Chromium cement workers

Repeated and prolonged skin contact with cement can result in dermatitis of the hands, forearms, and feet this is a primary irritant dermatitis and may be complicated in some instances by a secondary contact sensitivity to hexavalent chromium. In a study of 95 cement workers, 15 had a mild dermatitis of the hands, which consisted of xerosis with erythema and mild scaling of 20 workers who were patch tested with 0.25% potassium dichromate, one person had a mild reaction and the others were negative. 

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 are officially unskilled workers. Unskilled chromium-sensitive workers are sometimes given the opportunity to change to a job within the factory where they will have no contact with wet cement (Coenraads 1983 Avnstorp 1989a). This initiative enables them to remain employed. 

The effect of decreasing the concentration of water-soluble chromium in cement from about 10 to below 2 ppm on the incidences of chromium-induced dermatitis was examined among construction workers in Finland (Roto et al. 1996). After 1987, when the decrease occurred, allergic dermatitis caused by chromium in the industry was reduced by 33% from previous levels, whereas irritant contact dermatitis remained unchanged. 

Roto P, Sainio H, Reunala T, et al. 1996. Addition of ferrous sulfate to cement and risk of chromium dermatitis among construction workers. Contact Dermatitis 34 43-50. 

Allergic contact dermatitis has apparently been most commonly due to occupational exposure of building workers to a form of cement containing a water-soluble form of chromium (SEDA-20,208) (15). Such reactions to medical exposure have not been described but could in principle occur. 

The lack of information dissemination within industry sectors is another barrier to the adoption of safer substitutes. A recent study details how cement manufacturers in Scandinavia solved the problem of skin contact with cement containing hexava-lent chromium back in the 1980s, but the information was not diffused to other European manufacturers, resulting in needless worker exposure (UBA, 2003). 

Contact dermatitis can occur from exposure to cement and has been considered an occupational hazard for construction workers (Turk and Rietschel 1993 Roto et al. 1996 Zachariae et al. 1996). The problem develops because chromium(VI)-con-taining residues from blast furnaces are incorporated into cement. Some countries add ferrous sulfate to cement to reduce the amount of soluble hexavalent chromate in the product (Turk and Rietschel 1993 Roto etal. 1996 Zachariae etal. 1996). In the UK, chromium and chromates accounted for 8.1% of the allergic contact dermatitis cases (Meyer et al. 2000). In Finland, chromium causes 5.6% of ACD, with tanners, cast concrete workers, leader goods workers, and metal plating/coating workers being at greatest risk (Kanerva et al. 2000). In Denmark, the chromium(VI) content of 35% of... 

Detroit and New Orleans. Frequency of chromium dermatitis was highest in constmc-tion workers using cement. Other occupational exposures associated with chromium sensitivity include chromium plating, tanning of leather, application of anticorrosive agents, and printing. Oral ingestion of chromium com-poimds can sometimes lead to skin reactions in sensitive people. Hexavalent chromium com-poimds are more potent inducers and elicitors of skin sensitivity than trivalent chromium compoimds, probably because Cr+ com-poimds can penetrate die skin more readily than Cr+ compoimds. 

Allergic contact dermatitis due to hexavalent chromium in cement, one of the occupational skin diseases known for a long time, is still the most important contact allergy in construction workers (bricklayers, manufacturers of concrete elements, etc.). However,... 

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. 

At the Finnish Institute of Occupational Health (FIOH) between 1974 and 1997, a total of 85 cases of allergic contact dermatitis were diagnosed in different kinds of painters, lacquerers, parquet installers and paint-factory workers. Synthetic resins caused 68 of the cases, 54 of them in paints, lacquers or raw materials of paints, 5 in floor coverings, 5 in car painters filling cements, 4 in parquet lacquers and one in a glue. The other agents included chromium, formaldehyde, cobalt, colophony, a mixture of isothi-azolinones, and rubber chemicals. No cases of type 1 sensitization to natural rubber latex were found. 

Roto P, Sainio H, Reunala T, Laippala P (1996) Addition of ferrous sulfate to cement and risk of chromium dermatitis among construction workers. Contact Dermatitis 34 43-50 Sinks T, O Malley M, Hartle R, Hales TR, Ruhe R (1991) An epidemic of dermatitis at a large construction site. J Occup Med 33 462-467... 

In Switzerland, construction workers with a declaration of medical inability are not allowed to perform any further work with contact to Cr(VI) or cement. Of a group of construction workers with allergic cement eczema, 72% (63 of 88) healed in the first few years, following strict avoidance of contact with cement and chromium salts (Lips et al. 1996). 

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