Occupational Asthma Reference

Walters GI, Moore VC, Robertson AS, Burge CBSG, Vellore A-D, Burge PS, An outbreak of occupational asthma due to chromium and cobalt, Occup Med, 2012;62:533-540,

Keywords: cobalt, metal working fluid, MWF,challenge, SIC, occupational asthma, cross section, urine, epidemiology, rhinitis, FeNO, FEV1, PEF, chromium

Known Authors

Sherwood Burge, Oasys Sherwood Burge

Vicky Moore, Oasys Vicky Moore

Cedd Burge, Oasys Cedd Burge

Alastair Robertson, Selly Oak Hospital Alastair Robertson

Arun Dev Vellore, Oasys Arun Dev Vellore

Gareth Walters, Heartlands Gareth Walters

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Abstract

Background
Five metal turners employed by an aerospace manufacturer presented to the Birmingham Chest Clinic occupational lung disease unit. Four cases of occupational asthma (OA) due to chromium salt (3) and cobalt (1) were diagnosed by serial peak-expiratory flow measurements and specific inhalation challenge testing.

Aims
To measure the extent of the outbreak and to provide epidemiological data to ascertain the aetiology.

Methods
Participants answered a detailed, self-administered questionnaire, designed to detect occupational lung disease. Urine chromium and cobalt excretion, spirometry and exhaled nitric oxide measurements were taken. Those with possible, probable or definite non-OA or OA, after questionnaire, were invited to undertake two-hourly peak flow measurements and received specialist follow-up.

Results
A total of 62 workers (95% of workforce) participated. Sixty-one per cent of employees were working in higher metalworking fluid (MWF) exposure areas. Ninety per cent of workers had urinary chromium excretion indicating occupational exposure. Sixty-six per cent of workers reported active respiratory symptoms, although there were no significant differences between exposure groups. Two further workers with probable OA were identified and had significantly higher urinary chromium and cobalt concentration than asymptomatic controls. Eighteen cases of occupational rhinitis (OR) were identified, with significantly raised urinary chromium concentration compared with asymptomatic controls.

Conclusions
Chromium salt and cobalt can be responsible for OA and OR in workers exposed to MWF aerosols. Onset of symptoms in those with positive specific challenges followed change in MWF brand. Workers with OA had increased urinary concentrations of chromium and cobalt, and those with OR had increased urinary concentrations of chromium.

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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.

Which agents cause occupational asthma and which workers are at risk?
burgeps Chrome occupational asthma can occur from machining stainless steel alloys, the chrome being present in airosolised metal-working fluid. Cpbalt can cause similar problems

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