Cement chromate allergy

Occupational allergic contact dermatitis to chromates in cement has been reported to persist even upon avoidance of cement. Burrows reported that only 8% of his patients with cement dermatitis had clearance of their dermatitis after a 10- to 13-year follow-up (Burrows 1972). In Sydney, the prognosis from occupational allergic contact dermatitis from chromate was worse than those caused by other occupational allergens only less than 20% of such patients had clearance of their dermatitis over a 2- to 10-year follow-up period (Rosen and Freeman 1993). Another study from Perth, Australia, also reported poor prognosis from cement dermatitis, where 89% of cement workers with chromate allergy had persistent dermatitis when followed up over a period between 6 months and 9 years (Halbert et al. 1992). 

In Denmark, follow-up of patients with chromate allergy after the introduction of ferrous sulphate in Danish cement to reduce hexavalent chromate concentration in cement continued to show poor prognosis. Only 30% of workers who remained on the job had total clearance of their dermatitis (Avnstorp 1989). 

Goh CL, Gan SL (1996) Change in cement manufacturing process, a cause for decline in chromate allergy Contact Dermatitis... 

Cement, of course, is by far the most common and best-recognised cause of chromate allergy. Cement contains varying amounts of chromate for instance, Ellis and Freeman (1986) found water-soluble cement in Australia to vary from less than 1 ppm to 124 ppm, with the majority tested showing less than 10 ppm. Cement, on the addition of water, becomes alkaline and is probably a factor in facilitating sensitization to the chromate in cement. This may be the reason why cases of contact dermatitis due to allergy to chromate... 

Chromate allergy in the cement industry is diminishing throughout the world whether ferrous sulphate is added or not. 

It was demonstrated that iron sulfate added to cement reduced the chromate completely and trivalent chromium was precipitated (Fregert et al. 1979). An amount of 0.35% iron sulfate is enough to reduce 20 pg Cr /g cement. In Denmark, the incidence of chromium allergy among cement workers, after addition of iron sulfate to the cement, has decreased. For details see Chap. 71. 

Construction workers risk occupational contact dermatitis from exposure to irritants, chromate, cobalt, rubber and epoxy. Nickel allergy, however, is not often discussed in relation to construction work (Coenraads et al. 1984). In construction workers it is often found together with allergy to chromate and/or cobalt, and nickel in cement has been proposed as a cause. However, nickel in cement exists mainly as insoluble salts (Wahlberg et al. 1977 Goh et al. 1986). 

Photosensitivity has been suggested as a factor in chrome allergy, if only because many patients have their dermatitis on the exposed areas. This might be expected in a substance that is a potential airborne allergen (El Sayed and Bazex 1994)- Goh (1986a), however, found little chromate in the atmosphere of a Singapore cement construction factory and a busy city center. 

Contact allergy to cobalt is common and is often associated with concomitant allergy to nickel or chromate (Chaps. 66, 67). This is interpreted as simultaneous sensitization due to combined exposure, because nickel is often contaminated with cobalt, and cement contains chromium as well as cobalt. Solitary cobalt allergy is seen mainly among hard-metal workers (Chap. 68) and in the glass and pottery industries. 

Fregert S, Rorsman H (1966) Allergy to chromium, nickel and cobalt. Acta Derm Venereol 46 114-118 Fregert S, Gruvberger B, Sandahl E (1979) Reduction of chromate in cement by iron sulfate. Contact Dermatitis 5 39-42 Fullerton A, Gammelgaard B, Avnstorp C, Menne T (1993) Chromium content in human skin after in vitro application of ordinary cement and ferrous-sulfate-reduced cement. Contact Dermatitis 29 133-137... 

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