Occupational asthma induced by chromium salts.

Five patients with asthma related to exposure to chromium salts, in their work area, are presented. All of them were non atopics and presented a history of contact dermatitis, with positive patch tests to potassium dichromate, previous to the onset of bronchial asthma. Solutions of K2Cr2O5 were prepared in normal saline at 0.01, 0.1 and 1 mg/ml for skin prick tests (SPT) and bronchial provocation tests (BPT). Immediate cutaneous reaction by SPT was negative for controls and patients. BPT were performed by the tidal breathing method, with positive results in all subjects. A negative response was recorded in 4 control unexposed asthmatics. An attempt to inhibit BPT with sodium cromoglycate was unsuccessful. The diversity of reactions (immediate, dual and late) registered in BPT, support that bronchial reactivity can be induced specifically by inhalation of chromium salts. The data of follow-up indicates a good prognosis, provided that patients remain out of exposure. The lack of facts suggesting an IgE-mediated reaction puts forward for consideration other pathophysiologic mechanisms.