Experimental skin deposition of chromium on the hands following handling of samples of leather and metal

Patch Testing With Nickel, Cobalt, and Chromium in Patients With Suspected Allergic Contact Dermatitis

Background: Allergic contact dermatitis is frequently caused by metals, including multiple metals simultaneously. Objectives: To assess characteristics and associations of positive and clinically relevant patch test (PT) reactions with solitary and concurrent metal sensitization. Methods: A retrospective analysis of PT results for nickel, cobalt, and/or chromium from the North American Contact Dermatitis Group between 2001 and 2018 (n = 43,522). Results: 18.0% had a positive/allergic reaction to nickel sulfate hexahydrate, 7.3% to cobalt chloride hexahydrate, and 3.0% to potassium dichromate. 87.9% patients had a currently relevant reaction to 0, 9.4% to 1, and 2.7% to multiple metals tested. Patients with 1 versus no currently relevant reactions to metal were more likely to have a primary dermatitis site of trunk, feet, and ears; patients with currently relevant reactions to multiple metals had more dermatitis affecting the trunk and ears. Metal sources varied by co-reacting metal, especially for patients with cobalt and chromium allergy. Jewelry was the most commonly identified source of nickel and cobalt for both solitary and concurrent metal allergy. Conclusions: Sensitization to multiple metals occurred in 6% of patients. Allergen sources varied between patients with sensitivity to 1 metal versus those who had concurrent sensitivity to cobalt and/or chromium.

Identifying dust as the dominant source of exposure to heavy metals for residents around battery factories in the Battery Industrial Capital of China

Heavy metals (HMs) are constantly released into the environment during the production and use of batteries. Battery manufacturing has been ongoing for over six decades in the "Battery Industrial Capital" (located in Xinxiang City) of China, but the potential exposure pathways of residents in this region to HMs remain unclear. To clarify the exposure pathways and health risk of human exposure to HMs, hand wipe samples (n=82) and fingernail samples (n=36) were collected from residents (including young children (0-6 years old), children (7-12 years old) and adults (30-60 years old)) living around battery factories. The total concentrations of the target HMs (Zn, Mn, Cu, Pb, Ni, Cr, Cd, Co) in hand wipes ranged from 133 to 8040 μg/m², and those in fingernails ranged from 9.7-566 μg/g. HM levels in the hand wipe and fingernail samples both decreased with age, and higher HM levels were observed for males than females. The HM composition profiles in these two matrices represented a high degree of similarity, with Zn as the predominant element, and thus, oral ingestion and dermal exposure via dust were expected to be the most important HM exposure pathways for residents in this region. The non-carcinogenic risks (HQs) from dermal and oral ingestion exposure to Cd, Cr, and Pb were higher than those of the other five elements for all three populations, and the HQ_derm of Cd for young children was 2.1 (HQ_oral=0.6). Moreover, the hazard index (HI) values of ∑₈HMs for young children (HI_total=5.2, HI_oral=2.0, HI_dermal=3.2) and children (HI_total=1.6, HI_oral=1.3, HI_dermal=0.3) exceeded the safe threshold (1.0). Therefore, young children and children should be prioritized for protection from HM pollution, and more attention should be paid to young children's dermal exposure to Cd in this region.

Occupational exposure to nickel, cobalt, and chromium in the Lithuanian hard metal industry

BACKGROUND

Metalworkers are said to have heavy exposure to metals, but the amount of released metal ions from alloys and deposition on the hands is unknown.

OBJECTIVE

To analyze nickel, cobalt, and chromium in vitro release to the artificial sweat from nails and wire made of different alloys, and to test metal deposition on the fingers of metalworkers.

MATERIAL AND METHODS

Six different samples of nails and wire were kept in artificial sweat for 24 hours and one week, respectively. The metal release was determined by atomic absorption spectrometry (AAS). Eighty-eight consecutive metal plant workers immersed their index fingers and thumbs in separate laboratory tubes filled with deionized water for 2 minutes. The sample analysis for metals was carried out with an inductively coupled plasma mass spectrometer (ICP-MS).

RESULTS

The average released concentration of Ni was 0.0012 μg/cm² , for Co it was 0.0007 μg/cm² , and for Cr 0.0037 μg/cm² after 24 hours and 0.0135, 0.0029, and 0.0042 μg/cm² , respectively, after 1 week. There was a statistically significant increase in released concentration of Ni during one week: 0.0012 μg/cm² vs 0.0135 μg/cm² (P = .04). Medians of the detected Co amount on fingers reflected a statistically significant difference between workplaces: 0.004 μg/cm² for metalworkers vs 0.001 μg/cm² for office staff (P = .04).

