title: Occupational allergic contact dermatitis to chromium from cement: Estimating the size of the problem in Australia.
abstract: BACKGROUND
  Allergic contact dermatitis (ACD) caused by chromium in cement is a significant occupational hazard. However, legislation in Europe over the past two decades to reduce the concentration of chromium in cement to <2 ppm through the addition of ferrous sulphate to cement, has seen a significant decrease in the incidence of chromium allergy. No such legislation exists in Australia.
  
  
  METHODS
  A retrospective analysis of results from the Patchcams database of patients attending the Occupational Dermatology Clinic at the Skin & Cancer Foundation, Melbourne, who were patch tested for chromium between 1 January 1993 to 31 December 2013, was conducted.
  
  
  RESULTS
  Our review revealed that there has not been any significant change in the number of cases of ACD to chromium attributed to sensitisation through cement. Based on our data, we estimate that a minimum of 24 cases of chromium occupational ACD (OACD) from cement is found in Australia yearly, causing considerable morbidity, often associated with an inability to work, costly workers' compensation claims and sometimes the development of the disabling condition, persistent post-occupational dermatitis.
  
  
  CONCLUSIONS
  These findings highlight the need for high-level discussions about adopting European legislation in Australia in order to reduce the likelihood of developing chromium OACD from cement.
authors.affiliation: Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, Melbourne, Victoria, Australia.
authors.forename: Celestine C
authors.initials: CC
authors.lastname: Wong
authors.affiliation: Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, Melbourne, Victoria, Australia.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Gamboni
authors.affiliation: Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, Melbourne, Victoria, Australia.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Palmer
authors.affiliation: Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, Melbourne, Victoria, Australia.
authors.forename: Rosemary L
authors.initials: RL
authors.lastname: Nixon
mesh_terms: D001315:Australia / Q000453:epidemiology; D002857:Chromium / Q000633:toxicity*; D003252:Construction Materials / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000209:etiology; D009783:Dermatitis, Occupational / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D002857:Chromium
keywords: allergic contact dermatitis; cement; chromium; contact dermatitis; occupational allergic