DERMAL AND RESPIRATORY SENSITIZATION TO CHROMATE IN A CEMENT FLOORER

Background To report a well-documented case of both allergic contact d ermatitis and occupational asthma due to chromate exposure in a 48-yea r-old floorer Methods and Results A 48-year-old floorer, occupationall y exposed to cement and with a documented chromate contact dermatitis, reported dyspnea and wheezing after work. These conditions were demon strated by self-measured sequential peak expiratory flows. A first bro nchial provocation test (BPT) with potassium dichromate (K2Cr2O7) (0.3 % nebulized for a total of 60 minutes) led to pronounced and sustained decreases in forced expiratory volume in 1 second (FEV1) and forced v ital capacity, accompanied by pruritus, a decrease in arterial Po-2, a slight rise in temperature, and peripheral blood leukocytosis. (This concentration of K2Cr2O7 is not recommended for BPT). Bronchoalveolar lavage performed 2 days later showed 18% eosinophils. Two years later a BPT with a lower dose of K2Cr2O7 (0.01% for a total of 31 min) led t o an ''early late'' reaction (FEV1 dropped by 29% compared with the in itial FEV1 value), accompanied by pruritus. A BPT with dry cement cont aining 12 ppm hexavalent chromium, was borderline (FEV1 dropped by 13% ), and a similar result (FEV1 dropped by 14%) was obtained after smoki ng five cigarettes, laced with 10 mg of cement per cigarette. Conclusi ons This report illustrates that a subject, with allergic contact derm atitis to chromates, may develop a respiratory allergic reaction to ar t airborne source of this metal. The main novelty of our report is tha t the smoking of cigarettes contaminated with cement may have been a s ignificant factor in the causation or elicitation of these reactions. (C) 1998 Wiley-Liss, Inc.