Dermatitis from hexavalent chromate in the accelerator of an epoxy sealant (PR1422) used in the aircraft industry

4 aircraft construction workers developed allergic contact dermatitis of the hands and forearms. The allergen was hexavalent chromate in the accelerating solution of an epoxy-based sealant (PR1422). Although chromate dermatitis from an epoxy resin has been described, epoxy system accelerators are a hitherto unrecognized source of occupational chromate dermatitis.

Cement dermatitis in underground workers during construction of the Channel Tunnel

The construction of the Channel Tunnel is one of the largest civil engineering projects ever undertaken. The British drive employed 5900 underground workers, and a number developed dermatitis during 1990/1991. As a result, the Translink Joint Venture (TLJV) Medical Centre set up a surveillance programme aiming to monitor and investigate the men working closely with cement as well as other groups of workers with skin problems. Men attended the Medical Centre voluntarily and were assessed, including history, examination and patch tests to a series of 15 test substances (from the European standard series) where indicated. A programme of education about the hazards of working with cement was instituted, including leaflets, videos, local newspaper articles and personal explanation by the Medical Centre staff. Between January 1990 and January 1992, 1138 men were seen at the Medical Centre regarding their skin and 332 were diagnosed as having occupational dermatitis, past or present. Patch tests were performed on 180 men from all trades. Of the 800 grouters, 466 (58 per cent) were assessed and 111 had a history of occupational dermatitis at some time. Many gave a history of a single episode of dermatitis during a particularly hot and wet phase of tunnelling. Patch tests performed on 86 grouters showed allergy to chromate in 56 (65 per cent). Of the 466 grouters assessed, 17 per cent had positive patch tests to chromate but men with no skin problems past or present were not patch tested. Cobalt allergy was often found with chromate allergy (50 out of 56).(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchial carcinoma mortality in the German chromate-producing industry: the effects of process modification

This study updates a 1982 report on mortality at two German chromate-producing factories. The main objective of the study was to establish whether the change-over to a production process using lime-free conversion of chromite ore, thus eliminating the formation of calcium chromate, had resulted in a distinct reduction in bronchial carcinoma mortality among workers exposed for the first time after the change-over (completed in 1958 in Leverkusen and 1964 in Uerdingen). A total of 1417 workers with at least 1 year of exposure were enrolled in the study. The observation period ended on 31 December 1988. The expected number of deaths was calculated using population statistics for North Rhine-Westphalia. The risk was determined in the form of a standardised mortality ratio (SMR), i.e. the ratio of observed deaths to expected deaths. In the group of 739 workers exposed before the process change-over was completed, 432 died during the observation period, 66 of them from bronchial carcinoma. This significant excess produced an SMR of 2.27 (95% confidence interval: 1.78-2.85). Where the cause of death was unknown, cases were allocated to a cause of death on the basis of the percentage occurrence of various causes of death in the specific subcohort. The cohort of 678 workers first exposed after the process modification had been completed had a slightly increased SMR for lung cancer of 1.26 (95% confidence interval: 0.58-2.38) based on nine cases.(ABSTRACT TRUNCATED AT 250 WORDS)

High-risk notification of chromate and bichromate production workers

A high-risk notification program is in progress for 4,862 former chromate and bichromate production workers. A previous mortality study of this cohort found a 29-fold increase in mortality for respiratory cancer. The increase was greater in black than white workers (80-fold vs. 15-fold). The cohort was compiled from Social Security Administration records. Notification was performed mainly using addresses on file with the Internal Revenue Service. At this time, 68% of the cohort has either been determined to have died or has been contacted. A description of the various steps of notification is included. This project has demonstrated that it is possible to perform high-risk notification in an economical manner even in the absence of employer personnel records or current addresses. The methodology used in this project is generalizable to other cohorts.

Prognosis of occupational chromate dermatitis

To elucidate further the natural history and prognosis of occupational chromate dermatitis, 120 affected patients, diagnosed between 1980 and 1989, were reviewed. The incidence of chromate dermatitis in Western Australia appeared to remain unchanged over the decade. 65% of patients were construction workers with cement-induced chromate dermatitis. Workers at greatest risk of sensitization were those mixing bagged cement at the work site. The median age at onset of symptoms was 34 years, with 48% having been exposed to chromate for 5 years or less. Only 37% presented to the dermatologist within 12 months of developing symptoms. 76% of patients had ongoing dermatitis at the time of review. Although 48% of the study population had completely changed their occupation to avoid chromate exposure, symptoms persisted in 69%. A delayed diagnosis of chromate sensitivity was noted to be a predictor of chronicity. In view of the potential chronicity of chromate dermatitis and its associated social and occupational impairment, we recommend the addition of ferrous sulphate while mixing bagged cement at the work site. This simple technique targets the workers at greatest risk of becoming sensitized.

