The total body burden of chromium associated with skin disease and smoking among cement workers

Background: Hand eczema and other skin diseases have been associated with the exposure of chromium among cement workers. Studies on skin disease and other factors associated with the body burden of chromium are limited. Objective: The present study investigated the role of skin disease and smoking in the association with body burden of chromium among cement workers. Methods: Forty five workers (38 men and 7 women) were recruited for this study and interviewed to obtain information on demographic status, lifestyle, employment history, and affecting factors. Urine samples were collected to measure the urinary chromium concentration to represent the body burden of chromium. Results: The average urinary chromium concentration was approximately 6 times higher in non-smoking workers with hand eczema than in non-smoking workers with no skin disease (45.5 vs. 7.6 μg/L). The average chromium level increase to 87.0 μg/L for smokers with the disease. Compared with workers with no hand eczema, the odds ratio of having urinary chromium concentration exceeding the biological exposure index level significantly increased to 11.6 (95% CI = 1.3–102.2) for non-smoking workers with skin disease, and to 48.0 (95% CI = 4.5–510.8) for smoking workers with skin disease. The multiple regression analysis showed that the use of gloves may reduce significantly the chromium exposure. Conclusions: Inadequate protection and personal behavior increase the internal dose of chromium in cement workers. Total body burden of chromium are higher among cement workers with skin disease and smoking habit. These workers deserve intervention education on personal hygiene to reduce the exposure of chromium.