title: Cement-Induced Chromate Occupational Allergic Contact Dermatitis.
abstract: BACKGROUND
  Hexavalent chromium in cement is a common cause of occupational allergic contact dermatitis (OACD).
  
  
  METHODS
  Analysis of patch test data during 1999 to 2013 was done. Patients with cement-induced chromate OACD filled the Dermatology Life Quality Index, graded 1 to 5.
  
  
  RESULTS
  Of 4846 consecutive patients who were patch tested, 146 (3%) were chromate-sensitive. Of 46 (31.5%) who presented with chromate OACD, 27 (59%) had cement-induced chromate OACD. The proportion of chromate-sensitive patients with clinically relevant cement exposure increased from 7.7% in 2002 to 2004 to 28.7% in 2011 to 2013 (P = 0.04). The median age of presentation was younger than for other chromate-sensitive patients (32 vs 42 years). Hand eczema (88.9%) was the most frequent clinical presentation. Of the 27 with cement-induced chromate OACD, 21 (77.8%) had ongoing dermatitis at the time of the review. Although 14/27 (51.9%) changed their occupation to avoid exposure to cement, symptoms persisted in 9/14 (64.3%). Prolonged exposure to cement before development of symptoms was associated with chronicity. All the symptomatic patients experienced at least a moderate effect on their quality of life (grade 3 or higher on the Dermatology Life Quality Index).
  
  
  CONCLUSIONS
  We recommend the adoption of the European legislation in Israel, to reduce the prevalence of chromate OACD from cement.
authors.affiliation: From the *Department of Dermatology, and †Institute of Endocrinology, Diabetes and Metabolism and Internal Medicine D, Rambam Medical Center and RB Rappaport Faculty of Medicine, Technion; and ‡School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors.forename: Khalaf
authors.initials: K
authors.lastname: Kridin
authors.forename: Reuven
authors.initials: R
authors.lastname: Bergman
authors.forename: Mogher
authors.initials: M
authors.lastname: Khamaisi
authors.forename: Shira
authors.initials: S
authors.lastname: Zelber-Sagi
authors.forename: Sara
authors.initials: S
authors.lastname: Weltfriend
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002840:Chromates / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D002840:Chromates