THE PREVALENCE OF CHROMIUM ALLERGY IN THE UNITED-STATES AND ITS IMPLICATIONS FOR SETTING SOIL CLEANUP - A COST-EFFECTIVENESS CASE-STUDY

Hexavalent chromium [Cr(VI)] elicits allergic contact dermatitis (ACD) among previously sensitized individuals, and some regulatory agencies have suggested the need for Cr(VI) soil standards that are protective of this health end point. To assess the cost effectiveness of impleme nting ACD-based standards, it is necessary to understand the prevalenc e of Cr(VI) sensitivity in the general population. More than 30 publis hed studies from 1950 to 1997 were reviewed to determine the prevalenc e of Cr(VI) sensitivity. No random survey of the general United States (U.S.) population has been performed to date, but the prevalence of C r(VI) sensitization among North American clinical cohorts (e.g., patie nts of dermatological clinics) was reported to be 1% in 1996. The prev alence of Cr(VI) sensitivity among the general U.S, population is esti mated to be 0.08%. This estimate was calculated by dividing the curren t U.S. clinical prevalence estimate (1%) by the ratio of Cr(VI) sensit ization in clinical vs general populations in The Netherlands (12). A retrospective cost/benefit analysis for sites in Jersey City, New Jers ey, suggests that remediation of soils to protect against elicitation of ACD in sensitized individuals is not a cost-effective use of public health resources. (C) 1998 Academic Press.