title: Exposure-response analyses for platinum salt-exposed workers and sensitization: A retrospective cohort study among newly exposed workers using routinely collected surveillance data.
abstract: BACKGROUND
  Chloroplatinate salts are well-known respiratory sensitizing agents leading to work-related sensitization and allergies in the work environment. No quantitative exposure-response relation has been described for chloroplatinate salts.
  
  
  OBJECTIVE
  We sought to evaluate the quantitative exposure-response relation between occupational chloroplatinate exposure and sensitization.
  
  
  METHODS
  A retrospective cohort study was conducted using routinely collected health surveillance data and chloroplatinate exposure data. Workers who newly entered work between January 1, 2000, and December 31, 2010, were included, and the relation between measured chloroplatinate exposure and sensitization (as determined by skin prick test responses) was analyzed in more than 1000 refinery workers from 5 refineries for whom a total of more than 1700 personal exposure measurements were available.
  
  
  RESULTS
  A clear exposure-response relation was observed, most strongly for more recent platinum salt exposure. Average or cumulative exposure over the follow-up period was less strongly associated with sensitization risk. The exposure-response relation was modified by smoking and atopy.
  
  
  CONCLUSIONS
  Indications exist that recent exposure explains the risk of platinum salt sensitization most strongly. The precision of the estimate of the exposure-response relation derived from this data set appears superior to previous epidemiologic studies conducted on platinum salt sensitization and as a result, might have possible utility for the development of preventive strategies.
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. Electronic address: d.heederik@uu.nl.
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Jose
authors.initials: J
authors.lastname: Jacobs
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Department of Occupational Health, Health Faculty, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Sadegh
authors.initials: S
authors.lastname: Samadi
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Arbo Unie, Expert Center for Chemical Risk Management, Utrecht, The Netherlands.
authors.forename: Frits
authors.initials: F
authors.lastname: van Rooy
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Lützen
authors.initials: L
authors.lastname: Portengen
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; The Netherlands Expert Center for Occupational Respiratory Diseases, Utrecht, The Netherlands.
authors.forename: Remko
authors.initials: R
authors.lastname: Houba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology*; D007114:Immunization; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D010984:Platinum / Q000009:adverse effects*; D016016:Proportional Hazards Models; D062486:Public Health Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D010984:Platinum
keywords: Sensitization; chloroplatinate salts; exposure response; retrospective cohort study