Lead chromate exposures and elevated blood lead levels in workers in the plastics pigmenting industry--Texas, 1990

In June 1990, the Dallas (Texas) County Health Department received a physician's report of an elevated blood lead level (BLL) (52 micrograms/dL) for an employee of a company that formulates color concentrates for the plastics industry. The physician had been evaluating the employee for severe headaches of uncertain etiology; however, he requested a BLL analysis when the employee's occupational history suggested possible lead exposure.

In vivo nephrotoxicity induced in mice by chromium(VI). Involvement of glutathione and chromium(V)

The role of glutathione (GSH) and chromium (V) in chromium (VI)-induced nephrotoxicity in mice was investigated at 24 h after K2Cr(VI)2O7 ip injection. Nephrotoxicity was assessed by measurements of relative kidney weight and serum urea nitrogen. Cr(VI) nephrotoxicity was accompanied by decreased renal GSH and glutathione reductase (GSSG-R) levels. Pretreatment with buthionine sulfoximine, an inhibitor of GSH biosynthesis, enhanced Cr(VI)-induced nephrotoxicity, and remarkably diminished kidney GSH and GSSG-R levels. In contrast, pretreatment with glutathione methyl ester, a GSH-supplying agent, prevented Cr(VI) from exerting a harmful effect on mouse kidney and restored kidney GSH level. Administration of a Cr(V) compound, K3Cr(V)O8, induced much higher toxicity in mouse kidney than Cr(VI), but it failed to diminish renal GSH level. Another Cr(V) compound, Cr(V)-GSH complex, and Cr(III) nitrate did not cause a nephrotoxic effect in mice. The mechanism of Cr(VI)-induced nephrotoxicity was explained using GSH and Cr(V).

Risk factors for cement eczema

Risk factors for cement eczema were studied among workers employed in the Danish construction industry. 2 cohorts exposed to cement containing different concentrations of water-soluble chromate were examined. A statistically significant decrease in the number of workers with allergic cement eczema was found in the cohort exposed to cement with the lower water-soluble chromate concentration. Allergic cement eczema was found to have a greater extent of involvement than irritant cement eczema. A 3rd cohort was followed to evaluate individual risk factors. The degree of exposure to wet cement seems to have a certain, though not statistically significant, effect on the risk of developing irritant cement eczema. Individual preventive measures, such as the use of gloves and creams, did not seem to reduce the development of irritant cement eczema.

Chromium and disease: review of epidemiologic studies with particular reference to etiologic information provided by measures of exposure

Dozens of epidemiologic studies have been conducted since the late 1940s in an attempt to elucidate the relationship between exposure to chromium compounds and increased rates of certain cancers observed in several industries. The relationship between employment in industries producing chromium compounds from chromite ore and lung cancer has been well established in numerous studies. The relationship between exposure to certain chromium-based pigments and chromic acid and lung cancer, although not as strong, is fairly well accepted. The data concerning emissions from stainless-steel manufacturing and disease are contradictory. Although individual studies have indicated excesses of gastrointestinal and occasionally other cancers in these industries, results are not consistent and not universally accepted. There is general agreement that chromite ore does not have an associated risk of cancer. Although the chromium compound (or compounds) responsible for disease have yet to be identified, there is general agreement that hexavalent species are responsible for these diseases and that the trivalent species are not. Hypotheses about the carcinogenicity of specific chromium compounds generally relate to their solubility in body fluids. These hypotheses, however, have generally been produced as a result of toxicologic, not epidemiologic, investigation. Well-designed epidemiologic studies incorporating detailed assessments of worker exposures have the potential to help elucidate causality, identify specific carcinogenic compounds, and quantify risk in humans, eliminating the need to extrapolate from animal data. Although the need for exposure data crucial to this effort was identified in the earliest epidemiologic studies of chromium, such studies have not been conducted. As a result, little more is known today about the relationship between this chemical and disease in humans than was known 40 years ago.

Mortality from respiratory cancer and other causes in United Kingdom chromate production workers

