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Transdermal exposure to Chrome-III oxide resulting in intoxicaitons and morbidity in two tanning workers—a case report

  • Jung Taek Park1,†
  • Kyoung Ho Choi1,*,†,

1Department of Emergency medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 11765 Uijeongbu-si, Republic of Korea

DOI: 10.22514/sv.2024.033 Vol.20,Issue 3,March 2024 pp.97-101

Submitted: 08 February 2023 Accepted: 10 March 2023

Published: 08 March 2024

*Corresponding Author(s): Kyoung Ho Choi E-mail: ergogo@catholic.ac.kr

† These authors contributed equally.

Abstract

Here, we report two cases of chrome-III oxide intoxications following transdermal exposure in tanning workers. A 58-year-old man (case 1) and his 41-year-old co-worker (case 2) were brought to our ED with unconsciousness six hours after accidental transdermal exposure to chrome-III oxide crystals (Tankrom® AB, Chrome-III oxide 25.5% and Schorlemmer Basicity 33%). Upon arrival, both patients presented with agitation and chemical burns affecting 11% (case 1) and 3% (case 2) of their total body surface area, respectively. Chemical burns were mainly distributed on injured skin. Initial arterial blood gas analysis revealed moderate (case 1, pH: 7.268) to mild acidosis (case 2, pH: 7.352). One of our patients (case 1) had significant respiratory depression. Laboratory results of case 1 and case 2 showed increased white blood cell counts, (16,630 mm3 and 19,950 mm3) and elevated blood glucose (178 mg/dL and 193 mg/dL), creatinine (1.33 mg/dL and 1.52 mg/dL), liver enzyme (aspartate aminotransferase/alanine aminotransferase of 416/322 U/L and 141/118 U/L) and creatine phosphokinase level (474 U/L and 566 U/L), respectively. Radiologic examinations revealed an orbital wall fracture and L2 compression fracture in case 1, while case 2 had a subdural hematoma, subarachnoid hemorrhage and scapular fracture and had to undergo an operation for external ventricular drainage. Both patients became alert on day three (case 1) and day six (case 2) and were discharged on day 27. We serially measured their serum and urinary chromium concentrations after hospital arrival. The calculated serum half-lives were 35.7 hours and 25.1 hours, and urinary half-lives were 2.3 hours and 2.5 hours in case 1 and case 2, respectively. We suggest that transdermal exposure to chrome-III oxide, especially to injured skin, may result in significant toxicity and morbidity. Therefore, it is essential to take necessary precautions and preventive measures to avoid transdermal exposure to chromium.


Keywords

Chromium; Transdermal intoxication; Toxicokinetic


Cite and Share

Jung Taek Park,Kyoung Ho Choi. Transdermal exposure to Chrome-III oxide resulting in intoxicaitons and morbidity in two tanning workers—a case report. Signa Vitae. 2024. 20(3);97-101.

References

[1] Barceloux DG. Chromium. Journal of Toxicology: Clinical Toxicology. 1999; 37: 173–194.

[2] Hantson P, Van Caenegem O, Decordier I, Haufroid V, Lison D. Hexavalent chromium ingestion: biological markers of nephrotoxicity and genotoxicity. Clinical Toxicology. 2005; 43: 111–112.

[3] Sunilkumar M, Ajith T, Parvathy V. Acute ammonium dichromate poisoning in a 2-year-old child. Indian Journal of Critical Care Medicine. 2014; 18: 757–758.

[4] Jagannati M, Ramya I, Sathyendra S. Occupation-related chromium toxicity a rare cause of renal failure and rhabdomyolysis. Indian Journal of Occupational and Environmental Medicine. 2016; 20: 150.

[5] van Heerden PV, Jenkins IR, Woods WPD, Rossi E, Cameron PD. Death by tanning—a case of fatal basic chromium sulphate poisoning. Intensive Care Medicine. 1994; 20: 145–147.

[6] Kelly WF, Ackrill P, Day JP, O'Hara M, Tye CT, Burton I, et al. Cutaneous absorption of trivalent chromium: tissue levels and treatment by exchange transfusion. Occupational and Environmental Medicine. 1982; 39: 397–400.

[7] Lin CC, Wu ML, Yang CC, Ger J, Tsai WJ, Deng JF. Acute severe chromium poisoning after dermal exposure to hexavalent chromium. Journal of the Chinese Medical Association. 2009; 72: 219–221.

[8] Lindberg E, Vesterberg O. Urinary excretion of chromium in chromeplaters after discontinued exposure. American Journal of Industrial Medicine. 1989; 16: 485–492.

[9] Katz SA, Salem H. The toxicology of chromium with respect to its chemical speciation: a review. Journal of Applied Toxicology. 1993; 13: 217–224.

[10] Kołaciński Z, Kołacinski Z, Kostrzewski P, Kruszewska S, Raźniewska G, Mielczarska J. Acute potassium dichromate poisoning: a toxicokinetic case study. Journal of Toxicology: Clinical Toxicology. 1999; 37: 785–791.


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