Occupational asthma caused by chromium.

We report four cases of occupational asthma caused by chromium salts, three of whom showed dual and one isolated early asthmatic responses on specific chromium bronchoprovocation test (BPT). All of them were ex-smokers. Two showed positive skin-prick tests to 10 mg/ml of Cr2(SO4)3, but negative results on patch testing. The remaining two showed positive results on patch testing with Cr2(SO4)3. Three had airway hyperresponsiveness to methacholine on initial examination. Although initial methacholine airway challenge testing showed a negative result in the remaining patient, airway hyperresponsiveness developed transiently 24 h after an isolated immediate asthmatic reaction induced by chromium. Three patients were reassessed after complete avoidance of chromium. Two subjects showed marked improvement of their symptoms with significant increases of PC20 methacholine. We conclude that chromium induces occupational asthma in exposed workers. Further investigations are needed to clarify the pathogenetic mechanism.