CONCLUSION

Nickel (Ni), cobalt (Co), and chromium (Cr) can be released in different concentrations from nails and wire. Detected Ni and Cr levels can elicit dermatitis in already sensitized patients. Co can be extracted from alloys even if not mentioned on material safety data sheets. The finger immersion technique was used for cobalt and chromium detection on fingers for the first time.

Contact Allergy: A Review of Current Problems from a Clinical Perspective

Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline^® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.

Chromium(III) release from chromium-tanned leather elicits allergic contact dermatitis: a use test study

Background

Chromium (Cr) is a common skin sensitizer. The use of Cr(VI) in leather is restricted in the EU, but that of Cr(III) is not.

Objectives

To assess whether prolonged exposure to Cr‐tanned leather with mainly Cr(III) release may elicit allergic contact dermatitis in Cr‐allergic individuals.

Method

Ten Cr‐allergic subjects and 22 controls were patch tested with serial dilutions of Cr(III) and Cr(VI), and with leather samples. They then conducted a use test with a Cr‐tanned and a Cr‐free leather bracelet over a period of 3 weeks, for 12 h per day. Cr deposited on the skin from the bracelets was measured in the controls, and the diphenylcarbazide test for Cr(VI) and extraction tests for Cr(III) and Cr(VI) were conducted for the different leathers.

Results

Four of 10 Cr‐allergic subjects developed positive reactions to the Cr‐tanned bracelet within 7–21 days, whereas only 1 of 10 had a positive patch test reaction to this leather. Cr released from the Cr‐tanned leather was most probably entirely Cr(III), with a quantifiable amount being deposited on the skin.

Conclusions

This study strongly suggests that prolonged and repeated exposure to Cr‐tanned leather with mainly Cr(III) release is capable of eliciting allergic contact dermatitis in Cr‐allergic individuals.

Survey of Occupational Allergic Contact Dermatitis and Patch Test among Clothing Employees in Beijing

Occupational population-based epidemiological data relating to occupational contact allergies in the Chinese clothing industry are limited. To investigate the prevalence of occupational allergic contact dermatitis (OACD) and to identify the causative allergens among clothing employees in China, a cross-sectional study was conducted in 529 clothing employees at 12 clothing factories in Beijing. All employees were subjected to an interview using self-administered questionnaire and skin examination, and those who were diagnosed with occupational contact dermatitis (OCD) were patch tested. In the present survey, we found that the overall 1-year prevalence of OACD among the clothing employees was 8.5%. The 1-year prevalence of OACD among workers (10.8%) was significantly higher than that among managers (3.2%). The lesions were primarily on the hands and wrists in workers, but the face and neck in managers. The major allergens were nickel sulfate and cobalt dichloride in workers and colophony and p-tert-butylphenol formaldehyde resin in managers. In conclusion, workers are at a higher risk of OACD compared with managers in the Chinese clothing industry. In addition to hand dermatitis in workers, airborne contact dermatitis on the face and neck should be also addressed in managers.

Experimental patch testing with chromium-coated materials

BACKGROUND

Chromium coatings on metal alloys can be decorative, and prevent corrosion and metal ion release. We recently showed that handling of a chromium-containing disc resulted in chromium deposition on the skin.

OBJECTIVES

To examine patch test reactivity to chromium-coated discs.

METHODS

We included 15 patients: 10 chromium-allergic patients, and 5 patients without chromium allergy. All were patch tested with potassium dichromate, cobalt chloride, nickel sulfate, and nine different metallic discs. The chromium-allergic patients were also patch tested with serial dilutions of potassium dichromate.

RESULTS

Positive/weaker reactions were observed to disc B (1 of 10), disc C (1 of 10), and disc D, disc E, and disc I (4 of 10 each). As no controls reacted to any of the discs, the weak reactions indicate allergic reactions. Positive patch test reactions to 1770 ppm chromium(VI) in the serial dilutions of potassium dichromate were observed in 7 of 10 patients. When the case group was narrowed down to include only the patients with a current positive patch test reaction to potassium dichromate, elicitation of dermatitis by both chromium(III) and chromium(VI) discs was observed in 4 of 7 of patients.

CONCLUSIONS

Many of the patients reacted to both chromium(III) and chromium(VI) surfaces. Our results indicate that both chromium(VI) and chromium(III) pose a risk to chromium-allergic patients.