title: Occupational asthma due to chromium and nickel salts.
abstract: BACKGROUND
  Exposure to chromium and nickel salts is a poorly characterized cause of occupational asthma.
  
  
  METHODS
  We describe four patients with work-related asthma due to metallic salts. Skin-prick tests to potassium dichromate and nickel sulfate were performed. The patients underwent methacholine inhalation tests and specific inhalation challenges (SIC) with both chromium and nickel salts.
  
  
  RESULTS
  Two patients showed positive skin-prick tests to potassium dichromate and nickel sulfate. All patients had bronchial hyperresponsiveness to methacholine, which increased 24 h after SIC with metallic salts. SIC with potassium dichromate elicited late asthmatic reactions (LAR) in two workers, one subject had an early asthmatic reaction (EAR), and another subject showed a dual asthmatic reaction (DAR). SIC with nickel sulfate induced a DAR in one subject and a late asthmatic reaction in another.
  
  
  CONCLUSIONS
  Chromium and nickel salts can give rise to occupational asthma in exposed workers. The underlying mechanism may be IgE-mediated in some cases.
authors.affiliation: Department of Allergy, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Av. Reyes Católicos, 2, 28040 Madrid, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Fernández-Nieto
authors.forename: Santiago
authors.initials: S
authors.lastname: Quirce
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Carnés
authors.forename: Joaquín
authors.initials: J
authors.lastname: Sastre
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001249:Asthma / Q000209:etiology* / Q000503:physiopathology; D016535:Bronchial Hyperreactivity / Q000139:chemically induced*; D001985:Bronchial Provocation Tests; D004595:Electroplating; D019652:Extraction and Processing Industry; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D001239:Inhalation; D008297:Male; D009532:Nickel / Q000009:adverse effects*; D009784:Occupational Diseases / Q000209:etiology*; D011192:Potassium Dichromate / Q000009:adverse effects*; D012882:Skin Tests
chemical_list: D000395:Air Pollutants, Occupational; D007073:Immunoglobulin E; C029938:nickel sulfate; D009532:Nickel; D011192:Potassium Dichromate