Occupational asthma caused by cobalt chloride in a diamond polisher after cessation of occupational exposure: a case report.
OBJECTIVE
The inspiration of cobalt containing dust leads to various respiratory symptoms, including asthma and interstitial lung disease. Occupational asthma caused by cobalt chloride has been diagnosed in a 35-year-old patient, who worked as a diamond polishing disc former. The patient presented a 2-year history of dyspnea, cough and symptoms of rhinitis.


METHODS
The patient underwent a medical history interview, skin prick tests with common and occupational allergens (cobalt and nickel chloride), and pulmonary function testing both before and after the nasal provocation with 0.05% cobalt chloride. Additionally, the authors analyzed morphological and biochemical changes before and after the specific nasal challenge test. Cell proliferation analysis was also carried out.


RESULTS
Skin prick tests (SPTs) with common environmental allergens were found to be negative, while SPTs with cobalt chloride were positive for all applied solutions. The provocation with cobalt chloride caused a significant increase in the proportion of eosinophils, basophils and albumin during the late allergic reaction. The positive lymphocyte transformation caused by cobalt was also observed.


CONCLUSIONS
Cobalt salts may induce occupational asthma. The mechanism of this asthma may be IgE-mediated. The cobalt-sensitized lymphocytes may play an important role in this disease.
Krakowiak
Anna
A
Department of Occupational Diseases, Center of Occupational and Environmental Allergy, Nofer Institute of Occupational Medicine, Lódź, Poland. annakrak@imp.lodz.pl
Dudek
Wojciech
W
Tarkowski
Maciej
M
Swiderska-Kiełbik
Sylwia
S
Nieścierenko
Ewa
E
Pałczyński
Cezary
C
D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology*; D003035:Cobalt / Q000633:toxicity*; D018130:Diamond; D004391:Dust; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D008297:Male; D008487:Medical History Taking; D017817:Nasal Lavage Fluid; D009299:Nasal Provocation Tests; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012129:Respiratory Function Tests; D012882:Skin Tests
D000395:Air Pollutants, Occupational; D004391:Dust; D003035:Cobalt; D018130:Diamond; C018021:cobaltous chloride