Occupational Asthma Reference

Sauni R, Linna A, Oksa P, Nordman H, Tuppurainen M, Uitti J, Cobalt asthma — a case series from a cobalt plant, Occup Med, 2010;60:301-306,
(Plain text: Sauni R, Linna A, Oksa P, Nordman H, Tuppurainen M, Uitti J, Cobalt asthma - a case series from a cobalt plant, Occup Med)

Keywords: Cobalt, refiner, Finland, epidemiology, longitudinal study, occupational asthma, skin prick test, methacholine reactivity, NSBR, challenge, air measurements, hydrogen fluoride, dose response, follow-up, key

Known Authors

Henrik Nordman, Finnsh Institute of Occupational Health Henrik Nordman

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Abstract

Background
Cobalt has been shown to induce mainly asthma, allergic contact dermatitis and hard metal disease. The data on cobalt asthma are mainly based on case reports.

Aims
To characterize all the cases of occupational cobalt asthma encountered in a cobalt plant at the time of diagnosis and 6 months later. We also evaluated the incidence of cobalt asthma in different departments on the basis of data on occupational exposures.

Methods
We identified cases of cobalt asthma confirmed with specific bronchial challenge tests in the Kokkola cobalt plant in Finland where exposure levels have been regularly monitored.

Results
Between 1967 and 2003, a total of 22 cases of cobalt asthma were diagnosed in the cobalt plant. On challenge tests, mostly late or dual asthmatic reactions were observed. The incidence of cobalt asthma was the highest in the departments with the highest cobalt exposure levels. All cases of cobalt asthma were encountered in departments where irritant gases were present in the ambient air in addition to cobalt. At the time of the follow-up examination 6 months later, non-specific hyperreactivity had mostly remained at the same level or increased.

Conclusions
The incidence of cobalt asthma correlated with the exposure levels of cobalt in corresponding departments. An irritating effect of gaseous compounds may enhance the risk of cobalt asthma and even the smallest amounts of cobalt may be harmful to susceptible workers. Symptoms of asthma may continue despite the fact that occupational exposure to cobalt has ceased.

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Associated Questions

Registered users of this website have associated this reference with the following questions. This association is not a part of the BOHRF occupational asthma guidelines.

Is exposure to agents in the workplace a risk factor for developing occupational asthma?
burgeps Longitudinal study of a cobalt refinery with cases defined by specific challenge. Increased incidence in high exposure areas, also odd ed effect of hydrogen fluoride and irritant gasses
What are the sensitivity and the specificity of a normal measurement of non-specific reactivity while at work in the diagnosis of occupational asthma?
burgeps Study of cobalt asthma in a refinery with cases defined by specific inhaltion challenge to cobalt dust. Normal NSBR in 5/22 (23%) at diagnosis
What are the sensitivity and the specificity of specific IgE testing in the diagnosis of validated cases of occupational asthma?
burgeps skin prick tests to cobalt chloride 1mg/ml negative in all challenge positive cases

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