This report updates a 1981 study of mortality at three United Kingdom chromate producing factories, and pays special attention to workers engaged after major plant and process changes were completed during 1958-60. The study covers 2298 payroll workers in post on 1 January 1950 or entering employment up to 30 June 1976 and remaining at least one year, with mortality observed up to 31 December 1988. Expected numbers of deaths were calculated from national death rates adjusted for social class and area differences. At the two largest factories 1422 men starting work before the process changes showed a highly significant excess of deaths from lung cancer (observed deaths/adjusted expected deaths (obs/expA) 175/88.97, adjusted standardised mortality ratio (SMRA) 197). They also had a significant excess of deaths from nasal cancer (obs/expA 4/0.26, SMRA 1538); the four affected men all had over 20 years of employment. Six hundred and seventy seven men starting work after the completion of process changes showed no excess of lung cancer deaths (obs/expA 14/13.7, SMRA 102, 95% confidence interval (95% CI) 56-171), but the possibility of the risk persisting at a reduced level cannot be excluded. The risk among earlier entrants affected men with two or more years of employment and was highest among those working for 10 years or longer (SMRA 225). The relative risk was already raised 5-14 years after first employment; it was highest in the 25-40 year period, but was still raised 50 years after first exposure. The risk showed most clearly at young ages, with a SMRA of 355 for ages under 50 (obs/expA 21/5.91). The excess was greater among men in jobs with high exposure to chromates (obs/expA 151/61.73, SMRA 245) than among men in less exposed jobs (obs/expA 21/19.57, SMRA 107). Less evidence of a lung cancer excess was found among 199 men employed at a third small factory (obs/expA 12/9.91, SMRA 121). No risk was apparent in further groups of 214 salaried works staff (obs/expA 1/2.53), or 95 workers at an adjacent fertiliser plant (obs/expA 3/3.95). No significant excesses of deaths from cancers of other sites were found.

Chromated steel and contact allergy. Recommendation concerning a "threshold limit value" for the release of hexavalent chromium

Steel surfaces can be treated with zinc and chromates to prevent the steel from rusting. Cases of allergic contact dermatitis due to the release of hexavalent chromium (Cr64) from chromated surfaces have been reported. The main purpose of the present study was to develop a simple procedure for the determination of leachable Cr64 that could be used in industrial applications to check the quality of chromated products and to establish a "threshold limit value" for such products. Occlusive tests were performed in chromate-sensitive patients using chromated discs, and discs representing a release of 0.6 microgram/cm2 or more elicited positive results in all patients tested. It was proposed that the mean release of Cr64 from chromated parts should not exceed 0.3 microgram/cm2. Approximately 1 out of 4 yellow chromated parts, collected from a chromating plant and a car assembly plant, gave values above this limit. Today, several tests are performed to evaluate the technical quality of the chromate layers. It is suggested that the present method should be added to the test program in order to reduce the risk of causing chromate allergy.

The micronucleus assay in human exfoliated cells of the nose and mouth: application to occupational exposures to chromic acid and ethylene oxide

We have applied the micronucleus (MN) assay to exfoliated cells of buccal and nasal cavities to monitor the genotoxic risk in a group of workers exposed to chromic acid and in another group exposed to ethylene oxide (EtO). The first group comprised 16 subjects working in a 'hard' type chrome-plating factory showing increased chromium absorption and chromium-induced rhinopathy. The second group comprised 9 subjects working in a sterilization unit, exposed to EtO concentrations lower than 0.38 ppm as timed weighted average (TWA) for a working shift; 3 of them were involved in a acute exposure too. The frequency of MN in buccal mucosa was within the norm for exposure both to chromium and to EtO. The MN frequency in nasal mucosa was not altered in chromium platers, whereas a significant increase (p less than 0.01) in MN was found in 2 out of 3 subjects involved in the accidental EtO leakage and a non-significant increase in MN was found in the group chronically exposed to EtO.

Lung cancer in chromate workers: high-risk group for multiple lung cancer

We diagnosed eight (8.9%) lung cancer patients in 90 workers exposed to chromate compounds. The duration of exposure ranged from 8 to 31 years, with a mean value of 18 +/- 8 years. The histological classification was squamous-cell carcinoma in seven patients and adenocarcinoma in one patient. The site of origin of the primary tumors was located peripherally in two (25%) and centrally in six (75%). All but one of these patients underwent surgery. In three (37.5%) of these patients, lung cancer foci were detected during the postoperative follow-up by sputum cytology and bronchoscopy. Two of these three patients had multicentric cancer foci: double primary early squamous-cell carcinoma in one and early squamous-cell carcinoma + small-cell lung cancer in the other. In a high-risk group such as chromate workers, we should emphasize early detection of lung cancer by serial sputum cytology, chest x-rays, and bronchoscopy. Lung cancer patients with chromate exposure should be treated with due regard to the possibility of synchronous or metachronous cancer.

Cancer mortality among workers in the Tuscan tanning industry

The mortality of 2926 male workers at the tanneries in the "leather area" of Tuscany was examined from 1950 to 1983 comparing it with the national mortality. Cancer mortality was of particular concern because of the many chemicals known to be definite or suspected carcinogens used in the tanning cycle, in particular chromate pigments, benzidine based dyes, formaldehyde, and organic solvents. There was no excess of deaths for cancers of all sites but slight increases in deaths from cancer of the lung (SMR = 131, CI 95% = 88-182), bladder (SMR = 150, CI 95% = 48-349), kidney (SMR = 323, CI 95% = 86-827), pancreas (SMR = 146, CI 95% = 39-373), and leukaemias (SMR = 164, CI 95% = 53-382) occurred. Two cases of soft tissue sarcomas were observed versus 0.09 expected (SMR = 2178, CI 95% = 250-8023).