. J. Smoking and occupational allergy in workers in a platinum refinery. BMJ. 1989 Oct 14;299(6705):939–942. doi: 10.1136/bmj.299.6705.939. [DOI] [PMC free article] [PubMed] [Google Scholar]